APPLICATION OF GROOVED PEGBOARD TEST IN CEREBROSPINAL FLUID TAP TEST OF PATIENTS WITH IDIOPATHIC NORMAL PRESSURE HYDROCEPHALUS

Abstract

Background: Motor impairment in NPH can extend beyond gait to include deficits in upper extremity functions and psychomotor speed. The upper extremity function evaluation will be helpful for the NPH patients who are unable to ambulate (e.g. patients is wheelchair bound) may not be able to comply with the gait evaluation. Our study aimed to explore the role of grooved pegboard test in evaluating cerebrospinal fluid tap test in patients with idiopathic normal pressure hydrocephalus. Methods: The patients with possible idiopathic normal pressure hydrocephalus in the outpatient clinic, the department of neurology, Peking Union Medical College Hospital from 2013 to 2017 were enrolled. All patients underwent detailed neuropsychological and walking assessments, as well as head magnetic resonance imaging. Fortythree patients with iNPH were recruited in the study, excluding patients with severe dementia and those who did not complete the four time points evaluation of CSF tap test for various reasons. The correlation between grooved pegboard test performance and other clinical assessment were analyzed. In DTI analysis of white matter, the FA and MD values of 19 regions of interest were measured by ROI method. The correlation between grooved pegboard test performance and the white matter lesions were also analyzed. Results: There was no significant difference in the results of CSF tap test between positive and negative patients. The results of the grooved pegboard test were significantly correlated with patients’ walking ability (10 m walking time, 5 m up-go test time), cognitive function (MMSE, MOCA, Trail Making Test A Z score, digital symbol Z score, STROOP-C Test Z score) and functional score (ADL, iNPHGS total score, iNPHGS walking, iNPHGS cognition) (P< 0.05). The time of left grooved pegboard test was significantly correlated with FAvalue of right periventricular lesions (P1⁄40.017). Conclusions: The performance of the grooved pegboard test was related to lower extremity motor ability and cognitive function. It can be used as an alternative evaluation tool for patients who are unable to ambulate and may not be able to comply with the gait evaluation. This project was supported by grant from CAMS 2016-12M-1-004, National NSFC81550021, 2016YFC1306300, grant XDPB10.