SynthesisFluids and barriers of the CNS2025
Cerebral blood flow, autoregulation and vascular reactivity in normal pressure hydrocephalus: a systematic review.
Synthesis in Fluids and barriers of the CNS, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNormal pressure hydrocephalus (NPH) is one of the few remediable causes of decline in gait and cognitive function in the ageing population. The roles of the cerebral circulation including haemodynamic reserve and cardiovascular co-morbidity in the pathogenesis, management and prognostication of NPH remain ill-defined. In this systematic review, we have updated Owler & Pickard’s review of 2001 to examine whether: global/regional Cerebral Blood Flow (CBF) changes are specific to NPH, appropriately coupled to cerebral metabolism and/or reflect cerebral ischaemia; changes in global/regional CBF are predictive of outcome after CSF drainage; global and regional cerebrovascular autoregulation and reactivity are more sensitive predictors of outcome after CSF drainage than baseline regional CBF (rCBF); changes in global or regional CBF a cause or effect (‘chicken and the egg’) of NPH; a trial is warranted that combines assessments of haemodynamic reserve, CSF outflow resistance and response to temporary CSF drainage. MAIN BODY: We have systematically reviewed studies from 2000–2024 assessing CBF, autoregulation, and cerebrovascular reactivity (CVR) in adult NPH. Global and regional CBF were consistently reduced in NPH, particularly in periventricular white matter and deep grey matter, but these reductions were not predictive of shunt response. CVR varied from impaired to preserved and showed greater promise as a predictor of clinical improvement after CSF drainage or shunting. Methodological heterogeneity and small sample sizes limited meta-analysis. The interplay between CBF, CSF dynamics, and brain biomechanics remains complex, with evidence suggesting that impaired haemodynamic reserve may precede irreversible tissue damage.
conclusionsBaseline rCBF and borderline ischaemia reflect NPH networks but do not predict shunt response. CVR impairment does. It is suggested that randomised controlled trials be used to assess the predictive accuracy of combining the response of temporary CSF drainage with changes in CVR.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.