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Clinical significance of vitamin D in idiopathic normal pressure hydrocephalus

  • Original Article - CSF Circulation
  • Published:
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Abstract

Background

Although recent studies show vitamin D deficiency is associated with cognitive decline, urinary incontinence, and gait instability, there has been no study on the effect of vitamin D on idiopathic normal pressure hydrocephalus (iNPH) characterized by the classic symptom triad of cognitive decline, urinary incontinence, and gait instability. We investigated the clinical significance of vitamin D in patients with iNPH.

Methods

Between 2017 and 2020, 44 patients who underwent ventriculoperitoneal shunt surgery were divided into low (< 15 ng/mL) and high (≥ 15 ng/mL) vitamin D groups according to the concentration of 25(OH)D, an effective indicator of vitamin D status. They were respectively evaluated according to clinical and radiological findings.

Results

The low vitamin D group (n = 24) showed lower preoperative cognition compared to the high vitamin D group (n = 20) in terms of Korean-Mini Mental Status Examination (K-MMSE) and iNPH grading scale (iNPHGS) (K-MMSE: 20.5 ± 5.4 versus 24.0 ± 4.5, p = 0.041; iNPHGS cognitive score: 2 ± 0.9 versus 1 ± 0.6, p = 0.025). And the low vitamin D group showed pre- and postoperatively more severe urinary incontinence (preoperative iNPHGS urinary score: 1 ± 1.0 versus 0 ± 0.9, p = 0.012; postoperative iNPHGS urinary score:1 ± 1.0 versus 0 ± 0.9, p = 0.014). The score of narrow high-convexity sulci for the low vitamin D group was lower (low vitamin D group: 1 ± 0.7 versus high vitamin D group: 2 ± 0.4, p = 0.031).

Conclusion

Lower concentration of vitamin D in iNPH may be related to lower preoperative cognition, pre- and postoperative urinary incontinence, and brain morphological change.

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Acknowledgements

We also appreciate Wade Martin of Emareye for his critical English revision. This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korean Government (NRF-2018R1C1B5046065).

Funding

This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korea Government (NRF-2018R1C1B5046065 and 2018R1C1B5085134).

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Author notes

  1. Drs. Chaejin Lee and Hyunwoo Seo contributed equally to this work

Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Chaejin Lee, Sang-Youl Yoon, Sung Hyun Chang, Seong-Hyun Park, Jeong-Hyun Hwang & Ki-Su Park

  2. School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Hyunwoo Seo

  3. Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Kyunghun Kang & Chi-Hun Kim

  4. Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Myong Hun Hahm

  5. Department of Physical and Rehabilitation Medicine, Kyungpook National University Medical Center, Daegu, Republic of Korea

    Eunhee Park

  6. Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Jae Yun Ahn

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  1. Chaejin Lee
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Lee, C., Seo, H., Yoon, SY. et al. Clinical significance of vitamin D in idiopathic normal pressure hydrocephalus. Acta Neurochir 163, 1969–1977 (2021). https://doi.org/10.1007/s00701-021-04849-5

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