Early Cognitive, Functional, and Behavioral Changes after Ventriculoperitoneal Shunt Surgery in Idiopathic Normal...

Area of Science:

• Neurosurgery
• Neurology
• Neuropsychology

Background:

• Idiopathic normal pressure hydrocephalus (iNPH) presents with gait, cognitive, and urinary issues.
• Ventriculoperitoneal shunt (VPS) surgery is a treatment, but early cognitive/behavioral changes are not well understood.
• Limited data exists on early neuropsychological recovery after VPS in iNPH patients.

Purpose of the Study:

• To investigate early changes in functional autonomy, cognition, and apathy one month after VPS surgery in iNPH patients.
• To assess domain-specific cognitive and behavioral responses to VPS surgery.
• To provide evidence on early neuropsychological recovery patterns following VPS placement.

Main Methods:

• Prospective evaluation of 73 iNPH patients before (T0) and one month after (T1) VPS surgery.
• Utilized a neuropsychological battery including ADL, IADL, MMSE, FAB, CDT, Digit Symbol Test, and Apathy Evaluation Scale (AES).
• Paired-samples t-tests and Wilcoxon signed-rank tests were used for pre-post difference analysis.

Main Results:

• Significant improvements observed in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Digit Symbol Test, and Apathy Evaluation Scale (AES) at one month.
• No statistically significant change was found in executive functions as measured by the Frontal Assessment Battery (FAB).
• Results indicate domain-specific improvements in functional, cognitive, and behavioral domains post-VPS.

Conclusions:

• One-month follow-up post-VPS surgery shows early changes in functional, cognitive, and behavioral domains for iNPH patients.
• The pattern suggests domain-specific responses, with improvements in functional autonomy, processing speed, visuoconstruction, and apathy.
• Executive functions demonstrated relative stability in the early postoperative period.