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Validation of Davson’s equation in patients suffering from idiopathic Normal Pressure Hydrocephalus

View ORCID ProfileAfroditi-Despina Lalou, View ORCID ProfileVirginia Levrini, Matthew Garnett, Eva Nabbanja, Dong-Joo Kim, Laurent Gergele, Anna Bjornson, Zofia Czosnyka, Marek Czosnyka
doi: https://doi.org/10.1101/268698
Afroditi-Despina Lalou
1Division of Neurosurgery, University of Cambridge Department of Clinical Neuroscience, Addenbrooke’s Hospital, Cambridge, UK
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Virginia Levrini
2School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Matthew Garnett
1Division of Neurosurgery, University of Cambridge Department of Clinical Neuroscience, Addenbrooke’s Hospital, Cambridge, UK
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Eva Nabbanja
1Division of Neurosurgery, University of Cambridge Department of Clinical Neuroscience, Addenbrooke’s Hospital, Cambridge, UK
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Dong-Joo Kim
3University of Korea, Seoul
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Laurent Gergele
1Division of Neurosurgery, University of Cambridge Department of Clinical Neuroscience, Addenbrooke’s Hospital, Cambridge, UK
4Ramsay Générale de Santé, Hôpital de la Loire, Saint Etienne, Frances
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Anna Bjornson
1Division of Neurosurgery, University of Cambridge Department of Clinical Neuroscience, Addenbrooke’s Hospital, Cambridge, UK
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Zofia Czosnyka
1Division of Neurosurgery, University of Cambridge Department of Clinical Neuroscience, Addenbrooke’s Hospital, Cambridge, UK
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Marek Czosnyka
1Division of Neurosurgery, University of Cambridge Department of Clinical Neuroscience, Addenbrooke’s Hospital, Cambridge, UK
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Abstract

Introduction The so called Davson’s equation relates baseline intracranial pressure (ICP) to resistance to cerebrospinal fluid outflow (Rout), formation of cerebrospinal fluid (If) and sagittal sinus pressure (PSS) There is a controversy over whether this fundamental equation is applicable in patients with normal pressure hydrocephalus (NPH). We investigated the relationship between Rout and ICP and also other compensatory, clinical and demographic parameters in NPH patients.

Method We carried out a retrospective study of 229 patients with primary NPH who had undergone constant-rate infusion studies in our hospital. Data was recorded and processed using ICM+ software. Relationships between variables were sought by calculating Pearson product correlation coefficients and p values.

Results We found a significant, albeit weak, relationship between ICP and Rout (R=0.17, p=0.0049), Rout and peak-to-peak amplitude of ICP (AMP) (R=0.27, p=3.577e−05) and Rout and age (R=0.16, p=0.01306).

Conclusions The relationship found between ICP and Rout provides indirect evidence to support disturbed Cerebrospinal fluid circulation as a key factor in disturbed CSF dynamics in NPH. Weak correlation may indicate that other factors: variable Pss and formation of CSF outflow contribute heavily to linear model expressed by Davson’s equation.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.
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Posted February 20, 2018.
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Validation of Davson’s equation in patients suffering from idiopathic Normal Pressure Hydrocephalus
Afroditi-Despina Lalou, Virginia Levrini, Matthew Garnett, Eva Nabbanja, Dong-Joo Kim, Laurent Gergele, Anna Bjornson, Zofia Czosnyka, Marek Czosnyka
bioRxiv 268698; doi: https://doi.org/10.1101/268698
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Validation of Davson’s equation in patients suffering from idiopathic Normal Pressure Hydrocephalus
Afroditi-Despina Lalou, Virginia Levrini, Matthew Garnett, Eva Nabbanja, Dong-Joo Kim, Laurent Gergele, Anna Bjornson, Zofia Czosnyka, Marek Czosnyka
bioRxiv 268698; doi: https://doi.org/10.1101/268698

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