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Brain comorbidities in normal pressure hydrocephalus.

G Allali1,2, M Laidet1, S Armand3

  • 1Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.

European Journal of Neurology
|December 10, 2017
PubMed
Summary
This summary is machine-generated.

Brain comorbidities, particularly Alzheimer's disease, impair gait improvement in normal pressure hydrocephalus (NPH) patients after a cerebrospinal fluid (CSF) tap test. This highlights the impact of co-existing conditions on NPH patient outcomes.

Keywords:
biomarkerscomorbiditydementiagait disordersnormal pressure hydrocephalus

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Area of Science:

  • Neurology
  • Geriatrics
  • Biomedical Engineering

Background:

  • Normal pressure hydrocephalus (NPH) is a neurological disorder characterized by gait disturbance.
  • The cerebrospinal fluid (CSF) tap test is used to assess NPH but its effectiveness can be influenced by co-existing brain conditions.
  • Brain comorbidities are common in NPH patients and may affect their response to CSF tap testing.

Purpose of the Study:

  • To compare gait changes after the CSF tap test in NPH patients with and without brain comorbidities.
  • To identify specific brain comorbidities that contribute to poor gait response after the CSF tap test in NPH patients.

Main Methods:

  • A cross-sectional study involving 52 NPH patients (mean age 77.4 years).
  • Gait parameters, specifically stride time variability (STV), were measured using an optoelectronic system before and 24 hours after the CSF tap test.
  • Brain comorbidities assessed included Alzheimer's disease biomarkers, white matter changes, and parkinsonian syndromes.

Main Results:

  • Patients without brain comorbidities (NPH-) showed significantly better gait improvement (reduced STV) after the CSF tap test compared to patients with comorbidities (NPH+).
  • In NPH+ patients, comorbid Alzheimer's disease was significantly associated with poorer gait improvement (increased STV) after the CSF tap test.
  • The association between Alzheimer's disease and gait deterioration was evident in both single and dual-task conditions, though more pronounced in the dual task.

Conclusions:

  • Brain comorbidities significantly impact gait improvement following the CSF tap test in NPH patients.
  • Alzheimer's disease pathology is a key driver of this impaired gait response.
  • These findings underscore the importance of considering comorbidities when interpreting CSF tap test results in NPH.