{"title":"Intracranial Compliance, Resistance to CSF-Outflow, and Pressure-Volume Index in Hydrocephalus Patients: A Systematic Review and Meta-Analysis","authors":"Seifollah Gholampour , Amber Nguyen , Saad Chaudry","doi":"10.1016/j.irbm.2023.100785","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p><span>How changes in intracranial compliance (ICC), resistance to cerebrospinal fluid (CSF)-outflow (R</span><sub>out</sub><span><span>), and pressure-volume index (PVI) can play a prominent role in clarifying the complexities in the biomechanism and treatment outcomes of </span>hydrocephalus. This study aims to provide a comprehensive review to find the correlation between ICC, R</span><sub>out</sub><span>, and PVI with intracranial pressure<span> (ICP) characteristics, as well as morphometric parameters, in hydrocephalus patients.</span></span></p></div><div><h3>Material and methods</h3><p>Electronic searches were conducted using the PubMed/MEDLINE, Scopus, Google Scholar, Ovid, Cochrane, and EMBASE databases from their dates of inception to December 2022 using filters for English-language articles. The article selection and data collection were conducted in accordance with PRISMA<span> guidelines and recommendations. We assigned a quality score for each study to evaluate the information and selection bias. The certainty of the pooled data for all articles was assessed based on GRADE criteria. The Funnel plot asymmetry study was used to evaluate publication bias.</span></p></div><div><h3>Results</h3><p>The overall pre-treatment ICC, R<sub>out</sub>, and PVI were 0.45 ml/mmHg (95% CI, 0.33-0.57; I<sup>2</sup>=99.7%; P<0.001), 14.93 mmHg/(ml/min) (95% CI, 13.65-16.21; I<sup>2</sup>= 99.7%; P<0.001) and 19.26 ml (95% CI, 15.63-22.89; I<sup>2</sup>=98.7%; P<0.001), respectively. The pooled R<sub>out</sub><span><span> was observed to be higher in adult hydrocephalus compared to pediatric hydrocephalus, whereas the opposite trend was found for PVI. Patients with </span>normal pressure hydrocephalus (NPH) exhibited a higher pooled R</span><sub>out</sub><span> compared to communicating hydrocephalus. Patients with unimproved outcomes demonstrated a decrease in the effect size of the pooled R</span><sub>out</sub>. The results also showed significant correlations were observed between all ICP characteristics and both the ICC and R<sub>out</sub>. The correlation between ICC and the ventricular score was significant. R<sub>out</sub> had a significant correlation with the third ventricle index. PVI had significant correlations with Evan's ratio, inverse cella media, and ventricular score.</p></div><div><h3>Conclusion</h3><p>The results indicate the possible reason for publication bias in some subgroups may be related to methodological heterogeneity in the measurement of pressure-volume parameters. This finding motivates researchers to investigate the effects of different invasive and non-invasive methods on the measurement results of ICC, R<sub>out</sub>, and PVI.</p></div>","PeriodicalId":14605,"journal":{"name":"Irbm","volume":"44 5","pages":"Article 100785"},"PeriodicalIF":5.6000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Irbm","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1959031823000349","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 1
Abstract
Objectives
How changes in intracranial compliance (ICC), resistance to cerebrospinal fluid (CSF)-outflow (Rout), and pressure-volume index (PVI) can play a prominent role in clarifying the complexities in the biomechanism and treatment outcomes of hydrocephalus. This study aims to provide a comprehensive review to find the correlation between ICC, Rout, and PVI with intracranial pressure (ICP) characteristics, as well as morphometric parameters, in hydrocephalus patients.
Material and methods
Electronic searches were conducted using the PubMed/MEDLINE, Scopus, Google Scholar, Ovid, Cochrane, and EMBASE databases from their dates of inception to December 2022 using filters for English-language articles. The article selection and data collection were conducted in accordance with PRISMA guidelines and recommendations. We assigned a quality score for each study to evaluate the information and selection bias. The certainty of the pooled data for all articles was assessed based on GRADE criteria. The Funnel plot asymmetry study was used to evaluate publication bias.
Results
The overall pre-treatment ICC, Rout, and PVI were 0.45 ml/mmHg (95% CI, 0.33-0.57; I2=99.7%; P<0.001), 14.93 mmHg/(ml/min) (95% CI, 13.65-16.21; I2= 99.7%; P<0.001) and 19.26 ml (95% CI, 15.63-22.89; I2=98.7%; P<0.001), respectively. The pooled Rout was observed to be higher in adult hydrocephalus compared to pediatric hydrocephalus, whereas the opposite trend was found for PVI. Patients with normal pressure hydrocephalus (NPH) exhibited a higher pooled Rout compared to communicating hydrocephalus. Patients with unimproved outcomes demonstrated a decrease in the effect size of the pooled Rout. The results also showed significant correlations were observed between all ICP characteristics and both the ICC and Rout. The correlation between ICC and the ventricular score was significant. Rout had a significant correlation with the third ventricle index. PVI had significant correlations with Evan's ratio, inverse cella media, and ventricular score.
Conclusion
The results indicate the possible reason for publication bias in some subgroups may be related to methodological heterogeneity in the measurement of pressure-volume parameters. This finding motivates researchers to investigate the effects of different invasive and non-invasive methods on the measurement results of ICC, Rout, and PVI.
期刊介绍:
IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux).
As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in:
-Physiological and Biological Signal processing (EEG, MEG, ECG…)-
Medical Image processing-
Biomechanics-
Biomaterials-
Medical Physics-
Biophysics-
Physiological and Biological Sensors-
Information technologies in healthcare-
Disability research-
Computational physiology-
…