Geriatrics Unit, Maggiore Hospital, Department of Integration, Azienda USL Di Bologna, Bologna, Italy.
IRCCS Istituto Delle Scienze Neurologiche Di Bologna, UOC Clinica Neurologica Rete Metropolitana NEUROMET, Bologna, Italia.
Acta Neurochir (Wien). 2024 Sep 19;166(1):373. doi: 10.1007/s00701-024-06271-z.
Idiopathic Normal Pressure Hydrocephalus (iNPH) is a neurological syndrome defined by gait disturbance, cognitive impairment and urinary incontinence. However, its clinical presentation can vary widely due to overlapping syndromes and common comorbidities in older adults. This study aims to provide practical guidance to aid in the clinical suspicion and support the diagnostic and therapeutic processes for these patients.
Six quantitative variables regarding clinical, functional, and demographic aspects were considered for a large sample of patients with diagnosed iNPH. Principal component analysis (PCA) was adopted to define the main dimensions explaining the variability of the phenomenon. Then, two clusters of iNPH patients were described.
178 patients were included in the analysis. The PCA produced two dimensions covering 61.8% of the total variability. The first one relied mainly on both clinical (mRS, iNPHGs) and functional (TUG, Tinetti) variables, while the second one was represented mainly on the demographic pattern (age and education). Cluster analysis depicted two main groups of patients. Cluster n.1 is composed of individuals who are older, more disabled, with poor functional performances, and highly symptomatic. Cluster n.2 patients are slightly younger, more educated, fitter, and with more nuanced clinical aspects.
Profiling iNPH patients using quantitative variables and cluster analysis can help identify distinct characteristics of these patients, aiding in the guidance of both medical and surgical interventions.
特发性正常压力脑积水（iNPH）是一种以步态障碍、认知障碍和尿失禁为特征的神经综合征。然而，由于老年人重叠的综合征和常见的合并症，其临床表现可能存在很大差异。本研究旨在为临床疑似病例提供实用的指导，以支持这些患者的诊断和治疗过程。
对大量确诊为 iNPH 的患者，考虑了 6 个关于临床、功能和人口统计学方面的定量变量。采用主成分分析（PCA）来定义解释现象变异性的主要维度。然后，对 iNPH 患者进行了两个聚类描述。
共纳入 178 例患者进行分析。PCA 产生了两个维度，涵盖了总变异性的 61.8%。第一个维度主要依赖于临床（mRS、iNPHGs）和功能（TUG、Tinetti）变量，而第二个维度主要由人口统计学模式（年龄和教育程度）代表。聚类分析描述了两个主要的患者群体。簇 1 由年龄较大、功能较差、功能表现较差、症状较重的个体组成。簇 2 患者的年龄稍小、受教育程度较高、身体状况较好，且临床表现更为细微。
使用定量变量和聚类分析对 iNPH 患者进行分析，可以帮助识别这些患者的不同特征，有助于指导医疗和手术干预。
