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Research ArticleSpine
Open Access

Validity of the Bern Score as a Surrogate Marker of Clinical Severity in Patients with Spontaneous Intracranial Hypotension

J.L. Houk, S. Morrison, S. Peskoe, T.J. Amrhein and P.G. Kranz
American Journal of Neuroradiology September 2023, 44 (9) 1096-1100; DOI: https://doi.org/10.3174/ajnr.A7962
J.L. Houk
aFrom the Department of Radiology (J.L.H., T.J.A., P.G.K.), Duke University Medical Center, Durham, North Carolina
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S. Morrison
bDepartment of Biostatistics and Bioinformatics (S.M., S.P.), Duke University School of Medicine, Durham, North Carolina
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S. Peskoe
bDepartment of Biostatistics and Bioinformatics (S.M., S.P.), Duke University School of Medicine, Durham, North Carolina
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T.J. Amrhein
aFrom the Department of Radiology (J.L.H., T.J.A., P.G.K.), Duke University Medical Center, Durham, North Carolina
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P.G. Kranz
aFrom the Department of Radiology (J.L.H., T.J.A., P.G.K.), Duke University Medical Center, Durham, North Carolina
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  • FIG 1.
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    FIG 1.

    Scatterplot with best-fit line for the overall cohort shows a negligible correlation between the HIT-6 and Bern scores.

  • FIG 2.
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    FIG 2.

    Subgroup analysis of subjects based on the time interval between brain MR imaging and HIT-6 administration. Scatterplots with best-fit lines show negligible correlations between the Bern score and the HIT-6 score in both the 0- to 3-month and 3- to 6-month subgroups.

  • FIG 3.
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    FIG 3.

    Subgroup analysis of subjects based on symptom duration before brain MR imaging. Scatterplots with best-fit lines show weak correlation between Bern scores and HIT-6 scores for subjects with symptoms of 0- to 3-month duration and negligible correlation for subjects with symptoms of >3 months' duration.

  • FIG 4.
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    FIG 4.

    Subgroup analysis of subjects who received or did not receive an EBP in the interval between brain MR imaging and HIT-6 administration. Scatterplots with best-fit lines show negligible correlation between HIT-6 and Bern scores in subjects who received an EBP and weak correlation in subjects who did not receive an EBP.

  • FIG 5.
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    FIG 5.

    ROC curves depicting the ability of the Bern score to discriminate severe from not severe HIT-6 groups in both the overall cohort (AUC = 0.606; 95% CI, 0.347–0.864) and subgroup of subjects with brain MR imaging 0–3 months from completion of the HIT-6 (AUC = 0.635; 95% CI, 0.385–0.884). Bern scores performed poorly in both groups in discriminating clinical headache severity.

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American Journal of Neuroradiology: 44 (9)
American Journal of Neuroradiology
Vol. 44, Issue 9
1 Sep 2023
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Cite this article
J.L. Houk, S. Morrison, S. Peskoe, T.J. Amrhein, P.G. Kranz
Validity of the Bern Score as a Surrogate Marker of Clinical Severity in Patients with Spontaneous Intracranial Hypotension
American Journal of Neuroradiology Sep 2023, 44 (9) 1096-1100; DOI: 10.3174/ajnr.A7962

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Bern Score Validity for SIH
J.L. Houk, S. Morrison, S. Peskoe, T.J. Amrhein, P.G. Kranz
American Journal of Neuroradiology Sep 2023, 44 (9) 1096-1100; DOI: 10.3174/ajnr.A7962
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