scholarly journals Neuropsychiatric Symptoms in Patients with Idiopathic Normal Pressure Hydrocephalus

2009 ◽  
Vol 21 (3-4) ◽  
pp. 165-174 ◽  
Author(s):  
Yumiko Kito ◽  
Hiroaki Kazui ◽  
Yoshihiko Kubo ◽  
Tetsuhiko Yoshida ◽  
Masahiko Takaya ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Motor Activity ◽  
Frontal Lobe ◽  
Normal Pressure Hydrocephalus ◽  
Neuropsychiatric Symptoms ◽  
Normal Pressure ◽  
Neuropsychiatric Symptom ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Neuropsychiatric Inventory ◽  
Prevalent Symptom

Objective:To clarify the characteristics of neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus (iNPH).Methods:Neuropsychiatric symptoms of 64 iNPH patients with mild triad symptoms from three kinds of hospitals were evaluated with the Neuropsychiatric Inventory (NPI) and compared with 126 patients with Alzheimer’s disease (AD).Results:The most frequently observed neuropsychiatric symptom in the iNPH patients was apathy followed by anxiety and aggression. No symptom was more prevalent or more severe in iNPH than in AD. The severity of cognitive impairment was correlated with both aberrant motor activity and apathy.Conclusions:Neuropsychiatric symptoms were mild in patients with iNPH and apathy was the most prevalent symptom. The correlation between neuropsychiatric symptoms and cognitive impairment in iNPH appears to arise from a common pathology in the frontal lobe.

scholarly journals Idiopathic normal pressure hydrocephalus: increased supplementary motor activity accounts for improvement after CSF drainage

Brain ◽  
2008 ◽  
Vol 131 (11) ◽  
pp. 2904-2912 ◽  
Author(s):  
N. Lenfeldt ◽  
A. Larsson ◽  
L. Nyberg ◽  
M. Andersson ◽  
R. Birgander ◽  
...  
Keyword(s):  
Motor Activity ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Csf Drainage

scholarly journals Idiopathic normal pressure hydrocephalus. Retrospective review of pathogenesis and modern theories

2020 ◽  
pp. 146-155
Author(s):  
Г.В. Гаврилов ◽  
А.В. Станишевский ◽  
Б.В. Гайдар ◽  
Д.В. Свистов
Keyword(s):  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Normal Pressure Hydrocephalus ◽  
Retrospective Review ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Ventricular Enlargement ◽  
Csf Pressure ◽  
Morphological Studies ◽  
Disease Mechanisms

Идиопатическая нормотензивная гидроцефалия - хроническое прогрессирующее дегенеративное заболевание головного мозга, характеризующееся изменением конфигурации боковых желудочков и других ликворсодержащих пространств головного мозга на фоне нормального давления ликвора, проявляющееся клинически триадой симптомов: нарушением походки, развитием деменции и нарушением мочеиспускания. Патофизиология и патоморфогенез этого заболевания до конца не ясны. С появлением термина и описания клинической картины нормотензивной гидроцефалии в 1964 г. S. Hakim выполнено множество экспериментальных, морфологических и клинических исследований, направленных на выяснение ключевых звеньев патогенеза заболевания. В представленной работе приведена ретроспектива взглядов на закономерности патогенеза идиопатической нормотензивной гидроцефалии, анализируются современные исследования, посвящённые данной проблеме, а также обобщены и сформулированы основные теории, касающиеся ключевых звеньев патологического процесса. Idiopathic normal pressure hydrocephalus is a chronic, progressive degenerative brain disease characterized by ventricular enlargement disproportionate to other cerebrospinal fluid (CSF) spaces with normal CSF pressure. This disease presents with gait disturbance, cognitive impairment, and incontinence. The pathophysiology and morphogenesis of this condition are not well studied. Since the first description by S. Hakim in 1964, a number of experimental and morphological studies have focused on investigation of the disease mechanisms. This review retrospectively analyzed and summarized principal ideas about the pathogenesis of idiopathic normal pressure hydrocephalus.

scholarly journals P.007 Familial idiopathic normal pressure hydrocephalus in a Canadian family

2018 ◽  
Vol 45 (s2) ◽  
pp. S17-S17
Author(s):  
BC Shettar ◽  
S Mirsattari
Keyword(s):  
Cognitive Impairment ◽  
Normal Pressure Hydrocephalus ◽  
Large Volume ◽  
Fluid Pressure ◽  
Cerebral Atrophy ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Opening Pressure ◽  
Vp Shunt ◽  
Surgery Patient

Background: Idiopathic Normal-pressure hydrocephalus (iNPH) is characterized by cognitive impairment, gait disturbance, enlarged ventricles with/without cerebral atrophy, with/without urinary incontinence, and normal cerebrospinal fluid pressure. Familial iNPH is very rarely described in the literature. A Canadian family with more than one generation of iNPH has never been described. Methods: Patient 1: 50-year-old female presented with wide-based and magnetic gait, multiple falls with subsequent freezing. LP with large volume tap was performed. Patient had ventriculo peritoneal (VP) shunt surgery. Patient 2: 52 year male (brother): Presented with long-standing cognitive impairment and fatigue. Montreal Cognitive Assessment (MOCA) was performed. Whole exome sequencing(WES) of both siblings as well as an unaffected first cousin was done. The father and grandmother of both patients was diagnosed with iNPH. Results: Patient 1: Opening pressure on LP was 22 cm-H2O. She responded well to large volume tap. She had VP shunt resulting in improved gait. Patient 2: Opening pressure on LP was 16cm-H2O. CSF flow study was slow for age indicative of NPH. MoCA score was 25/30. WES of patients and unaffected first cousin is underway. Conclusions: We present an undescribed Canadian family with iNPH in more than one generation. WES is underway for better understanding of genetic predesposition and inheritance of familial iNPH

scholarly journals Frontal Behavior Syndromes in Idiopathic Normal Pressure Hydrocephalus as a Function of Alzheimer’s Disease Biomarker Status

2020 ◽  
Vol 26 (9) ◽  
pp. 883-893
Author(s):  
Madison Niermeyer ◽  
Chad Gaudet ◽  
Paul Malloy ◽  
Irene Piryatinsky ◽  
Stephen Salloway ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Normal Pressure Hydrocephalus ◽  
Neuropsychiatric Symptoms ◽  
Executive Dysfunction ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Future Research ◽  
Positron Emission ◽  
Neuropsychiatric Manifestations

AbstractObjectives:Cognitive impairment and apathy are well-documented features of idiopathic normal pressure hydrocephalus (iNPH). However, research examining other neuropsychiatric manifestations of iNPH is scant, and it is unknown whether the neuropsychiatric presentation differs for iNPH patients with comorbid Alzheimer’s disease (AD) versus iNPH without AD. This study aims to advance our understanding of neuropsychiatric syndromes associated with iNPH.Methods:Fifty patients from Butler Hospital’s Normal Pressure Hydrocephalus Clinic met inclusion criteria. Caregiver ratings on the Frontal Systems Behavior Scale (FrSBe) were examined to appraise changes in apathy, executive dysfunction, and disinhibition. Patients also completed cognitive tests of global cognition, psychomotor speed, and executive functioning. AD biomarker status was determined by either amyloid-beta (Aβ) positron emission tomography (PET) imaging or cerebrospinal fluid (CSF) total tau to Aβ-42 ratio.Results:Results revealed clinically significant elevations on the FrSBe’s apathy and executive dysfunction scales and modest correlations among these scales and cognitive measures. Of the 44 patients with available neuroimaging or CSF draw data, 14 presented with comorbid AD. Relative to the iNPH-only group, the iNPH + AD group showed a larger increase from pre-illness to current informant ratings on the executive dysfunction scale, but not the apathy or disinhibition scales.Conclusions:These results replicate and extend prior research by identifying apathy and executive dysfunction as prominent neuropsychiatric symptoms of iNPH and suggest comorbid AD exacerbates dysexecutive behaviors. Future research is warranted to examine the effects of comorbid AD pathology in response to shunt surgery for iNPH, neuropsychiatric symptom changes, and resultant caregiver burden.

scholarly journals White Matter Characteristics of Cognitive Impairment in Tap-Test Positive Idiopathic Normal Pressure Hydrocephalus: A Diffusion Tensor Tract-Based Spatial Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Yufeng Tang ◽  
Xiaoqin Yuan ◽  
Jinfeng Duan ◽  
Xianwen Zhang ◽  
Jiao Chen ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Corpus Callosum ◽  
Normal Pressure Hydrocephalus ◽  
Diffusion Tensor ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Cingulate Gyrus ◽  
Tap Test ◽  
Cognitive Improvement

The present study was designed to systemically evaluate changes in the diffusion tensor imaging (DTI)-derived parameters of iNPH (idiopathic normal pressure hydrocephalus) patients with different responses to the tap test (TT), and to correlate cognitive impairment with white matter (WM) degeneration. This study included 22 iNPH patients and 14 healthy controls with structural magnetic resonance imaging (MRI) and DTI scanning. DTI was used to explore the differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) for all participants. DTI parameters were evaluated using an ROI (region of interest)-based and tract-based spatial statistics (TBSS) approach. Neuropsychological assessments and the idiopathic normal pressure hydrocephalus grading scoring scale (iNPHGS) were performed. Compared to the TT non-responders, the TT responders group had significantly lower FA values in the corpus callosum, cingulum cingulate gyrus, superior longitudinal fasciculus, and lower AD values in the right cingulum cingulate gyrus and the left posterior thalamic radiation. Besides, the MD values were significantly increased in the corpus callosum, left anterior corona radiata, and the RD values in the corpus callosum and cingulum cingulate gyrus. In addition, the cognitive improvement was negatively correlated with FA of the corpus callosum, cingulum cingulate gyrus, and MD values of the genu of corpus callosum. While, the cognitive improvement was positively related to the AD of the cingulum cingulate gyrus, superior longitudinal, and RD values of the corpus callosum, cingulum cingulate gyrus and uncinate fasciculus. The ROI specific WM lesions in iNPH patients are the underlying basis for cognitive impairment.

scholarly journals Incidence, diagnostic criteria and outcome following ventriculoperitoneal shunting of idiopathic normal pressure hydrocephalus in a memory clinic population: a prospective observational cross-sectional and cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e028103 ◽  
Author(s):  
George Razay ◽  
Melissa Wimmer ◽  
Iain Robertson
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Diagnostic Criteria ◽  
Diagnostic Test ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Gait Disorders ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Index Test ◽  
Shunt Surgery

ObjectiveTo evaluate diagnostic criteria for idiopathic normal pressure hydrocephalus (INPH) among patients with memory impairment, and to estimate the incidence of INPH.DesignProspective observational cross-section and cohort study of diagnostic accuracy.SettingMemory Disorders Clinic following referral by the medical practitioners.Participants408 consecutive patients enrolled 2010–2014.Outcome measuresReference diagnostic test was the clinical judgement of an experienced specialist based on the presence of cognitive impairment and/or balance and gait disorders in the presence of dilated ventricles. Mini-Mental State Examination (MMSE), Tinetti balance and gait tests were performed before and 12 months after ventriculoperitoneal shunt surgery. The association between reference diagnosis, clinical and brain CT scan measurements was estimated by multivariate Poisson regression. Triage index diagnostic test scores were calculated from the regression coefficients, with diagnostic thresholds selected using receiver operating characteristic analysis.ResultsThe presence of balance and/or gait disorders, especially fear of falling, difficulty standing on toes/heals, urinary disturbances, ventriculomegaly with Evans ratio greater than Combined Diagnostic Threshold (0.377-{Maximum width of posterior horns*0.0054}), strongly predict the diagnosis of INPH; while hallucinations and/or delusions and forgetfulness reduce the likelihood of the diagnosis. This triage index test had high sensitivity (95.2%) and specificity (91.7%). 62 of 408 (15%) participants with cognitive impairment had INPH, an incidence of 11.9/100 000/year and 120/100 000/year over 75 years. 96% of participants following shunting, compared with 45% of the non-shunted, improved by over 25% of available measurable improvement in either MMSE or balance/gait scores (51% difference; 95% CI 28% to 74%; p<0.001), and 56% vs 5% improved by over 50% of maximum in both (51% difference; 95% CI 30% to 73%; p<0.001).ConclusionThe triage index test score is a simple tool that may be useful for physicians to identify INPH diagnoses and need for referral for shunt surgery, which may improve cognitive, balance and gait functioning.

Association between Cognitive Impairment and Gait Disturbance in Patients with Idiopathic Normal Pressure Hydrocephalus

2005 ◽  
Vol 20 (2-3) ◽  
pp. 71-76 ◽  
Author(s):  
Noriko Miyoshi ◽  
Hiroaki Kazui ◽  
Atsushi Ogino ◽  
Masatsune Ishikawa ◽  
Hiroji Miyake ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Gait Disturbance
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