Journal article
A combined cognitive and gait quantification to identify normal pressure hydrocephalus from its mimics: The Geneva's protocol.
- Allali G Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and University of Geneva, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA. Electronic address: gilles.allali@hcuge.ch.
- Laidet M Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and University of Geneva, Switzerland.
- Armand S Willy Taillard Laboratory of Kinesiology, 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, Switzerland.
- Marques B Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Saj A Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and University of Geneva, Switzerland.
- Assal F Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and University of Geneva, Switzerland.
- 2017-06-13
Published in:
- Clinical neurology and neurosurgery. - 2017
Assessment
Dual task
Gait analysis
Mental imagery
Mimics
Neuropsychology
Normal pressure hydrocephalus
Aged
Aged, 80 and over
Clinical Protocols
Cognitive Dysfunction
Dementia, Vascular
Diagnosis, Differential
Feasibility Studies
Female
Gait Disorders, Neurologic
Humans
Hydrocephalus, Normal Pressure
Imagination
Male
Motor Activity
English
OBJECTIVES
Idiopathic normal pressure hydrocephalus (iNPH) is very prevalent in aging, underdiagnosed, and represents a rare cause of reversible neurological condition. The clinical triad of iNPH - gait, cognitive and urinary symptoms - and its neuroradiological features (i.e. ventriculomegaly) are not specific and found a various neurodegenerative and/or vascular conditions. We present our iNPH standardized protocol at the Geneva University Hospitals involving a multispecialty team of behavioral neurologists, neurosurgeons, neuropsychologists, engineers, and physical therapists. Based on a pragmatic approach, the goal of this protocol is to improve the identification of older patients with iNPH from its mimics (i.e. vascular dementia or other parkinsonian syndromes).
PATIENTS AND METHODS
We used a novel standardized paradigm with a simultaneous quantification of cognition and gait (dual task gait assessment and mental imagery of locomotion) before and 24h after CSF tapping.
RESULTS
We assessed 125 patients with suspicion of iNPH (age: 75.9±7.4years; 34.4% female) in 5 years: 54.4% of probable/possible iNPH and 45.6% of mimics. Among the mimics, vascular dementia (24.6%) and patients with multifactorial conditions (19.9%) were the two most common diagnoses. A total of 27 patients with iNPH (39.7%) accepted the neurosurgical shunt procedure.
CONCLUSION
This report shows that a quantified gait and cognitive assessment - using dual-task paradigms - before and after CSF tapping is feasible among older adults with suspicion of iNPH and that this multidisciplinary approach contributes to the identification of patients with iNPH from its mimics.
Idiopathic normal pressure hydrocephalus (iNPH) is very prevalent in aging, underdiagnosed, and represents a rare cause of reversible neurological condition. The clinical triad of iNPH - gait, cognitive and urinary symptoms - and its neuroradiological features (i.e. ventriculomegaly) are not specific and found a various neurodegenerative and/or vascular conditions. We present our iNPH standardized protocol at the Geneva University Hospitals involving a multispecialty team of behavioral neurologists, neurosurgeons, neuropsychologists, engineers, and physical therapists. Based on a pragmatic approach, the goal of this protocol is to improve the identification of older patients with iNPH from its mimics (i.e. vascular dementia or other parkinsonian syndromes).
PATIENTS AND METHODS
We used a novel standardized paradigm with a simultaneous quantification of cognition and gait (dual task gait assessment and mental imagery of locomotion) before and 24h after CSF tapping.
RESULTS
We assessed 125 patients with suspicion of iNPH (age: 75.9±7.4years; 34.4% female) in 5 years: 54.4% of probable/possible iNPH and 45.6% of mimics. Among the mimics, vascular dementia (24.6%) and patients with multifactorial conditions (19.9%) were the two most common diagnoses. A total of 27 patients with iNPH (39.7%) accepted the neurosurgical shunt procedure.
CONCLUSION
This report shows that a quantified gait and cognitive assessment - using dual-task paradigms - before and after CSF tapping is feasible among older adults with suspicion of iNPH and that this multidisciplinary approach contributes to the identification of patients with iNPH from its mimics.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.clineuro.2017.06.001
- PMID 28605723
- Persistent URL
- https://sonar.ch/global/documents/232798
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