Age-Dependence of Cerebrospinal Fluid Pressure Metrics During Queckenstedt’s Test

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2025-12-02 DOI:10.1155/ane/2761843

Najmeh Kheram, Andrea Boraschi, Maria Rasenack, Nikolai Pfender, Andreas Spiegelberg, Martin Schubert, Vartan Kurtcuoglu, Armin Curt, Carl Moritz Zipser

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引用次数: 0

Abstract

Introduction

Quantification of craniospinal compliance is a known practice in neurological diagnostics. It is regularly done through external volume application during infusion testing and takes 30–60 min. We previously described a reliable method to obtain cerebrospinal fluid pressure (CSFP) pulsatility curve using a 10-s auto-infusion test, also known as Queckenstedt’s test (QT). Metrics such as relative pulse pressure coefficient (RPPC-Q) and pressure at infinite compliance (P₀-Q) obtained by QT may contain information on cerebrospinal compliance. As compliance changes with age, it would be of value to quantify potential age-dependent changes in these QT-derived metrics.

Materials and Methods

Lumbar puncture was performed in lateral recumbent position in 14 adults < 50 years (38.7 ± 7.8 years, 7F) with no suspicion of spinal canal stenosis. Results were compared to 14 older patients (59.7 ± 9.3 years, 6F) (NCT02170155). CSFP was recorded during resting state and QT, and was repeated during head reclination. RPPC-Q and P₀-Q were computed from repeated QTs.

Results

Between the two groups, there was no difference in mean CSFP (p = 0.65), cardiac-driven CSFP peak-to-valley amplitude (CSFPp) (p = 0.75), or in mean CSFP rise during QT (△CSFP) (p = 0.10). However, CSFPp at peak QT was lower in the young cohort (3.1 {1.7} mmHg vs. 3.7 {1.7}, p = 0.002), as were median RPPC-Q (0.09 {0.09} vs. 0.18 {0.06}, p = 0.009), and P₀-Q (3.1 {5.4} vs. 7.1 {3.5}, p = 0.004). Regression analysis showed a positive correlation between age and both RPPC-Q (0.003, p = 0.02) and P₀-Q (0.2, p = 0.02).

Conclusions

The differences in RPPC-Q and P₀-Q between the two age groups suggest that information on craniospinal compliance can be derived from this simple bedside test. A study comparing these QT-derived metrics to their corresponding metrics obtained by infusion testing is warranted.

Trial Registration: ClinicalTrials.gov Registry NCT02170155

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Queckenstedt试验中脑脊液压力指标的年龄依赖性

量化颅脊柱顺应性是神经学诊断的一种已知做法。在输液试验期间，定期通过外部体积应用，耗时30-60分钟。我们之前描述了一种可靠的方法来获得脑脊液压力（CSFP）脉搏曲线使用10秒自动输液试验，也被称为Queckenstedt试验（QT）。QT获得的相对脉压系数（RPPC-Q）和无限顺应性压力（P0-Q）等指标可能包含脑脊液顺应性的信息。由于依从性随着年龄的变化而变化，量化这些qt衍生指标中潜在的年龄相关变化将是有价值的。材料与方法对14例50岁（38.7±7.8岁，7F）成人患者行侧卧位腰椎穿刺，无椎管狭窄嫌疑。结果与14例老年患者（59.7±9.3岁，6F）（NCT02170155）进行比较。在静息状态和QT间期记录ccsf，并在仰卧时重复。RPPC-Q和P0-Q由重复的QTs计算。结果两组间平均CSFP （p = 0.65）、心脏驱动的CSFP峰谷振幅（CSFPp）（p = 0.75）、QT间期平均CSFP升高（△CSFP）（p = 0.10）无差异。然而，QT峰值时的CSFPp在年轻队列中较低（3.1 {1.7}mmHg对3.7 {1.7},p = 0.002），中位RPPC-Q（0.09{0.09}对0.18 {0.06},p = 0.009）和P0-Q（3.1{5.4}对7.1 {3.5},p = 0.004）。回归分析显示，年龄与RPPC-Q （0.003, p = 0.02）、P0-Q （0.2, p = 0.02）呈正相关。结论RPPC-Q和P0-Q在两个年龄组之间的差异表明，可以从这个简单的床边试验中获得颅脊柱顺应性的信息。一项比较这些qt衍生指标与输液测试获得的相应指标的研究是必要的。试验注册：ClinicalTrials.gov注册中心NCT02170155

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.