Brain and nerve = Shinkei kenkyū no shinpo
-
Review Case Reports
[Cognitive impairment in patients with idiopathic normal pressure hydrocephalus].
The major cognitive impairment in patients with idiopathic normal pressure hydrocephalus (iNPH) is frontal lobe symptoms, such as psychomotor slowing and impairment of attention, working memory, verbal fluency and executive function. Compared with Alzheimer's disease (AD), frontal lobe symptoms are disproportionately severe and the impairment of memory and orientation is disproportionately mild in patients with iNPH. Concerning memory impairment, recognition memory is relatively preserved compared with recall in iNPH. ⋯ However, in iNPH patients with impairment of memory and either of visuoconstructive or executive function, improvement of overall cognitive deficits after shunt surgery is less, suggesting that a higher degree of neural impairment may identify less reversible injury or that superimposed AD might limit the potential to show improvement. Neuroanatomical bases of cognitive impairment of iNPH are not well documented. However, damage of periventricular structures, such as corpus callosum, frontal subcortical and cortical areas, thalamus, basal ganglia and hippocampus, could be associated with cognitive impairment of iNPH.