{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:49:36Z","timestamp":1791985776791,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lumbar puncture (LP) is essential for detecting intracranial hypertension (IH) but is often non\u2010diagnostic and not without complications. A skull extensometer\u2010based non\u2010invasive intracranial pressure waveform assessment (NIWA) has shown promise in detecting IH in neurocritical settings. This study investigated its feasibility and accuracy among outpatient neurological individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study enrolled adults referred to routine outpatient LP at a tertiary\u2010care hospital. Subjects underwent baseline supine NIWA, then were sequentially divided (2:1:1 ratio) to: LP then follow\u2010up supine NIWA; follow\u2010up NIWA while sitting then LP; or follow\u2010up NIWA during Valsalva maneuver then LP. Several waveform parameters and their variation between baseline and follow\u2010up assessments were compared with LP results. IH was defined as LP opening pressure\u2009&gt;\u200925cmH\n                      <jats:sub>2<\/jats:sub>\n                      O.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 130 subjects, and 28 (21.5%) presented with IH. Dicrotic peak slope &lt;\u20090.143 predicted IH with 89.5% sensitivity and 29.7% specificity (AUROC\u2009=\u20090.680, 95% CI 0.541\u20130.819). Equations derived from multivariate logistic regression models including mostly latency\u2010related parameters of the entire waveform and its percussion and dicrotic peaks predicted cerebrospinal fluid (CSF) chemocytology changes with AUROC\u2009=\u20090.661 (95% CI 0.542\u20130.780) and overall abnormal LP results (IH and\/or altered CSF chemocytology) with 96.2% sensitivity and 24.1% specificity (AUROC\u2009=\u20090.696, 95% CI 0.572\u20130.820). Parameter changes after LP, during Valsalva maneuver, and sitting position did not improve diagnostic accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NIWA was feasible and detected IH and CSF changes with high sensitivity among real\u2010world neurological outpatients. While LP remains pivotal to many cases, pre\u2010LP screening with NIWA may enhance diagnostic yield and mitigate complications and healthcare\u2010related costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70776","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:16:33Z","timestamp":1791983793000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non\u2010Invasive Intracranial Pressure Waveform Assessment as a Screening Test for Abnormal Lumbar Puncture Results"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7790-8111","authenticated-orcid":false,"given":"Gabriel Taricani","family":"Kubota","sequence":"first","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"},{"name":"Pain Treatment Center, Sao Paulo State Cancer Institute University of Sao Paulo Clinics Hospital  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra Santos","family":"da Fonseca","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0250-8858","authenticated-orcid":false,"given":"Cintya Yukie","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Brain4Care Brazil  S\u00e3o Carlos Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca Gabriela","family":"de Oliveira Pereira","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thauan","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Brain4Care Brazil  S\u00e3o Carlos Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helio Rodrigues","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"},{"name":"Cerebrospinal Fluid Sector, LIM\u201015, Central Laboratory Division University of Sao Paulo Clinics Hospital  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4113-1766","authenticated-orcid":false,"given":"Valqu\u00edria Aparecida","family":"da Silva","sequence":"additional","affiliation":[{"name":"Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry University of S\u00e3o Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Fortini","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7754-4178","authenticated-orcid":false,"given":"Eberval Gadelha","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5810-6236","authenticated-orcid":false,"given":"Lin Tchia","family":"Yeng","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"},{"name":"Physical Medicine and Rehabilitation Division, Orthopaedics and Traumatology Institute University of Sao Paulo Clinics Hospital  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7974-6045","authenticated-orcid":false,"given":"Manoel Jacobsen","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3411-632X","authenticated-orcid":false,"given":"Daniel Ciampi","family":"de Andrade","sequence":"additional","affiliation":[{"name":"Center for Neuroplasticity and Pain, Department of Health Sciences and Technology, Faculty of Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"8","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1007\/s00415-012-6413-x","article-title":"Cerebrospinal Fluid and Lumbar Puncture: A Practical Review","volume":"259","author":"Wright B. 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