BackgroundIntracranial pressure (ICP) is a physiological parameter that conventionally requires invasive monitoring for accurate measurement. Utilising multivariate predictive models, we sought to evaluate the utility of non-invasive, accessible MRI biomarkers in predicting ICP and their reversibility following cerebrospinal fluid (CSF) diversion.MethodsThe retrospective study included 325 adult patients with suspected CSF dynamic disorders who underwent brain MRI scans within three months of elective 24-hour ICP monitoring. Five MRI biomarkers were assessed: Yuh sella grade, optic nerve vertical tortuosity (VT), optic nerve sheath distension (ONSD), posterior globe flattening (PGF) and optic disc protrusion (ODP). The association between MRI biomarkers and 24-hour ICP was examined and reversibility of each following CSF diversion was assessed using uni- and multivariate techniques.ResultsAll five biomarkers were significantly associated with median 24-hour ICP (p<0.0001). Using a pair-wise approach, the presence of each abnormal biomarker was significantly associated with higher median 24- hour ICP (p<0.0001). On multivariate analysis, ICP was significantly and positively associated with Yuh grade (p<0.0001), VT (p<0.0001) and ODP (p=0.003), after accounting for age and suspected diagnosis. Bayesian multiple linear regression predicted 24-hour median ICP with a mean absolute error of 2.71 mmHg. Following CSF diversion, we found Yuh grade to show significant pairwise reversibility (p<0.001).ConclusionsICP was predicted with clinically useful precision utilising a compact Bayesian model, offering an easily interpretable tool that utilised non-invasive imaging data. MRI biomarkers are anticipated to play a more significant role in the screening, triaging, and referral of patients with suspected CSF dynamic disorders.Key messagesBrain MRI biomarkers have been found to be correlated with cerebrospinal fluid (CSF) pressures. However, previous studies have not examined these imaging features with continuous intracranial pressure (ICP) measurements, or in patient cohorts with sizable numbers or different CSF dynamic disorders than idiopathic intracranial hypertension.In this retrospective cohort study, patients with abnormal neuroradiological markers (optic nerve sheath diameter, pituitary: sella grade, optic nerve vertical tortuosity, posterior globe flattening or optic disc protrusion) had significantly higher median 24-hour ICP readings. After adjusting for age and diagnosis, Yuh sella grade, vertical tortuosity and optic disc protrusion were significantly associated with ICP. Our multiple linear regression model was able to predict 24-hour median ICP using routine MR-imaging in those with chronic CSF disorders. Pituitary deformation resolved following CSF diversion, suggesting reversibility of certain radiological biomarkers.Brain MRIs are widely accessible and non-invasive, and are commonly used in elective patients with suspected raised ICP. Our study provides a tool incorporating simple clinico-radiological parameters for the screening, triaging, and referral of patients with suspected abnormal ICP, and our results have important implications for the diagnostic routine of patients with suspected intracranial hypertension.

Background Clinical neuroscience training programmes are becoming increasingly competitive to enter. UK university neuroscience societies act as a local environment for students to develop their career interests and provide portfolio building opportunities through hosting events such as annual conferences. Recently there has been a transition to more of these events being held online yet the impact of this, if any, remains unclear. This prospective study aimed to identify the impact of student-led neuroscience conferences on delegates and examine attitudes towards an online delivery approach. Methods Multi-centre prospective survey study using pre-conference, post-conference, and 6-month post-conference online questionnaires distributed at 6 virtual student-led neuroscience conferences in 2021. The questionnaires had five-domains: demographics, career aspirations, academic skillsets, an educational manipulation check (EMC) and mode of delivery preference. Results 924 surveys were completed across 559 conference attendances. 79.5% of delegates were medical students. Interest in a neuroscience career (p < 0.001), preparedness to undertake research (p < 0.001) and presentation (p < 0.001), and EMC scores (p < 0.001) increased immediately post conference and were retained at 6 months. Most participants at 6 months post-attendance had completed an academic project (71.9%) or presentation (50.9%). Online format was preferred (65%) with reasons including elimination of travel and access to home facilities whilst lack of face-to-face interaction and engagement were recognised limitations. Conclusion UK student-led online neuroscience conferences play a role in developing knowledge, academic skillsets and career interest as well as inspiring and facilitating future portfolio building. A hybrid virtual and in-person experience would offer an ideal solution to future conferencing, providing options promoting engagement and interactivity whilst advocating sustainability, accessibility and widening participation.