title: Apathy and higher level of gait control in normal pressure hydrocephalus.
abstract: Apathy represents the most common behavioral disturbance in patients with suspicion of idiopathic normal pressure hydrocephalus (iNPH) and has a major impact on quality of life. However, its impact on gait -the hallmark motor disturbance of iNPH - has never been studied yet. This study aims to evaluate the impact of apathy on higher level of gait control in patients with suspicion of iNPH. Stride time variability (STV), a marker of higher level of gait control, was quantified during usual walking (single task) and during walking while performing simultaneously cognitive tasks (dual task) of counting and verbal fluency. Among 46 patients with suspicion of iNPH (77.6±6.7years; 34.8% women), 30 (65.2%) presented apathy (defined by a score≥14 on the Starkstein apathy scale). Backward counting induced more important worsening of STV (i.e. increasing STV) in apathetic compared to non-apathetic patients (14.8±25.1% versus 9.0±20.4%; p=0.005), while both groups presented similar executive functioning. These findings suggest that apathy contributes to gait disorders in iNPH. Apathy is easy to monitor and should be considered as a target symptom of treatment.
authors.affiliation: Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: gilles.allali@hcuge.ch.
authors.forename: Gilles
authors.initials: G
authors.lastname: Allali
authors.affiliation: Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Magali
authors.initials: M
authors.lastname: Laidet
authors.affiliation: Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Armand
authors.affiliation: Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Saj
authors.affiliation: Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Krack
authors.affiliation: Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Assal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057565:Apathy / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications*; D008297:Male
keywords: Apathy; Dual tasking; Gait disorders; Mimics; Normal pressure hydrocephalus