title: A computerized neuropsychological test battery designed for idiopathic normal pressure hydrocephalus.
abstract: BACKGROUND
  A tool for standardized and repeated neuropsychological assessments in patients with idiopathic normal pressure hydrocephalus (INPH) is needed. The objective of this study was to develop a computerized neuropsychological test battery designed for INPH and to evaluate its reliability, validity and patient's ability to complete the tests.
  
  
  METHODS
  Based on a structured review of the literature on neuropsychological testing in INPH, the eight tests most sensitive to the INPH cognitive profile were implemented in a computerized format. The Geriatric Depression Scale (GDS) was also included. Tests were presented on a touch-screen monitor, with animated instructions and speaker sound. The battery was evaluated with the following cohorts: A. Test-retest reliability, 44 healthy elderly; B. Validity against standard pen and pencil testing, 28 patients with various cognitive impairments; C. Ability to complete test battery, defined as completion of at least seven of the eight tests, 40 investigated for INPH.
  
  
  RESULTS
  A. All except the figure copy test showed good test-retest reliability, r = 0.67-0.90; B. A high correlation was seen between conventional and computerized tests (r = 0.66-0.85) except for delayed recognition and figure copy task; C. Seventy-eight percent completed the computerized battery; Patients diagnosed with INPH (n = 26) performed worse on all tests, including depression score, compared to healthy controls.
  
  
  CONCLUSIONS
  A new computerized neuropsychological test battery designed for patients with communicating hydrocephalus and INPH was introduced. Its reliability, validity for general cognitive impairment and completion rate for INPH was promising. After exclusion of the figure copy task, the battery is ready for clinical evaluation and as a next step we suggest validation for INPH and a comparison before and after shunt surgery.
  
  
  BACKGROUND
  ClinicalTrials.org NCT01265251.
authors.affiliation: Blekinge Centre of Competence, Blekinge Hospital Karlskrona, Karlskrona, Sweden ; Department of Clinical Neuroscience, Umeå University, Umeå, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Behrens
authors.affiliation: Centre for Biomedical Engineering and Physics, Umeå University, Umeå, Sweden ; Department of Radiation Science, Umeå University, Umeå, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Eklund
authors.affiliation: Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Elgh
authors.affiliation: The Sandra and Malcolm Berman Brain & Spine Institute, Sinai Hospital of Baltimore, Baltimore, MD, USA ; Division of Neuropsychology, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Smith
authors.affiliation: The Sandra and Malcolm Berman Brain & Spine Institute, Sinai Hospital of Baltimore, Baltimore, MD, USA ; Adult Hydrocephalus Center, Sinai Hospital of Baltimore, Baltimore, MD, USA ; Department of Neurology, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Williams
authors.affiliation: Department of Clinical Neuroscience, Umeå University, Umeå, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Malm
keywords: Dementia; Hydrocephalus, Normal pressure; Neuropsychological tests; Neuropsychology; Reliability and validity; Software