European Study of Prodromal iNPH
To investigate if progression from prodromal into symptomatic NPH can be predicted from advanced neuroimaging, biomarkers in cerebrospinal fluid (CSF) and plasma and investigate the unknown mechanisms causing deterioration by investigating longitudinal changes in the above-mentioned variables. Three different cohorts with both asymptomatic and symptomatic patients as well as healthy controls will be investigated over time, both without intervention and before and after shunt surgery.
• Brain imaging with both:
‣ Evans index \> 0.3
⁃ Callosal angle ≤ 90 º or:
⁃ Disproportionately enlarged subarachnoid space hydrocephalus (DESH) - defined as: enlarged ventricles, dilated sylvian fissures and tight sulci at the high convexity.
• Absence of symptoms or too mild symptoms to motivate shunt surgery according to local routine, and all of the following:
‣ Normal gait pattern, or slight disturbance of the gait pattern that is not considered to be caused by a disease in the central nervous system (CNS).
⁃ Gait velocity (maximum gait speed), men ≥ 1.4 m/s; women ≥ 1.25 m/s.
⁃ Rombergs test with eyes open \> 60 seconds
⁃ Mini Mental State Examination (MMSE) ≥ 27 or Montreal Cognitive Assessment (MoCA) ≥ 23
• Informed consent
∙ • Age \> 65 years
• iNPH diagnosis according to international guidelines.19
• Age matched with the individual in Group 1 (+/- 3 years)