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.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Luikku AJ,Hall A,Nerg O,Koivisto AM,Hiltunen M,Helisalmi S,Herukka SK,Sutela A,Kojoukhova M,Mattila J,Lötjönen J,Rummukainen J,Alafuzoff I,Jääskeläinen JE,Remes AM,Soininen H,Leinonen Vdoi
10.1007/s00701-016-2980-4subject
Has Abstractpub_date
2016-12-01 00:00:00pages
2311-2319issue
12eissn
0001-6268issn
0942-0940pii
10.1007/s00701-016-2980-4journal_volume
158pub_type
杂志文章abstract::A case of primary intraspinal melanoma is presented. This is a very rarely observed lesion, as only 37 cases have been described up to now. Patient presenting with signs and symptoms of spinal cord compression after MRI and spinal angiography was operated upon. Total removal of an intraspinal cervical tumour was perfo...
journal_title:Acta neurochirurgica
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