title: Cognitive disturbances and neuropsychological changes after surgical treatment in a cohort of 185 patients with idiopathic normal pressure hydrocephalus.
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.
authors.affiliation: Neurosurgery and Neurotraumatology Research Unit, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Spain.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Solana
authors.forename: Juan
authors.initials: J
authors.lastname: Sahuquillo
authors.forename: Carme
authors.initials: C
authors.lastname: Junqué
authors.forename: Manuel
authors.initials: M
authors.lastname: Quintana
authors.forename: Maria A
authors.initials: MA
authors.lastname: Poca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000523:psychology* / Q000601:surgery; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000503:physiopathology* / Q000523:psychology; D011597:Psychomotor Performance; D014656:Vascular Surgical Procedures / Q000009:adverse effects*; D014796:Visual Perception