Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a progressive clinical syndrome that includes gait disturbances, urinary incontinence, and cognitive impairment. iNPH shows similarities to other neurodegenerative disorders, primarily Alzheimer’s Disease (AD). Definition of the neuropsychological profile of iNPH and the qualitative analysis of systematic mistakes made in cognitive tests could represent a valid method for systematizing possible specific markers of iNPH dementia and differentiating it from other dementias. To evaluate the role and the efficacy of a neuropsychological protocol, designed at our institution, based on psychometric analysis and qualitative assessment, in the differential diagnosis of iNPH from AD dementia, we prospectively enrolled 12 patients with suspected iNPH, 11 patients with AD, and 10 healthy controls (HC) who underwent neuropsychological assessment. The assessment was done with the Mini Mental State Examination (MMSE), Mental Deterioration Battery (MDB), Frontal Assessment Battery (FAB), and the Deux Barrage Test. Evaluation in the iNPH group was performed before extended lumbar drainage (ELD), 48 h after ELD, and 1 week and 3 months after the insertion of a ventriculoperitoneal shunt (VPS). Statistical analysis demonstrated the cognitive profile of iNPH, which was mainly characterized by executive function and immediate verbal memory impairment compared with AD. Additionally, the neuropsychological markers were different between the two groups. The qualitative analysis of systematic mistakes made on the tests demonstrated differences in cognitive performances between the iNPH, AD, and HC cohorts. Neuropsychological assessment and qualitative evaluation could represent a useful tool for achieving effective management and restoration of functions in patients with iNPH.
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References
Bergsneider M, Black MP, Klinge P, Marmarou A, Relkin N (2005) Surgical management of idiopathic normal-pressure hydrocephalus. Neurosurgery 57:29–39
Campos Gomes Pinto F, Saad F, Fernades de Oliveira M, Pereira RM, Letsaske de Miranda F, Benevenuto Tornai J, Romao Lopes MI, Carvalhal Ribas ES, Valinetti E, Teixeira MJ (2013) Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. Neurosurgery 72:845–854
Devito EE, Pickard JD, Salmond CH, Iddon JL, Loveday C, Sahakian BJ (2005) The neuropsychology of normal pressure hydrocephalus (NPH). Br J Neurosurg 19(3):217–224
Gainotti G, Marra C, Villa G, Parlato V, Chiarotti F (1998) Sensitivity and specificity of some neuropsychological markers of Alzheimer dementia. Alzheimer Dis Assoc Disord 12(3):152–162
Golz L, Ruppert FH, Meir U, Lemcke J (2014) Outcome of modern shunt therapy in patients with idiopathic normal pressure hydrocephalus 6 years postoperatively. J Neurosurg 121(4):771–775
Hellstrom P, Edsbagge M, Archer T, Tisel M, Tullberg M, Wikkelso C (2007) The neuropsychology of patients with clinically diagnosed idiopathic normal pressure hydrocephalus. Neurosurgery 61:1219–1228
Hellstrom P, Klinge P, Tans J, Wikkelso C (2012) A new scale for assessment of severity and outcome in iNPH. Acta Neurol Scand 126:229–237
Hellstrom P, Klinge P, Tans J, Wikkelso C (2012) The neuropsychology of iNPH: findings and evaluation of tests in the European multicentre study. Clin Neurol Neurosurg 114:130–134
Iddon JL, Pickard JD, Cross JJ, Griffiths PD, Czosnyka M, Sahakian BJ (1999) Specific patterns of cognitive impairment in patients with idiopathic normal pressure hydrocephalus and Alzheimer’s disease: a pilot study. J Neurol Neurosurg Psychiatry 67:723–732
Iseki C, Kawanami T, Nagasawa H, Wada M, Koyama S, Kikuchi K, Arawaka S, Kurita K, Daimon M, Mori E, Kato T (2009) Asymptomatic ventriculomegaly with features of idiopathic normal pressure hydrocephalus on MRI (AVIM) in the elderly: a prospective study in a Japanese population. J Neurol Sci 277(1–2):54–57
Ishikawa M, Hashimoto M, Kuwana N, Mori E, Miyake H, Wachi A, Takeuchi T, Kazui H, Koyama H (2008) Guidelines for management of idiopathic normal pressure hydrocephalus: guidelines from the Guidelines Committee of Idiopathic Normal Pressure Hydrocephalus, the Japanese Society of Normal Pressure Hydrocephalus. Neurol Med Chir (Tokyo) 48(Suppl):S1–S23
Johanson CE (2011) Chapter 33. Production and flow of cerebrospinal fluid. In: Winn HR. Youmans: neurological surgery. Elsevier, Philadelphia
Kanno S, Saito M, Hayashi A, Uchiyama M, Hiraoka K, Nishio Y, Hisanaga K, Mori E (2012) Counting-backward test for executive function in idiopathic normal pressure hydrocephalus. Acta Neurol Scand 126:279–286
Kaplan E (1988) A process approach to neuropsychological assessment. In: Boll T, Bryant BK (eds) Clinical neuropsychology and brain function: research, measurement, and practice. American Psychological association, Washington, DC, pp 129–167
Kiefer M, Unterberg A (2012) The differential diagnosis and treatment of normal-pressure hydrocephalus. Dtsch Aztebt Int 109:15–26
Klinge P, Marmarou A, Bergsneider M, Relkin N, Black MP (2005) Outcome of shunting in idiopathic normal-pressure hydrocephalus and the value of outcome assessment in shunted patients. Neurosurgery 57:S40–S52
Lamar M, Libon DJ, Ashley AV, Lah JJ, Levey AI, Goldstein FC (2010) The impact of vascular comorbidities on qualitative error analysis of executive impairment in Alzheimer’s disease. J Int Neuropsychol Soc 16(1):77–83
Marmarou A, Bergsneider M, Klinge P, Relkin N, Black MP (1998) The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery 57:S2-17–S2-28
Mori E, Ishikawa M, Kato T, Kazui H, Miyake H, Miyajima M, Nakajima M, Hashimoto M, Kurijama N, Tokuda T, Ishii K, Kaijima M, Hirata Y, Saito M, Arai H (2012) Guidelines for management of idiopathic normal pressure hydrocephalus: second edition. Neurol Med Chir (Tokyo) 52:775–809
Relkin N, Marmarou A, Klinge P, Bergsneider M, Black MP (2005) Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 57:S2-4–S2-16
Saito M, Nishio Y, Kanno S, Uchiyama M, Haiashi A, Takagi M, Kikuchi H, Yamasaki H, Shimonura T, Iizuka O, Mori E (2011) Cognitive profile of idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Dis Extra 1:202–211
Solana E, Sauquillo J, Junquè C, Quintana M, Poca MA (2012) Cognitive disturbances and neuropsychological changes after surgical treatment in cohort of 185 patients with idiopathic normal pressure hydrocephalus. Arch Clin Neuropsychol 27:304–317
SPSS Inc. Released (2007) SPSS for Windows, Version 16.0. SPSS Inc, Chicago
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Sindorio, C. et al. (2017). Neuropsychological Assessment in the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus. An Important Tool for the Maintenance and Restoration of Neuronal and Neuropsychological Functions. In: Visocchi, M., Mehdorn, H.M., Katayama, Y., von Wild, K.R.H. (eds) Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement, vol 124. Springer, Cham. https://doi.org/10.1007/978-3-319-39546-3_41
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DOI: https://doi.org/10.1007/978-3-319-39546-3_41
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