The Brain Structure and Neural Network Changing the Before and After Ventriculo-peritoneal Shunting in the Normal Pressure Hydrocephalus Patients

Study Overview
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Brief Summary
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With the advent of the aging society, dementia becomes the focus of common people. As for the neurodegeneration dementia, no disease modifying treatments have been discovered. Idiopathic normal pressure hydrocephalus (iNPH) is considered as one of reversible dementia, which can be hint by the surgery. In addition, dementia of iNPH is the typical subcortical dementia. Therefore exploring the pathogenic mechanism is conducive to the early diagnosis and treatment. This research is to monitor the changing of iNPHGS, cognitive function, walking ability as well as brain construction imaging and neural network before and after ventriculo-peritoneal shunting in order to demonstrate the pathogenesis of triads. In the process, the supplementary test, for instance, CSF tap test, will be validated the predictive value.

Official Title
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The Brain Structure and Neural Network Changing the Before and After Ventriculo-peritoneal Shunting in the Normal Pressure Hydrocephalus Patients

Conditions
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Normal Pressure Hydrocephalus

Intervention / Treatment
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* Procedure: ventriculo-peritoneal shunting


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ncluded will be subjects with a probable diagnosis of NPH. The diagnosis will be based primarily on presence of gait impairment plus at least one other impairment in urinary symptoms, cognition impairment or both. Are 50 years old or older Patients who understand the study protocol Patients who meet the criteria for NPH A typical personal history A typical brain imaging on head CT or MRI Normal LP findings excluding other conditions Exclusion of other conditions causing the symptomatology Exclusion Criteria: Patients below the age of 50 years. Patients who underwent shunt surgery before

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| normal pressure hydrocephalus<br>Included will be subjects with a probable diagnosis of NPH. The diagnosis will be based primarily on presence of gait impairment plus at least one other impairment in urinary symptoms, cognition impairment or both The NPH patients will undergo the CSF tap test and then receive the ventriculo-peritoneal shunting surgery. They will have the examination of brain constructure neuroimaging and functional MRI prior to and posterior to the shunting. | Procedure: ventriculo-peritoneal shunting<br>* A mainstream therapy for NPH. It involves the device of CSF flow control of shunts and accessories(CFDA(I)20143665605)<br>|
| normal control<br>Healthy volunteers will undergo the examination of brain constructure and functional MRI. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The brain constructure and neural network changing one day after shunting | Using the voxel based morphology technique to measure the ventricular volume and brain lobe volume Neural network( DMN)by the resting functional MRI | Day 1 after shunting | 
| The brain constructure and neural network changing 90 days after shunting | Using the voxel based morphology technique to measure the ventricular volume and brain lobe volume •Neural network( DMN)by the resting functional MRI | Day 90 after shunting | 
| The brain constructure and neural network changing one year after shunting | Using the voxel based morphology technique to measure the ventricular volume and brain lobe volume •Neural network( DMN)by the resting functional MRI | one year after shunting | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of the clinical syndrome of normal pressure hydrocephalus | iNPHGS | Day 1 after shunting | 
| Assessment of the clinical syndrome of normal pressure hydrocephalus | iNPHGS | Day 90 after shunting | 
| Assessment of the clinical syndrome of normal pressure hydrocephalus | iNPHGS | one year after shunting | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shunting, Brain constructure, Neural network