This study aims to evaluate changes in extrapyramidal signs after TT in patients suspected of having iNPH using the original UPDRS.
This retrospective study included 45 patients with Possible iNPH who underwent TT between May 2017 and March 2023. Extrapyramidal signs were assessed using the original UPDRS part III. Patients were classified as having improved symptoms if they demonstrated improvement in one or more of the following criteria: a one-step improvement in the iNPH Grading Scale (iNPHGS), an improvement of more than 10% in the Timed Up and Go (TUG) test, or an improvement of 3 points or more in the Mini-Mental State Examination (MMSE). Statistical analysis was conducted using the Wilcoxon signed-rank test to evaluate changes before and after TT in both the symptom improvement and non-improvement groups. JMP version 15 statistical software was used, with the significance level set at p 0.05.
Of the 45 cases analyzed, 23 (51.1%) were male, with a mean age of 75.9 ± 8.6 years. The symptom improvement group included 27 (60.0%) cases, with no significant differences in gender or age between the improvement and non-improvement groups. In the improvement group, UPDRS part III scores significantly improved from 20.0 [15.0–24.0] to 17.0 [13.0–22.0] (p 0.05), particularly in bradykinesia, rigidity, and axial symptoms (p 0.05). In the non-improvement group, UPDRS part III scores changed from 13.5 [7.0–23.5] to 12.5 [7.0–22.3], with no significant changes, and no significant differences were observed in any sub-items.
Similar to previous reports, this study in Japan yielded consistent results, confirming extrapyramidal signs may serve as supplementary indicators for characterizing the clinical symptoms of patients with suspected iNPH.
This study observed changes in extrapyramidal signs before and after TT in Japan. Furthermore, the findings suggest that the original UPDRS, with fewer items than the MDS-UPDRS, is still capable of assessing extrapyramidal signs.
Extrapyramidal signs
UPDRS
