Non-invasive Diagnostics of Shunt Obstruction in Adult Hydrocephalus

Summary

The goal of this RCT is to test whether volumetric assessment of magnetic resonance imaging (MRI) could diagnose shunt obstruction in Adult Hydrocephalus patients, and in addition to explore correlations of blood biomarkers surrounding shunt obstruction. Thirdly to investigate correlations with clinical symptom burden before and after surgery.

The main questions it aims to answer are:

Can volumetric assessment of cerebrospinal fluid (CSF) aid in diagnosis of shunt obstruction? Are there dynamical changes in blood biomarker concentrations after shunt obstruction? How are clinical symptom burden and dynamics correlated with blood biomarker changes and volumetric changes in CSF?

After three months of shunt treatment, researchers will compare patients with "Virtual OFF" setting, to explore if simulated shunt obstruction affect measures mentioned above.

Participants randomized to the intervention group will undergo the 'Virtual OFF' setting for a period of 5-7 days, starting 3 months after initiation of shunt treatment. Symptom burden will be assessed preoperatively, at follow-up, and following the week of the shunt setting change. MRI scans will be conducted at these same time points. Participants in the control group will also meet with a nurse, but their shunt settings will remain unchanged. The control group will receive the same symptom assessments and MRI scans as the intervention group.

Conditions

• Normal Pressure Hydrocephalus Patients
• Normal Pressure Hydrocephalus

Interventions

DEVICE

Intervention group "Virtual OFF"

Patients randomized to shunt setting "Virtual Off" at the three month follow-up visit. After 5-7 days, the setting will be restored to the previous setting.

DEVICE

Control group (no change in shunt setting)

Patients randomized to continue their shunt setting unchanged

Sponsors & Collaborators

• Department of Neurological Surgery, Sahlgrenska University Hospital

  collaborator UNKNOWN

• Hydrocephalus Research Unit, Sahlgrenska University Hospital

  collaborator UNKNOWN

• Department of Neurological Surgery, Linköping University Hospital

  collaborator UNKNOWN

• Department of Neurology, Linköping University Hospital

  collaborator UNKNOWN

• Göteborg University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-09-15

Primary Completion

2028-05-01

Completion

2034-12-31

FDA Device

Yes