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 ◽  
...  

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.

2020 ◽  
Author(s):  
Caiyan Liu ◽  
Liling Dong ◽  
Chenhui Mao ◽  
Jie Li ◽  
Xinying Huang ◽  
...  

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.


2021 ◽  
Author(s):  
Caiyan Liu ◽  
Liling Dong ◽  
Chenhui Mao ◽  
Jie Li ◽  
Xinying Huang ◽  
...  

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.


2009 ◽  
Vol 111 (9) ◽  
pp. 752-757 ◽  
Author(s):  
Diamanto Tsakanikas ◽  
Heather Katzen ◽  
Lisa D. Ravdin ◽  
Norman R. Relkin

1997 ◽  
Vol 55 (2) ◽  
pp. 179-185 ◽  
Author(s):  
Benito P. Damasceno ◽  
Edmur F. Carelli ◽  
Donizeti C. Honorato ◽  
Jose J. Facure

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.


2016 ◽  
Vol 6 (3) ◽  
pp. 447-457 ◽  
Author(s):  
Katrin Abram ◽  
Silvia Bohne ◽  
Peter Bublak ◽  
Panagiota Karvouniari ◽  
Carsten M. Klingner ◽  
...  

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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