CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test?
OBJECTIVE: To assess whether gait, neuropsychological, and multimodal MRI parameters predict short-term symptom reversal after cerebrospinal fluid (CSF) tap test in idiopathic normal pressure hydrocephalus (iNPH). METHODS: Thirty patients (79.3 ± 5.9 years, 12 women) with a diagnosis of probable iNP...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9363476/ https://www.ncbi.nlm.nih.gov/pubmed/35598251 http://dx.doi.org/10.1007/s00415-022-11168-x |
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author | Griffa, Alessandra Bommarito, Giulia Assal, Frédéric Preti, Maria Giulia Goldstein, Rachel Armand, Stéphane Herrmann, François R. Van De Ville, Dimitri Allali, Gilles |
author_facet | Griffa, Alessandra Bommarito, Giulia Assal, Frédéric Preti, Maria Giulia Goldstein, Rachel Armand, Stéphane Herrmann, François R. Van De Ville, Dimitri Allali, Gilles |
author_sort | Griffa, Alessandra |
collection | PubMed |
description | OBJECTIVE: To assess whether gait, neuropsychological, and multimodal MRI parameters predict short-term symptom reversal after cerebrospinal fluid (CSF) tap test in idiopathic normal pressure hydrocephalus (iNPH). METHODS: Thirty patients (79.3 ± 5.9 years, 12 women) with a diagnosis of probable iNPH and 46 healthy controls (74.7 ± 5.4 years, 35 women) underwent comprehensive neuropsychological, quantitative gait, and multimodal MRI assessments of brain morphology, periventricular white-matter microstructure, cortical and subcortical blood perfusion, default mode network function, and white-matter lesion load. Responders were defined as an improvement of at least 10% in walking speed or timed up and go test 24 h after tap test. Univariate and multivariable tap test outcome prediction models were evaluated with logistic regression and linear support vector machine classification. RESULTS: Sixteen patients (53%) respondedpositively to tap test. None of the gait, neuropsychological, or neuroimaging parameters considered separately predicted outcome. A multivariable classifier achieved modest out-of-sample outcome prediction accuracy of 70% (p = .028); gait parameters, white-matter lesion load and periventricular microstructure were the main contributors. CONCLUSIONS: Our negative findings show that short-term symptom reversal after tap test cannot be predicted from single gait, neuropsychological, or MRI parameters, thus supporting the use of tap test as prognostic procedure. However, multivariable approaches integrating non-invasive multimodal data are informative of outcome and may be included in patient-screening procedures. Their value in predicting shunting outcome should be further explored, particularly in relation to gait and white-matter parameters. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11168-x. |
format | Online Article Text |
id | pubmed-9363476 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-93634762022-08-11 CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? Griffa, Alessandra Bommarito, Giulia Assal, Frédéric Preti, Maria Giulia Goldstein, Rachel Armand, Stéphane Herrmann, François R. Van De Ville, Dimitri Allali, Gilles J Neurol Original Communication OBJECTIVE: To assess whether gait, neuropsychological, and multimodal MRI parameters predict short-term symptom reversal after cerebrospinal fluid (CSF) tap test in idiopathic normal pressure hydrocephalus (iNPH). METHODS: Thirty patients (79.3 ± 5.9 years, 12 women) with a diagnosis of probable iNPH and 46 healthy controls (74.7 ± 5.4 years, 35 women) underwent comprehensive neuropsychological, quantitative gait, and multimodal MRI assessments of brain morphology, periventricular white-matter microstructure, cortical and subcortical blood perfusion, default mode network function, and white-matter lesion load. Responders were defined as an improvement of at least 10% in walking speed or timed up and go test 24 h after tap test. Univariate and multivariable tap test outcome prediction models were evaluated with logistic regression and linear support vector machine classification. RESULTS: Sixteen patients (53%) respondedpositively to tap test. None of the gait, neuropsychological, or neuroimaging parameters considered separately predicted outcome. A multivariable classifier achieved modest out-of-sample outcome prediction accuracy of 70% (p = .028); gait parameters, white-matter lesion load and periventricular microstructure were the main contributors. CONCLUSIONS: Our negative findings show that short-term symptom reversal after tap test cannot be predicted from single gait, neuropsychological, or MRI parameters, thus supporting the use of tap test as prognostic procedure. However, multivariable approaches integrating non-invasive multimodal data are informative of outcome and may be included in patient-screening procedures. Their value in predicting shunting outcome should be further explored, particularly in relation to gait and white-matter parameters. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11168-x. Springer Berlin Heidelberg 2022-05-22 2022 /pmc/articles/PMC9363476/ /pubmed/35598251 http://dx.doi.org/10.1007/s00415-022-11168-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Communication Griffa, Alessandra Bommarito, Giulia Assal, Frédéric Preti, Maria Giulia Goldstein, Rachel Armand, Stéphane Herrmann, François R. Van De Ville, Dimitri Allali, Gilles CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? |
title | CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? |
title_full | CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? |
title_fullStr | CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? |
title_full_unstemmed | CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? |
title_short | CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? |
title_sort | csf tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? |
topic | Original Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9363476/ https://www.ncbi.nlm.nih.gov/pubmed/35598251 http://dx.doi.org/10.1007/s00415-022-11168-x |
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