Assessment in the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus. An Important Tool for the Maintenance and Restoration of Neuronal and Neuropsychological Functions

 

iNPH

AD

HC

Cutoff

Neuropsychological assessment

Mini Mental State Examination

18.8 (±6.7) ** ###

16.5(±4) ****

27(±2)

0–30

Mental assessment battery

RAVLT immediate

25.8 (±5) **

22.4(±5) ****

39 (±9.3)

>28.53

RAVLT delayed

4.87(±2.4) *** #

3(±2) ****

10(±2)

>4.69

RAVLT recognition

9(±2)

6(±3)

13.4(±1.5)

0–15

Episodic memory

8(±3) #

4.6(±2.2) **

11(±4.4)

0–28

Immediate visual memory

15.7(±2.7) ##

12.6(±4.6) ***

19(±3)

0–22

Raven’s Colored Progressive Matrices

18(±5.4) *

16(±6.4) ***

27(±5.3)

>18.96

Semantic verbal fluency

11. 3(±3) *

9.3(±3.5) ***

18(±5)

>7.25

Phonological verbal fluency

18.3(±12) **

17.2(±10) **

35.3(±9.4)

>17.35

Phrase construction

13.7(±8) ** ##

5(±5) ****

23(±3)

0–25

Copy drawing

5.5(±3) * #

4(±2.7) ***

9.3(±1.2)

>7.17

Copy drawing with landmarks

54.5(±7.2) **

35.3(±26) ***

66.5(±4)

>61.85

Frontal Assessment Battery

9(±4) #

9(±5.6) *

14(±3.4)

>12.03


Data are presented as means ± SD

iNPH idiopathic normal pressure hydrocephalus, AD Alzheimer’s Disease, HC healthy control, RAVLT Rey Auditory Verbal Learning Test

* = p < 0.05, ** = p < 0.01, *** = p < 0.005, **** = p < 0.0001 when comparing iNPH and AD vs HC, # = p < 0.05, ## = p < 0.01, ### = p < 0.005 when comparing iNPH vs AD




Table 2
Frequencies of different mistakes in iNPH and AD patients


























































 
iNPH

AD

Fisher test

Primacy effect

10

2

p = 0.03

Recency effect

10

10


Tendency to produce intrusions during free recall of words

10

24


Tendency to produce false alarms during delayed recognition of words

21

95

p = 0.001

Globalistic responses

0

22

p = 0.0003

Odd responses

4

42

p = 0.01

Positional preference responses

134

53


Inaccuracy on the Deux Barrage test

1

8

p = 0.0001

Occurrence of closing-in phenomenon

1

53

p = 0.001



Table 3
Neuropsychological performance in 12 iNPH patients on admission, and after surgical treatment in 7 patients





















































iNPH

Pre ELD

Post ELD

Post VPS

Post 1 month

Post 3 months

Cutoff

Neuropsychological assessment

Mini Mental State Examination

18.8(±6.7)

23.5 (±3.3)

24(±3)

24(±3)

25.4(±4)

0–30

Mental assessment battery

RAVLT immediate

25.8 (±5)

30.3 (±5)

39(±13) *

42.3(±16.5) #

40(±19)

>28.53

RAVLT delayed

4.8(±2.4)

5.5(±2.4)

8(±4.5)

8(±3.5) ##

6(±4.2)

>4.69

RAVLT recognition

9(±2)

12.3(±3)

13.6(±1.5)

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Jun 24, 2017 | Posted by in NEUROSURGERY | Comments Off on Assessment in the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus. An Important Tool for the Maintenance and Restoration of Neuronal and Neuropsychological Functions

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