Motor skills, cognitive impairment, and quality of life in normal pressure hydrocephalus: early effects of shunt placement

• Published in: Acta neurochirurgica 2022-07, Vol.164 (7), p.1765-1775
• Main Authors: Hülser, Matthias, Spielmann, Hannah, Oertel, Joachim, Sippl, Christoph
• Format: Article
• Language: English
• Subjects: Cognitive ability; Comorbidity; CSF Circulation; Gait; Hydrocephalus; Interventional Radiology; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Morbidity; Motor ability; Motor skill; Motor task performance; Neurology; Neuropsychology; Neuroradiology; Neurosurgery; Original - CSF Circulation; Original Article - CSF Circulation; Patients; Performance evaluation; Pressure; Quality of life; Surgery; Surgical Orthopedics
• ISSN: 0942-0940; 0001-6268; 0942-0940
• DOI: 10.1007/s00701-022-05149-2

Background Traditionally, clinical findings of normal pressure hydrocephalus are mainly characterized by the Hakim triad. The aim of this study is to evaluate the performance of patients suffering from idiopathic normal pressure hydrocephalus (iNPH) in a more holistic manner regarding motor skills, cognitive impairment, and quality of life. Methods In total, 30 individuals diagnosed with iNPH as well as a reference group with another 30 individuals were included. The iNPH patients and the reference group were age, educational, and morbidity matched. A standardized test battery for psychomotor skills, gait, neuropsychological abilities as well as questionnaires for quality of life was applied. The iNPH group was tested prior to surgery, at 6 weeks, and 3 months postoperatively. The reference group was tested once. Results Patients showed a significant improved performance in various items of the test battery during the first 3 months postoperatively. This included neuropsychological evaluation, motor skills including gait and upper motor function as well as the quality of life of the patients. Compared to reference individuals, neuropsychological aspects and quality of life of iNPH patients improved in some parts nearly to normal values. Conclusion Our findings underline that shunt surgery does not only improve the symptoms in iNPH patients but also ameliorates the quality of life to a great extent close to those of age and comorbidity matched reference individuals. This data enables an optimized counseling of iNPH patients regarding the expectable outcome after shunt surgery especially regarding cognitive performance, motor skills as well as life quality.