Abstract
Introduction: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a complex and often misdiagnosed syndrome, whose major challenge is to identify which patients will benefit from surgery. Previous studies reported a variability in positive surgery response. The role of tap test(TT) in screening patients suitable for shunting is controversial. The primary aim of this study was to describe the clinical/instrumental features and their longitudinal progression after surgery in iNPH patients. Secondarily, we aimed to investigate the response of the three iNPH domains and the best time of outcome assessment after TT. Methods: Patients compatible with iNPH underwent a 3-T-MRI and an inpatients program with TT including standardized clinical evaluations, neuropsychological assessments and instrumental gait analysis pre- and after-(24-h and 72-h) TT. The multidisciplinary team selected candidates for surgery. Patients were evaluated 6- and 12-months after surgery. Results: A total of 154 consecutive patients were included from 2015 to 2018, 76 with an iNPH diagnosis (43 underwent surgery, 35 were evaluated after 6-months). Clinical and instrumented quantitative gait measures and urinary symptoms improved over time along with some neuropsychological functions. Concerning pre- and post-TT analyses, the three iNPH domains showed a different response after TT, the delayed motor assessment was more appropriate than the early one and the instrumental measures highlighted the motor improvement. Conclusion: iNPH patients improved after surgery, when accurately selected. A multidisciplinary team focused on this disease and a standardized protocol helped in achieving a correct diagnosis and management of iNPH. Our results could impact the management of this disease.
| Original language | English |
|---|---|
| Pages (from-to) | 117-124 |
| Number of pages | 8 |
| Journal | Parkinsonism and Related Disorders |
| Volume | 66 |
| DOIs | |
| Publication status | Published - Sep 2019 |
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Keywords
- Clinical practice
- Idiopathic Normal pressure hydrocephalus
- Movement disorders
- Neuropsychological features
- Observational prospective study
- Ventriculo-peritoneal shunt
ASJC Scopus subject areas
- Neurology
- Geriatrics and Gerontology
- Clinical Neurology
Cite this
A prospective evaluation of clinical and instrumental features before and after ventriculo-peritoneal shunt in patients with idiopathic Normal pressure hydrocephalus : The Bologna PRO-Hydro study. / the BOLOGNA PRO-HYDRO Study Group.
In: Parkinsonism and Related Disorders, Vol. 66, 09.2019, p. 117-124.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A prospective evaluation of clinical and instrumental features before and after ventriculo-peritoneal shunt in patients with idiopathic Normal pressure hydrocephalus
T2 - The Bologna PRO-Hydro study
AU - Giannini, Giulia
AU - Palandri, Giorgio
AU - Ferrari, Alberto
AU - Oppi, Federico
AU - Milletti, David
AU - Albini-Riccioli, Luca
AU - Mantovani, Paolo
AU - Magnoni, Stefania
AU - Chiari, Lorenzo
AU - Cortelli, Pietro
AU - Cevoli, Sabina
AU - the BOLOGNA PRO-HYDRO Study Group
AU - Agati, Raffaele
AU - Calandra-Buonaura, Giovanna
AU - Capellari, Sabina
AU - Parchi, Piero
AU - Stanzani-Maserati, Michelangelo
AU - Marliani, Anna Federica
AU - Merola, Margherita
AU - Piserchia, Vito Antonio
AU - Sambati, Luisa
AU - Sturiale, Carmelo
AU - Supino, Antonella
AU - Nicola, Monica
AU - Urli, Tiziana
N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Cortelli Pietro)
PY - 2019/9
Y1 - 2019/9
N2 - Introduction: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a complex and often misdiagnosed syndrome, whose major challenge is to identify which patients will benefit from surgery. Previous studies reported a variability in positive surgery response. The role of tap test(TT) in screening patients suitable for shunting is controversial. The primary aim of this study was to describe the clinical/instrumental features and their longitudinal progression after surgery in iNPH patients. Secondarily, we aimed to investigate the response of the three iNPH domains and the best time of outcome assessment after TT. Methods: Patients compatible with iNPH underwent a 3-T-MRI and an inpatients program with TT including standardized clinical evaluations, neuropsychological assessments and instrumental gait analysis pre- and after-(24-h and 72-h) TT. The multidisciplinary team selected candidates for surgery. Patients were evaluated 6- and 12-months after surgery. Results: A total of 154 consecutive patients were included from 2015 to 2018, 76 with an iNPH diagnosis (43 underwent surgery, 35 were evaluated after 6-months). Clinical and instrumented quantitative gait measures and urinary symptoms improved over time along with some neuropsychological functions. Concerning pre- and post-TT analyses, the three iNPH domains showed a different response after TT, the delayed motor assessment was more appropriate than the early one and the instrumental measures highlighted the motor improvement. Conclusion: iNPH patients improved after surgery, when accurately selected. A multidisciplinary team focused on this disease and a standardized protocol helped in achieving a correct diagnosis and management of iNPH. Our results could impact the management of this disease.
AB - Introduction: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a complex and often misdiagnosed syndrome, whose major challenge is to identify which patients will benefit from surgery. Previous studies reported a variability in positive surgery response. The role of tap test(TT) in screening patients suitable for shunting is controversial. The primary aim of this study was to describe the clinical/instrumental features and their longitudinal progression after surgery in iNPH patients. Secondarily, we aimed to investigate the response of the three iNPH domains and the best time of outcome assessment after TT. Methods: Patients compatible with iNPH underwent a 3-T-MRI and an inpatients program with TT including standardized clinical evaluations, neuropsychological assessments and instrumental gait analysis pre- and after-(24-h and 72-h) TT. The multidisciplinary team selected candidates for surgery. Patients were evaluated 6- and 12-months after surgery. Results: A total of 154 consecutive patients were included from 2015 to 2018, 76 with an iNPH diagnosis (43 underwent surgery, 35 were evaluated after 6-months). Clinical and instrumented quantitative gait measures and urinary symptoms improved over time along with some neuropsychological functions. Concerning pre- and post-TT analyses, the three iNPH domains showed a different response after TT, the delayed motor assessment was more appropriate than the early one and the instrumental measures highlighted the motor improvement. Conclusion: iNPH patients improved after surgery, when accurately selected. A multidisciplinary team focused on this disease and a standardized protocol helped in achieving a correct diagnosis and management of iNPH. Our results could impact the management of this disease.
KW - Clinical practice
KW - Idiopathic Normal pressure hydrocephalus
KW - Movement disorders
KW - Neuropsychological features
KW - Observational prospective study
KW - Ventriculo-peritoneal shunt
UR - http://www.scopus.com/inward/record.url?scp=85069689297&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069689297&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2019.07.021
DO - 10.1016/j.parkreldis.2019.07.021
M3 - Article
C2 - 31358442
AN - SCOPUS:85069689297
VL - 66
SP - 117
EP - 124
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
SN - 1353-8020
ER -