Assessment of neurofluid dynamics in relation to clinical improvement after tap-test: pilot study - Université de Picardie Jules Verne
Article Dans Une Revue Acta Neurochirurgica Année : 2024

Assessment of neurofluid dynamics in relation to clinical improvement after tap-test: pilot study

Résumé

Purpose Idiopathic Normal pressure hydrocephalus (iNPH) is an under-diagnosed in elderly patients but none of the diagnostic tests are currently sufficiently sensitive or specific. The objective of this study was to analyze the dynamics of neurofluids by PC-MRI in relation to clinical evolution as measured using the iNPH grading scale after tap-test. Method We prospectively included patients with suspected iNPH. All these patients underwent PCMRI to assess craniospinal hemohydrodynamics with analysis of the stroke volume of the cephalospinal fluid (CSF) within the Sylvius’ aqueduct, within the high cervical subarachnoid spaces and the arteriovenous stroke volume. By this means, we calculated a compliance index. Morphological analysis was carried out using the DESH score. The infusion test was measuring the resistance to CSF flow. We analysed all these parameters according to the clinical improvement of the patients. Results 23 patients were included. Compliance index assessed by PC-MRI was significantly higher in the group of patients with improvement > 10% (p = 0.015). Conclusions Our study highlights the importance of investigating arteriovenous and CSF interactions in iNPH. This involves understanding the physiological and pathophysiological mechanisms related to the circulation of neurofluids. The analysis of the interactions of these neurofluids allows for a comprehensive understanding of the system.

Domaines

Neurosciences
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Dates et versions

hal-04688475 , version 1 (05-09-2024)

Identifiants

Citer

Julien Moyet, Olivier Baledent, Tomislav Slovenski, Pietro Todessayi, Serge Metanbou, et al.. Assessment of neurofluid dynamics in relation to clinical improvement after tap-test: pilot study. Acta Neurochirurgica, 2024, 166 (1), pp.358. ⟨10.1007/s00701-024-06239-z⟩. ⟨hal-04688475⟩
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