Neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus

Article type: Research Article

Authors: Kito, Yumiko | Kazui, Hiroaki | Kubo, Yoshihiko^; | Yoshida, Tetsuhiko^; | Takaya, Masahiko | Wada, Tamiki | Nomura, Keiko | Hashimoto, Mamoru^; | Ohkawa, Shingo^; | Miyake, Hiroji | Ishikawa, Masatsune^; | Takeda, Masatoshi

Affiliations: Psychiatry, Department of Integrated Medicine, Division of Internal Medicine, Osaka University Graduate School of Medicine, Suita-city, Osaka, Japan | Department of Psychiatry, Japan Labour Health and Welfare Organization Kansai Rousai Hospital, Amagasaki-city, Hyogo, Japan | Department of Psychiatry, National Hospital Organization Osaka National Hospital, Chuo-ku, Osaka-city, Osaka, Japan | Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center at Himeji, Himeji-city, Hyogo, Japan | Department of Psychiatry and Neuropathobiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto-city, Kumamoto, Japan | Ohue Hospital, Asagoshi-cho, Asagoshi-city, Hyogo, Japan | Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya-city, Hyogo, Japan | Department of Neurosurgery, Kitano Hospital, Kita-ku, Osaka-city, Osaka, Japan | Department of Neurosurgery, Rakuwakai Otowa Hospital, Yamashina-ku, Kyoto-city, Kyoto, Japan

Note: [] Corresponding author: Hiroaki Kazui, M.D., Ph.D. Psychiatry, Department of Integrated Medicine, Division of Internal Medicine, Osaka University Graduate School of Medicine, D3 2–2 Yamadaoka, Suita-city, Osaka, 565-0871, Japan. Tel.: +81 6 6879 3051; Fax: +81 6 6879 3059; E-mail: [email protected]

Abstract: Objective: To clarify the characteristics of neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods: Neuropsychiatric symptoms of 64 iNPH patients with mild triad symptoms from three kinds of hospitals were evaluated with the Neuropsychiatric Inventory (NPI) and compared with 126 patients with Alzheimer's disease (AD). Results: The most frequently observed neuropsychiatric symptom in the iNPH patients was apathy followed by anxiety and aggression. No symptom was more prevalent or more severe in iNPH than in AD. The severity of cognitive impairment was correlated with both aberrant motor activity and apathy. Conclusions: Neuropsychiatric symptoms were mild in patients with iNPH and apathy was the most prevalent symptom. The correlation between neuropsychiatric symptoms and cognitive impairment in iNPH appears to arise from a common pathology in the frontal lobe.

Keywords: idiopathic normal pressure hydrocephalus, neuropsychiatric symptoms, apathy, Neuropsychiatric Inventory (NPI), Alzheimer's disease

DOI: 10.3233/BEN-2009-0233

Journal: Behavioural Neurology, vol. 21, no. 3-4, pp. 165-174, 2009