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Idiopathic normal pressure hydrocephalus

Vasco Vanhala, Antti Junkkari, Ville E Korhonen, Mitja I Kurki, Mikko Hiltunen, Tuomas Rauramaa, Ossi Nerg, Anne M Koivisto, Anne M Remes, Jonna Perälä, Jaana Suvisaari, Soili M Lehto, Heimo Viinamäki, Hilkka Soininen, Juha E Jääskeläinen, Ville Leinonen
BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive and potentially treatable neurodegenerative disease affecting elderly people, characterized by gait impairment and ventricular enlargement in brain imaging. Similar findings are seen in some patients with schizophrenia (SCZ). OBJECTIVE: To determine the prevalence of SCZ among patients suffering from probable or possible iNPH and the specific effects of comorbid SCZ on the outcome of the cerebrospinal fluid (CSF) shunting...
May 8, 2018: Neurosurgery
Ping-Huei Tsai, Yung-Chieh Chen, Shih-Wei Chiang, Teng-Yi Huang, Ming-Chung Chou, Hua-Shan Liu, Hsiao-Wen Chung, Giia-Sheun Peng, Hsin-I Ma, Hung-Wen Kao, Cheng-Yu Chen
OBJECTIVES: To compare diffusion tensor (DT)-derived indices from the thalamic nuclei and cerebrospinal fluid (CSF) hydrodynamic parameters for the prediction of gait responsiveness to the CSF tap test in early iNPH patients. METHODS: In this study, 22 patients with iNPH and 16 normal controls were enrolled with the approval of an institutional review board. DT imaging and phase-contrast magnetic resonance imaging were performed in patients and controls to determine DT-related indices of the sensorimotor-related thalamic nuclei and CSF hydrodynamics...
May 7, 2018: European Radiology
Kurt Grahnke, Ignacio Jusue-Torres, Caroline Szujewski, Cara Joyce, Michael Schneck, Vikram Prabhu, Douglas Anderson
BACKGROUND: Diagnosing normal pressure hydrocephalus (NPH) and selecting patients who will experience a sustained benefit from fluid diversion surgery remains challenging. This study seeks to evaluate the association between the callosal angle (CA) and the long-term post-operative response to ventriculoperitoneal shunt (VPS) surgery in a different subgroup population than previously studied to assess its generalizability. METHODS: We studied 73 patients with idiopathic NPH who underwent VPS surgery and had at least 18 months of follow-up between 2000-2016...
April 30, 2018: World Neurosurgery
Sami Abu Hamdeh, Ganna Shevchenko, Jia Mi, Sravani Musunuri, Jonas Bergquist, Niklas Marklund
The early molecular response to severe traumatic brain injury (TBI) was evaluated using biopsies of structurally normal-appearing cortex, obtained at location for intracranial pressure (ICP) monitoring, from 16 severe TBI patients. Mass spectrometry (MS; label free and stable isotope dimethyl labeling) quantitation proteomics showed a strikingly different molecular pattern in TBI in comparison to cortical biopsies from 11 idiopathic normal pressure hydrocephalus patients. Diffuse TBI showed increased expression of peptides related to neurodegeneration (Tau and Fascin, p < 0...
May 1, 2018: Scientific Reports
Chihiro Akiba, Madoka Nakajima, Masakazu Miyajima, Ikuko Ogino, Yumiko Motoi, Kaito Kawamura, Satoshi Adachi, Akihide Kondo, Hidenori Sugano, Takahiko Tokuda, Kazuhiro Irie, Hajime Arai
BACKGROUND: Alzheimer's disease (AD) pathology in idiopathic normal pressure hydrocephalus (iNPH) contributes to poor shunt responses. Amyloid-β 1- 42 (Aβ42) toxic conformer was recently identified with features of rapid oligomerization, strong neurotoxicity and synaptotoxicity. OBJECTIVE: This observational study points to Aβ42 toxic conformer as a biomarker for AD pathology and for poor postoperative prognosis in patients with iNPH. METHODS: The first cohort consisted of patients with AD (n = 17) and iNPH (n = 17), and cognitively normal individuals (CN, n = 12)...
April 25, 2018: Journal of Alzheimer's Disease: JAD
Ryan Gallagher, Jodie Marquez, Peter Osmotherly
OBJECTIVES: To identify in patients with Idiopathic Normal Pressure Hydrocephalus (iNPH) undergoing a Cerebrospinal Fluid (CSF) Tap Test (TT) for consideration of a Ventricular peritoneal shunt: 1. Gait and balance measures which identify symptom change 2. Differences present between pre and post CSF TT scores between patient's classified responders and non-responders 3. Ability of patients with iNPH to accurately quantify change in their gait and balance symptoms from a CSF TT. DESIGN: Prospective observational study...
April 24, 2018: Archives of Physical Medicine and Rehabilitation
Yuta Murakami, Yuka Matsumoto, Kyoka Hoshi, Hiromi Ito, Takashi J Fuwa, Yoshiki Yamaguchi, Madoka Nakajima, Masakazu Miyajima, Hajime Arai, Kenneth Nollet, Naho Kato, Rie Nishikata, Naohito Kuroda, Takashi Honda, Jun Sakuma, Kiyoshi Saito, Yasuhiro Hashimoto
Idiopathic normal pressure hydrocephalus (iNPH) is a dementia-inducing disorder. Primary cause of iNPH is speculated to be a reduction of cerebrospinal fluid (CSF) absorption, which secondarily induces hydrocephalus, compression of brain, and reduction of CSF production. Patients are treated by surgically inserting a shunt to deliver excess CSF to the abdominal cavity. The prognosis for cognitive improvement after shunt surgery has been difficult to predict. We therefore investigated various CSF proteins, hoping to find a biomarker predictive of cognitive performance one to two years after shunt surgery...
April 25, 2018: Journal of Biochemistry
Yasutaka Nikaido, Toshihiro Akisue, Yoshinaga Kajimoto, Takuya Ikeji, Yuki Kawami, Hideyuki Urakami, Hisatomo Sato, Tadayuki Nishiguchi, Tetsuya Hinoshita, Yuka Iwai, Kenji Kuroda, Hiroshi Ohno, Ryuichi Saura
BACKGROUND: Although gait and balance disturbances are core symptoms of idiopathic normal pressure hydrocephalus (iNPH), the ambulatory center of mass (COM) movements in patients with iNPH remain unclear. We aimed to clarify the ambulatory COM movements using an accelerometer on the patients' lower torsos and to investigate the changes in COM movement after cerebrospinal fluid tap tests (TT) and shunt surgeries (SS). METHODS: Twenty-three patients with iNPH and 18 age-matched healthy controls (HCs) were recruited...
April 21, 2018: Gait & Posture
Madoka Nakajima, Masakazu Miyajima, Chihiro Akiba, Ikuko Ogino, Kaito Kawamura, Hidenori Sugano, Takeshi Hara, Yuichi Tange, Keiko Fusegi, Kostadin Karagiozov, Hajime Arai
BACKGROUND: Treating idiopathic normal pressure hydrocephalus (iNPH) with lumboperitoneal shunts (LPSs) may cause cerebrospinal fluid (CSF) overdrainage. OBJECTIVE: To investigate whether LPSs, including gravitational "add-on" and programmable pressure valves (PPVs/+GVs), reduce complications and improve outcomes. METHODS: We compared PPVs/+small lumen abdominal catheters (SLs) to PPVs/+GVs using different opening pressures for supine and standing positions...
April 23, 2018: Operative Neurosurgery (Hagerstown, Md.)
Alan J Wein
No abstract text is available yet for this article.
April 2018: Journal of Urology
A Cucca, M C Biagioni, K Sharma, J Golomb, R M Gilbert, A Di Rocco, J E Fleisher
Idiopathic normal pressure hydrocephalus (iNPH) is the most common cause of hydrocephalus in adults. The diagnosis may be challenging, requiring collaborative efforts between different specialists. According to the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, iNPH should be considered in the differential of any unexplained gait failure with insidious onset. Recognizing iNPH can be even more difficult in the presence of comorbid neurologic disorders. Among these, idiopathic Parkinson's disease (PD) is one of the major neurologic causes of gait dysfunction in the elderly...
2018: Case Reports in Neurological Medicine
Sunee Bovonsunthonchai, Theerapol Witthiwej, Chanon Ngamsombat, Sith Sathornsumetee, Roongtiwa Vachalathiti, Weerasak Muangpaisan, Pichaya Hengsomboon, Suthasinee Thong-On, Supattra Jankhum, Pusanisa Yangyoo
The aim of the study was to investigate the effect of the spinal tap test on sit-to-stand (STS), walking, and turning and to determine the relationship among the outcome measures of STS, walking, and turning in patients with iNPH. Twenty-seven patients with clinical symptoms of iNPH were objectively examined for STS, walking, and turning by the Force Distribution Measurement (FDM) platform connected with a video camera. Assessments were performed at before and 24 hours after spinal tap. Motor abilities were assessed by the STS time, time of walking over 3 meters, and time and number of steps when turning over 180 degrees...
February 2018: Nagoya Journal of Medical Science
Yun Jeong Hong, Min-Jeong Kim, Eunhye Jeong, Ji-Eun Kim, Jihye Hwang, Jung-Il Lee, Jae-Hong Lee, Duk L Na
INTRODUCTION: Idiopathic normal pressure hydrocephalus (INPH) is known to be a potentially treatable neurologic condition. The neurocognitive outcomes after surgery, however, have been variable. It is important to define preoperative characteristics of patients that predicts the shunting outcome. We aimed to compare baseline differences between shunt-responsive and unresponsive patients after 1year from surgery in order to identify preoperative predictors showing favorable clinical outcomes...
April 15, 2018: Journal of the Neurological Sciences
Kyunghun Kang, Uicheul Yoon, Jinwoo Hong, Shin Young Jeong, Pan-Woo Ko, Sang-Woo Lee, Ho-Won Lee
BACKGROUND: The first aim of our study was to determine whether cortical 18F-florbetaben retention was different between healthy controls and idiopathic normal-pressure hydrocephalus (INPH) patients. Our second aim was to investigate whether there were any relationships between 18F-florbetaben retention and either hippocampal volume or clinical symptoms in INPH patients. METHODS: Seventeen patients diagnosed with INPH and 8 healthy controls underwent studies with magnetic resonance imaging and 18F-florbetaben positron emission tomography imaging...
March 22, 2018: European Neurology
Karen Brastad Evensen, Michael O'Rourke, Fabrice Prieur, Sverre Holm, Per Kristian Eide
This study explored the hypothesis that the central aortic blood pressure (BP) waveform may be used for non-invasive estimation of the intracranial pressure (ICP) waveform. Simultaneous invasive ICP and radial artery BP waveforms were measured in 29 individuals with idiopathic normal pressure hydrocephalus (iNPH). The central aortic BP waveforms were estimated from the radial artery BP waveforms using the SphygmoCor system. For each individual, a transfer function estimate between the central aortic BP and the invasive ICP waveforms was found (Intra-patient approach)...
March 16, 2018: Scientific Reports
Takuma Ohmichi, Masaki Kondo, Masahiro Itsukage, Hidetaka Koizumi, Shigenori Matsushima, Nagato Kuriyama, Kazunari Ishii, Etsuro Mori, Kei Yamada, Toshiki Mizuno, Takahiko Tokuda
OBJECTIVE The gold standard for the diagnosis of idiopathic normal pressure hydrocephalus (iNPH) is the CSF removal test. For elderly patients, however, a less invasive diagnostic method is required. On MRI, high-convexity tightness was reported to be an important finding for the diagnosis of iNPH. On SPECT, patients with iNPH often show hyperperfusion of the high-convexity area. The authors tested 2 hypotheses regarding the SPECT finding: 1) it is relative hyperperfusion reflecting the increased gray matter density of the convexity, and 2) it is useful for the diagnosis of iNPH...
March 16, 2018: Journal of Neurosurgery
Afroditi-Despina Lalou, Virginia Levrini, Matthew Garnett, Eva Nabbanja, Dong-Joo Kim, Laurent Gergele, Anna Bjornson, Zofia Czosnyka, Marek Czosnyka
INTRODUCTION: The so-called Davson's equation relates baseline intracranial pressure (ICP) to resistance to cerebrospinal fluid outflow (Rout), formation of cerebrospinal fluid (If ) and sagittal sinus pressure (PSS ) There is a controversy over whether this fundamental equation is applicable in patients with normal pressure hydrocephalus (NPH). We investigated the relationship between Rout and ICP and also other compensatory, clinical and demographic parameters in NPH patients. METHOD: We carried out a retrospective study of 229 patients with primary NPH who had undergone constant-rate infusion studies in our hospital...
May 2018: Acta Neurochirurgica
Per K Eide, Geir Ringstad
The glymphatic system plays a key role for clearance of waste solutes from the rodent brain. We recently found evidence of glymphatic circulation in the human brain when using magnetic resonance imaging (MRI) contrast agent as cerebrospinal fluid (CSF) tracer in conjunction with multiple MRI acquisitions (gMRI). The present study explored the hypothesis that reduced glymphatic clearance in entorhinal cortex (ERC) may be instrumental in idiopathic normal pressure hydrocephalus (iNPH) dementia. gMRI acquisitions were obtained over a 24-48 h time span in cognitively affected iNPH patients and non-cognitively affected patients with suspected CSF leaks...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Charlotte Selge, Florian Schoeberl, Andreas Zwergal, Georg Nuebling, Thomas Brandt, Marianne Dieterich, Roman Schniepp, Klaus Jahn
OBJECTIVE: To test whether quantitative gait analysis of gait under single- and dual-task conditions can be used for a differential diagnosis of progressive supranuclear palsy (PSP) and idiopathic normal-pressure hydrocephalus (iNPH). METHODS: In this cross-sectional study, temporal and spatial gait parameters were analyzed in 38 patients with PSP (Neurological Disorders and Stroke and Society for Progressive Supranuclear Palsy diagnostic criteria), 27 patients with iNPH (international iNPH guidelines), and 38 healthy controls...
March 20, 2018: Neurology
D C Engel, S D Adib, M U Schuhmann, C Brendle
BACKGROUND: Many radiological signs are known for the diagnosis of idiopathic normal pressure hydrocephalus (iNPH). However, there is little information about these signs in the pre-symptomatic phase. For pathophysiological investigative purposes we conducted a descriptive image analysis study on pre-symptomatic patients. METHODS: Patients that had contact with either the neurological or neurosurgical department of the university hospital Tuebingen from 2010 through 2016 with magnetic resonance images > 3 years before onset of symptoms, were included...
February 9, 2018: Fluids and Barriers of the CNS
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