Observational studyBMJ open2019
Incidence, diagnostic criteria and outcome following ventriculoperitoneal shunting of idiopathic normal pressure hydrocephalus in a memory clinic population: a prospective observational cross-sectional and cohort study.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- Differential improvement in patient-reported outcomes measurement information system (PROMIS) domains after ventriculoperitoneal shunting (VPS) for idiopathic normal pressure hydrocephalus (iNPH).Acta neurologica Belgica · 2026Article
- Neuropsychiatric Features in Patients With Idiopathic Normal Pressure Hydrocephalus: A Systematic Review and Meta-Analysis.Neurology. Clinical practice · 2026Review
- Increasing incidence of normal pressure hydrocephalus in Germany: an analysis of the Federal Statistical Office Database from 2005 to 2022.Scientific reports · 2024Article
- Peripheral immunity changes are associated with neurodegeneration and worse clinical outcome in idiopathic normal pressure hydrocephalus.European journal of neurology · 2024Article
- Idiopathic Normal Pressure Hydrocephalus: The Real Social and Economic Burden of a Possibly Enormous Underdiagnosis Problem.Tomography (Ann Arbor, Mich.) · 2023Article
- Imaging Markers for Normal Pressure Hydrocephalus: An Overview.Biomedicines · 2023Review
- Evaluation of Patients With Cognitive Impairment Due to Suspected Idiopathic Normal-Pressure Hydrocephalus at Medical Centers for Dementia: A Nationwide Hospital-Based Survey in Japan.Frontiers in neurology · 2022Article
- Long term follow-up of shunted idiopathic normal pressure hydrocephalus patients: a single center experience.Acta neurologica Belgica · 2021Article
- The Pathogenesis Based on the Glymphatic System, Diagnosis, and Treatment of Idiopathic Normal Pressure Hydrocephalus.Clinical interventions in aging · 2021Review
- Idiopathic Chronic Hydrocephalus in Middle-age male with lower urinary tract symptoms, erectile dysfunction, gait disturbance, and papilledema.Urology case reports · 2020Article
- Diagnosis and treatment for normal pressure hydrocephalus: From biomarkers identification to outcome improvement with combination therapy.Tzu chi medical journalReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate diagnostic criteria for idiopathic normal pressure hydrocephalus (INPH) among patients with memory impairment, and to estimate the incidence of INPH.
designProspective observational cross-section and cohort study of diagnostic accuracy.
settingMemory Disorders Clinic following referral by the medical practitioners.
participants408 consecutive patients enrolled 2010-2014. OUTCOME MEASURES: Reference diagnostic test was the clinical judgement of an experienced specialist based on the presence of cognitive impairment and/or balance and gait disorders in the presence of dilated ventricles. Mini-Mental State Examination (MMSE), Tinetti balance and gait tests were performed before and 12 months after ventriculoperitoneal shunt surgery. The association between reference diagnosis, clinical and brain CT scan measurements was estimated by multivariate Poisson regression. Triage index diagnostic test scores were calculated from the regression coefficients, with diagnostic thresholds selected using receiver operating characteristic analysis.
resultsThe presence of balance and/or gait disorders, especially fear of falling, difficulty standing on toes/heals, urinary disturbances, ventriculomegaly with Evans ratio greater than Combined Diagnostic Threshold (0.377-{Maximum width of posterior horns*0.0054}), strongly predict the diagnosis of INPH; while hallucinations and/or delusions and forgetfulness reduce the likelihood of the diagnosis. This triage index test had high sensitivity (95.2%) and specificity (91.7%). 62 of 408 (15%) participants with cognitive impairment had INPH, an incidence of 11.9/100 000/year and 120/100 000/year over 75 years. 96% of participants following shunting, compared with 45% of the non-shunted, improved by over 25% of available measurable improvement in either MMSE or balance/gait scores (51% difference; 95% CI 28% to 74%; p<0.001), and 56% vs 5% improved by over 50% of maximum in both (51% difference; 95% CI 30% to 73%; p<0.001).
conclusionThe triage index test score is a simple tool that may be useful for physicians to identify INPH diagnoses and need for referral for shunt surgery, which may improve cognitive, balance and gait functioning.
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