title: The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus.
abstract: OBJECTIVE
  Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients.
  
  
  METHODS
  Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic posturography (CDP), and neuropsychological assessment. Examinations were done before and after spinal tap test.
  
  
  RESULTS
  The gait score showed a significant improvement 24 h after spinal tap test in all subtests and in the sum score (p < 0.003), while neuropsychological assessment did not reveal significant differences 72 h after spinal tap test. CDP showed significant improvements after spinal tap test in the Sensory Organization Tests 2 (p = 0.017), 4 (p = 0.001), and 5 (p = 0.009) and the composite score (p = 0.01). Patients showed best performance in somatosensory and worst performance in vestibular dominated tests. Vestibular dominated tests did not improve significantly after spinal tap test, while somatosensory and visual dominated tests did.
  
  
  CONCLUSIONS
  Postural stability in NPH is predominantly affected by deficient vestibular functions, which did not improve after spinal tap test. Conditions which improved best were mainly independent from visual control and are based on proprioceptive functions.
authors: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
authors: Katrin
authors: K
authors: Abram
authors: Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
authors: Silvia
authors: S
authors: Bohne
authors: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
authors: Peter
authors: P
authors: Bublak
authors: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany; Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany.
authors: Panagiota
authors: P
authors: Karvouniari
authors: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany; Biomagnetic Center, Jena University Hospital, Jena, Germany.
authors: Carsten M
authors: CM
authors: Klingner
authors: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
authors: Otto W
authors: OW
authors: Witte
authors: Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
authors: Orlando
authors: O
authors: Guntinas-Lichius
authors: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany; Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany.
authors: Hubertus
authors: H
authors: Axer
keywords: Computerized dynamic posturography; Normal pressure hydrocephalus; Postural stability; Spinal tap test