Is frontal gait a myth in normal pressure hydrocephalus?

Details

Serval ID
serval:BIB_91DD2565BC27
Type
Article: article from journal or magazin.
Collection
Publications
Title
Is frontal gait a myth in normal pressure hydrocephalus?
Journal
Journal of the neurological sciences
Author(s)
Morel E., Armand S., Assal F., Allali G.
ISSN
1878-5883 (Electronic)
ISSN-L
0022-510X
Publication state
Published
Issued date
15/07/2019
Peer-reviewed
Oui
Volume
402
Pages
175-179
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Patients with idiopathic normal pressure hydrocephalus (iNPH) are considered to present a magnetic, slow, wide-based gait, also called frontal gait. However, this gait profile is not specific for iNPH and encountered in patients with other neurological conditions mimicking iNPH (i.e. iNPH mimics), such as vascular dementia. We aimed to characterize the gait profiles in iNPH and their mimics and to compare the prevalence of clinical gait abnormalities between both groups.
This retrospective study included 140 patients suspected of iNPH (76.3 ± 6.8 yo; 30.7% female). Eighty patients (57.1%) were diagnosed with iNPH according to the NPH consensus guidelines criteria; the remaining sixty patients were classified as mimics (23 neurodegenerative conditions, 12 multifactorial conditions, 9 vascular dementia, 7 mixed dementias, 6 toxic conditions, 2 psychiatric conditions, and 1 stroke). Two independent diagnosis-blinded clinicians (kappa, 0.73) evaluated gait according to four categories: frontal gait, parkinsonian gait, other clinical gait abnormalities, and normal gait.
iNPH patients and mimics shared similar clinical characteristics. Frontal gait occurred in only 26% of patients (with a similar prevalence for the mimics). Parkinsonian gait was significantly more prevalent among the mimics (32% versus 15%; p-value: 0.032). This association between parkinsonian gait and mimics remained significant after adjusting for age, gender, comorbidities and white matter changes (OR: 2.404; 95% CI: [1.03-5.64]; p value: 0.044).
Frontal gait is not the most prevalent gait abnormality in iNPH and does not discriminate iNPH from its mimics. Parkinsonian gait is more prevalent among the mimics.
Keywords
Aged, Dementia, Vascular/diagnosis, Dementia, Vascular/physiopathology, Diagnosis, Differential, Female, Gait/physiology, Gait Disorders, Neurologic/diagnosis, Gait Disorders, Neurologic/physiopathology, Humans, Hydrocephalus, Normal Pressure/diagnosis, Hydrocephalus, Normal Pressure/physiopathology, Male, Middle Aged, Retrospective Studies, Dementia, Frontal gait, Gait disorders, Normal pressure hydrocephalus, Parkinsonism
Pubmed
Web of science
Create date
11/08/2023 14:49
Last modification date
03/10/2023 6:58
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