Idiopathic Normal Pressure HydrocephalusNCT07832877
Prediction of Response to Shunt Surgery in Normal Pressure Hydrocephalus Using Radscale and Lumbar Puncture
An observational study of Idiopathic Normal Pressure Hydrocephalus and Normal Pressure Hydrocephalus, run by Assiut University.
Trial summary
Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder in older adults characterized by walking difficulties, cognitive decline, and urinary dysfunction. While ventriculoperitoneal (VP) shunt surgery can relieve symptoms, identifying which patients will experience meaningful recovery remains… Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Idiopathic Normal Pressure Hydrocephalus, Normal Pressure Hydrocephalus
- How many people
- 40 participants
- Where
- No sites listed yet
- Study dates
- Oct 2026to Nov 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- Adult, Older adult
Study population: Elderly patients aged 60 years or older presenting to the Department of Neurosurgery at Assiut University Hospitals with clinical suspicion of idiopathic normal pressure hydrocephalus (iNPH) characterized by the clinical triad of gait disturbance, cognitive impairment, and/or urinary dysfunction, alongside neuroimaging (CT or MRI) evidence of ventriculomegaly compatible with iNPH.
Who may be able to join
- Age 60 years or older.
- Clinical suspicion of idiopathic normal pressure hydrocephalus (iNPH), including the clinical triad (gait disturbance, cognitive impairment, and/or urinary dysfunction).
- Neuroimaging (brain CT or MRI) demonstrating ventriculomegaly compatible with possible iNPH.
- Physical ability to perform standardized gait testing.
- Ability to provide written informed consent, or consent provided via a legally authorized representative.
Who cannot join
- Secondary hydrocephalus with an identifiable alternative cause (e.g., recent subarachnoid or intraventricular hemorrhage, major head trauma, or central nervous system infection).
- Presence of any contraindication to lumbar puncture (including relevant bleeding risk/coagulopathy, puncture-site infection, or intracranial mass effect).
- Previous cerebrospinal fluid (CSF) shunt or definitive hydrocephalus surgical intervention prior to enrollment.
- Concurrent acute illness preventing valid clinical or functional assessment.
About this study
Official title: Prediction of Response to Shunt Surgery in Normal Pressure Hydrocephalus Patients Using Radscale and Lumbar Puncture
Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder in older adults characterized by walking difficulties, cognitive decline, and urinary dysfunction. While ventriculoperitoneal (VP) shunt surgery can relieve symptoms, identifying which patients will experience meaningful recovery remains challenging.
The purpose of this study is to determine how accurately two preoperative diagnostic tools, the iNPH Radscale (a structured brain imaging score) and a standardized cerebrospinal fluid (CSF) tap test (lumbar puncture), predict symptom and gait improvement following shunt surgery.
Read more
Participants enrolled in this study will undergo:
- Baseline neurological evaluations, cognitive screening via the Mini-Mental State Examination, and standardized walking tests (Timed Up and Go and 10-meter walk tests).
- Review of brain CT or MRI scans using the 7-feature iNPH Radscale (scored 0 to 12).
- A standardized CSF tap test, involving the removal of 30 to 50 mL of spinal fluid via lumbar puncture, followed by repeat walking evaluations at 2-4 hours and 24 hours to monitor temporary symptom response.
- Standard-of-care VP shunt surgery if determined clinically appropriate by the treating surgical team.
- Postoperative follow-up visits at 1, 3, and 6 months to evaluate functional recovery and gait changes using the Hellström iNPH scale.
- Keywords
- iNPH Radscale, CSF Tap Test, Lumbar Puncture, Ventriculoperitoneal Shunt, Shunt Responsiveness, Hellström iNPH Scale, Gait Disturbance, Timed Up and Go
- Medical subject headings
- Hydrocephalus, Normal Pressure, Mobility Limitation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Idiopathic Normal Pressure Hydrocephalus (iNPH) Cohort | Elderly patients aged 60 years or older presenting with clinical suspicion of the iNPH symptom triad (gait disturbance, cognitive impairment, and/or urinary dysfunction) and neuroimaging-confirmed ventriculomegaly. All participants undergo baseline clinical and cognitive assessments, preoperative neuroimaging evaluation using the iNPH Radscale (scores 0-12), and a standardized cerebrospinal fluid (CSF) tap test with 30-50 mL removal via lumbar puncture. Patients who proceed to clinically indicated ventriculoperitoneal (VP) shunt surgery (PS Medical medium-pressure valve, Medtronic) are followed prospectively at 1, 3, and 6 months postoperatively to assess functional outcomes and gait recovery. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from Baseline in Hellström iNPH Scale Gait Domain Score at 6 Months
The Hellström idiopathic normal pressure hydrocephalus (iNPH) scale gait domain assesses walking speed, step count during a standardized 10-meter walk test, and ordinal rating of gait pattern. Scores are converted to a normalized scale ranging from 0 to 100, where 0 represents the most severe gait dysfunction and 100 represents normal performance of healthy individuals. Higher scores or positive changes from baseline indicate clinical improvement in gait function.
Measured: Baseline and 6 months postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Sep 2026
- Study startOct 2026 (estimated)
- Primary completionOct 2027 (estimated)
- Study completionNov 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Idiopathic Normal Pressure HydrocephalusStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hassan Mohamed Hani Thabet, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07832877
- Sponsor's protocol ID
- Predicting NPH Shunt Response
- Status last verified
- Sep 2026
- First submitted
- 16 Sep 2026
- Last updated
- 22 Sep 2026
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 22 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prediction of Response to Shunt Surgery in Normal Pressure Hydrocephalus Patients Using Radscale and Lumbar Puncture
- ClinicalTrials.gov ID
- NCT07832877
- Acronym / sponsor ID
- Predicting NPH Shunt Response
- Keywords
- iNPH Radscale, CSF Tap Test, Lumbar Puncture, Ventriculoperitoneal Shunt, Shunt Responsiveness, Hellström iNPH Scale, Gait Disturbance, Timed Up and Go
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- Oct 2026 (estimated)
- Primary completion
- Oct 2027 (estimated)
- Study completion
- Nov 2027 (estimated)
- First posted
- 22 Sep 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder in older adults characterized by walking difficulties, cognitive decline, and urinary dysfunction. While ventriculoperitoneal (VP) shunt surgery can relieve symptoms, identifying which patients will experience meaningful recovery remains challenging.
The purpose of this study is to determine how accurately two preoperative diagnostic tools, the iNPH Radscale (a structured brain imaging score) and a standardized cerebrospinal fluid (CSF) tap test (lumbar puncture), predict symptom and gait improvement following shunt surgery.
Participants enrolled in this study will undergo:
- Baseline neurological evaluations, cognitive screening via the Mini-Mental State Examination, and standardized walking tests (Timed Up and Go and 10-meter walk tests).
- Review of brain CT or MRI scans using the 7-feature iNPH Radscale (scored 0 to 12).
- A standardized CSF tap test, involving the removal of 30 to 50 mL of spinal fluid via lumbar puncture, followed by repeat walking evaluations at 2-4 hours and 24 hours to monitor temporary symptom response.
- Standard-of-care VP shunt surgery if determined clinically appropriate by the treating surgical team.
- Postoperative follow-up visits at 1, 3, and 6 months to evaluate functional recovery and gait changes using the Hellström iNPH scale.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Idiopathic Normal Pressure Hydrocephalus (iNPH) Cohort | – | –Elderly patients aged 60 years or older presenting with clinical suspicion of the iNPH symptom triad (gait disturbance, cognitive impairment, and/or urinary dysfunction) and neuroimaging-confirmed ventriculomegaly. All participants undergo baseline clinical and cognitive assessments, preoperative neuroimaging evaluation using the iNPH Radscale (scores 0-12), and a standardized cerebrospinal fluid (CSF) tap test with 30-50 mL removal via lumbar puncture. Patients who proceed to clinically indicated ventriculoperitoneal (VP) shunt surgery (PS Medical medium-pressure valve, Medtronic) are followed prospectively at 1, 3, and 6 months postoperatively to assess functional outcomes and gait recovery. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- Elderly patients aged 60 years or older presenting to the Department of Neurosurgery at Assiut University Hospitals with clinical suspicion of idiopathic normal pressure hydrocephalus (iNPH) characterized by the clinical triad of gait disturbance, cognitive impairment, and/or urinary dysfunction, alongside neuroimaging (CT or MRI) evidence of ventriculomegaly compatible with iNPH.
Key inclusion criteria (5 listed)
- Age 60 years or older.
- Clinical suspicion of idiopathic normal pressure hydrocephalus (iNPH), including the clinical triad (gait disturbance, cognitive impairment, and/or urinary dysfunction).
- Neuroimaging (brain CT or MRI) demonstrating ventriculomegaly compatible with possible iNPH.
- Physical ability to perform standardized gait testing.
- Ability to provide written informed consent, or consent provided via a legally authorized representative.
Key exclusion criteria (4 listed)
- Secondary hydrocephalus with an identifiable alternative cause (e.g., recent subarachnoid or intraventricular hemorrhage, major head trauma, or central nervous system infection).
- Presence of any contraindication to lumbar puncture (including relevant bleeding risk/coagulopathy, puncture-site infection, or intracranial mass effect).
- Previous cerebrospinal fluid (CSF) shunt or definitive hydrocephalus surgical intervention prior to enrollment.
- Concurrent acute illness preventing valid clinical or functional assessment.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Change from Baseline in Hellström iNPH Scale Gait Domain Score at 6 Months
Time frame: Baseline and 6 months postoperatively
The Hellström idiopathic normal pressure hydrocephalus (iNPH) scale gait domain assesses walking speed, step count during a standardized 10-meter walk test, and ordinal rating of gait pattern. Scores are converted to a normalized scale ranging from 0 to 100, where 0 represents the most severe gait dysfunction and 100 represents normal performance of healthy individuals. Higher scores or positive changes from baseline indicate clinical improvement in gait function.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Sep 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of Idiopathic Normal Pressure Hydrocephalus and Normal Pressure Hydrocephalus, run by Assiut University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 22 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change from Baseline in Hellström iNPH Scale Gait Domain Score at 6 Months (time frame: Baseline and 6 months postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2026.