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Shanks, J., Bloch, K. M., Laurell, K., Cesarini, K. G., Fahlstroem, M., Larsson, E.-M. & Virhammar, J. (2019). Aqueductal CSF Stroke Volume Is Increased in Patients with Idiopathic Normal Pressure Hydrocephalus and Decreases after Shunt Surgery. American Journal of Neuroradiology, 40(3), 453-459
Öppna denna publikation i ny flik eller fönster >>Aqueductal CSF Stroke Volume Is Increased in Patients with Idiopathic Normal Pressure Hydrocephalus and Decreases after Shunt Surgery
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2019 (Engelska)Ingår i: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 40, nr 3, s. 453-459Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND AND PURPOSE: Increased CSF stroke volume through the cerebral aqueduct has been proposed as a possible indicator of positive surgical outcome in patients with idiopathic normal pressure hydrocephalus; however, consensus is lacking. In this prospective study, we aimed to compare CSF flow parameters in patients with idiopathic normal pressure hydrocephalus with those in healthy controls and change after shunt surgery and to investigate whether any parameter could predict surgical outcome.

MATERIALS AND METHODS: Twenty-one patients with idiopathic normal pressure hydrocephalus and 21 age- and sex-matched healthy controls were prospectively included and examined clinically and with MR imaging of the brain. Eighteen patients were treated with shunt implantation and were re-examined clinically and with MR imaging the day before the operation and 3 months postoperatively. All MR imaging scans included a phase-contrast sequence.

RESULTS: The median aqueductal CSF stroke volume was significantly larger in patients compared with healthy controls (103.5 μL; interquartile range, 69.8–142.8 μL) compared with 62.5 μL (interquartile range, 58.3–73.8 μL; P < .01) and was significantly reduced 3 months after shunt surgery from 94.8 μL (interquartile range, 81–241 μL) to 88 μL (interquartile range, 51.8–173.3 μL; P < .05). Net flow in the caudocranial direction (retrograde) was present in 11/21 patients and in 10/21 controls. Peak flow and net flow did not differ between patients and controls. There were no correlations between any CSF flow parameters and surgical outcomes.

CONCLUSIONS: Aqueductal CSF stroke volume was increased in patients with idiopathic normal pressure hydrocephalus and decreased after shunt surgery, whereas retrograde aqueductal net flow did not seem to be specific for patients with idiopathic normal pressure hydrocephalus. On the basis of the results, the usefulness of CSF flow parameters to predict outcome after shunt surgery seem to be limited.

Ort, förlag, år, upplaga, sidor
American Society of Neuroradiology, 2019
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:umu:diva-157768 (URN)10.3174/ajnr.A5972 (DOI)000461201600016 ()30792248 (PubMedID)2-s2.0-85062962080 (Scopus ID)
Tillgänglig från: 2019-04-04 Skapad: 2019-04-04 Senast uppdaterad: 2019-04-04Bibliografiskt granskad
de Flon, P., Laurell, K., Sundström, P., Blennow, K., Söderström, L., Zetterberg, H., . . . Svenningsson, A. (2019). Comparison of plasma and cerebrospinal fluid neurofilament light in a multiple sclerosis trial. Acta Neurologica Scandinavica, 139(5), 462-468
Öppna denna publikation i ny flik eller fönster >>Comparison of plasma and cerebrospinal fluid neurofilament light in a multiple sclerosis trial
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2019 (Engelska)Ingår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 139, nr 5, s. 462-468Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: The main objective of this study was to evaluate the axonal component neurofilament light protein (NFL) in plasma and cerebrospinal fluid (CSF) as an outcome measure in a clinical trial on disease-modifying treatments in multiple sclerosis.

Materials and methods: Seventy-five patients with clinically stable relapsing-remitting multiple sclerosis (RRMS) participating in the clinical trial "Switch-To RItuXimab in MS" (STRIX-MS) were switched to rituximab from first-line injectable therapy and then followed up for 2 years. Thirty patients from the extension trial (STRIX-MS extension), accepting repeated lumbar punctures, were followed up for an additional 3 years. Plasma and CSF samples were collected yearly during the follow-up. NFL concentration in plasma was measured by an in-house NF-light assay on the Simoa platform with a Homebrew kit. NFL concentration in CSF was measured by sandwich ELISA.

Results: The mean levels of NFL, in both CSF and plasma, were low. The reduction of CSF-NFL was 25% during the first year of follow-up (from a mean of 471 [SD 393] to 354 [SD 174] pg/mL; P = 0.006) and was statistically significant. The corresponding reduction in plasma NFL was 18% (from 9.73 [SD 7.04] to 7.94 [SD 3.10] pg/mL; P = 0.055) and did not reach statistical significance.

Conclusion: This study indicates that NFL in plasma is less sensitive as an endpoint in group comparisons than NFL in CSF. Given that plasma NFL is far easier to access, it is a promising and awaited method but further studies are needed to optimize the use in clinical trials.

Nyckelord
cerebrospinal fluid, clinical trial, multiple sclerosis, neurofilament light, plasma, rituximab, treatment
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:umu:diva-158568 (URN)10.1111/ane.13078 (DOI)000464338600008 ()30740668 (PubMedID)
Tillgänglig från: 2019-05-27 Skapad: 2019-05-27 Senast uppdaterad: 2019-05-27Bibliografiskt granskad
Virhammar, J., Laurell, K., Cesarini, K. G. & Larsson, E.-M. (2019). Increase in callosal angle and decrease in ventricular volume after shunt surgery in patients with idiopathic normal pressure hydrocephalus. Journal of Neurosurgery, 130(1), 130-135
Öppna denna publikation i ny flik eller fönster >>Increase in callosal angle and decrease in ventricular volume after shunt surgery in patients with idiopathic normal pressure hydrocephalus
2019 (Engelska)Ingår i: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 130, nr 1, s. 130-135Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE

Postoperative decrease in ventricle size is usually not detectable either by visual assessment or by measuring the Evans index in patients with idiopathic normal pressure hydrocephalus (iNPH). The aim of the present study was to investigate whether the angle between the lateral ventricles (the callosal angle [CA]) increases and ventricular volume decreases after shunt surgery in patients with iNPH.

METHODS

Magnetic resonance imaging of the brain was performed before and 3 months after shunt surgery in 18 patients with iNPH. The CA and Evans index were measured on T1-weighted 3D MR images, and ventricular volume contralateral to the shunt valve was measured with quantitative MRI.

RESULTS

The CA was larger postoperatively (mean 78°, 95% CI 69°–87°) than preoperatively (mean 67°, 95% CI 60°–73°; p < 0.001). The volume of the lateral ventricle contralateral to the shunt valve decreased from 73 ml (95% CI 66–80 ml) preoperatively to 63 ml (95% CI 54–72 ml) postoperatively (p < 0.001). The Evans index was 0.365 (95% CI 0.35–0.38) preoperatively and 0.358 (95% CI 0.34–0.38) postoperatively (p < 0.05). Postoperative change of CA showed a negative correlation with change of ventricular volume (r = −0.76, p < 0.01).

CONCLUSIONS

In this sample of patients with iNPH, the CA increased and ventricular volume decreased after shunt surgery. The relative difference was most pronounced for the CA, indicating that this accessible, noninvasive radiological marker should be evaluated further as an indirect method to determine shunt function in patients with iNPH.

Ort, förlag, år, upplaga, sidor
American Association of Neurological Surgeons, 2019
Nyckelord
normal pressure hydrocephalus, callosal angle, Evans index, postoperative radiology, quantitative MRI, NPH, shunt dysfunction
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:umu:diva-155641 (URN)10.3171/2017.8.JNS17547 (DOI)000454604000015 ()29393749 (PubMedID)
Forskningsfinansiär
Erik, Karin och Gösta Selanders stiftelse
Tillgänglig från: 2019-01-25 Skapad: 2019-01-25 Senast uppdaterad: 2019-01-25Bibliografiskt granskad
Libard, S., Laurell, K., Cesarini, K. G. & Alafuzoff, I. (2019). Neuronal loss and progression of Alzheimer's disease related pathology observed in a Swedish patient with clinical diagnosis of idiopathic normal pressure hydrocephalus. Paper presented at 19th International Congress of Neuropathology, SEP 23-27, 2018, Tokyo, JAPAN. Brain Pathology, 29, 69-69
Öppna denna publikation i ny flik eller fönster >>Neuronal loss and progression of Alzheimer's disease related pathology observed in a Swedish patient with clinical diagnosis of idiopathic normal pressure hydrocephalus
2019 (Engelska)Ingår i: Brain Pathology, ISSN 1015-6305, E-ISSN 1750-3639, Vol. 29, s. 69-69Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2019
Nationell ämneskategori
Neurologi Neurovetenskaper
Identifikatorer
urn:nbn:se:umu:diva-157591 (URN)000459814800214 ()
Konferens
19th International Congress of Neuropathology, SEP 23-27, 2018, Tokyo, JAPAN
Anmärkning

Supplement: 1

Special Issue: SI

Meeting Abstract: P2-1

Tillgänglig från: 2019-03-29 Skapad: 2019-03-29 Senast uppdaterad: 2019-03-29Bibliografiskt granskad
Irewall, A.-L., Ögren, J., Bergström, L., Laurell, K., Söderström, L. & Mooe, T. (2019). Nurse-led, telephone-based secondary preventive follow-up benefits stroke/TIA patients with low education: a randomized controlled trial sub-study. Trials, 20, Article ID 52.
Öppna denna publikation i ny flik eller fönster >>Nurse-led, telephone-based secondary preventive follow-up benefits stroke/TIA patients with low education: a randomized controlled trial sub-study
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2019 (Svenska)Ingår i: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, artikel-id 52Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: The objective of this study was to analyze the impact of two forms of secondary preventive followup on the association between education level and levels of blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) after stroke/transient ischemic attack (TIA).

Methods: We included a population-based cohort of 771 stroke and TIA patients randomly assigned (1:1) to secondary preventive follow-up within primary health care (control) or nurse-led, telephone-based follow-up (intervention) between January 1, 2010, and December 31, 2013, as part of the NAILED (nurse-based ageindependent intervention to limit evolution of disease) stroke risk factor trial. We compared BP and LDL-C levels 12 months after hospital discharge in relation to education level (low, ≤10 years; high, >10 years) separately for the intervention and control groups.

Results: Among controls, systolic BP (SBP) decreased only among the highly educated (−2.5 mm Hg, 95% confidence interval (CI) −0.2 to −4.8), whereas LDL-C increased in the low-education group (0.2 mmol/L, 95% CI 0.1 to 0.3). At 12 months, controls with low education not more than 70 years of age had higher SBP than controls of the same age with high education (5.8 mm Hg, 95% CI 1.0 to 10.6). In contrast, SBP in the intervention group decreased similarly regardless of education level, LDL-C decreased among those with low education (−0.3 mmol/L, 95% CI −0.2 to −0.4) and, in the subgroup not more than 70 years old, low-educated participants had lower LDL-C at 12 months than those with high education (0.3 mmol/L, 95% CI 0.1 to 0.5).

Conclusions: Nurse-led, telephone-based secondary preventive follow-up led to comparable improvements in BP across education groups, while routine follow-up disfavored those with low education.

Trial registration: ISRCTN Registry ISRCTN23868518, June 19, 2012 - Retrospectively registered

Ort, förlag, år, upplaga, sidor
BioMed Central, 2019
Nyckelord
Secondary prevention, Stroke, Transient ischemic attack, Socioeconomic position
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:umu:diva-130496 (URN)10.1186/s13063-018-3131-4 (DOI)000455819200001 ()30646948 (PubMedID)
Anmärkning

Originally included in thesis in manuscript form with title: Nurse-led, telephone-based secondary preventive follow-up benefits stroke/TIA patients with low education: a prospective cohort study

Tillgänglig från: 2017-01-20 Skapad: 2017-01-20 Senast uppdaterad: 2019-09-04Bibliografiskt granskad
Andersson, J., Rosell, M., Kockum, K., Lilja-Lund, O., Soderstrom, L. & Laurell, K. (2019). Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. PLoS ONE, 14(5), Article ID e0217705.
Öppna denna publikation i ny flik eller fönster >>Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study
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2019 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 5, artikel-id e0217705Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Idiopathic normal pressure hydrocephalus (iNPH) causing gait impairment, dementia and urinary incontinence among the elderly, is probably under-diagnosed and under-treated. Despite being known since the 1960s, there is still a lack of prospective, population-based studies on the prevalence of iNPH. Such studies are warranted to minimize selection bias and estimate the true prevalence of the disease.

Methods: The prevalence of iNPH was determined in a randomly selected sample of residents, aged 65 years and older, in the Swedish county of Jämtland. Out of 1,000 individuals invited to participate, 673 (67.3%) completed a questionnaire with seven questions on iNPH symptoms. A subgroup, with and without self-reported symptoms, participated in clinical and radiological evaluations and were diagnosed according to international guidelines. Measurement of cerebrospinal fluid opening pressure was not performed as it was considered too invasive.

Results: Those who reported at least two symptoms in the questionnaire (n = 117) and 51 randomly selected individuals with 0–1 symptom participated in further examinations. Out of them, 25 individuals received the diagnosis probable iNPH according to American-European guidelines (except for the criterion of CSF opening pressure) corresponding to a prevalence of 3.7%. The prevalence of iNPH was four times higher among those aged 80 years and older (8.9%) than among those aged 65–79 years (2.1%) (p <0.001). The difference in prevalence between men (4.6%) and women (2.9%) was not significant (p = 0.24). When iNPH was diagnosed according to the Japanese guidelines the prevalence was 1.5%

Conclusions: In this prospective, population-based study the prevalence of iNPH was 3.7% among individuals 65 years and older, and more common in the higher age group, 80 years and above. INPH should be increasingly recognized since it is a fairly common condition and an important cause of gait impairment and dementia among the elderly that can be effectively treated by shunt surgery.

Ort, förlag, år, upplaga, sidor
Public Library Science, 2019
Nationell ämneskategori
Geriatrik Neurologi
Identifikatorer
urn:nbn:se:umu:diva-160294 (URN)10.1371/journal.pone.0217705 (DOI)000469323000074 ()31141553 (PubMedID)
Tillgänglig från: 2019-06-17 Skapad: 2019-06-17 Senast uppdaterad: 2019-06-17Bibliografiskt granskad
de Flon, P., Söderström, L., Laurell, K., Dring, A., Sundström, P., Gunnarsson, M. & Svenningsson, A. (2018). Immunological profile in cerebrospinal fluid of patients with multiple sclerosis after treatment switch to rituximab and compared with healthy controls. PLoS ONE, 13(2), Article ID e0192516.
Öppna denna publikation i ny flik eller fönster >>Immunological profile in cerebrospinal fluid of patients with multiple sclerosis after treatment switch to rituximab and compared with healthy controls
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2018 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 2, artikel-id e0192516Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: To investigate changes in the cerebrospinal fluid (CSF) immunological profile after treatment switch from first-line injectables to rituximab in patients with relapsing-remitting MS (RRMS), and to compare the profile in MS patients with healthy controls (HC).

METHOD: Cerebrospinal fluid from 70 patients with clinically stable RRMS and 55 HC was analysed by a multiplex electrochemiluminescence method for a broad panel of cytokines and immunoactive substances before, and over a two-year period after, treatment switch to rituximab. After quality assessment of data, using a predefined algorithm, 14 analytes were included in the final analysis.

RESULTS: Ten of the 14 analytes differed significantly in MS patients compared with HC at baseline. Levels of IP-10 (CXCL10), IL-12/23p40, IL-6, sVCAM1, IL-15, sICAM1 and IL-8 (CXCL8) decreased significantly after treatment switch to rituximab. The cytokines IP-10 and IL-12/IL-23p40 displayed the largest difference versus HC at baseline and also the largest relative reduction after therapy switch to rituximab.

CONCLUSION: We found significant changes in the immunological profile after therapy switch to rituximab in RRMS in the direction towards the values of HC. IP-10 and IL12/IL-23p40 deserve further studies as part of the immunopathogenesis of MS as well as for the mode of action of rituximab in MS.

Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:umu:diva-145871 (URN)10.1371/journal.pone.0192516 (DOI)000424517900086 ()29420590 (PubMedID)
Tillgänglig från: 2018-03-20 Skapad: 2018-03-20 Senast uppdaterad: 2019-05-07Bibliografiskt granskad
Andrén, K., Wikkelsö, C., Sundström, N., Agerskov, S., Israelsson, H., Laurell, K., . . . Tullberg, M. (2018). Long-term effects of complications and vascular comorbidity in idiopathic normal pressure hydrocephalus: a quality registry study. Journal of Neurology, 265(1), 178-186
Öppna denna publikation i ny flik eller fönster >>Long-term effects of complications and vascular comorbidity in idiopathic normal pressure hydrocephalus: a quality registry study
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2018 (Engelska)Ingår i: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 265, nr 1, s. 178-186Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: There is little knowledge about the factors influencing the long-term outcome after surgery for idiopathic normal pressure hydrocephalus (iNPH).

Objective: To evaluate the effects of reoperation due to complications and of vascular comorbidity (hypertension, diabetes, stroke and heart disease) on the outcome in iNPH patients, 2–6 years after shunt surgery.

Methods: We included 979 patients from the Swedish Hydrocephalus Quality Registry (SHQR), operated on for iNPH during 2004–2011. The patients were followed yearly by mailed questionnaires, including a self-assessed modified Rankin Scale (smRS) and a subjective comparison between their present and their preoperative health condition. The replies were grouped according to the length of follow-up after surgery. Data on clinical evaluations, vascular comorbidity, and reoperations were extracted from the SHQR.

Results: On the smRS, 40% (38–41) of the patients were improved 2–6 years after surgery and around 60% reported their general health condition to be better than preoperatively. Reoperation did not influence the outcome after 2–6 years. The presence of vascular comorbidity had no negative impact on the outcome after 2–6 years, assessed as improvement on the smRS or subjective improvement of the health condition, except after 6 years when patients with hypertension and a history of stroke showed a less favorable development on the smRS.

Conclusion: This registry-based study shows no negative impact of complications and only minor effects of vascular comorbidity on the long-term outcome in iNPH.

Ort, förlag, år, upplaga, sidor
Springer, 2018
Nyckelord
hydrocephalus, normal pressure, dementia, gait, complications, concomitant disease, risk factors, registries
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:umu:diva-144413 (URN)10.1007/s00415-017-8680-z (DOI)000419777000023 ()29188384 (PubMedID)
Tillgänglig från: 2018-02-09 Skapad: 2018-02-09 Senast uppdaterad: 2019-05-07Bibliografiskt granskad
Libard, S., Laurell, K., Cesarini, K. G. & Alafuzoff, I. (2018). Progression of Alzheimer's Disease-Related Pathology and Cell Counts in a Patient with Idiopathic Normal Pressure Hydrocephalus. Journal of Alzheimer's Disease, 61(4), 1451-1462
Öppna denna publikation i ny flik eller fönster >>Progression of Alzheimer's Disease-Related Pathology and Cell Counts in a Patient with Idiopathic Normal Pressure Hydrocephalus
2018 (Engelska)Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 61, nr 4, s. 1451-1462Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

We had an opportunity to assess the change observed in the brain regarding Alzheimer's disease (AD)-related alterations, cell count, and inflammation that took place during a period of 21 months in a subject with a definite diagnosis of AD and idiopathic Normal Pressure Hydrocephalus (iNPH). Four neuronal markers, i.e., synaptophysin, microtubule associated protein 2, non-phosphorylated neurofilament H (SMI32), and embryonic lethal abnormal visual system proteins 3/4 HuC/HuD (HuC/HuD); three microglial markers CD68, Human Leucocytic Antigen DR, ionized calcium-binding adaptor molecule 1, glial fibrillary acidic protein (GFAP); and AD-related markers, hyperphosphorylated iota (HP iota) and amyloid-beta (A beta, A beta(40), A beta(42)) were assessed. Morphometrically assessed immunoreactivity of all neuronal and all microglial markers and A beta(42) decreased parallel with an increase in the HP iota in the frontal cortex. The expression of GFAP was stable with time. The first sample was obtained during the therapeutic shunting procedure for iNPH, and the second sample was obtained postmortem. Negligible reactive changes were observed surrounding the shunt channel. In conclusion, in the late stage of AD with time, a neuronal loss, increase in the HP iota, and decrease in A beta(42) and microglia was observed, whereas the expression of GFAP was rather stable. The observations described here suggest that when a brain biopsy has been obtained from an adult subject with iNPH, the assessment of postmortem brain is of major significance.

Ort, förlag, år, upplaga, sidor
IOS Press, 2018
Nyckelord
Amyloid-beta, astrocytes, hyperphosphorylated tau, idiopathic normal pressure hydrocephalus, munohistochemistry, microglia, neurons
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:umu:diva-144967 (URN)10.3233/JAD-170446 (DOI)000423364400018 ()29376849 (PubMedID)
Tillgänglig från: 2018-02-21 Skapad: 2018-02-21 Senast uppdaterad: 2019-05-07Bibliografiskt granskad
Kockum, K., Lilja-Lund, O., Larsson, E.-M. -., Rosell, M., Söderström, L., Virhammar, J. & Laurell, K. (2018). The idiopathic normal-pressure hydrocephalus Radscale: a radiological scale for structured evaluation. European Journal of Neurology, 25(3), 569-576
Öppna denna publikation i ny flik eller fönster >>The idiopathic normal-pressure hydrocephalus Radscale: a radiological scale for structured evaluation
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2018 (Engelska)Ingår i: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 25, nr 3, s. 569-576Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background and purpose: Despite the important role of imaging in diagnosing idiopathic normal‐pressure hydrocephalus (iNPH), a structured overall assessment of radiological signs is still lacking. The purpose of this study was to construct a radiological scale, composed of morphological signs of iNPH, and compare it with clinical symptoms.

Methods: In this prospective, population‐based study of iNPH, 168 individuals (93 females) [mean age 75 (range 66–92) years] underwent computed tomography of the brain and a neurological examination with assessment of clinical symptoms according to Hellström's iNPH scale. Two radiologists, blinded to clinical data, independently evaluated and measured eight radiological parameters, i.e. Evans’ index, callosal angle, size of temporal horns, narrow high‐convexity sulci, dilated Sylvian fissures, focally dilated sulci, peri‐ventricular hypodensities and bulging of the lateral ventricular roof.

Results: In a linear regression model, all parameters except ventricular roof bulging were significantly associated with clinical iNPH symptoms. The seven remaining parameters were summarized into a total iNPH Radscale score ranging from 0 to 12. There was a significant correlation (r = 0.55, < 0.001) between the total iNPH Radscale score and clinical symptoms. The inter‐rater agreement for the included radiological parameters was high (intraclass correlation, 0.74–0.97).

Conclusion: The iNPH Radscale may become a valuable diagnostic screening tool, allowing a structured radiological assessment. A high iNPH Radscale score together with clinical symptoms should raise suspicion of iNPH, motivating further evaluation for shunt surgery.

Nyckelord
computed tomography, neurologic gait disorders, normal pressure hydrocephalus, memory disorders
Nationell ämneskategori
Radiologi och bildbehandling
Identifikatorer
urn:nbn:se:umu:diva-145580 (URN)10.1111/ene.13555 (DOI)000425631500025 ()29281156 (PubMedID)
Tillgänglig från: 2018-03-22 Skapad: 2018-03-22 Senast uppdaterad: 2019-05-07Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-7504-8354

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