Neuropsychiatric Features in Patients With Idiopathic Normal Pressure Hydrocephalus: A Systematic Review and...

Area of Science:

• Neurology
• Psychiatry
• Neuroscience

Background:

• Idiopathic normal pressure hydrocephalus (iNPH) is a treatable neurological disorder affecting gait, cognition, and bladder function.
• Neuropsychiatric symptoms are recognized in iNPH but remain poorly understood.
• This study addresses the knowledge gap regarding the prevalence, severity, and treatment response of neuropsychiatric symptoms in iNPH.

Purpose of the Study:

• To conduct the first systematic review and meta-analysis on neuropsychiatric symptoms in iNPH.
• To estimate the prevalence and severity of various neuropsychiatric symptoms and diagnoses.
• To assess the treatment responsiveness of these symptoms in iNPH patients.

Main Methods:

• A comprehensive search of multiple databases (PubMed, CINAHL, Embase, etc.) was performed up to October 23, 2024.
• Included peer-reviewed studies on adults with iNPH reporting neuropsychiatric features using validated tools or clinician diagnosis.
• Random-effects meta-analysis was employed to pool data, with meta-regression and subgroup analyses conducted.

Main Results:

• Apathy (69.2%) and depression (30.1%) were highly prevalent in iNPH patients.
• Other symptoms like agitation, anxiety, disinhibition, and psychotic syndromes were less common.
• Depression scores were significantly higher in iNPH patients compared to controls, with a potential, though not statistically significant, reduction post-treatment.

Conclusions:

• Apathy and depression are common in iNPH, potentially exceeding prevalence in other neurodegenerative conditions.
• Evidence suggests iNPH treatment may alleviate neuropsychiatric symptoms, especially depression.
• Limitations include study heterogeneity and lack of baseline data, underscoring the need for further research.