RecruitingNot Applicable

White Matter Distortion and Dementia Biomarkers in Normal Pressure Hydrocephalus (NPH)

United Kingdom100 participantsStarted 2025-03-25

Plain-language summary

Idiopathic Normal Pressure Hydrocephalus (iNPH) is a progressive condition of the elderly that results in severe disability. iNPH can dramatically respond to Cerebral spinal fluid(CSF)-shunting where excess ventricular fluid is diverted from the brain. Not all patients with iNPH respond to CSF-shunting however. The reasons for this are uncertain. Aim 1: To understand if specific nerve pathways (white matter tracts) that are near ventricles are damaged in patients that respond to shunting as opposed to those that do not. Aim 2: Can we explain shunt non-responsiveness by screening for dementia like illnesses (neurodegeneration) using a large array of methods. Aim 3: To understand whether wearable activity and bed sleep monitors are palatable in a NPH population and to understand if these metrics relate to quality of life. Aim 4: To see whether self-administered digital cognitive assessments can measure improvements pre and post surgery.

Who can participate

Age range60 Years

SexALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Group 1 (communicating hydrocephalus): Inclusion Criteria: * Adult patients \>60 * With gait apraxia * With or without cognitive impairment * Urinary dysfunction * Communicating Hydrocephalus Exclusion Criteria: * Asymptomatic hydrocephalus * High pressure-hydrocephalus * Serious head injury within 5 years of presentation or a clear secondary cause (e.g. brain infection) * History of childhood gait disturbance * Clear alternative explanation for symptoms (e.g. Parkinson's disease with limb rigidity, peripheral neuropathy with sensory ataxia, cervical myelopathy). * Too frail for shunt surgery * Medically unstable (e.g. active angina, respiratory disease, recurrent delirium, active epilepsy). * Unable to tolerate MRI brain imaging * Unable to have a lumbar puncture * Immobile * Unable to attend the hospital for study visits Group 2 (asymptomatic and non-hydrocepahlus dementia and healthy controls): Inclusion Criteria (Any of the following): * Healthy Carers * Members of the Public * Staff of Imperial College/ICHT * Non-NPH Dementias (including Alzheimer's disease or vascular dementia) * Asymptomatic Hydrocephalus Exclusion Criteria: \- Unable to attend the hospital for study visits

What they're measuring

White Matter Pathway Diffusion Metrics

Timeframe: Perioperative

Trial details

NCT IDNCT07103681

SponsorImperial College London

Sponsor typeOTHER

Study typeOBSERVATIONAL

Primary completion2028-02

Contact for this trial

Chris Carswell

+44 20311 1234 NPH@imperial.ac.uk