Investigating Shunt Responsiveness in iNPH
Research type
Research Study
Full title
Observational study to investigate the effect of White matter tract distortion and Neurodegenerative biomarkers on shunt-responsiveness in NPH (OWN-NPH)
IRAS ID
311620
Contact name
Christopher J Carswell
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 2 months, 2 days
Research summary
Normal Pressure Hydrocephalus (NPH) is a common and disorder in which adults over 60 years develop walking, cognitive and urinary impairment due to build-up of normal brain fluid. Surgically inserting a tube to drain the excessive cerebrospinal fluid (CSF) to an area of lower pressure (CSF-shunting) can improve these symptoms. For unknown reasons some with NPH do not improve after CSF-shunting.
Key brain nerve “motorways” (white matter tracts) can be visualised using a Magnetic Resonance Imaging (MRI) technique called diffusion tensor imaging (DTI). We hypothesise that only hydrocephalus that distorts particular white matter tract will CSF-shunt responsive. We also suspect that CSF-shunt non-responders may have neurodegenerative disease (such as Alzheimer’s disease) that limits the capacity for improvement. Neurodegenerative diseases can now be detected using novel research arrays of “neurodegenerative biomarker” panels in blood and CSF, skin and brain tissue. Such panels may bring vital insight.
OWN-NPH is an observational study designed to better understand who will benefit from shunt surgery. In out Deep-Phenotyping Group (Group A) we plan to very intensively examine 30 participants with NPH with MRI scans, blood, spinal fluid, skin and brain biopsies and activity/sleep monitors as they have routine NHS treatment. We intend to perform detailed but less intensive clinical examinations on a further 20 NPH patients (Extended Examination Group (Group B). We intend to examine and perform MRI scanning on 30 patients with shunted or asymptomatic NPH in our NPH-Control Group (Group C). We will examine 30 healthy controls and those with non-NPH dementias as our Non-NPH Control group (Group D).REC name
South Central - Oxford C Research Ethics Committee
REC reference
24/SC/0390
Date of REC Opinion
6 Feb 2025
REC opinion
Further Information Favourable Opinion