Real-Time Neuropsychological Testing for Hydrocephalus: Ultra-Fast Neuropsychological Testing During Infusion and Tap Test in Patients with Idiopathic Normal-Pressure Hydrocephalus.

IF 2.7 3区医学 Q3 NEUROSCIENCES

Brain Sciences Pub Date : 2025-01-01 DOI:10.3390/brainsci15010036

Ilaria Guarracino, Sara Fabbro, Daniele Piccolo, Serena D'Agostini, Miran Skrap, Enrico Belgrado, Marco Vindigni, Francesco Tuniz, Barbara Tomasino

{"title":"Real-Time Neuropsychological Testing for Hydrocephalus: Ultra-Fast Neuropsychological Testing During Infusion and Tap Test in Patients with Idiopathic Normal-Pressure Hydrocephalus.","authors":"Ilaria Guarracino, Sara Fabbro, Daniele Piccolo, Serena D'Agostini, Miran Skrap, Enrico Belgrado, Marco Vindigni, Francesco Tuniz, Barbara Tomasino","doi":"10.3390/brainsci15010036","DOIUrl":null,"url":null,"abstract":"Background/objectives: Ventriculoperitoneal shunting is a validated procedure for the treatment of idiopathic normal-pressure hydrocephalus. To select shunt-responsive patients, infusion and tap tests can be used. Only gait is evaluated after the procedure to establish a potential improvement. In this study, we present our Hydro-Real-Time Neuropsychological Testing protocol to assess the feasibility of performing an ultra-fast assessment of patients during the infusion and tap test.Methods: We tested 57 patients during the infusion and tap test to obtain real-time feedback on their cognitive status. Data were obtained immediately before the infusion phase (T0), when the pressure plateau was reached (T1), and immediately after cerebrospinal fluid subtraction (T2). Based on cerebrospinal fluid dynamics, 63.15% of the patients presented a resistance to outflow > 12 mmHg/mL/min, while 88% had a positive tap test response.Results: Compared to T0, cerebrospinal fluid removal significantly improved performance on tasks exploring executive functions (counting backward, p < 0.001; verbal fluency, p < 0.001). Patients were significantly faster at counting backward at T2 vs. T1 (p < 0.05) and at T2 vs. T0 (p < 0.001) and were significantly faster at counting forward at T2 vs. T1 (p < 0.005), suggesting an improvement in speed at T2. There was a significantly smaller index at T1 vs. T0 (p = 0.005) and at T2 vs. T0 (p < 0.001), suggesting a more marked improvement in patients' executive abilities at T2 and a smaller improvement at T1. Regarding verbal fluency, patients were worse at T1 vs. T0 (p < 0.001) and at T2 vs. T0 (p < 0.001).Conclusions: Patients' performance can be monitored during the infusion and tap test as significant changes in executive functions are observable. In future, this protocol might help improve patients' selection for surgery.","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"15 1","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763780/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/brainsci15010036","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background/objectives: Ventriculoperitoneal shunting is a validated procedure for the treatment of idiopathic normal-pressure hydrocephalus. To select shunt-responsive patients, infusion and tap tests can be used. Only gait is evaluated after the procedure to establish a potential improvement. In this study, we present our Hydro-Real-Time Neuropsychological Testing protocol to assess the feasibility of performing an ultra-fast assessment of patients during the infusion and tap test.

Methods: We tested 57 patients during the infusion and tap test to obtain real-time feedback on their cognitive status. Data were obtained immediately before the infusion phase (T0), when the pressure plateau was reached (T1), and immediately after cerebrospinal fluid subtraction (T2). Based on cerebrospinal fluid dynamics, 63.15% of the patients presented a resistance to outflow > 12 mmHg/mL/min, while 88% had a positive tap test response.

Results: Compared to T0, cerebrospinal fluid removal significantly improved performance on tasks exploring executive functions (counting backward, p < 0.001; verbal fluency, p < 0.001). Patients were significantly faster at counting backward at T2 vs. T1 (p < 0.05) and at T2 vs. T0 (p < 0.001) and were significantly faster at counting forward at T2 vs. T1 (p < 0.005), suggesting an improvement in speed at T2. There was a significantly smaller index at T1 vs. T0 (p = 0.005) and at T2 vs. T0 (p < 0.001), suggesting a more marked improvement in patients' executive abilities at T2 and a smaller improvement at T1. Regarding verbal fluency, patients were worse at T1 vs. T0 (p < 0.001) and at T2 vs. T0 (p < 0.001).

Conclusions: Patients' performance can be monitored during the infusion and tap test as significant changes in executive functions are observable. In future, this protocol might help improve patients' selection for surgery.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Brain Sciences Neuroscience-General Neuroscience

CiteScore

4.80

自引率

9.10%

发文量

1472

审稿时长

18.71 days

期刊介绍： Brain Sciences (ISSN 2076-3425) is a peer-reviewed scientific journal that publishes original articles, critical reviews, research notes and short communications in the areas of cognitive neuroscience, developmental neuroscience, molecular and cellular neuroscience, neural engineering, neuroimaging, neurolinguistics, neuropathy, systems neuroscience, and theoretical and computational neuroscience. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. Electronic files or software regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material.