Effect of Shunt Operation on Idiopathic Normal Pressure Hydrocephalus Patients in Reducing Caregiver Burden: Evidence from SINPHONI

Kazui, Hiroaki; Mori, Etsuro; Hashimoto, Masaaki; Ishikawa, Masatsune; Hirono, Nobutsugu; Takeda, Masatoshi

doi:10.1159/000328625

Cited by 36 publications

(27 citation statements)

References 67 publications

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“…A correlation between cognitive symptoms and caregiver burden was found in the study by Kazui et al, 16 and we found the same result with our study, as processing skills correlated to level of burden.…”

Section: Caregiver Burdensupporting

confidence: 93%

“…Our results differ from those of Kazui et al, who found a decreased total burden after treatment according to the Zarit Burden Interview (ZBI). 16 The difference could be due to differences in sensitivity between the 2 scales, but there is no validated Swedish version of ZBI.…”

Section: Caregiver Burdenmentioning

confidence: 99%

“…29 In one of few reports, Kazui et al found that caregiver burden decreased after iNPH surgery, with improvement in patients' cognitive functions having the highest impact on the reduction of caregiver burden. 16 The aim of this study was to investigate the social impact of shunt surgery in iNPH patients, specifically changes in activities of daily living (ADL), participation, Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus autonomy, caregiver burden, and patient's health-related quality of life (HRQOL).…”

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confidence: 99%

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Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus

Petersen

Hellström²,

Wikkelsø³

et al. 2014

JNS

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Object To investigate the impact of shunt surgery on the activity, participation, autonomy, and health-related quality of life (HRQOL) of patients with idiopathic normal-pressure hydrocephalus (iNPH) as well as the effect on caregiver burden. Methods Thirty-seven patients (median age 70 years, range 50–89 years) with iNPH were evaluated before and 6 months after surgery. Symptoms and signs were assessed by the iNPH scale, activities of daily living (ADL) with the Functional Independence Measure (FIM) and Assessment of Motor and Process Skills (AMPS), autonomy and participation with Impact on Participation and Autonomy (IPA), and caregiver burden with the Caregiver Burden Scale (CBS). HRQOL was evaluated with the EQ-5D (EuroQol Group–5 Dimension health survey). Results Twenty-four patients (65%) improved clinically (iNPH scale score) and 31 (86%) improved their HRQOL after surgery, almost to the same level as found in the normal population. The patients became more independent in physical and cognitive activities, and participation and autonomy improved. The caregiver burden was decreased among caregivers to male patients but remained unchanged on the overall group level. Conclusions After shunt surgery, patients with iNPH showed improvement in most aspects of social life, they became more independent, and their quality of life returned to nearly normal.

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Section: Caregiver Burdensupporting

confidence: 93%

Section: Caregiver Burdenmentioning

confidence: 99%

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confidence: 99%

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Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus

Petersen

Hellström²,

Wikkelsø³

et al. 2014

JNS

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“…There is doubt if depressive symptoms are consequence to a primary disturbance in frontal neurotransmitter machinery 12 or if symptoms are a result of self conscience of limited motor, continence and cognitive abilities, representing a burden to himself and to the family, thus leading to chronic sad humor 18 . Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment 5,6,7 .…”

Section: Discussionmentioning

confidence: 99%

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Oliveira

Rotta

et al. 2014

Arq. Neuro-Psiquiatr.

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Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment.Keywords: normal pressure hydrocephalus, psychiatry, symptoms. RESUMO A hidrocefalia de pressão normal (HPN) é caracterizada por distúrbios da marcha, demência e/ou incontinência urinária associada com dilatação do sistema ventricular e pressão de abertura do líquido cefalorraquidiano normal. Evidências científicas confirmam associação entre HPN e sintomas psiquiátricos. Foram selecionados 35 pacientes com hidrocefalia de pressão normal idiopática, de janeiro de 2010 a janeiro de 2012 em um hospital terciário brasileiro e realizada uma avaliação psiquiátrica formal para identificar transtornos psiquiátricos. Transtornos psiquiátricos foram detectados em 71% dos pacientes, principalmente depressão, ansiedade e síndromes psicóticas. Pacientes com HPN podem desenvolver sintomas com predomínio frontal, tais como mudanças de personalidade, ansiedade, depressão, síndromes psicóticas, transtorno obsessivo compulsivo, síndrome de Otelo, furtos e mania. Sintomas incomuns de HPN podem dificultar o diagnóstico precoce e o tratamento adequado.Palavras-chave: hidrocefalia de pressão normal, sintomas, psiquiatria.Normal pressure hydrocephalus (NPH) is a syndrome characterized by gait disturbance, dementia and urinary incontinence plus dilation of ventricular system due to disturbance of cerebrospinal fluid (CSF) circulation with normal CSF pressure 1,2,3,4,5,6 . Dilated ventricles theoretically impair perfusion in ventricular walls, generating hypoperfusional states especially in frontal lobes, basal ganglia and thalamus, thus resulting classic symptomatology 7 . NPH can present in two forms: primary (also known as idiopathic), when there are no causative disorders and secondary, where other disorders such as trauma, infection and hemorrhage are putative causes for hydrocephalus 1,2,3,4,5,6 . Idiopathic NPH (INPH) is associated with communicating hydrocephalus (as demonstrated by brain CT or MRI) and CSF pressure within normal range (7-24 cm H2O) 1,2,3,4,5,6 . With improvements in quality of life and subsequent increase in life expectancy, it is expected that a greater number of elderly individuals will suffe...

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“…The clinical manifestations are gait disturbance, dementia, and urinary incontinence without preceding disorders. 1) Patients with these symptoms often need care to cope with the activities of daily living, 8,21) so adequate diagnosis and treatment (e.g., ventriculoperitoneal shunt or lumbo-peritoneal shunt) 28) are essential to reduce medical and social-welfare costs in countries with aging populations. The diagnosis is based on clinical observations supported by computed tomography (CT) and magnetic resonance (MR) imaging, and other neuroradiographical examinations.…”

Section: Introductionmentioning

confidence: 99%

Diffusion Tensor Imaging of Idiopathic Normal Pressure Hydrocephalus: A Voxel-Based Fractional Anisotropy Study

Koyama

Marumoto

Domen

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Diffusion tensor imaging (DTI) using a 3.0 tesla magnetic resonance scanner was used to investigate white matter changes caused by idiopathic normal pressure hydrocephalus (INPH) in 10 patients diagnosed by clinical symptoms (gait disturbance, dementia, and/or urinary incontinence) and Evans index À0.3, and compared with findings for 10 age-matched controls (AE60 years). Then, using a computer-automated method, fractional anisotropy (FA) brain maps were generated and finally transformed into the standard space. Voxel-based FA values within two regions of interests (ROIs), the forceps minor and corticospinal tracts, were then separately evaluated. Within each ROI, statistical comparisons of results from the INPH and control groups were performed. In addition, for INPH patients, grading scores for clinical symptoms and FA values were correlated. The forceps minor mean FA value was much smaller for the INPH group (0.504) than for the control group (0.631). The corticospinal tract mean FA value was slightly smaller for the INPH group (0.588) than for the control group (0.632). Additional analyses indicated that lower FA values within the forceps minor tended to be associated with clinical symptoms such as urinary incontinence and gait disturbance. Our findings indicate FA values decreased in the forceps minor of INPH patients. We also found that lower values were associated with severer clinical symptoms, implying that DTI techniques may be developed for more accurate diagnosis.

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Effect of Shunt Operation on Idiopathic Normal Pressure Hydrocephalus Patients in Reducing Caregiver Burden: Evidence from SINPHONI

Cited by 36 publications

References 67 publications

Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus

Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Diffusion Tensor Imaging of Idiopathic Normal Pressure Hydrocephalus: A Voxel-Based Fractional Anisotropy Study

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