Effect of Depletive Lumbar Puncture on Lower Urinary Tract Dysfunction in iNPH

NCT ID: NCT03877107

Last Updated: 2019-03-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-13

Study Completion Date

2021-03-01

Brief Summary

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Lower urinary tract dysfunction in normal pressure hydrocephalus has received little attention from the scientific community. Urinary symptoms in normal pressure hydrocephalus are mainly represented by overactive bladder, which is a significant burden for the concerned patients. A harmonization of neuro-urological practices in the pre-therapeutic evaluation of patients suffering from normal pressure hydrocephalus is necessary.

The investigators conducted a bicentric prospective study aiming to evaluate the effect of depletive lumbar puncture on urinary symptoms in iNPH.

The secondary objective was to evaluate, in the same participants previously diagnosed, the effect of cerebrospinal fluid shunt surgery on urinary symptoms.

Detailed Description

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Prospective study interventional but non invasive Bicentric in two universitarian hospitals in France On a cohort of patients presenting at least two out of three symptoms of the classic triad (urinary symptoms, cognitive symptoms and gait disturbance) and enlargement of ventricles non explained by cortical atrophy.

Participants are offered, as routine care, a diagnostic evaluation of the effect of depletive lumbar puncture on these triad symptoms (this exam is part of routine care).

Before the planned lumbar puncture, the participants are requested to participate to the study, with written consent and information given. The participants are requested to fill in a USP (urinary symptoms profile, validated international questionnaire) questionnaire and a micturition calendar. The same urinary evaluation is made 5 days after lumbar puncture. Gait and cognition are evaluated as in routine practice.

Of the participants initially evaluated, some will be proposed shunt surgery (routine care). These participants will be proposed to fill in the same questionnaire and micturition calendar around 3 months after shunt surgery (post operative evaluation).

Conditions

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Normal Pressure Hydrocephalus

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Evaluation of urinary symptoms before and after depletive lumbar puncture and after shunt surgery
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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single cohort

Participants presenting at least 2/3 of symptom triad : gait disturbance, urinary symptoms and cognitive disturbance Ventricular enlargement non explained by cortical atrophy Cognitive capacity to understand the study and give informed consent (mini mental state \> 13), speaking and reading french.

Group Type OTHER

Urinary symptoms profile questionnaire

Intervention Type DIAGNOSTIC_TEST

Validated questionnaire (international) with validated french translation, before and after lumbar puncture, and after surgery if surgery is realized

Micturition calendar

Intervention Type DIAGNOSTIC_TEST

Micturition calendar on 2 consecutive days, before and after lumbar puncture, and after surgery if surgery is realized

Interventions

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Urinary symptoms profile questionnaire

Validated questionnaire (international) with validated french translation, before and after lumbar puncture, and after surgery if surgery is realized

Intervention Type DIAGNOSTIC_TEST

Micturition calendar

Micturition calendar on 2 consecutive days, before and after lumbar puncture, and after surgery if surgery is realized

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* 2/3 symptoms triad : gait disturbance + cognitive disturbance + urinary symptoms
* Ventricular enlargement non explained by cortical atrophy

Exclusion Criteria

* analphabetism or not french speaking
* Cognitive disability making understanding of study impossible (as informed consent)
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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EssaiClinique_PL-HPN

OTHER

Sponsor Role lead

Responsible Party

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EssaiClinique_PL-HPN

Clinical Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Jean Alexandre LONG, MD PHD

Role: STUDY_DIRECTOR

University Hospital, Grenoble

Locations

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University Hospital of Grenoble

Grenoble, , France

Site Status RECRUITING

University Hospital of Lyon

Lyon, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Jean Alexandre LONG, MD PHD

Role: CONTACT

+334 76 76 76 42

Elsa Bey, Resident

Role: CONTACT

+66668636136

Facility Contacts

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Jean Alexandre LONG, MD PHD

Role: primary

+334 76 76 76 42

Caroline Tilikete, MD PHD

Role: primary

References

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Mary P, Gallisa JM, Laroque S, Bedou G, Maillard A, Bousquet C, Negre C, Gaillard N, Dutray A, Fadat B, Jurici S, Olivier N, Cisse B, Sablot D. [Predictive value of postural and dynamic walking parameters after high-volume lumbar puncture in normal pressure hydrocephalus]. Rev Neurol (Paris). 2013 Apr;169(4):321-7. doi: 10.1016/j.neurol.2012.09.010. Epub 2013 Feb 12. French.

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Campos-Juanatey F, Gutierrez-Banos JL, Portillo-Martin JA, Zubillaga-Guerrero S. Assessment of the urodynamic diagnosis in patients with urinary incontinence associated with normal pressure hydrocephalus. Neurourol Urodyn. 2015 Jun;34(5):465-8. doi: 10.1002/nau.22600. Epub 2014 Apr 12.

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PMID: 24729303 (View on PubMed)

Kazui H, Mori E, Ohkawa S, Okada T, Kondo T, Sakakibara R, Ueki O, Nishio Y, Ishii K, Kawaguchi T, Ishikawa M, Takeda M. Predictors of the disappearance of triad symptoms in patients with idiopathic normal pressure hydrocephalus after shunt surgery. J Neurol Sci. 2013 May 15;328(1-2):64-9. doi: 10.1016/j.jns.2013.02.020. Epub 2013 Mar 16.

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Reference Type RESULT
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Griffiths D, Tadic SD. Bladder control, urgency, and urge incontinence: evidence from functional brain imaging. Neurourol Urodyn. 2008;27(6):466-74. doi: 10.1002/nau.20549.

Reference Type RESULT
PMID: 18092336 (View on PubMed)

Sakakibara R, Panicker J, Fowler CJ, Tateno F, Kishi M, Tsuyusaki Y, Yamanishi T, Uchiyama T, Yamamoto T, Yano M. Is overactive bladder a brain disease? The pathophysiological role of cerebral white matter in the elderly. Int J Urol. 2014 Jan;21(1):33-8. doi: 10.1111/iju.12288. Epub 2013 Sep 30.

Reference Type RESULT
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Sakakibara R, Uchida Y, Ishii K, Hashimoto M, Ishikawa M, Kazui H, Yamamoto T, Uchiyama T, Tateno F, Kishi M, Tsuyusaki Y, Aiba Y, Tateno H, Nagao T, Terada H, Inaoka T; Members of SINPHONI (Study of Idiopathic Normal Pressure Hydrocephalus On Neurological Improvement). Bladder recovery relates with increased mid-cingulate perfusion after shunt surgery in idiopathic normal-pressure hydrocephalus: a single-photon emission tomography study. Int Urol Nephrol. 2016 Feb;48(2):169-74. doi: 10.1007/s11255-015-1162-2. Epub 2015 Nov 17.

Reference Type RESULT
PMID: 26578001 (View on PubMed)

Kang K, Hwang SK, Lee HW. Shunt-responsive idiopathic normal pressure hydrocephalus patient with delayed improvement after tap test. J Korean Neurosurg Soc. 2013 Nov;54(5):437-40. doi: 10.3340/jkns.2013.54.5.437. Epub 2013 Nov 30.

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Aruga S, Kuwana N, Shiroki Y, Takahashi S, Samejima N, Watanabe A, Seki Y, Igawa Y, Homma Y. Effect of cerebrospinal fluid shunt surgery on lower urinary tract dysfunction in idiopathic normal pressure hydrocephalus. Neurourol Urodyn. 2018 Mar;37(3):1053-1059. doi: 10.1002/nau.23399. Epub 2017 Sep 11.

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Krzastek SC, Bruch WM, Robinson SP, Young HF, Klausner AP. Characterization of lower urinary tract symptoms in patients with idiopathic normal pressure hydrocephalus. Neurourol Urodyn. 2017 Apr;36(4):1167-1173. doi: 10.1002/nau.23084. Epub 2016 Aug 4.

Reference Type RESULT
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Other Identifiers

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PL HPN

Identifier Type: -

Identifier Source: org_study_id

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