scholarly journals Grooved pegboard test performance before and after cerebrospinal fluid tap test in patients with idiopathic normal pressure hydrocephalus

2021 ◽  
Author(s):  
Caiyan Liu ◽  
Liling Dong ◽  
Chenhui Mao ◽  
Jie Li ◽  
Xinying Huang ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Test Performance ◽  
Diffusion Tensor ◽  
Normal Pressure ◽  
Dominant Hand ◽  
Imaging Analysis ◽  
Tap Test ◽  
Before And After ◽  
Hand Performance ◽  
Grooved Pegboard Test

Abstract Introduction Motor impairment in patients with idiopathic normal pressure hydrocephalus (iNPH) can extend beyond gait and include deficits in upper extremity functions and psychomotor speed. Evaluation of upper extremity function will be helpful for iNPH patients who are unable to ambulate (e.g., wheelchair-bound patients) and may not be able to comply with the gait evaluation. Our study aimed to explore the use of the grooved pegboard test (GPT) to assess responsiveness to the cerebrospinal fluid (CSF) tap test (TT) in iNPH patients. Methods Sixty-five possible NPH patients were enrolled retrospectively and all underwent detailed neuropsychological and walking assessments, CSF TTs, and brain magnetic resonance imaging. The GPT results before and after the CSF TT were compared and correlated with the other clinical assessments. In diffusion tensor imaging analysis, the fractional anisotropy (FA) and mean diffusivity (MD) values of periventricular white matter were measured by the region of interest method and were correlated with pegboard test performance. Results Compared with 0-hour GPT-dominant and nondominant hand performance, GPT-dominant hand and nondominant hand performance on the 24-hour and 72-hour CSF TT were significantly improved (all P < 0.01). There were no statistically significant differences between 24-hour and 72-hour dominant hand GPT performance. The improvement ratios in the complex visual motor speed index (i.e., the GPT performance combined with the symbol-digit modalities test score) were significantly different between the CSF TT responder and nonresponder groups. The baseline GPT performance correlated with walking test, cognitive function, and functional scores. The diffusion tensor imaging analysis of eighteen patients showed that bilateral GPT performance was significantly correlated with FA values in right periventricular lesions (both P < 0.05). Conclusion GPT could measure the change of upper extremity motor function after TT and correlated the lower extremity motor function. It was worth further investigation to its application for iNPH patients unable to comply with the gait evaluation.

scholarly journals Grooved Pegboard Test Performance Before and After Cerebral-Spinal Fluid Tap Test in Patients with Normal Pressure Hydrocephalus

2020 ◽  
Author(s):  
Caiyan Liu ◽  
Liling Dong ◽  
Chenhui Mao ◽  
Jie Li ◽  
Xinying Huang ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Upper Extremity ◽  
Normal Pressure Hydrocephalus ◽  
Test Performance ◽  
Normal Pressure ◽  
Periventricular White Matter ◽  
Tap Test ◽  
Functional Scores ◽  
Before And After ◽  
Grooved Pegboard Test

Abstract Background Motor impairment in patients with normal pressure hydrocephalus (NPH) can extend beyond gait and include deficits in upper extremity functions and psychomotor speed. Evaluation of upper extremity function will be helpful for NPH patients who are unable to ambulate (e.g., wheelchair-bound patients) and may not be able to comply with the gait evaluation. Our study aimed to explore the use of the grooved pegboard test to assess responsiveness to the cerebrospinal fluid (CSF) tap test in patients with NPH. Methods Seventy-seven possible NPH patients were enrolled from 2013 to 2018. All patients underwent detailed neuropsychological and walking assessments, CSF tap tests, and brain magnetic resonance imaging. The grooved pegboard test results before and after the CSF tap test were compared and correlated with the other clinical assessments. In diffusion tensor imaging analysis, the fractional anisotropy (FA) and mean diffusivity (MD) values of periventricular white matter were measured by the region of interest method and were correlated with pegboard test performance.Results The grooved pegboard test scores significantly improved after the CSF tap test and correlated with patient walking ability, cognitive function, and functional scores (P < 0.01). The improvement ratios in the complex visual motor speed index (i.e., the grooved pegboard test performance combined with the Symbol-Digit Modalities Test performance) were significantly different between the CSF tap test responder and nonresponder groups. The grooved pegboard test times were significantly correlated with the FA values in right periventricular lesions (P=0.017).Conclusions The performance on the grooved pegboard test was related to lower extremity motor ability and cognitive function. It can be used as an alternative evaluation tool for patients who are unable to ambulate and may not be able to comply with the gait evaluation.

scholarly journals Grooved pegboard test performance before and after cerebral-spinal fluid tap test in patients with normal pressure hydrocephalus

2020 ◽  
Author(s):  
Caiyan Liu ◽  
Liling Dong ◽  
Chenhui Mao ◽  
Jie Li ◽  
Xinying Huang ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Upper Extremity ◽  
Normal Pressure Hydrocephalus ◽  
Test Performance ◽  
Normal Pressure ◽  
Periventricular White Matter ◽  
Tap Test ◽  
Functional Scores ◽  
Before And After ◽  
Grooved Pegboard Test

Abstract Background Motor impairment in patients with normal pressure hydrocephalus (NPH) can extend beyond gait and include deficits in upper extremity functions and psychomotor speed. Evaluation of upper extremity function will be helpful for NPH patients who are unable to ambulate (e.g., wheelchair-bound patients) and may not be able to comply with the gait evaluation. Our study aimed to explore the use of the grooved pegboard test to assess responsiveness to the cerebrospinal fluid (CSF) tap test in patients with NPH. Methods Seventy-five possible NPH patients were enrolled from 2012 to 2018. All patients underwent detailed neuropsychological and walking assessments, CSF tap tests, and brain magnetic resonance imaging. The grooved pegboard test results before and after the CSF tap test were compared and correlated with the other clinical assessments. In diffusion tensor imaging analysis, the fractional anisotropy (FA) and mean diffusivity (MD) values of periventricular white matter were measured by the region of interest method and were correlated with pegboard test performance. Results The grooved pegboard test scores significantly improved after the CSF tap test and correlated with patient walking ability, cognitive function, and functional scores (P < 0.01). The improvement ratios in the complex visual motor speed index (i.e., the grooved pegboard test performance combined with the Symbol-Digit Modalities Test performance) were significantly different between the CSF tap test responder and nonresponder groups. The grooved pegboard test times were significantly correlated with the FA values in right periventricular lesions (P=0.017). Conclusions The performance on the grooved pegboard test was related to lower extremity motor ability and cognitive function. It can be used as an alternative evaluation tool for patients who are unable to ambulate and may not be able to comply with the gait evaluation.

Deficits of hand coordination and laterality of carotid endarterectomy

2015 ◽  
Vol 122 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Eric J. Heyer ◽  
Kaitlin A. Mallon ◽  
Joanna L. Mergeche ◽  
Yaakov Stern ◽  
E. Sander Connolly
Keyword(s):  
Carotid Artery ◽  
Motor Coordination ◽  
Dominant Hand ◽  
Neurocognitive Performance ◽  
Rate Analysis ◽  
Before And After ◽  
Group Rate ◽  
Z Scores ◽  
Hand Coordination ◽  
Grooved Pegboard Test

OBJECT Neurocognitive performance is used to assess multiple cognitive domains, including motor coordination, before and after carotid endarterectomy (CEA). Although gross motor strength is impaired with ischemia of large cortical areas or of the internal capsule, the authors hypothesize that patients undergoing CEA demonstrate significant motor deficits of hand coordination contralateral to the operative side, which is more clearly manifest in the nondominant hand than in the dominant hand with ischemia of smaller cortical areas. METHODS The neurocognitive performance of 374 patients was evaluated with a battery of neuropsychometric tests. Both asymptomatic and symptomatic patients undergoing CEA were included. The authors evaluated the patients' dominant and nondominant hand performance on the Grooved Pegboard test, a test of hand coordination, to demonstrate their functional laterality. Neurocognitive dysfunction was evaluated as the difference in performance before and after CEA according to group-rate and event-rate analyses. The z scores were generated for all tests using a reference group of patients who were having simple spine surgery. Dominant and nondominant motor coordination functions were evaluated as raw scores and as calculated z scores. RESULTS According to event-rate analysis, significantly more patients undergoing CEA of the opposite carotid artery demonstrated nondominant than dominant hand deficits of coordination (41.2% vs 26.4%, respectively, p = 0.02). Similarly, according to group-rate analysis, in patients undergoing CEA of the opposite carotid artery, raw difference scores from the Grooved Pegboard test reflected greater nondominant than dominant hand deficits of coordination (21.0 ± 54.4 vs 9.7 ± 37.0, respectively, p = 0.02). CONCLUSIONS Patients undergoing CEA of the opposite carotid artery are more likely to demonstrate nondominant than dominant hand deficits of coordination because of greater dexterity in the dominant hand before surgery.

Diffusion Tensor Imaging Reveals Supplementary Lesions to Frontal White Matter in Idiopathic Normal Pressure Hydrocephalus

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. 1586-1593 ◽  
Author(s):  
Niklas Lenfeldt ◽  
Anne Larsson ◽  
Lars Nyberg ◽  
Richard Birgander ◽  
Anders Eklund ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Corpus Callosum ◽  
Normal Pressure Hydrocephalus ◽  
Diffusion Tensor ◽  
White Matter Lesions ◽  
Normal Pressure ◽  
Centrum Semiovale ◽  
Frontal White Matter ◽  
Before And After

Abstract BACKGROUND: Idiopathic normal-pressure hydrocephalus (INPH) is associated with white matter lesions, but the extent and severity of the lesions do not cohere with symptoms or improvement after shunting, implying the presence of further, yet undisclosed, injuries to white matter in INPH. OBJECTIVE: To apply diffusion tensor imaging (DTI) to explore white matter lesions in patients with INPH before and after drainage of cerebrospinal fluid (CSF). METHODS: Eighteen patients and 10 controls were included. DTI was performed in a 1.5T MRI scanner before and after 3-day drainage of 400 mL of CSF. Regions of interest included corpus callosum, capsula interna, frontal and lateral periventricular white matter, and centrum semiovale. White matter integrity was quantified by assessing fractional anisotropies (FA) and apparent diffusion coefficients (ADC), comparing them between patients and controls and between patients before and after drainage. The significance level corresponded to .05 (Bonferroni corrected). RESULTS: Decreased FA in patients was found in 3 regions (P &lt; .002, P &lt; .001, and P &lt; .001) in anterior frontal white matter, whereas elevated ADC was found in genu corpus callosum (P &lt; .001) and areas of centrum semiovale associated with the precentral gyri (P &lt; .002). Diffusion patterns in these areas did not change after drainage. CONCLUSION: DTI reveals subtle injuries—interpreted as axonal loss and gliosis—to anterior frontal white matter where high-order motor systems between frontal cortex and basal ganglia travel, further supporting the notion that motor symptoms in INPH are caused by a chronic ischemia to the neuronal systems involved in the planning processes of movements.

Upper extremity motor measures of Tap Test response in Normal Pressure Hydrocephalus

2009 ◽  
Vol 111 (9) ◽  
pp. 752-757 ◽  
Author(s):  
Diamanto Tsakanikas ◽  
Heather Katzen ◽  
Lisa D. Ravdin ◽  
Norman R. Relkin
Keyword(s):  
Upper Extremity ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Tap Test ◽  
Test Response

scholarly journals White Matter Characteristics of Cognitive Impairment in Tap-Test Positive Idiopathic Normal Pressure Hydrocephalus: A Diffusion Tensor Tract-Based Spatial Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Yufeng Tang ◽  
Xiaoqin Yuan ◽  
Jinfeng Duan ◽  
Xianwen Zhang ◽  
Jiao Chen ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Corpus Callosum ◽  
Normal Pressure Hydrocephalus ◽  
Diffusion Tensor ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Cingulate Gyrus ◽  
Tap Test ◽  
Cognitive Improvement

The present study was designed to systemically evaluate changes in the diffusion tensor imaging (DTI)-derived parameters of iNPH (idiopathic normal pressure hydrocephalus) patients with different responses to the tap test (TT), and to correlate cognitive impairment with white matter (WM) degeneration. This study included 22 iNPH patients and 14 healthy controls with structural magnetic resonance imaging (MRI) and DTI scanning. DTI was used to explore the differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) for all participants. DTI parameters were evaluated using an ROI (region of interest)-based and tract-based spatial statistics (TBSS) approach. Neuropsychological assessments and the idiopathic normal pressure hydrocephalus grading scoring scale (iNPHGS) were performed. Compared to the TT non-responders, the TT responders group had significantly lower FA values in the corpus callosum, cingulum cingulate gyrus, superior longitudinal fasciculus, and lower AD values in the right cingulum cingulate gyrus and the left posterior thalamic radiation. Besides, the MD values were significantly increased in the corpus callosum, left anterior corona radiata, and the RD values in the corpus callosum and cingulum cingulate gyrus. In addition, the cognitive improvement was negatively correlated with FA of the corpus callosum, cingulum cingulate gyrus, and MD values of the genu of corpus callosum. While, the cognitive improvement was positively related to the AD of the cingulum cingulate gyrus, superior longitudinal, and RD values of the corpus callosum, cingulum cingulate gyrus and uncinate fasciculus. The ROI specific WM lesions in iNPH patients are the underlying basis for cognitive impairment.

scholarly journals The predictive value of cerebrospinal fluid tap-test in normal pressure hydrocephalus

1997 ◽  
Vol 55 (2) ◽  
pp. 179-185 ◽  
Author(s):  
Benito P. Damasceno ◽  
Edmur F. Carelli ◽  
Donizeti C. Honorato ◽  
Jose J. Facure
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Gait Pattern ◽  
Shunt Surgery ◽  
Motor Speed ◽  
Tap Test ◽  
Mental Deterioration ◽  
Before And After ◽  
Duration Of Disease

Eighteen patients (mean age of 66.5 years) with normal pressure hydrocephalus (NPH) underwent a ventriculo-peritoneal shunt surgery. Prior to operation a cerebrospinal fluid tap-test (CSF-TT) was performed with measurements of gait pattern and psychometric functions (memory, visuo-motor speed and visuo-constructive skills) before and after the removal of 50 ml CSFby lumbar puncture (LP). Fifteen patients improved and 3 were unchanged after surgery. Short duration of disease, gait disturbance preceding mental deterioration, wide temporal horns and small sulci on CT-scan were associated with good outcome after shunting. There was a good correlation between the results of CSF-TT and shunt surgery (X² = 4,11 ,phi = 0.48, p < 0.05), with gait test showing highest correlation (r = 0.99, p = 0.01). In conclusion, this version of CSF-TT proved to be an effective test to predict improvement after shunting in patients with NPH.

scholarly journals The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus

2016 ◽  
Vol 6 (3) ◽  
pp. 447-457 ◽  
Author(s):  
Katrin Abram ◽  
Silvia Bohne ◽  
Peter Bublak ◽  
Panagiota Karvouniari ◽  
Carsten M. Klingner ◽  
...  
Keyword(s):  
Neuropsychological Assessment ◽  
Normal Pressure Hydrocephalus ◽  
Postural Stability ◽  
Clinical Symptoms ◽  
Normal Pressure ◽  
Dynamic Posturography ◽  
Tap Test ◽  
Sensory Organization ◽  
Sum Score ◽  
Before And After

Background/Aims: Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients. Methods: Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic posturography (CDP), and neuropsychological assessment. Examinations were done before and after spinal tap test. Results: The gait score showed a significant improvement 24 h after spinal tap test in all subtests and in the sum score (p < 0.003), while neuropsychological assessment did not reveal significant differences 72 h after spinal tap test. CDP showed significant improvements after spinal tap test in the Sensory Organization Tests 2 (p = 0.017), 4 (p = 0.001), and 5 (p = 0.009) and the composite score (p = 0.01). Patients showed best performance in somatosensory and worst performance in vestibular dominated tests. Vestibular dominated tests did not improve significantly after spinal tap test, while somatosensory and visual dominated tests did. Conclusion: Postural stability in NPH is predominantly affected by deficient vestibular functions, which did not improve after spinal tap test. Conditions which improved best were mainly independent from visual control and are based on proprioceptive functions.

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