A protocol for a cohort study investigating clinical and radiological features of normal pressure hydrocephalus in South London memory services

Clara Belessiotis-Richards, Psychological Medicine, King's College London Institute of Psychiatry Psychology & Neuroscience, London, England, SE5 8AB, UK.
Gill Livingston, University College London Division of Psychiatry, London, England, W1T 7NF, UK.
Ashwin Venkataraman, Centre for Neuroimaging Science, King's College London School of Neuroscience, London, England, SE5 8AB, UK.
František Váša, Centre for Neuroimaging Science, King's College London School of Neuroscience, London, England, SE5 8AB, UK.
Anthony Mann, Lived experience expert, London, UK.
Jenny Smith-Wymant, Spina Bifida Hydrocephalus Information Networking Equality (SHINE) Charity, Peterborough, PE2 6FT, UK.
Shahriar Islam, Imperial College London Department of Surgery and Cancer, London, England, SW7 5NH, UK.
Eileen Joyce, The Institute of Neurology, University College London, London, England, UK.
Kevin King, Department of Neuro-radiology, Barrow Neurological Institute, Phoenix, Arizona, AZ 85013, USA.
Sennett Yang, Creighton University School of Medicine Phoenix Regional Campus, Phoenix, Arizona, AZ 85012, USA.
Matthew Borzage, Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, CA 90027, USA.
Robert Leech, Department of Neuroimaging, King's College London Institute of Psychiatry Psychology & Neuroscience, London, England, SE5 8AF, UK.
Robert Stewart, Psychological Medicine, King's College London Institute of Psychiatry Psychology & Neuroscience, London, England, SE5 8AB, UK.

Document Type

Article

Abstract

BACKGROUND: Normal pressure hydrocephalus (NPH) is a potentially treatable condition causing dementia. Treatment is through insertion of a 'shunt', which improves symptoms and prolongs independence, but NPH may be under-treated. Automated brain imaging measures might have potential to identify NPH. Little is known about NPH presentation in memory clinics. This study investigates the period prevalence of NPH and potential use of imaging biomarkers for NPH, especially callosal angle (CA), in detecting NPH in UK memory services. METHODS: This cohort study will use retrospective data from South London and Maudsley Clinical Records Interactive Search and linked datasets. The study population will comprise individuals aged ≥60 years with at least one referral to memory services from 2007-2024 (estimated n>20,000). Automated tools will be used to measure imaging biomarkers using routinely collected brain magnetic resonance imaging scans that are electronically linked to health records in a subset of the population (estimated n>5,000). RESULTS: We will estimate the period prevalence of NPH in this population. We will evaluate automated measurement tools for imaging features of NPH, describe their distributions, and their variation by covariates (eg. demographics). We hypothesise that people with a diagnosis of NPH will have smaller CA compared to people with a diagnosis of dementia, and that imaging features of NPH will predict future diagnosis of NPH. Depending on our findings, we may undertake more detailed analyses, such as a nested case-control or survival analysis. CONCLUSIONS: This study will give a first understanding of NPH in UK memory services. It will inform future work to improve identification of NPH, for example through a clinical decision support tool. With rising global dementia rates, research into this potentially treatable condition causing dementia is a priority.

Publication Date

1-1-2025

Publication Title

Wellcome open research

ISSN

2398-502X

Volume

10

First Page

454

PubMed ID

41140637

Digital Object Identifier (DOI)

10.12688/wellcomeopenres.23678.2

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