Cortical metabolic changes and clinical outcome in normal pressure hydrocephalus after ventriculoperitoneal shunt: Our preliminary results

A. Chiaravalloti , L. Filippi , O. Bagni , O. Schillaci , Z Czosnyka , Marek Czosnyka , M.F. de Pandis , G. Federici , M. Galli , A. Pompucci , G Petrella


Introduction: Our objective was to evaluate the cortical metabolic changes and clinical outcome in patients affected by idiopathic normal pressure hydrocephalus (iNPH) after a placement of ventriculoperitoneal (VP) shunt. Materials and methods: 10 patients affected by suspected iNPH underwent a CSF hydrodynamics evaluation based on a lumbar infusion test (LIT). The main selection criterion for surgery was based on intracranial elasticity (IE) > 0.30. All subjects with an IE > 0.30 underwent a PET scan with 18 fluorodeoxiglucose (18F-FDG) at baseline (PET1) and 1 month after surgery (PET2). Furthermore, the same patients were submitted to clinical evaluation before and 1 month after surgery through neuropsychological tests and gait analysis. Results: An overall number of 20 18F-FDG PET scans were performed in all the enrolled patients. As compared to PET1, PET2 showed an increase in glucose consumption in the left frontal and left parietal lobe in PET2 as compared to PET1 (P <.001). All the enrolled patients presented a significant increase in neuropsychological scores (i.e Frontal Assessment Battery and Montreal Cognitive Assessment) and have clinically improved at gait analysis. A significant correlation was found between the increase of cortical glucose consumption in the left parietal area and the cognitive improvement as detectable by neuropsychological assessment. Conclusions: Improvement in 18F FDG PET glucose metabolism could be considered a useful imaging marker for the assessment of iNPH response to VP shunting.
Author A. Chiaravalloti
A. Chiaravalloti,,
, L. Filippi
L. Filippi,,
, O. Bagni
O. Bagni,,
, O. Schillaci
O. Schillaci,,
, Z Czosnyka
Z Czosnyka,,
, Marek Czosnyka (FEIT / PE)
Marek Czosnyka,,
- The Institute of Electronic Systems
, M.F. de Pandis
M.F. de Pandis,,
, G. Federici
G. Federici,,
, M. Galli
M. Galli,,
, A. Pompucci
A. Pompucci,,
et al.`
Other language title versionsCambios metabólicos corticales y resultado clínico en la hidrocefalia normotensiva después de la derivación ventrículo-peritoneal: nuestros resultados preliminares
Journal seriesRevista Espanola de Medicina Nuclear e Imagen Molecular, ISSN 2253-654X
Issue year2020
Publication size in sheets0.5
ASJC Classification2741 Radiology Nuclear Medicine and imaging
Languageen angielski
Score (nominal)40
Score sourcejournalList
ScoreMinisterial score = 40.0, 22-07-2020, ArticleFromJournal
Publication indicators Scopus SNIP (Source Normalised Impact per Paper): 2016 = 0.354; WoS Impact Factor: 2018 = 0.928 (2) - 2018=0.996 (5)
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