Ambulatory intracranial pressure in humans: ICP increases during movement between body positions

Introduction: Positional changes in intracranial pressure (ICP) have been described in humans when measured over minutes or hours in a static posture, with ICP higher when lying supine than when sitting or standing upright. However, humans are often ambulant with frequent changes in position self-ge...

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Main Authors: Eleanor M. Moncur, Linda D'Antona, Amy L. Peters, Graziella Favarato, Simon Thompson, Celine Vicedo, Lewis Thorne, Laurence D. Watkins, Brian L. Day, Ahmed K. Toma, Matthew J. Bancroft
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772529424000274
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author Eleanor M. Moncur
Linda D'Antona
Amy L. Peters
Graziella Favarato
Simon Thompson
Celine Vicedo
Lewis Thorne
Laurence D. Watkins
Brian L. Day
Ahmed K. Toma
Matthew J. Bancroft
author_facet Eleanor M. Moncur
Linda D'Antona
Amy L. Peters
Graziella Favarato
Simon Thompson
Celine Vicedo
Lewis Thorne
Laurence D. Watkins
Brian L. Day
Ahmed K. Toma
Matthew J. Bancroft
author_sort Eleanor M. Moncur
collection DOAJ
description Introduction: Positional changes in intracranial pressure (ICP) have been described in humans when measured over minutes or hours in a static posture, with ICP higher when lying supine than when sitting or standing upright. However, humans are often ambulant with frequent changes in position self-generated by active movement. Research question: We explored how ICP changes during movement between body positions. Material and methods: Sixty-two patients undergoing clinical ICP monitoring were recruited. Patients were relatively well, ambulatory and of mixed age, body habitus and pathology. We instructed patients to move back and forth between sitting and standing or lying and sitting positions at 20 s intervals after an initial 60s at rest. We simultaneously measured body position kinematics from inertial measurement units and ICP from an intraparenchymal probe at 100 Hz. Results: ICP increased transiently during movements beyond the level expected by body position alone. The amplitude of the increase varied between participants but was on average ∼5 mmHg during sit-to-stand, stand-to-sit and sit-to-lie movements and 10.8 mmHg [95%CI: 9.3,12.4] during lie-to-sit movements. The amplitude increased slightly with age, was greater in males, and increased with median 24-h ICP. For lie-to-sit and sit-to-lie movements, higher BMI was associated with greater mid-movement increase (β = 0.99 [0.78,1.20]; β = 0.49 [0.34,0.64], respectively). Discussion and conclusion: ICP increases during movement between body positions. The amplitude of the increase in ICP varies with type of movement, age, sex, and BMI. This could be a marker of disturbed ICP dynamics and may be particularly relevant for patients with CSF-diverting shunts in situ.
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spelling doaj-art-3ef3fbfd9ebe430db5fc7933685080e52025-08-20T02:35:40ZengElsevierBrain and Spine2772-52942024-01-01410277110.1016/j.bas.2024.102771Ambulatory intracranial pressure in humans: ICP increases during movement between body positionsEleanor M. Moncur0Linda D'Antona1Amy L. Peters2Graziella Favarato3Simon Thompson4Celine Vicedo5Lewis Thorne6Laurence D. Watkins7Brian L. Day8Ahmed K. Toma9Matthew J. Bancroft10National Hospital for Neurology and Neurosurgery, UK; UCL Queen Square Institute of Neurology, Department of Brain Repair and Rehabilitation, UK; Corresponding author.National Hospital for Neurology and Neurosurgery, UK; UCL Queen Square Institute of Neurology, Department of Brain Repair and Rehabilitation, UKUCL Queen Square Institute of Neurology, Department of Brain Repair and Rehabilitation, UK; UCL Queen Square Institute of Neurology, Department of Clinical and Movement Neurosciences, UKUCL Queen Square Institute of Neurology, Department of Brain Repair and Rehabilitation, UKNational Hospital for Neurology and Neurosurgery, UKNational Hospital for Neurology and Neurosurgery, UKNational Hospital for Neurology and Neurosurgery, UKNational Hospital for Neurology and Neurosurgery, UKUCL Queen Square Institute of Neurology, Department of Clinical and Movement Neurosciences, UKNational Hospital for Neurology and Neurosurgery, UK; UCL Queen Square Institute of Neurology, Department of Brain Repair and Rehabilitation, UKUCL Queen Square Institute of Neurology, Department of Brain Repair and Rehabilitation, UK; UCL Queen Square Institute of Neurology, Department of Clinical and Movement Neurosciences, UKIntroduction: Positional changes in intracranial pressure (ICP) have been described in humans when measured over minutes or hours in a static posture, with ICP higher when lying supine than when sitting or standing upright. However, humans are often ambulant with frequent changes in position self-generated by active movement. Research question: We explored how ICP changes during movement between body positions. Material and methods: Sixty-two patients undergoing clinical ICP monitoring were recruited. Patients were relatively well, ambulatory and of mixed age, body habitus and pathology. We instructed patients to move back and forth between sitting and standing or lying and sitting positions at 20 s intervals after an initial 60s at rest. We simultaneously measured body position kinematics from inertial measurement units and ICP from an intraparenchymal probe at 100 Hz. Results: ICP increased transiently during movements beyond the level expected by body position alone. The amplitude of the increase varied between participants but was on average ∼5 mmHg during sit-to-stand, stand-to-sit and sit-to-lie movements and 10.8 mmHg [95%CI: 9.3,12.4] during lie-to-sit movements. The amplitude increased slightly with age, was greater in males, and increased with median 24-h ICP. For lie-to-sit and sit-to-lie movements, higher BMI was associated with greater mid-movement increase (β = 0.99 [0.78,1.20]; β = 0.49 [0.34,0.64], respectively). Discussion and conclusion: ICP increases during movement between body positions. The amplitude of the increase in ICP varies with type of movement, age, sex, and BMI. This could be a marker of disturbed ICP dynamics and may be particularly relevant for patients with CSF-diverting shunts in situ.http://www.sciencedirect.com/science/article/pii/S2772529424000274Intracranial pressureCerebrospinal fluidIntracranial pressure monitoringMovementBody positionIntracranial dynamics
spellingShingle Eleanor M. Moncur
Linda D'Antona
Amy L. Peters
Graziella Favarato
Simon Thompson
Celine Vicedo
Lewis Thorne
Laurence D. Watkins
Brian L. Day
Ahmed K. Toma
Matthew J. Bancroft
Ambulatory intracranial pressure in humans: ICP increases during movement between body positions
Brain and Spine
Intracranial pressure
Cerebrospinal fluid
Intracranial pressure monitoring
Movement
Body position
Intracranial dynamics
title Ambulatory intracranial pressure in humans: ICP increases during movement between body positions
title_full Ambulatory intracranial pressure in humans: ICP increases during movement between body positions
title_fullStr Ambulatory intracranial pressure in humans: ICP increases during movement between body positions
title_full_unstemmed Ambulatory intracranial pressure in humans: ICP increases during movement between body positions
title_short Ambulatory intracranial pressure in humans: ICP increases during movement between body positions
title_sort ambulatory intracranial pressure in humans icp increases during movement between body positions
topic Intracranial pressure
Cerebrospinal fluid
Intracranial pressure monitoring
Movement
Body position
Intracranial dynamics
url http://www.sciencedirect.com/science/article/pii/S2772529424000274
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