Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives.

IF 5.9 1区 医学 Q1 NEUROSCIENCES
Vojtěch Novák, Adéla Bubeníková, Petr Skalický, Arnošt Mládek, Václav Gerla, Afroditi Despina Lalou, Aleš Vlasák, Róbert Leško, Ondřej Bradáč
{"title":"Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives.","authors":"Vojtěch Novák, Adéla Bubeníková, Petr Skalický, Arnošt Mládek, Václav Gerla, Afroditi Despina Lalou, Aleš Vlasák, Róbert Leško, Ondřej Bradáč","doi":"10.1186/s12987-025-00662-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The lumbar infusion test (LIT) is a routine part of the diagnostic process of various CSF dynamics disorders in adults. However, it is rarely used in the paediatric population due to a lack of evidence substantiating its efficacy and overall indications.</p><p><strong>Methods: </strong>Articles utilizing the LIT in a paediatric cohort (≤ 18 years) were included according to the PRISMA guidelines with the Newcastle-Ottawa Scale to assess the risk of bias. This review was registered at PROSPERO database under number: CRD42024625857.</p><p><strong>Results: </strong>A total of 15 studies, yielding 441 patients, were included in the review. The most common indications for LIT were to predict shunt responsiveness in hydrocephalus and idiopathic intracranial hypertension (IIH). In IIH, the interaction between cerebrospinal fluid pressure (CSFp) and sagittal sinus pressure (SSp) may offer valuable diagnostic insights and present a novel assessment approach. The LIT is a validated tool, especially effective for predicting shunt responsiveness and detecting malfunctions in both IIH and hydrocephalus.</p><p><strong>Conclusions: </strong>Data surrounding LIT usage in children is lacking and most studies are outdated. Caution is needed when interpreting resistance to outflow (Rout) due to potential overestimation, with more attention directed to CSFp and the pressure within the venous system coupling in IIH. Future studies should focus on standardizing LIT protocols across age groups with focusing more on signal characteristics rather than individual parameters and fostering interdisciplinary collaboration to optimize diagnostic accuracy.</p>","PeriodicalId":12321,"journal":{"name":"Fluids and Barriers of the CNS","volume":"22 1","pages":"50"},"PeriodicalIF":5.9000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082959/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Fluids and Barriers of the CNS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12987-025-00662-9","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The lumbar infusion test (LIT) is a routine part of the diagnostic process of various CSF dynamics disorders in adults. However, it is rarely used in the paediatric population due to a lack of evidence substantiating its efficacy and overall indications.

Methods: Articles utilizing the LIT in a paediatric cohort (≤ 18 years) were included according to the PRISMA guidelines with the Newcastle-Ottawa Scale to assess the risk of bias. This review was registered at PROSPERO database under number: CRD42024625857.

Results: A total of 15 studies, yielding 441 patients, were included in the review. The most common indications for LIT were to predict shunt responsiveness in hydrocephalus and idiopathic intracranial hypertension (IIH). In IIH, the interaction between cerebrospinal fluid pressure (CSFp) and sagittal sinus pressure (SSp) may offer valuable diagnostic insights and present a novel assessment approach. The LIT is a validated tool, especially effective for predicting shunt responsiveness and detecting malfunctions in both IIH and hydrocephalus.

Conclusions: Data surrounding LIT usage in children is lacking and most studies are outdated. Caution is needed when interpreting resistance to outflow (Rout) due to potential overestimation, with more attention directed to CSFp and the pressure within the venous system coupling in IIH. Future studies should focus on standardizing LIT protocols across age groups with focusing more on signal characteristics rather than individual parameters and fostering interdisciplinary collaboration to optimize diagnostic accuracy.

腰椎输液试验在儿科人群中的应用综述:最新的和未来的观点。
背景:腰椎灌注试验(LIT)是成人各种脑脊液动力学障碍诊断过程的常规部分。然而,由于缺乏证据证实其有效性和总体适应症,它很少用于儿科人群。方法:根据PRISMA指南和纽卡斯尔-渥太华量表纳入在儿科队列(≤18岁)中使用LIT的文章,以评估偏倚风险。本综述在PROSPERO数据库注册,编号:CRD42024625857。结果:共纳入15项研究,441例患者。LIT最常见的适应症是预测脑积水和特发性颅内高压(IIH)的分流反应性。在IIH中,脑脊液压力(CSFp)和矢状窦压力(SSp)之间的相互作用可能提供有价值的诊断见解,并提出一种新的评估方法。LIT是一种经过验证的工具,特别有效地预测分流反应和检测IIH和脑积水的故障。结论:关于儿童LIT使用的数据缺乏,大多数研究都是过时的。在解释由于潜在的高估而导致的流出阻力(route)时需要谨慎,更多地关注CSFp和IIH中静脉系统内的压力耦合。未来的研究应侧重于标准化跨年龄组的LIT协议,更多地关注信号特征而不是个体参数,并促进跨学科合作以优化诊断准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Fluids and Barriers of the CNS
Fluids and Barriers of the CNS Neuroscience-Developmental Neuroscience
CiteScore
10.70
自引率
8.20%
发文量
94
审稿时长
14 weeks
期刊介绍: "Fluids and Barriers of the CNS" is a scholarly open access journal that specializes in the intricate world of the central nervous system's fluids and barriers, which are pivotal for the health and well-being of the human body. This journal is a peer-reviewed platform that welcomes research manuscripts exploring the full spectrum of CNS fluids and barriers, with a particular focus on their roles in both health and disease. At the heart of this journal's interest is the cerebrospinal fluid (CSF), a vital fluid that circulates within the brain and spinal cord, playing a multifaceted role in the normal functioning of the brain and in various neurological conditions. The journal delves into the composition, circulation, and absorption of CSF, as well as its relationship with the parenchymal interstitial fluid and the neurovascular unit at the blood-brain barrier (BBB).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信