Supplemental Tests in iNPH (Version 1.0)
Research type
Research Study
Full title
How useful are supplemental tests in the selection of patients with suspected idiopathic normal pressure hydrocephalus for shunt surgery?
IRAS ID
283387
Contact name
Richard Edwards
Contact email
Sponsor organisation
North Bristol NHS Trust
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Since 2001, many patients have been investigated for possible shunt-responsive Normal Pressure Hydrocephalus (NPH) at our institution. These patients were referred to our Adult Hydrocephalus Clinic with problems affecting walking or balance, often combined with cognitive and bladder control difficulties. All of these patients underwent clinical and radiological assessment, and most were also investigated with extended lumbar drainage (which involves insertion of a drain into the spinal canal and drainage of cerebrospinal fluid over two days). This is done to assess for potential improvement of their NPH symptoms with insertion of a permanent CSF shunt. A subset of these patients also underwent neuropsychological assessment and another test called an infusion study, which measures the resistance to the normal re-absorption of CSF around the brain (known as resistance to outflow of CSF or ‘R-OUT’). Previous researchers have suggested that a series of radiological findings known collectively as features of ‘Disproportionately Enlarged Subarachnoid Spaces Hydrocephalus’ (or ‘DESH’) are predictive of shunt response, and the aim of our study is to determine the predictive value of these features, together with the supplemental tests described above. We also plan to investigate if any patient characteristics (such as duration of symptoms, order of symptom development, previous dementia diagnoses/symptoms) are predictive of shunt response. This is important because such data will allow clinicians to more reliably select patients who will benefit from shunt surgery and prevent patients from either undergoing unnecessary surgery or not receiving an intervention that might have offered significant benefit.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
20/EM/0242
Date of REC Opinion
29 Sep 2020
REC opinion
Favourable Opinion