Related Experiment Video
Updated: Oct 17, 2026

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
Published on: October 17, 2017
Apathy in normal pressure hydrocephalus: frequency, clinical correlates, and relationship to cerebrospinal fluid
Shweta Chilka1,2, C Munro Cullum1,2,3,4, Laura Lacritz1,2,3
1Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Abstract:
Apathy is a highly prevalent neuropsychiatric feature of normal pressure hydrocephalus (NPH), but its clinical correlates and relevance to cerebrospinal fluid (CSF) removal trial response are poorly understood. We evaluated 161 adults with possible or probable NPH whose informants completed the Frontal Systems Behavior Scale (FrSBe), which provides normative ratings for premorbid (i.e. before symptom onset) and current apathy. Apathy change was defined as current minus premorbid ratings of apathy. Among the sample, 69.6% showed clinically elevated apathy (T-score ≥ 65) compared to 18.0% premorbidly; 91.9% showed increased apathy (Mean T-Score Change = 25.5, p < .001, d = 1.29). Partial Spearman correlations (controlling for cognitive symptom duration and depression) examined associations between apathy and gait, neuropsychological, functional, and disability measures. Gait responders were defined by clinical change in ≥2 gait measures post CSF-removal. The strongest correlates with apathy and apathy change were the World Health Organization Disability Assessment Schedule (ρ = .707 and .614) and the Quick Dementia Rating System (ρ = .682 and .587). Gait and cognitive composites (attention/speed/executive, overall) showed weaker (|ρ| = .208-.418) associations. Neither apathy nor apathy change differed between gait responders (n = 87) and non-responders (n = 48). Apathy is common in NPH and is related to disability and functional severity. It should therefore be routinely assessed in NPH evaluations.
Related Concept Videos
Increased Intracranial Pressure l: Introduction
Increased Intracranial Pressure ll: Pathophysiology
Cerebral Edema ll: Pathophysiology
Cerebral Edema l: Introduction
Cytotoxic Edema: Pathophysiology