Picascia Marta, Zangaglia Roberta, Bernini Sara, Minafra Brigida, Sinforiani Elena, Pacchetti Claudio
Funct Neurol. 2015 Oct-Dec;30(4):217-28. doi: 10.11138/fneur/2015.30.4.217.
Idiopathic normal pressure hydrocephalus (iNPH) is a complex and still underestimated pathology. In the early stages, the cognitive profile is characterized mainly by impairments of attention, psychomotor speed and memory, suggesting frontal involvement; patients with more advanced iNPH show overall cognitive deterioration. The memory impairment, however, seems to be milder than that seen in Alzheimer's disease (AD). Clinical and neuroimaging data are crucial for the diagnosis of iNPH, but the presence of different variables, such as comorbidities, and the possible overlapping with other neurodegenerative diseases, AD in particular, make the differential diagnosis difficult. To date studies seeking to identify possible biological markers have provided inconclusive results; moreover reliable indices predictive of a good response to surgery are still lacking. There is a need for further studies with longer follow-ups and for closer interaction among the different professionals involved.
特发性正常压力脑积水（iNPH）是一种复杂且仍未得到充分认识的病症。在早期阶段，认知特征主要表现为注意力、精神运动速度和记忆力受损，提示额叶受累；病情更严重的iNPH患者会出现整体认知功能衰退。然而，与阿尔茨海默病（AD）相比，iNPH的记忆障碍似乎较轻。临床和神经影像学数据对iNPH的诊断至关重要，但诸如合并症等不同变量的存在，以及与其他神经退行性疾病（尤其是AD）可能存在的重叠，使得鉴别诊断变得困难。迄今为止，旨在识别可能生物标志物的研究结果尚无定论；此外，仍缺乏预测手术良好疗效的可靠指标。需要进行更长时间随访的进一步研究，并加强不同专业人员之间的密切协作。
