Assessment of Autonomic Neuronal Changes During Moderate Rise of Intracranial Pressure in Human

Study Overview
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Brief Summary
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The purpose of this project is to determine during moderate rise of intracranial pressure (ICP) in awake patient, the change in autonomic function and its influence on cerebral and systemic haemodynamics.

Detailed Description
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From preliminary data, we know that changes in ICP influences both systemic and cerebral haemodynamics, introducing the concept of intracranial baroreflex We have to i) confirm the presence of this intracranial baroreflex, ii) analyze the changes in autonomic function during moderate rise in intracranial pressure (ICP) in human, and iii) correlate the changes in cerebral and systemic haemodynamics with autonomic function.

Official Title
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Assessment of Autonomic Neuronal Changes During Moderate Rise of Intracranial Pressure in Human

Conditions
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Increased Intracranial Pressure Disorders

Intervention / Treatment
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* Other: Infusion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient suspect of hydrocephalus with gait problems, urine incontinence and mild cognitive impairment. signed consent Exclusion Criteria: psychiatric problems severe cognitive decline

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Hydrocephalus<br>Patients suffering of hydrocephalus (cognitive impairment, gait disturbance, urinary incontinence and enlargement of the ventricles) require for clinical purpose infusion studies i.e. injection of mock cerebrospinal fluid (CSF) in the sub arachnoid space to artificially increase ICP. We aim at using infusion studies as a indirect tool to assess whether a moderate increase in ICP has any influence on haemodynamics. | Other: Infusion<br>* Infusion studies are performed in daily clinical routine to measure cerebrospinal fluid resistance outflow. During this test ICP is slowly and securely raised. Investigators plan to analyze what are the consequences of this ICP rise in terms of autonomic system and hemodynamics.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in sympathetic nerve activity after rise in ICP | Assessment of autonomic neural function using. microneurography to assess the muscle sympathetic nerve activity measurement of the plasma level changes of noradrenaline power spectral analysis of heart rate and arterial blood pressure | within few minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in hemodynamics after rise in ICP | Assessment of haemodynamics Cerebral haemodynamics. using Transcranial doppler Systemic haemodynamics measured with photoplethysmography | within few minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intracranial baroreflex