Toma 2016.

Study characteristics
Methods	Study design: 1‐arm, cross‐over randomised controlled trial, assessor and participant blinded Number randomised: 15 Exclusions: all participants had the intended intervention. 1 withdrew consent following surgery in the inactive group. Length of follow‐up: 12 months How data were handled: modified intention‐to‐treat
Participants	Country: United Kingdom Setting: single centre Baseline characteristics: Immediate‐shunt group Mean age in years: 75 Female: 25% Delayed‐shunt group Mean age in years: 74.4 Female: 14% Number of Hakim symptoms: gait + 1 other Inclusion criteria: Diagnosis of probable iNPH (Relkin guidelines) Clear improvement of walking speed following 72 hours of extended lumbar drainage Clinical findings of gait/balance disturbance, plus at least 1 other area of impairment in cognition, urinary symptoms, or both A brain imaging study (CT or MRI) must show evidence of ventricular enlargement (Evans index > 0.3) CSF opening pressure < 18 mmHg No evidence of an antecedent event such as head trauma, intracerebral haemorrhage, meningitis, or other known causes of secondary hydrocephalus No other neurological, psychiatric, or general medical conditions that are sufficient to explain the presenting symptoms Exclusion criteria: Evidence of concomitant Alzheimer’s disease or vascular dementia
Interventions	Intervention 1: active VP shunt Intervention 2: initially inactive VP shunt changed to active at 3 months
Outcomes	Primary outcome: Improvement in gait, as determined by the timed walking test Secondary outcomes: Improvement in mental function, as determined by neuropsychological testing Improvement in urinary function Incidence of complications
Notes	Sources of support: nil Possible conflicts of interest: Toma PhD funded by B Braun.

10 MWT: 10‐metre walk test
CSF: cerebrospinal fluid
CSFTT: cerebrospinal fluid tap test
CT: computed tomography
FAB: frontal assessment battery
iNPH: idiopathic normal pressure hydrocephalus
iNPHGS: idiopathic normal pressure hydrocephalus grading scale
LP: lumboperitoneal
MMSE: Mini‐Mental State Examination
MoCA: Montreal Cognitive Assessment
MRI: magnetic resonance imaging
mRS: modified Rankin Scale
n/a: not available
NPH: normal pressure hydrocephalus
SD: standard deviation
SSS‐WAIS‐III: Symbol Search subset of Wechsler Adult Intelligence Scale, Third Edition
TMT‐A: trail making test A
TUG: timed up‐and‐go test
VP: ventriculoperitoneal