Τίτλος:
Finger tapping and verbal fluency post-tap test improvement in INPH: its value in differential diagnosis and shunt-treatment outcomes prognosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Idiopathic normal pressure hydrocephalus (INPH) diagnosis is challenging as it can be mimicked by other neurological conditions, such as neurodegenerative dementia and motor syndromes. Additionally, outcomes after lumbar puncture (LP) tap test and shunt treatment may vary due to the lack of a common protocol in INPH assessment. The present study aimed to assess whether a post-LP test amelioration of frontal cognitive dysfunctions, characterizing this syndrome, can differentiate INPH from similar neurological conditions and whether this improvement can predict INPH post–shunt outcomes. Method: Seventy-one consecutive patients referred for INPH suspicion and LP testing, were enrolled. According to the consensus guidelines criteria, 29 patients were diagnosed as INPH and 42 were assigned an alternative diagnosis (INPH-like group) after reviewing clinical, neuropsychological and imaging data, and before LP results. A comprehensive neuropsychological assessment for frontal executive, upper extremity fine motor functions, aphasias, apraxias, agnosias and gait evaluation were administered at baseline. Executive, fine motor functions and gait were re-examined post-LP test in all patients and post-shunt placement in INPH patients. Results: Of the INPH patients, 86.2% showed cognitive amelioration in the post-LP test; in addition, all but one (97%) presented with neurocognitive and gait improvement post-shunt. Verbal phonological fluency and finger tapping task post-LP improvement predicted positive clinical outcome post-shunt. None of the INPH-like group presented with neurocognitive improvement post-LP. Conclusions: Post-LP amelioration of verbal fluency and finger tapping deficits can differentiate INPH from similar disorders and predict positive post-shunt clinical outcome in INPH. This becomes of great importance when gait assessment is difficult to perform in clinical practice. © 2017, Springer-Verlag GmbH Austria.
Συγγραφείς:
Liouta, E.
Gatzonis, S.
Kalamatianos, T.
Kalyvas, A.
Koutsarnakis, C.
Liakos, F.
Anagnostopoulos, C.
Komaitis, S.
Giakoumettis, D.
Stranjalis, G.
Περιοδικό:
Acta Neurochirurgica
Εκδότης:
Springer-Verlag Wien
Λέξεις-κλειδιά:
aged; aphasia; aphasia test; apraxia; Article; brain ventricle peritoneum shunt; cerebrospinal fluid pressure; differential diagnosis; executive function test; female; finger tapping test; human; hygroma; lumbar puncture; major clinical study; male; Mini Mental State Examination; motor performance; neuroimaging; normotensive hydrocephalus; postoperative complication; practice guideline; priority journal; prognosis; prospective study; Stroop test; trail making test; treatment outcome; upper limb; verbal fluency post tap test; walk test; Wechsler adult intelligence scale; apraxia; dementia; differential diagnosis; executive function; gait; middle aged; neuropsychological test; normotensive hydrocephalus; physiology; predictive value; prognosis; psychology; psychomotor performance; speech; treatment outcome; very elderly, Aged; Aged, 80 and over; Apraxias; Dementia; Diagnosis, Differential; Executive Function; Female; Gait; Humans; Hydrocephalus, Normal Pressure; Male; Middle Aged; Neuropsychological Tests; Predictive Value of Tests; Prognosis; Psychomotor Performance; Speech; Spinal Puncture; Treatment Outcome
DOI:
10.1007/s00701-017-3301-2
