Normal Pressure Hydrocephalus and Comorbidities: A Quality Study of the University Hospital Münster

Nienhaus, Susanne; Stummer, Walter; Khaleghi Ghadiri, Maryam

doi:10.1016/j.wneu.2023.06.002

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…Most of them were able to walk on their own without any help from a physical therapist. The most common comorbidity for individuals with iNPH in this study was hypertension, consistent with previous reports 42 , 46 , 47 . It was reported that hypertension may be involved in mechanisms promoting iNPH pathogenesis 48 and was one of the predictors of unfavorable outcomes and independent walking after shunt surgery 44 .…”

Section: Discussionsupporting

confidence: 93%

Clinical improvements in temporospatial gait variables after a spinal tap test in individuals with idiopathic normal pressure hydrocephalus

Bovonsunthonchai,

Witthiwej,

Vachalathiti

et al. 2024

Sci Rep

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Idiopathic Normal Pressure Hydrocephalus (iNPH) is a neurological condition that often presents gait disturbance in the early stages of the disease and affects other motor activities. This study investigated changes in temporospatial gait variables after cerebrospinal fluid (CSF) removal using a spinal tap test in individuals with idiopathic normal pressure hydrocephalus (iNPH), and explored if the tap test responders and non-responders could be clinically identified from temporospatial gait variables. Sixty-two individuals with iNPH were recruited from an outpatient clinic, eleven were excluded, leaving a total of 51 who were included in the analysis. Temporospatial gait variables at self-selected speed were recorded at pre- and 24-h post-tap tests which were compared using Paired t-tests, Cohen’s d effect size, and percentage change. A previously defined minimal clinical important change (MCIC) for gait speed was used to determine the changes and to classify tap test responders and non-responders. A mixed model ANOVA was used to determine the within-group, between-group, and interaction effects. Comparisons of the data between pre- and post-tap tests showed significant improvements with small to medium effect sizes for left step length, right step time, stride length and time, cadence, and gait speed. Gait speed showed the largest percentage change among temporospatial gait variables. Within-group and interaction effects were found in some variables but no between-group effect was found. Tap test responders showed significant improvements in right step length and time, stride length and time, cadence, and gait speed while non-responders did not. Some individuals with iNPH showed clinically important improvements in temporospatial gait variables after the tap test, particularly in step/stride length and time, cadence, who could be classified by gait speed. However, gait-related balance variables did not change. Therefore, additional treatments should focus on improving such variables.

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Section: Discussionsupporting

confidence: 93%

Clinical improvements in temporospatial gait variables after a spinal tap test in individuals with idiopathic normal pressure hydrocephalus

Bovonsunthonchai,

Witthiwej,

Vachalathiti

et al. 2024

Sci Rep

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The benefits of ventriculoperitoneal shunting in normal pressure hydrocephalus patients—a follow-up of three years

Gencer,

Schwarm,

Nagl

et al. 2024

Acta Neurochir

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Objective The ventriculoperitoneal shunt (VPS) is an established approach in treating normal pressure hydrocephalus (NPH). This study aims to examine the long-term effects of VPS regarding clinical and radiological outcomes, to explore interdependencies with comorbidities and medication, and to determine a suitable opening pressure of the programmable valve. Methods 127 patients with VPS were retrospectively evaluated. The Hakim triad along with Evans index (EI) and callosal angle (CA) were examined preoperatively and postoperatively at various time points up to over thirty-six months. Preexisting comorbidities and medication were considered. Adjustments to valve settings were documented along with symptom development and complications. Wilcoxon and paired-sample t-tests were used to analyze postoperative change. Chi-square, Eta-squared, and Pearson coefficients were used in correlation analyses. Results Relief from individual symptoms was most prominent within the first 6 months (p < 0.01). EI and CA significantly decreased and increased, respectively (p < 0.05). Postoperative clinical and radiological improvement was largely maintained over the follow-up period. Diabetes mellitus and apoplexy correlated with surgical outcomes (p < 0.05). The median opening pressure as a function of overall symptom management was determined to be 120 mmH2O for women and 140 mmH2O for men. Conclusion VPS is effective in treating NPH with respect to both clinical and radiological outcomes, although these two components are independent of each other. Improvement is most pronounced in short-term and maintained in the long-term. Comorbidities have significant influence on the course of NPH. The valve setting does not forecast change in radiological findings; consequently, priority should be placed on the patient’s clinical condition.

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Normal Pressure Hydrocephalus and Comorbidities: A Quality Study of the University Hospital Münster

Cited by 2 publications

References 34 publications

Clinical improvements in temporospatial gait variables after a spinal tap test in individuals with idiopathic normal pressure hydrocephalus

Clinical improvements in temporospatial gait variables after a spinal tap test in individuals with idiopathic normal pressure hydrocephalus

The benefits of ventriculoperitoneal shunting in normal pressure hydrocephalus patients—a follow-up of three years

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