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01-12-2016 | Clinical Article - Abstract

Multimodal analysis to predict shunt surgery outcome of 284 patients with suspected idiopathic normal pressure hydrocephalus

Authors: Antti J. Luikku, Anette Hall, Ossi Nerg, Anne M. Koivisto, Mikko Hiltunen, Seppo Helisalmi, Sanna-Kaisa Herukka, Anna Sutela, Maria Kojoukhova, Jussi Mattila, Jyrki Lötjönen, Jaana Rummukainen, Irina Alafuzoff, Juha E. Jääskeläinen, Anne M. Remes, Hilkka Soininen, Ville Leinonen

Published in: Acta Neurochirurgica | Issue 12/2016

Abstract

Objectives

Optimal selection of idiopathic normal pressure hydrocephalus (iNPH) patients for shunt surgery is challenging. Disease State Index (DSI) is a statistical method that merges multimodal data to assist clinical decision-making. It has previously been shown to be useful in predicting progression in mild cognitive impairment and differentiating Alzheimer’s disease (AD) and frontotemporal dementia. In this study, we use the DSI method to predict shunt surgery response for patients with iNPH.

Methods

In this retrospective cohort study, a total of 284 patients (230 shunt responders and 54 non-responders) from the Kuopio NPH registry were analyzed with the DSI. Analysis included data from patients’ memory disorder assessments, age, clinical symptoms, comorbidities, medications, frontal cortical biopsy, CT/MRI imaging (visual scoring of disproportion between Sylvian and suprasylvian subarachnoid spaces, atrophy of medial temporal lobe, superior medial subarachnoid spaces), APOE genotyping, CSF AD biomarkers, and intracranial pressure.

Results

Our analysis showed that shunt responders cannot be differentiated from non-responders reliably even with the large dataset available (AUC = 0.58).

Conclusions

Prediction of the treatment response in iNPH is challenging even with our extensive dataset and refined analysis. Further research of biomarkers and indicators predicting shunt responsiveness is still needed.

Available only for authorised users

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Title: Multimodal analysis to predict shunt surgery outcome of 284 patients with suspected idiopathic normal pressure hydrocephalus
Authors: Antti J. Luikku
Anette Hall
Ossi Nerg
Anne M. Koivisto
Mikko Hiltunen
Seppo Helisalmi
Sanna-Kaisa Herukka
Anna Sutela
Maria Kojoukhova
Jussi Mattila
Jyrki Lötjönen
Jaana Rummukainen
Irina Alafuzoff
Juha E. Jääskeläinen
Anne M. Remes
Hilkka Soininen
Ville Leinonen
Publication date: 01-12-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 12/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2980-4

At a glance: The STEP trials

Springer Medicine

Multimodal analysis to predict shunt surgery outcome of 284 patients with suspected idiopathic normal pressure hydrocephalus

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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