Neuropsychological effects of shunt treatment in idiopathic normal pressure hydrocephalus.
OBJECTIVE
To prospectively evaluate the effects of shunting on the neuropsychological performance of patients with idiopathic normal pressure hydrocephalus (INPH), to compare their performance with that of healthy individuals, and to estimate the predictive utility of putatively important factors.


METHODS
A consecutive series of 47 patients with INPH underwent neurological, radiological, and neuropsychological examinations before and 3 months after shunt surgery. The same neuropsychological tests, measuring simple and target reaction times, dexterity, memory and learning, working memory, and aspects of executive functioning, were also administered to 159 healthy individuals.


RESULTS
Performance on all neuropsychological tests, except Simple Reaction Time and Digit Span, significantly improved after surgery, with more severe functional deficits showing greatest improvement. Age, education, duration, vascular comorbidity, sex, and onset symptom all failed to predict the neuropsychological effects of treatment. Despite improvement 3 months after shunt surgery, INPH patients were still outperformed by healthy individuals.


CONCLUSIONS
Most of the wide range of neuropsychological functions that are affected by INPH are markedly improved by shunt treatment, but not completely restored.
Hellström
Per
P
Institute of Neuroscience and Physiology, Göteborg University, Gothenburg, Sweden. per.hellstrom@vgregion.se
Edsbagge
Mikael
M
Blomsterwall
Elisabeth
E
Archer
Trevor
T
Tisell
Magnus
M
Tullberg
Mats
M
Wikkelsø
Carsten
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts / Q000379:methods; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult