PMID- 34213613
OWN - NLM
STAT- MEDLINE
DCOM- 20220125
LR  - 20220720
IS  - 1432-1459 (Electronic)
IS  - 0340-5354 (Linking)
VI  - 269
IP  - 2
DP  - 2022 Feb
TI  - Blink reflex recovery cycle distinguishes patients with idiopathic normal 
      pressure hydrocephalus from elderly subjects.
PG  - 1007-1012
LID - 10.1007/s00415-021-10687-3 [doi]
AB  - BACKGROUND: The R2 component of blink reflex recovery cycle (R2BRrc) is a simple 
      neurophysiological tool to detect the brainstem hyperexcitability commonly 
      occurring in several neurological diseases such as Parkinson's disease and 
      atypical parkinsonisms. In our study, we investigated for the first time the 
      usefulness of R2BRrc to assess brainstem excitability in patients with idiopathic 
      Normal Pressure Hydrocephalus (iNPH) in comparison with healthy subjects. 
      METHODS: Eighteen iNPH patients and 25 age-matched control subjects were 
      enrolled. R2BRrc was bilaterally evaluated at interstimulus intervals (ISIs) of 
      100, 150, 200, 300, 400, 500 and 750 ms in all participants. We investigated the 
      diagnostic performance of R2BRrc in differentiating iNPH patients from control 
      subjects using ROC analysis. Midbrain area and Magnetic Resonance Hydrocephalic 
      Index (MRHI), an MRI biomarker for the diagnosis of iNPH, were measured on 
      T1-weighted MR images, and correlations between R2BRrc values and MRI 
      measurements were investigated. RESULTS: Fourteen (78%) of 18 iNPH patients 
      showed an enhanced R2BRrc at ISIs 100-150-200 ms, while no control subjects had 
      abnormal R2BRrc. The mean amplitude of bilateral R2BRrc at the shortest ISIs 
      (100-150-200 ms) showed high accuracy in differentiating iNPH patients from 
      controls (AUC = 0.89). R2BRrc values significantly correlated with midbrain area 
      and MRHI values. CONCLUSIONS: This study represents the first evidence of 
      brainstem hyperexcitability in iNPH patients. Given its low cost and wide 
      availability, R2BRrc could be a useful tool for selecting elderly subjects with 
      mild gait and urinary dysfunction who should undergo an extensive diagnostic 
      workup for the diagnosis of NPH.
CI  - (c) 2021. Springer-Verlag GmbH Germany, part of Springer Nature.
FAU - Mechelli, Alessandro
AU  - Mechelli A
AD  - Department of Medical Sciences, Institute of Neurology, University Magna Graecia, 
      Catanzaro, Italy.
FAU - Quattrone, Andrea
AU  - Quattrone A
AD  - Department of Medical Sciences, Institute of Neurology, University Magna Graecia, 
      Catanzaro, Italy.
FAU - Nistico, Rita
AU  - Nistico R
AD  - Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, 
      National Research Council, Catanzaro, Italy.
FAU - Crasa, Marianna
AU  - Crasa M
AD  - Neuroscience Research Centre, University Magna Graecia, Catanzaro, Italy.
FAU - La Torre, Domenico
AU  - La Torre D
AD  - Department of Medical Sciences, Institute of Neurosurgery, University Magna 
      Graecia, Catanzaro, Italy.
FAU - Vescio, Basilio
AU  - Vescio B
AD  - Biotecnomed S.C.aR.L., Catanzaro, Italy.
FAU - Quattrone, Aldo
AU  - Quattrone A
AUID- ORCID: 0000-0003-2001-957X
AD  - Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, 
      National Research Council, Catanzaro, Italy. quattrone@unicz.it.
AD  - Neuroscience Research Centre, University Magna Graecia, Catanzaro, Italy. 
      quattrone@unicz.it.
AD  - Neuroscience Centre and Neuroimaging Research Unit, Institute of Molecular 
      Bioimaging and Physiology, National Research Council, Magna Graecia University, 
      88100, Catanzaro, Italy. quattrone@unicz.it.
LA  - eng
PT  - Journal Article
DEP - 20210702
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
SB  - IM
MH  - Aged
MH  - Blinking
MH  - Brain Stem
MH  - Humans
MH  - *Hydrocephalus, Normal Pressure/diagnosis
MH  - Magnetic Resonance Imaging
MH  - *Parkinson Disease
OTO - NOTNLM
OT  - Blink reflex recovery cycle
OT  - Brainstem hyperexcitability
OT  - Elderly subjects
OT  - Idiopathic normal pressure hydrocephalus
EDAT- 2021/07/03 06:00
MHDA- 2022/01/27 06:00
CRDT- 2021/07/02 12:19
PHST- 2021/03/14 00:00 [received]
PHST- 2021/06/24 00:00 [accepted]
PHST- 2021/06/18 00:00 [revised]
PHST- 2021/07/03 06:00 [pubmed]
PHST- 2022/01/27 06:00 [medline]
PHST- 2021/07/02 12:19 [entrez]
AID - 10.1007/s00415-021-10687-3 [pii]
AID - 10.1007/s00415-021-10687-3 [doi]
PST - ppublish
SO  - J Neurol. 2022 Feb;269(2):1007-1012. doi: 10.1007/s00415-021-10687-3. Epub 2021 
      Jul 2.