Exploring the Association Between Visual Field Testing and CERAD Neuropsychological Battery in Idiopathic Normal Pressure Hydrocephalus Patients

Article type: Research Article

Authors: Kemiläinen, Benjam^{a; b; *} | Tiainen, Sonja^a | Rauramaa, Tuomas^{c; d} | Luikku, Antti J.^a | Herukka, Sanna-Kaisa^e | Koivisto, Anne^{f; g; h} | Hiltunen, Mikko^h | Verdooner, Stevenⁱ | Johnson, Kenⁱ | Chambers, Miekoⁱ | Kaarniranta, Kai^{b; j} | Leinonen, Ville^a

Affiliations: [a] Neurosurgery of NeuroCenter, Kuopio University Hospital and Unit of Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland | [b] Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland | [c] Unit of Pathology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland | [d] Department of Pathology, Kuopio University Hospital, Kuopio, Finland | [e] Neurology of NeuroCenter, Kuopio University Hospital, Kuopio, Finland | [f] Unit of Neurosciences, Faculty of Medicine, University of Helsinki, Helsinki, Finland | [g] Geriatrics/Internal Medicine and Rehabilitation, Helsinki University Hospital, Helsinki, Finland | [h] Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland | [i] NeuroVision Imaging Inc., Sacramento, CA, USA | [j] Department of Molecular Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland

Correspondence: [*] Correspondence to: Benjam Kemiläinen, Department of Ophthalmology, University of Eastern Finland and Kuopio University Hospital, Yliopistonranta 1C, 70211, Kuopio, Finland. Tel.: +358 447 174 568; E-mail: benjam.kemilainen@pshyvinvointialue.fi.

Abstract: Background:Association between visual field test indices and The Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NB) is unknown. Idiopathic normal pressure hydrocephalus (iNPH) patients provide a unique set of patient data for analysis. Objective:To assess the reliability of visual field testing using the CERAD-NB in patients with iNPH and to investigate the association between visual field test results and cognitive function. Methods:62 probable iNPH patients were subjected to comprehensive ophthalmological examination, ophthalmological optical coherence tomography imaging studies, visual field testing, and CERAD-NB. Based on visual field indices, the patients were divided into two groups: unreliable (n = 19) and reliable (n = 43). Independent T-test analysis was performed to examine the relationship between visual field test results and cognitive function. Pearson Chi-square test was used for non-continuous variables. Results:The unreliable group performed worse in CERAD-NB subtests compared to the reliable group. Statistically significant differences were observed in nine out of ten subtests, with only Clock Drawing showing no statistical significance. Pairwise comparison of the groups showed no statistical significance between amyloid-β (Aβ) biopsy, hyperphosphorylated tau biopsy, apolipoprotein E allele or the ophthalmological status of the patient. But there was a statistically significant difference in cerebrospinal fluid Aβ42 and age between the groups. Conclusions:Patients with unreliable visual field tests performed worse on CERAD-NB subtests. CERAD-NB subtests do not provide a specific cut-off value to refrain patients from visual field testing. Should patients with unreliable visual field tests be screened for cognitive impairment?

Keywords: Alzheimer’s disease, amyloid-β , APOE , CERAD-NB, cognitive impairment, normal pressure hydrocephalus, optical coherence tomography, visual field tests

DOI: 10.3233/JAD-231414

Journal: Journal of Alzheimer's Disease, vol. 100, no. 1, pp. 247-260, 2024