Journal article
Improvement in executive subfunctions following cerebrospinal fluid tap test identifies idiopathic normal pressure hydrocephalus from its mimics.
- Laidet M Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- Herrmann FR Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- Momjian S Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- Assal F Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- Allali G Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- 2015-07-17
Published in:
- European journal of neurology. - 2015
cerebrospinal fluid
cerebrospinal fluid tap test
dementia
executive functions
idiopathic normal pressure hydrocephalus
mimics
neuropsychology
Aged
Aged, 80 and over
Cerebrospinal Fluid
Diagnosis, Differential
Executive Function
Female
Humans
Hydrocephalus, Normal Pressure
Male
Prospective Studies
Psychomotor Performance
Spinal Puncture
English
BACKGROUND AND PURPOSE
Patients with idiopathic normal pressure hydrocephalus (iNPH) present cognitive deficits that overlap with other neurological conditions such as Parkinson's disease or vascular dementia, therefore mimicking iNPH. This prospective study aimed to compare cognitive performances between iNPH and iNPH mimics before and after cerebrospinal fluid (CSF) tapping.
METHODS
A total of 57 patients with suspicion of iNPH (75.84 ± 6.42 years; 39% female) were included in this study (37 iNPH and 20 iNPH mimics). Neuropsychological assessments were performed before and 24 h after CSF tapping of 40 ml. Multivariate logistic regressions were used to examine the association between iNPH and cognitive functions, adjusted for age, education, baseline cognitive assessment and disease duration.
RESULTS
Both groups presented the same baseline cognitive performances. After CSF tapping, iNPH patients improved their semantic (P = 0.001) and phonemic verbal fluencies (P = 0.001), whereas iNPH mimics presented similar performances to before CSF tapping. The phonemic verbal fluency (odds ratio 1.43, 95% confidence interval 1.05; 1.96) and the Color Trails Test (odds ratio 0.10, 95% confidence interval 0.01; 0.76) improvements were the two discriminative cognitive tests that identified iNPH from iNPH mimics.
CONCLUSION
Improvement in executive subfunctions after CSF tapping identified iNPH patients from other neurological conditions that mimic iNPH. These findings respond to clinical issues encountered on a daily basis and would improve the diagnostic process of iNPH.
Patients with idiopathic normal pressure hydrocephalus (iNPH) present cognitive deficits that overlap with other neurological conditions such as Parkinson's disease or vascular dementia, therefore mimicking iNPH. This prospective study aimed to compare cognitive performances between iNPH and iNPH mimics before and after cerebrospinal fluid (CSF) tapping.
METHODS
A total of 57 patients with suspicion of iNPH (75.84 ± 6.42 years; 39% female) were included in this study (37 iNPH and 20 iNPH mimics). Neuropsychological assessments were performed before and 24 h after CSF tapping of 40 ml. Multivariate logistic regressions were used to examine the association between iNPH and cognitive functions, adjusted for age, education, baseline cognitive assessment and disease duration.
RESULTS
Both groups presented the same baseline cognitive performances. After CSF tapping, iNPH patients improved their semantic (P = 0.001) and phonemic verbal fluencies (P = 0.001), whereas iNPH mimics presented similar performances to before CSF tapping. The phonemic verbal fluency (odds ratio 1.43, 95% confidence interval 1.05; 1.96) and the Color Trails Test (odds ratio 0.10, 95% confidence interval 0.01; 0.76) improvements were the two discriminative cognitive tests that identified iNPH from iNPH mimics.
CONCLUSION
Improvement in executive subfunctions after CSF tapping identified iNPH patients from other neurological conditions that mimic iNPH. These findings respond to clinical issues encountered on a daily basis and would improve the diagnostic process of iNPH.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/ene.12779
- PMID 26178145
- Persistent URL
- https://sonar.ch/global/documents/144864
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