title: Predictors of the disappearance of triad symptoms in patients with idiopathic normal pressure hydrocephalus after shunt surgery.
abstract: We identified factors that predict the disappearance of the triad of symptoms (gait disturbance, cognitive impairment and urinary incontinence) of idiopathic normal pressure hydrocephalus (iNPH) following shunt surgery in this study. We classified 71 patients with iNPH into those whose objective symptoms disappeared (disappearance group) or remained (residual group), for each of the triad symptoms 12 months after shunt surgery. Logistic regression analyses were used to identify the predictors of the disappearance of symptoms among 10 variables before shunt surgery (e.g., age, sex, severity of symptoms, Evans index, cerebrospinal fluid (CSF) pressure, CSF stasis on computerized tomographic cisternography, regional cerebral blood flow on single photon emission computed tomography, three kinds of prior diseases). For each of the triad symptoms, mild symptoms before shunt surgery were predictors of the disappearance of the symptom. Young age was also a predictor of the disappearance of gait disturbance. When the analysis was conducted using subscores of the Mini Mental State Examination, a successful visuoconstruction subtest and an absence of hypertension were predictors of the disappearance of cognitive impairment. None of the neuroimaging examinations predicted the disappearance of symptoms after shunt surgery in this study.
authors.affiliation: Department of Psychiatry, Osaka University Graduate School of Medicine, D3 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. kazui@psy.med.osaka-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kazui
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
authors.forename: Shingo
authors.initials: S
authors.lastname: Ohkawa
authors.forename: Takaharu
authors.initials: T
authors.lastname: Okada
authors.forename: Takeo
authors.initials: T
authors.lastname: Kondo
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Osamu
authors.initials: O
authors.lastname: Ueki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nishio
authors.forename: Kazunari
authors.initials: K
authors.lastname: Ishii
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Masatsune
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D020367:Iofetamine; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
chemical_list: D020367:Iofetamine