Effect of lumbo-peritoneal shunt surgery on neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus

• Published in: Journal of the neurological sciences 2016-02, Vol.361, p.206-212
• Main Authors: Kanemoto, Hideki, Kazui, Hiroaki, Suzuki, Yukiko, Sato, Syunsuke, Kishima, Haruhiko, Yoshimine, Toshiki, Yoshiyama, Kenji
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Apathy; Apathy - physiology; Caregiver burden; Caregivers - psychology; Cerebrospinal Fluid Shunts; Depression; Depression - etiology; Depression - psychology; Depression - surgery; Female; Humans; Hydrocephalus, Normal Pressure - complications; Hydrocephalus, Normal Pressure - psychology; Hydrocephalus, Normal Pressure - surgery; Idiopathic normal pressure hydrocephalus; Inhibition (Psychology); Lumbo-peritoneal shunt surgery; Male; Neurology; Neuropsychiatric symptoms; Neuropsychological Tests; Quality of Life - psychology; Treatment Outcome
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2016.01.001

Abstract Introduction Patients with idiopathic normal pressure hydrocephalus (iNPH) have neuropsychiatric symptoms that could affect patients' quality of life and caregiver burden. In this study, we assessed the effect of lumbo-peritoneal (L-P) shunt surgery on neuropsychiatric symptoms and the association between neuropsychiatric symptoms and caregiver burden after L-P shunt surgery. Methods We recruited 22 iNPH patients who had L-P shunt surgery and who were followed up for 3 months after surgery. Neuropsychiatric symptoms and caregiver burden were evaluated with the Neuropsychiatric Inventory (NPI) and Zarit Burden Interview (ZBI), respectively, before and 3 months after surgery. We evaluated the changes of NPI and ZBI and the association between the changes in these 2 scores and the triad symptoms. Results NPI total, apathy, and depression scores significantly decreased after surgery. The improvement in NPI total, apathy, disinhibition, and irritability scores after surgery were significantly and positively associated with improvement in ZBI score after surgery. Improvement in NPI apathy score was significantly associated with improvement in Frontal Assessment Battery score after surgery. Conclusion L-P shunt surgery was effective in reducing not only the triad symptoms but also the neuropsychiatric symptoms, and the improved neuropsychiatric symptoms might decrease caregiver burden for iNPH patients.