Cognitive disturbances and neuropsychological changes after surgical treatment in a cohort of 185 patients with idiopathic normal pressure hydrocephalus

Arch Clin Neuropsychol. 2012 May;27(3):304-17. doi: 10.1093/arclin/acs002. Epub 2012 Mar 1.

Abstract

Although idiopathic normal pressure hydrocephalus (iNPH) is considered a treatable dementia, there is still some controversy regarding the cognitive improvement in these patients. The main aims of this study were to analyze baseline cognitive status and to study the neuropsychological changes after surgical treatment in a sample of 185 consecutive iNPH patients. An additional aim was to identify the variables that influenced the cognitive outcome. Specific tests assessing memory, attention, visual scanning, executive functions (EFs), and motor speed were used before and 6 months after shunting. The cognitive domains most affected at baseline were memory, EFs, attention, and psychomotor speed. After shunting, significant differences in the group as a whole were found in all tests except Digits Forward and Trail Making Part B. However, less than 50% of patients showed a significant improvement when analyzed individually. Previous global cognitive status assessed by Mini-Mental State Examination baseline scores was the best predictor for the cognitive outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Attention Deficit Disorder with Hyperactivity / etiology
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology*
  • Cohort Studies
  • Executive Function
  • Female
  • Humans
  • Hydrocephalus, Normal Pressure / psychology*
  • Hydrocephalus, Normal Pressure / surgery
  • Male
  • Memory Disorders / diagnosis
  • Memory Disorders / etiology
  • Mental Status Schedule
  • Middle Aged
  • Neuropsychological Tests*
  • Postoperative Complications / physiopathology*
  • Postoperative Complications / psychology
  • Psychomotor Performance
  • Vascular Surgical Procedures / adverse effects*
  • Visual Perception