The cerebrospinal fluid tap test (CSF TT) is used for selecting shunt surgery candidates among patients with idiopathic normal pressure hydrocephalus (iNPH). We aimed to evaluate the predictive value of the CSF TT, by using the Hellström iNPH scale for shunted iNPH patients with a standardized method. One hundred and sixteen shunt-operated iNPH patients were retrospectively included in this study. The gait and balance domains in the iNPH scale were used as outcome measures for the CSF TT and the total iNPH scale score as the postoperative outcome. A positive response to CSF TT was defined as a change of ≥ 5 points in the gait domain and ≥ 16 points in the balance domain. Differences between CSF TT responders and non-responders, sensitivity, specificity, positive and negative predictive values, accuracy, and correlations between changes from baseline to post CSF TT and from baseline to the postoperative follow-up, were calculated. In the CSF TT there were 63.8% responders in the gait domain and correspondingly 44.3% in the balance domain. CSF TT responders had a significantly better postoperative outcome in the total scale score (gait P ≤ 0.001, balance P ≤ 0.012) and gait CSF TT responders improved more in gait (P ≤ 0.001) and balance CSF TT responders in balance (P ≤ 0.001). No differences between CSF TT gait or balance responders could be found in neuropsychological or urinary continence assessments postoperatively. The sensitivity and specificity of the CSF TT and the outcome of the total iNPH scale score postoperatively were 68.1% and 52.0% for gait and 47.8% and 68.0% for balance, respectively. The CSF TT, with the Hellström iNPH scale as the outcome measure, has clear limitations in predicting postoperative results. The gait domain may be used to predict outcomes for gait, but the balance domain is too insensitive.

中文翻译：

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使用 Hellström iNPH 量表评估特发性正常压力脑积水患者的脑脊液抽检试验


脑脊液抽液试验（CSF TT）用于在特发性正常压力脑积水（iNPH）患者中选择分流手术候选者。我们旨在通过标准化方法使用 Hellström iNPH 量表对分流 iNPH 患者评估 CSF TT 的预测价值。本研究回顾性纳入了 116 名接受分流手术的 iNPH 患者。 iNPH 量表中的步态和平衡领域被用作 CSF TT 的结果测量，iNPH 量表总得分作为术后结果。对 CSF TT 的阳性反应定义为步态域改变≥ 5 点，平衡域改变≥ 16 点。计算了 CSF TT 应答者和无应答者之间的差异、敏感性、特异性、阳性和阴性预测值、准确性以及从基线到 CSF TT 变化以及从基线到术后随访之间的变化之间的相关性。在 CSF TT 中，步态领域有 63.8% 的响应者，平衡领域有 44.3% 的响应者。 CSF TT 反应者在总量表评分（步态 P ≤ 0.001，平衡 P ≤ 0.012）方面具有显着更好的术后结果，并且 CSF TT 反应者在步态（P ≤ 0.001）和平衡方面改善更多 CSF TT 反应者平衡（P ≤ 0.001） ）。在术后神经心理学或尿失禁评估中未发现 CSF TT 步态或平衡反应者之间存在差异。术后 CSF TT 的敏感性和特异性以及 iNPH 量表总评分的结果（步态）分别为 68.1% 和 52.0%，平衡能力分别为 47.8% 和 68.0%。 CSF TT 以 Hellström iNPH 量表作为结果衡量标准，在预测术后结果方面具有明显的局限性。 步态域可用于预测步态结果，但平衡域太不敏感。