Prevalence of Cerebral Microbleeds in Patients with Idiopathic Normal Pressure Hydrocephalus and their Impact on Post-Shunt Outcome
| Author | Affiliation | ||
|---|---|---|---|
Geneva University Hospitals, Division of Neurology, Department of Clinical Neuroscience, Geneva, Switzerland | University of Geneva, Faculty of Medicine, Geneva, Switzerland | ||
Lingenberg, Alma | University of Geneva, Switzerland | ||
| Date |
|---|
2020-04-25 |
Scientific Poster Session
Objective: To investigate the prevalence of small vessel disease (SVD) and cerebral amyloid angiopathy (CAA) biomarkers in patients with idiopathic normal pressure hydrocephalus (iNPH) and the 1-year post-shunt outcome. Background: iNPH is the leading cause of reversible dementia in older adults and frequently associated with Alzheimer’s disease and vascular dementia. Cerebral microbleeds (CMBs) are considered to be a robust biomarker of brain small-vessel disease (SVD) - frequently associated with cerebral amyloid angiopathy and hypertensive vasculopathy. However, the prevalence of CMBs and their impact on post-shunt outcome have never been studied in iNPH patients. Design/Methods: In this retrospective study, we included 73 consecutive patients (mean age 76±6.9 years, 38% female, median MMSE score 26, range 17–30) diagnosed with iNPH between 07/2004 and 02/2019. The presence and the repartition of CMBs were assessed using the Microbleed Anatomic Rating Scale (MARS). The 1-year post-ventriculoperitoneal shunt outcome has been defined by a clinical gait assessment. Results: CMBs were identified in 30/73 patients (41%, range 1–110) with 15 patients (21%) having at least 2 or more CMBs. The CMB localization was distributed as follows: deep in 9 (30%), superficial in 11 (37%), infratentorial in 3 (10%), and mixed in 7 patients (23%). The CMBs distribution met the diagnosis of probable-CAA according to Boston modified criteria in 10/73 iNPH patients (14%). Among the 24/73 iNPH patients, who underwent a shunt surgery and 1-year follow-up: 14/15 patients without CMBs and 8/9 patients with CMBs presented a gait improvement (p-value = 0.62). Conclusions: The prevalence of CMBs and the presence of CAA are higher in iNPH patients than those reported in the general population. However, the 1-year post shunt outcome did not differ between patients with and without CMBs. Future studies should investigate, if CAA affe[...].