Hellström Per, Edsbagge Mikael, Blomsterwall Elisabeth, Archer Trevor, Tisell Magnus, Tullberg Mats, Wikkelsø Carsten
Institute of Neuroscience and Physiology, Göteborg University, Gothenburg, Sweden.
Neurosurgery. 2008 Sep;63(3):527-35; discussion 535-6. doi: 10.1227/01.NEU.0000325258.16934.BB.
To prospectively evaluate the effects of shunting on the neuropsychological performance of patients with idiopathic normal pressure hydrocephalus (INPH), to compare their performance with that of healthy individuals, and to estimate the predictive utility of putatively important factors.
A consecutive series of 47 patients with INPH underwent neurological, radiological, and neuropsychological examinations before and 3 months after shunt surgery. The same neuropsychological tests, measuring simple and target reaction times, dexterity, memory and learning, working memory, and aspects of executive functioning, were also administered to 159 healthy individuals.
Performance on all neuropsychological tests, except Simple Reaction Time and Digit Span, significantly improved after surgery, with more severe functional deficits showing greatest improvement. Age, education, duration, vascular comorbidity, sex, and onset symptom all failed to predict the neuropsychological effects of treatment. Despite improvement 3 months after shunt surgery, INPH patients were still outperformed by healthy individuals.
Most of the wide range of neuropsychological functions that are affected by INPH are markedly improved by shunt treatment, but not completely restored.
前瞻性评估分流术对特发性正常压力脑积水（INPH）患者神经心理表现的影响，将其表现与健康个体进行比较，并评估可能重要因素的预测效用。
连续47例INPH患者在分流手术前及术后3个月接受了神经学、放射学和神经心理学检查。159名健康个体也接受了相同的神经心理学测试，这些测试测量简单和目标反应时间、灵活性、记忆与学习、工作记忆以及执行功能的各个方面。
除简单反应时间和数字广度外，所有神经心理学测试的表现术后均显著改善，功能缺损越严重改善越明显。年龄、教育程度、病程、血管合并症、性别和起病症状均未能预测治疗的神经心理效果。尽管分流手术后3个月有所改善，但INPH患者的表现仍逊于健康个体。
INPH所影响的广泛神经心理功能大多通过分流治疗得到显著改善，但未完全恢复。
