Evaluating the cerebrospinal fluid tap test with the Hellström iNPH scale for patients with idiopathic normal pressure hydrocephalus

Johanna Rydja; Andreas Eleftheriou; Fredrik Lundin

doi:10.1186/s12987-021-00252-5

Fluids and Barriers of the CNS

Table 2 Pre- and postoperative values and differences in iNPH scale scores for CSF TT responders and non-responders

From: Evaluating the cerebrospinal fluid tap test with the Hellström iNPH scale for patients with idiopathic normal pressure hydrocephalus

	CSF TT Gait responders (n = 74)	Within group differences P value	CSF TT Gait non-responders (n = 42)	Within group differences P value	Between group differences P value	CSF TT Balance responders (n = 51)	Within group differences P value	CSF TT Balance non-responder (n = 64)	Within group differences P value	Between group differences P value
Gait domain scores
Preop	47.5 ± 19.5		39.5 ± 26.2		0.031^c	42.4 ± 20.8		46.6 ± 23.6		NS^a
Postop	71.2 ± 23.7		49.2 ± 24.4		< 0.001^a	64.9 ± 23.7		61.4 ± 27.9		NS^a
Diff. preop-postop	23.7 ± 20.4	< 0.001^a	9.7 ± 16.8	0.001^a	< 0.001^c	22.5 ± 21.0	< 0.001^a	14.9 ± 18.5	< 0.001^a	NS^c
10 m (steps, n)^d
Preop	25.6 ± 14.0		32.4 ± 21.3		0.039^c	29.1 ± 20.6		27.1 ± 14.2		NS^c
Postop	19.5 ± 5.2		23.0 ± 5.9		< 0.001^c	19.7 ± 4.5		20.9 ± 6.3		NS^c
Diff. preop-postop	6.6 ± 13.2 n = 73	< 0.001^b	9.4 ± 20.0 n = 40	< 0.001^b	NS^c	9.2 ± 20.0 n = 49	< 0.001^b	6.2 ± 12.0 n = 63	< 0.001^b	NS^c
10 m (time, sec)^d
Preop	15.1 ± 6.1		22.0 ± 18.4		NS^c	17.4 ± 10.9		17.6 ± 13.6		NS^c
Postop	10.7 ± 4.0		13.9 ± 5.2		< 0.001^c	11.3 ± 3.6		12.3 ± 5.4		NS^c
Diff. preop-postop	4.3 ± 5.1 n = 73	< 0.001^b	8.1 ± 16.5 n = 40	< 0.001^b	NS^c	6.0 ± 10.0 n = 49	< 0.001^b	5.3 ± 11.4 n = 63	< 0.001^b	NS^c
Ordinal gait scale scores^d
Preop	3 (1–7)		3.5 (3–6)		0.011^c	3 (2–7)		3 (1–8)		NS^c
Postop	2 (1–4)		3 (2–4)		< 0.001^c	2 (1–4)		2 (1–8)		NS^c
Diff. preop-postop	1 (1–6)	< 0.001^b	0 (1–4)	< 0.001^b	NS^c	1 (− 1–6)	< 0.001^b	1 (− 1–3)	< 0.001^b	NS^c
Balance domain scores
Preop	65.9 ± 16.4		55.3 ± 23.2		0.006^c	52.2 ± 19.2		70.2 ± 16.5		< 0.001^c
Postop	76.2 ± 12.6		65.7 ± 17.8		< 0.001^c	72.0 ± 14.2		72.8 ± 16.6		NS^c
Diff. preop-postop	10.3 ± 18.6	< 0.00^b	10.4 ± 20.6	0.002^b	NS ^c	19.8 ± 22.4	< 0.001^b	2.6 ± 12.0	NS^b	< 0.00^c
NP domain scores
Preop	55.0 ± 18.4		42.5 ± 23.4		0.006^a	51.7 ± 21.8		50.0 ± 20.6		NS^a
Postop	60.1 ± 19.5		48.6 ± 22.8		0.008^a	57.8 ± 21.7		54.9 ± 21.4		NS^a
Diff. preop-postop	4.9 ± 11.3 n = 69	0.001^a	4.5 ± 12.6 n = 37	0.037^a	NS^c	4.6 ± 12.6 n = 43	0.006^a	4.6 ± 12.6 n = 60	0.007^a	NS^c
Continence domain scores
Preop	60.7 ± 27.0		55.5 ± 25.8		NS^c	60.9 ± 23.9		57.7 ± 28.5		NS^c
Postop	71.6 ± 26.2		71.0 ± 27.0		NS^c	74.1 ± 23.3	0.001^b	58.9 ± 28.4		NS^c
Diff. preop-postop	12.1 ± 27.4 n = 70	< 0.00^b	15.3 ± 27.7 n = 38	0.002^b	NS^c	14.4 ± 25.9 n = 45		11.6 ± 28.3 n = 61	0.003^b	NS^c
Total iNPH scale scores
Preop	55.2 ± 13.3		45.7 ± 20.6		0.010 ^a	48.9 ± 16.3		54.3 ± 17.0		NS^a
Postop	70.3 ± 16.5		55.4 ± 16.7		< 0.001^a	65.8 ± 16.4		63.9 ± 19.3		NS^a
Diff. preop-posto	15.1 ± 14.5	< 0.001^a	9.6 ± 11.9	< 0.001^a	< 0.001^c	16.8 ± 15.0	< 0.001^a	9.7 ± 11.3	< 0.001^a	0.012^c

CSF TT, Cerebrospinal fluid tap test
CSF TT Gait responders, improvement ≥ 5 points in the gait domain on the iNPH scale
CSF TT Balance responders, improvement ≥ 16 points in the balance domain on the iNPH scale
NP, Neuropsychology
^at-test, ^bRelated samples Wilcoxon signed rank test, ^cIndependent samples Mann–Whitney U-test. ^dsubtest within the gait domain. P ≤ 0.05. Values are presented as mean ± SD or median (min–max)

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