Department of Neurosurgery, Faculty of Medicine, Saarland University, HomburgSaar, Germany.
Acta Neurochir (Wien). 2022 Jul;164(7):1765-1775. doi: 10.1007/s00701-022-05149-2. Epub 2022 Feb 25.
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.
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.
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.
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.
传统上，正常压力脑积水的临床特征主要表现为 Hakim 三联征。本研究旨在更全面地评估特发性正常压力脑积水（iNPH）患者的运动技能、认知障碍和生活质量。
共纳入 30 名诊断为 iNPH 的患者和另外 30 名参照组患者。iNPH 患者和参照组在年龄、教育程度和发病率方面相匹配。采用标准化的心理运动技能、步态、神经心理学能力测试以及生活质量问卷对其进行测试。iNPH 组在术前、术后 6 周和 3 个月进行测试。参照组仅测试一次。
患者在术后 3 个月内的各项测试中表现出显著的改善。这包括神经心理学评估、运动技能（包括步态和上运动功能）以及患者的生活质量。与参照个体相比，iNPH 患者的神经心理学方面和生活质量在某些方面接近正常水平。
我们的研究结果表明，分流手术不仅可以改善 iNPH 患者的症状，而且在很大程度上可以改善他们的生活质量，使其接近年龄和合并症相匹配的参照个体。这些数据可以优化对 iNPH 患者进行分流手术后的预期结果的咨询，特别是关于认知表现、运动技能和生活质量。
