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Very long-term follow-up of cognitive function in adults treated in infancy for hydrocephalus
Barbro Lindquist1, Eva-Karin Persson, Elisabeth Fernell
1Department of Habilitation, Halmstad County Hospital, Halmstad, Sweden.
Insights
Adults treated for infantile hydrocephalus in infancy maintained normal cognitive function long-term. Despite shunt issues, intelligence remained stable, though working memory and processing speed showed deficits.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Cognitive Psychology
Background:
- Infantile hydrocephalus requires shunt treatment, impacting long-term neurological outcomes.
- Previous studies indicate variable cognitive development in individuals with hydrocephalus.
- Long-term cognitive trajectories following early-life shunt intervention are not fully understood.
Purpose of the Study:
- To investigate the very long-term cognitive outcomes in adults treated for hydrocephalus in infancy.
- To assess the cognitive status of individuals with a history of infantile hydrocephalus and normal childhood cognitive function.
- To evaluate the impact of shunt treatment on adult cognition.
Main Methods:
- A population-based cohort of 25 adults, previously treated for infantile hydrocephalus and exhibiting normal cognition in childhood, underwent follow-up cognitive assessment.
- Participants were assessed at a mean age of 35 years using the Wechsler Adult Intelligence Scale (WAIS-III).
- Cognitive function was compared to childhood assessments (WISC) where available.
Main Results:
- The median full-scale IQ was 101, with verbal IQ at 104 and performance IQ at 99.
- Cognitive scores remained stable compared to childhood IQs.
- Specific deficits were observed in working memory and processing speed, irrespective of shunt complications.
Conclusions:
- Adults with a history of infantile hydrocephalus and normal childhood cognition demonstrate preserved cognitive functions into adulthood.
- Neurosurgical intervention for hydrocephalus is associated with positive long-term cognitive outcomes.
- Ongoing research is crucial due to evolving hydrocephalus treatments and etiologies.
Purpose:
The aim was to investigate the very long-term cognitive outcome in adults who had been shunt treated for hydrocephalus during their first year of life.
Methods:
In a population-based series of 72 children born in 1967-1978 and shunt treated for infantile hydrocephalus, 43 were found to have a normal cognitive function when assessed at 6-17 years of age. Twenty-five of them agreed to participate in a follow-up study of cognition at a mean age of 35 years (range, 30-41 years). The Wechsler Adult Intelligence Scale (WAIS-III) was used.
Results:
The median full-scale IQ was 101 (range, 83-120), median verbal IQ was 104 (81-115) and performance IQ was 99 (80-127). The corresponding IQs in childhood in the 16 subjects who had been tested previously with the WISC were 101 (84-124), 108 (86-135), and 101 (73-124). Specific cognitive deficits were found for working memory and processing speed. Shunt complications did not affect IQ.
Conclusion:
This very long-term follow-up study of normally gifted children with hydrocephalus revealed that, as adults, they still had preserved cognitive functions despite recurrent shunt dysfunction. The results are encouraging and represent a tribute to neurosurgical intervention. Continued follow-up studies are needed since the etiological panorama and treatment procedures of children with hydrocephalus are changing over time.
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