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Cai H, Huang K, Hao Z, Hu N, Gao H, Yang F, Feng S, Qin L, Wang R, Yang X, Wang S, Liao Q, Liu Y, Zhou D, Zhou L, He J, Chen Q
Predictive Value of Digital Neuropsychological and Gait Assessments on Shunt Outcome in Patients With Idiopathic Normal Pressure Hydrocephalus: Prospective Cohort Study
Predictive value of digital neuropsychological and gait assessments on shunt outcome in patients with idiopathic normal pressure hydrocephalus: A prospective cohort study
Hanlin Cai;
Keru Huang;
Zilong Hao;
Na Hu;
Hui Gao;
Feng Yang;
Shiyu Feng;
Linyuan Qin;
Ruihan Wang;
Xiyue Yang;
Shan Wang;
Qian Liao;
Yi Liu;
Dong Zhou;
Liangxue Zhou;
Jiaojiang He;
Qin Chen
ABSTRACT
Background:
The cerebrospinal fluid (CSF) drainage test is crucial for evaluating patients with idiopathic normal pressure hydrocephalus (iNPH) before shunt surgery, while traditional methods have low sensitivity.
Objective:
This study aimed to investigate the predictive value of digital cognitive and gait assessments for shunt outcomes.
Methods:
Seventy probable iNPH patients were enrolled from the West China Hospital of Sichuan University. All patients underwent traditional and digital cognitive and gait assessments at baseline and 3-day after external lumbar drainage (ELD). Shunted patients were followed up at 3, 6, and 12 months postoperatively by modified Rankin scale (mRS) and the Japanese iNPH grading scales (iNPHGS). The multivariate logistic regression models and receiver operating characteristic (ROC) analysis were used to assess the predictive value of digital tests for shunt response.
Results:
The performance of the digital tests including one-back test (P=0.01), Stroop color-word test (P=0.009), and gait parameters exhibited significant improvement 3-day post-ELD. Of thirty-nine shunted patients, 34 exhibited at least 1-point improvement in mRS or iNPHGS post-shunt at their last follow-up. Greater improvement rate in combined digital neuropsychological and gait tests after ELD is associated with a better shunt outcome (adjusted odds ratio = 1.03, P=0.038). Combined digital neuropsychological and gait tests outperformed traditional tests in distinguishing shunt responders (Area under ROC curves=0.93 vs. 0.64, P=0.038).
Conclusions:
Our study has shown that digital neuropsychological and gait tests enhance predictive efficacy when compared to traditional testing methods. It could serve as objective evaluation tools for assessing patients with iNPH.
Citation
Please cite as:
Cai H, Huang K, Hao Z, Hu N, Gao H, Yang F, Feng S, Qin L, Wang R, Yang X, Wang S, Liao Q, Liu Y, Zhou D, Zhou L, He J, Chen Q
Predictive Value of Digital Neuropsychological and Gait Assessments on Shunt Outcome in Patients With Idiopathic Normal Pressure Hydrocephalus: Prospective Cohort Study