Valoración de la efectividad de la derivación lumboperitoneal en ancianos con hidrocefalia en las áreas cognitivas de atención, memoria y función ejecutiva prefrontal

Abstract

Objective to determine the effectiveness of ventricular shunting (lumboperitoneal) on «subcortical» cognitive function (attention, memory and prefrontal executive function) in elderly patients with a diagnosis of normal pressure hydrocephalus. Material and methods we performed a prospective, descriptive study of 10 patients diagnosed with normal pressure hydrocephalus, following strict selection criteria. The mean age was 74 years. The patients were evaluated using the protocol of a pilot screening study to evaluate the effectiveness of lumboperitoneal shunting on cognitive function. Evaluations were performed prior to the intervention, and 15 days and 3 months after shunting. Statistical tests were considered significant when p < 0.05 (95% confidence interval). Results most of the cognitive parameters showed a nonsignificant improvement 15 days and 3 months after shunting. A 7.67-meter (25 steps) walk test showed a statistically significant improvement 15 days after shunting, which was maintained at 3 months (p < 0.008). Conclusions cognitive evaluation, especially of subcortical cognitive involvement, prior to lumboperitoneal shunting is highly useful and effective in the classification, selection, and follow-up of patients with normal pressure hydrocephalus, thus contributing to the achievement of an optimal clinical response. The protocol applied is a tool that can be used in cognitive assessment.