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Journal of Neurology

03-05-2024 | Progressive Supranuclear Palsy | Original Communication

Is there a spinal tap responder in progressive supranuclear palsy? The first prospective study

Authors: Masahiro Ohara, Takaaki Hattori, Qingmeng Chen, Kaoru Shimano, Kosei Hirata, Mie Matsui, Takanori Yokota

Published in: Journal of Neurology

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Abstract

Objective

Progressive supranuclear palsy (PSP) is a progressive neurodegenerative disease, and sometimes shows idiopathic normal pressure hydrocephalus (iNPH)-like presentations. We aimed to evaluate spinal tap responsiveness in patients with PSP, including the effect of sham spinal tap.

Methods

Eleven patients with PSP, ten with probable/definite iNPH, and eight control patients were prospectively enrolled. All participants underwent sham spinal tap and spinal tap procedures. Gait was evaluated using wearable inertial sensors. We defined “tap responders” as individuals with a 10% or more improvement from baseline in any of the gait parameters (timed up-and-go test total time, stride length, and velocity during straight walking under single-task and cognitive dual-task conditions). We compared the ratio of responders in patients with PSP to patients with iNPH and controls.

Results

The ratio of tap responders and the ratio of sham tap responders in patients with PSP were significantly higher than those in control patients, and not different from those in patients with iNPH. PSP patients with iNPH-like MRI features tended to respond to the spinal tap compared to those without such imaging features. Notably, one patient with PSP, who responded to the spinal tap beyond the effect of sham spinal tap, was treated by the shunt operation.

Conclusion

This is the first prospective study to demonstrate tap and shunt responsiveness in patients with PSP while highlighting the placebo effects of the spinal tap in patients with PSP or iNPH. Our findings suggest that some PSP patients have impaired cerebrospinal fluid circulation, contributing to a distinct component of the clinical spectrum.
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Literature
1.
Steele JC, Richardson JC, Olszewski J (1964) Progressive supranuclear palsy. A heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia. Arch Neurol 10:333–359PubMedCrossRef
2.
Colosimo C, Bak TH, Bologna M et al (2014) Fifty years of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 85(8):938–944PubMedCrossRef
3.
4.
Ohara M, Hattori T, Yokota T (2020) Progressive supranuclear palsy often develops idiopathic normal pressure hydrocephalus-like magnetic resonance imaging features. Eur J Neurol 27(10):1930–1936PubMedCrossRef
5.
Adams RD, Fisher CM, Hakim S et al (1965) Symptomatic occult hydrocephalus with “normal” cerebrospinal-fluid pressure. A treatable syndrome. N Engl J Med 273:117–126PubMedCrossRef
6.
Espay AJ, Da Prat GA, Dwivedi AK et al (2017) Deconstructing normal pressure hydrocephalus: Ventriculomegaly as early sign of neurodegeneration. Ann Neurol 82(4):503–513PubMedCrossRef
7.
Magdalinou NK, Ling H, Smith JD et al (2013) Normal pressure hydrocephalus or progressive supranuclear palsy? A clinicopathological case series J Neurol 260(4):1009–1013PubMed
8.
9.
Curran T, Lang AE (1994) Parkinsonian syndromes associated with hydrocephalus: case reports, a review of the literature, and pathophysiological hypotheses. Mov Disord 9(5):508–520PubMedCrossRef
10.
Nakajima M, Yamada S, Miyajima M et al (2021) Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus. Neurol Med Chir (Tokyo) 61(2):63–97PubMedCrossRef
11.
Saper CB (2017) Is there even such a thing as “Idiopathic normal pressure hydrocephalus”? Ann Neurol 82(4):514–515PubMedCrossRef
12.
Mihalj M, Dolić K, Kolić K et al (2016) CSF tap test - Obsolete or appropriate test for predicting shunt responsiveness? A systemic review J Neurol Sci 362:78–84PubMedCrossRef
13.
Gupta A, Lang AE (2011) Potential placebo effect in assessing idiopathic normal pressure hydrocephalus. J Neurosurg 114(5):1428–1431PubMedCrossRef
14.
Synek V, Reuben JR, Du Boulay GH (1976) Comparing Evans’ index and computerized axial tomography in assessing relationship of ventricular size to brain size. Neurology 26(3):231–233PubMedCrossRef
15.
Ishii K, Kanda T, Harada A et al (2008) Clinical impact of the callosal angle in the diagnosis of idiopathic normal pressure hydrocephalus. Eur Radiol 18(11):2678–2683PubMedCrossRef
16.
Höglinger GU, Respondek G, Stamelou M et al (2017) Clinical diagnosis of progressive supranuclear palsy: The movement disorder society criteria. Mov Disord 32(6):853–864PubMedPubMedCentralCrossRef
17.
Goetz CG, Tilley BC, Shaftman SR et al (2008) Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 23(15):2129–2170PubMedCrossRef
18.
Kubo Y, Kazui H, Yoshida T et al (2008) Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus. Dement Geriatr Cogn Disord 25(1):37–45PubMedCrossRef
19.
Hattori T, Ohara M, Yuasa T, et al. (2023) Correlation of callosal angle at the splenium with gait and cognition in normal pressure hydrocephalus. J Neurosurg 1–11
20.
Shinoda N, Hirai O, Hori S et al (2017) Utility of MRI-based disproportionately enlarged subarachnoid space hydrocephalus scoring for predicting prognosis after surgery for idiopathic normal pressure hydrocephalus: clinical research. J Neurosurg 127(6):1436–1442PubMedCrossRef
21.
Quattrone A, Sarica A, La Torre D et al (2020) Magnetic resonance imaging biomarkers distinguish normal pressure hydrocephalus from progressive supranuclear palsy. Mov Disord 35(8):1406–1415PubMedCrossRef
22.
Kahraman D, Eggers C, Schicha H et al (2012) Visual assessment of dopaminergic degeneration pattern in 123I-FP-CIT SPECT differentiates patients with atypical parkinsonian syndromes and idiopathic Parkinson’s disease. J Neurol 259(2):251–260PubMedCrossRef
23.
Davidsson A, Georgiopoulos C, Dizdar N et al (2014) Comparison between visual assessment of dopaminergic degeneration pattern and semi-quantitative ratio calculations in patients with Parkinson’s disease and Atypical Parkinsonian syndromes using DaTSCAN® SPECT. Ann Nucl Med 28(9):851–859PubMedCrossRef
24.
Tossici-Bolt L, Hoffmann SM, Kemp PM et al (2006) Quantification of [123I]FP-CIT SPECT brain images: an accurate technique for measurement of the specific binding ratio. Eur J Nucl Med Mol Imaging 33(12):1491–1499PubMedCrossRef
25.
Orimo S, Suzuki M, Inaba A et al (2012) 123I-MIBG myocardial scintigraphy for differentiating Parkinson’s disease from other neurodegenerative parkinsonism: a systematic review and meta-analysis. Parkinsonism Relat Disord 18(5):494–500PubMedCrossRef
26.
Treglia G, Cason E, Stefanelli A et al (2012) MIBG scintigraphy in differential diagnosis of Parkinsonism: a meta-analysis. Clin Auton Res 22(1):43–55PubMedCrossRef
27.
Tateno F, Sakakibara R, Kishi M et al (2011) Sensitivity and specificity of metaiodobenzylguanidine (MIBG) myocardial accumulation in the diagnosis of Lewy body diseases in a movement disorder clinic. Parkinsonism Relat Disord 17(5):395–397PubMedCrossRef
28.
Hori K, Mao Y, Ono Y et al (2019) Inertial Measurement Unit-Based Estimation of Foot Trajectory for Clinical Gait Analysis. Front Physiol 10:1530PubMedCrossRef
29.
Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148PubMedCrossRef
30.
Ishikawa M, Yamada S, Yamamoto K (2016) Early and delayed assessments of quantitative gait measures to improve the tap test as a predictor of shunt effectiveness in idiopathic normal pressure hydrocephalus. Fluids Barriers CNS 13(1):20PubMedPubMedCentralCrossRef
31.
Nasreddine ZS, Phillips NA, Bédirian V et al (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53(4):695–699PubMedCrossRef
32.
Matsui M, Kasai Y, Nagasaki M (2010) Reliability and validity of the Japanese version of the repeatable battery for the assessment of neuropsychological status [in Japanese]. Toyama Med J 21:31–36
33.
Goodglass H, Kaplan E (1972) Assessment of aphasia and related disorders. Lee & Febiger, Philadelphia
34.
Wilson BA, Alderman N, Burgess PW et al (1996) Behavioural assessment of the dysexecutive syndrome. Bury St. Thames Valley Test Company, Edmunds, England
35.
Benton AL, Hamsher K, Sivan AB (1976) Multilingual aphasia examination. AJA Associates, Iowa city
36.
Reitan RM (1955) The relation of the trail making test to organic brain damage. J Consult Psychol 19(5):393–394PubMedCrossRef
37.
Dalrymple-Alford JC, Livingston L, MacAskill MR et al (2011) Characterizing mild cognitive impairment in Parkinson’s disease. Mov Disord 26(4):629–636PubMedCrossRef
38.
Litvan I, Goldman JG, Tröster AI et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 27(3):349–356PubMedPubMedCentralCrossRef
39.
Yamada S, Ishikawa M, Miyajima M et al (2017) Timed up and go test at tap test and shunt surgery in idiopathic normal pressure hydrocephalus. Neurol Clin Pract 7(2):98–108PubMedPubMedCentralCrossRef
40.
Schmidt H, Elster J, Eckert I et al (2014) Cognitive functions after spinal tap in patients with normal pressure hydrocephalus. J Neurol 261(12):2344–2350PubMedCrossRef
41.
Lee WJ, Wang SJ, Hsu LC et al (2010) Brain MRI as a predictor of CSF tap test response in patients with idiopathic normal pressure hydrocephalus. J Neurol 257(10):1675–1681PubMedCrossRef
42.
Naito H, Sugimoto T, Kimoto K et al (2021) Clinical comorbidities correlated with a response to the cerebrospinal fluid tap test in idiopathic normal-pressure hydrocephalus. J Neurol Sci 430:120024PubMedCrossRef
43.
Ishikawa M, Hashimoto M, Mori E et al (2012) The value of the cerebrospinal fluid tap test for predicting shunt effectiveness in idiopathic normal pressure hydrocephalus. Fluids Barriers CNS 9(1):1PubMedPubMedCentralCrossRef
44.
Galasko D, Abramson I, Corey-Bloom J et al (1993) Repeated exposure to the Mini-Mental State Examination and the Information-Memory-Concentration Test results in a practice effect in Alzheimer’s disease. Neurology 43(8):1559–1563PubMedCrossRef
45.
Boxer AL, Yu JT, Golbe LI et al (2017) Advances in progressive supranuclear palsy: new diagnostic criteria, biomarkers, and therapeutic approaches. Lancet Neurol 16(7):552–563PubMedPubMedCentralCrossRef
Metadata
Title
Is there a spinal tap responder in progressive supranuclear palsy? The first prospective study
Authors
Masahiro Ohara
Takaaki Hattori
Qingmeng Chen
Kaoru Shimano
Kosei Hirata
Mie Matsui
Takanori Yokota
Publication date
03-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-024-12391-4