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03.05.2024 | Original Communication

Is there a spinal tap responder in progressive supranuclear palsy? The first prospective study

verfasst von: Masahiro Ohara, Takaaki Hattori, Qingmeng Chen, Kaoru Shimano, Kosei Hirata, Mie Matsui, Takanori Yokota

Erschienen in: Journal of Neurology

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Abstract

Objective

Progressive supranuclear palsy (PSP) is a progressive neurodegenerative disease, and sometimes shows idiopathic normal pressure hydrocephalus (iNPH)-like presentations. We aimed to evaluate spinal tap responsiveness in patients with PSP, including the effect of sham spinal tap.

Methods

Eleven patients with PSP, ten with probable/definite iNPH, and eight control patients were prospectively enrolled. All participants underwent sham spinal tap and spinal tap procedures. Gait was evaluated using wearable inertial sensors. We defined “tap responders” as individuals with a 10% or more improvement from baseline in any of the gait parameters (timed up-and-go test total time, stride length, and velocity during straight walking under single-task and cognitive dual-task conditions). We compared the ratio of responders in patients with PSP to patients with iNPH and controls.

Results

The ratio of tap responders and the ratio of sham tap responders in patients with PSP were significantly higher than those in control patients, and not different from those in patients with iNPH. PSP patients with iNPH-like MRI features tended to respond to the spinal tap compared to those without such imaging features. Notably, one patient with PSP, who responded to the spinal tap beyond the effect of sham spinal tap, was treated by the shunt operation.

Conclusion

This is the first prospective study to demonstrate tap and shunt responsiveness in patients with PSP while highlighting the placebo effects of the spinal tap in patients with PSP or iNPH. Our findings suggest that some PSP patients have impaired cerebrospinal fluid circulation, contributing to a distinct component of the clinical spectrum.
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Metadaten
Titel
Is there a spinal tap responder in progressive supranuclear palsy? The first prospective study
verfasst von
Masahiro Ohara
Takaaki Hattori
Qingmeng Chen
Kaoru Shimano
Kosei Hirata
Mie Matsui
Takanori Yokota
Publikationsdatum
03.05.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-024-12391-4

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