BACKGROUND Idiopathic normal pressure hydrocephalus (iNPH) presents typical radiological signs that have been summarised in a semi-quantitative scale named the iNPH Radscale. However, the iNPH Radscale's predictive value for response to cerebrospinal fluid (CSF) tap test has never been studied. This study aims to investigate if the iNPH Radscale can predict locomotion improvement after CSF tap test. METHODS A total of 100 patients with iNPH (age: 76.3 ± 7.9, gender: 36% female) were included in this retrospective study. Two raters, blinded to the response of the CSF tap test, evaluated the iNPH Radscale and its seven subitems (Evan's index, callosal angle, size of temporal horns, narrow high-convexity sulci, dilated Sylvian fissures, focally dilated sulci, and periventricular hypodensities). Locomotion improvement was assessed by the Timed Up and Go (TUG) performed before, and 24 h after, the CSF tap test. RESULTS The iNPH Radscale (total score) was similar between the CSF tap test responders and non-responders (responders: 8.31 ± 1.96, non-responders: 9.18 ± 2.51, p = 0.128). However, the temporal horns score was smaller in the responders group (1.66 ± 0.57 versus 1.94 ± 0.24, p = 0.045), even after adjusting for age, gender, education level, white matter changes, and global cognition (β: -0.250, C.I. 95%: [-3.185; -0.161], p = 0.031). CONCLUSION The iNPH Radscale (total score) does not predict locomotion improvement after CSF tap test, while a smaller temporal horns score at baseline is associated with a positive tap test responder status.

中文翻译：

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放射学量表“iNPH Radscale”能否预测特发性正常压力脑积水的抽头试验反应？

背景 特发性正常压力脑积水 (iNPH) 表现出典型的放射学征象，这些征兆已被总结在称为 iNPH Radscale 的半定量量表中。然而，从未研究过 iNPH Radscale 对脑脊液 (CSF) 抽头试验反应的预测价值。本研究旨在调查 iNPH Radscale 是否可以预测脑脊液抽头测试后的运动改善。方法 本回顾性研究共纳入 100 名 iNPH 患者（年龄：76.3 ± 7.9，性别：36% 女性）。两名评估者对 CSF 抽头试验的反应不知情，评估了 iNPH Radscale 及其七个子项目（埃文指数、胼胝角、颞角大小、狭窄的高凸沟、扩张的侧裂、局灶性扩张的脑沟和脑室周围低密度） ）。通过在脑脊液抽头测试之前和之后 24 小时执行的 Timed Up and Go (TUG) 评估运动改善。结果 CSF 抽头测试响应者和无响应者的 iNPH Radscale（总分）相似（响应者：8.31 ± 1.96，无响应者：9.18 ± 2.51，p = 0.128）。然而，即使在调整了年龄、性别、教育水平、白质变化和全局认知后，响应者组的颞角评分较小（1.66 ± 0.57 对 1.94 ± 0.24，p = 0.045）（β：-0.250， CI 95%：[-3.185；-0.161]，p = 0.031)。结论 iNPH Radscale（总分）不能预测 CSF 敲击试验后的运动改善，而基线时较小的颞角评分与敲击试验反应者状态呈阳性相关。结果 CSF 抽头测试响应者和无响应者的 iNPH Radscale（总分）相似（响应者：8.31 ± 1.96，无响应者：9.18 ± 2.51，p = 0.128）。然而，即使在调整了年龄、性别、教育水平、白质变化和全局认知后，响应者组的颞角评分较小（1.66 ± 0.57 对 1.94 ± 0.24，p = 0.045）（β：-0.250， CI 95%：[-3.185；-0.161]，p = 0.031)。结论 iNPH Radscale（总分）不能预测 CSF 敲击试验后的运动改善，而基线时较小的颞角评分与敲击试验反应者状态呈阳性相关。结果 CSF 抽头测试响应者和无响应者的 iNPH Radscale（总分）相似（响应者：8.31 ± 1.96，无响应者：9.18 ± 2.51，p = 0.128）。然而，即使在调整了年龄、性别、教育水平、白质变化和全局认知后，响应者组的颞角评分较小（1.66 ± 0.57 对 1.94 ± 0.24，p = 0.045）（β：-0.250， CI 95%：[-3.185；-0.161]，p = 0.031)。结论 iNPH Radscale（总分）不能预测 CSF 敲击试验后的运动改善，而基线时较小的颞角评分与敲击试验反应者状态呈阳性相关。即使在调整了年龄、性别、教育水平、白质变化和整体认知后，响应者组的颞角评分更小（1.66 ± 0.57 对 1.94 ± 0.24，p = 0.045）（β：-0.250，CI 95 %: [-3.185; -0.161], p = 0.031)。结论 iNPH Radscale（总分）不能预测 CSF 敲击试验后的运动改善，而基线时较小的颞角评分与敲击试验反应者状态呈阳性相关。即使在调整了年龄、性别、教育水平、白质变化和整体认知后，响应者组的颞角评分更小（1.66 ± 0.57 对 1.94 ± 0.24，p = 0.045）（β：-0.250，CI 95 %: [-3.185; -0.161], p = 0.031)。结论 iNPH Radscale（总分）不能预测 CSF 敲击试验后的运动改善，而基线时较小的颞角评分与敲击试验反应者状态呈阳性相关。