Neuropsychiatric Symptoms in Patients with Idiopathic Normal Pressure Hydrocephalus

Yumiko Kito,Masahiko Takaya,Tetsuhiko Yoshida,Hiroaki Kazui,Hiroji Miyake,Mamoru Hashimoto,Masatsune Ishikawa,Masatoshi Takeda,Keiko Nomura,Tamiki Wada,Shingo Ohkawa,Yoshihiko Kubo

doi:10.1155/2009/791491

Abstract

Objective:To clarify the characteristics of neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus (iNPH).Methods:Neuropsychiatric symptoms of 64 iNPH patients with mild triad symptoms from three kinds of hospitals were evaluated with the Neuropsychiatric Inventory (NPI) and compared with 126 patients with Alzheimer’s disease (AD).Results:The most frequently observed neuropsychiatric symptom in the iNPH patients was apathy followed by anxiety and aggression. No symptom was more prevalent or more severe in iNPH than in AD. The severity of cognitive impairment was correlated with both aberrant motor activity and apathy.Conclusions:Neuropsychiatric symptoms were mild in patients with iNPH and apathy was the most prevalent symptom. The correlation between neuropsychiatric symptoms and cognitive impairment in iNPH appears to arise from a common pathology in the frontal lobe.

Highlights

Normal pressure hydrocephalus (NPH) was first characterized in 1965 by Hakim and Adams as a progressive syndrome accompanied by the triad of gait disturbance, cognitive impairment, and urinary dys-Y
Among the triad symptoms, the prevalences of cognitive impairment and urinary incontinence in idiopathic NPH (iNPH) patients referred to a department of neurosurgery (98% and 83%, respectively) [23] were higher than those in patients referred to a multidisciplinary memory clinic (69%, and 54%) [5]
The percent of the iNPH patients who showed at least one of the 10 neuropsychiatric symptoms included in the Neuropsychiatric Inventory (NPI) subscale was 73.4%, and the mean NPI total score was 7.5, which were significantly lower than those in Alzheimer’s disease (AD) patients

Summary

Introduction

Y. Kito et al / Neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus function [1]. The characteristics of the triad symptoms have been recently clarified [7,42,47,51], the characteristics of neuropsychiatric symptoms in iNPH patients remain unclear. A Swedish group evaluated the neuropsychiatric symptoms of iNPH patients and found some disorders, such as asthenoemotional syndrome [27,30]. These studies used small numbers of subjects, were biased toward one type of subject (those that visited a neurology department) and used a newly developed inventory [31] that did not fully cover the spectrum of neuropsychiatric symptoms

Methods

Results

Conclusion