Background
Traditionally, clinical findings of normal pressure hydrocephalus are mainly characterized by the Hakim triad. The aim of this study is to evaluate the performance of patients suffering from idiopathic normal pressure hydrocephalus (iNPH) in a more holistic manner regarding motor skills, cognitive impairment, and quality of life.
Methods
In total, 30 individuals diagnosed with iNPH as well as a reference group with another 30 individuals were included. The iNPH patients and the reference group were age, educational, and morbidity matched. A standardized test battery for psychomotor skills, gait, neuropsychological abilities as well as questionnaires for quality of life was applied. The iNPH group was tested prior to surgery, at 6 weeks, and 3 months postoperatively. The reference group was tested once.
Results
Patients showed a significant improved performance in various items of the test battery during the first 3 months postoperatively. This included neuropsychological evaluation, motor skills including gait and upper motor function as well as the quality of life of the patients. Compared to reference individuals, neuropsychological aspects and quality of life of iNPH patients improved in some parts nearly to normal values.
Conclusion
Our findings underline that shunt surgery does not only improve the symptoms in iNPH patients but also ameliorates the quality of life to a great extent close to those of age and comorbidity matched reference individuals. This data enables an optimized counseling of iNPH patients regarding the expectable outcome after shunt surgery especially regarding cognitive performance, motor skills as well as life quality.
Functional optical imaging (OI) of intrinsic signals (like blood oxygenation coupled reflection changes) and of extrinsic properties of voltage sensitive probes (like voltage-sensitive dyes (VSD)) forms a group of neuroimaging techniques that possess up to date highest temporal and spatial resolution on a meso-to macroscopic scale. An inherent problem of OI is a very low signal to noise ratio (SNR), which restricts the recordings to be completely motionless and requires detailed knowledge of the properties of the different noise sources. In our experiments we performed a durectomy and did not use an imaging chamber to allow us future joint electroencephalography-optical imaging (EEG-OI) measures, which resulted in movement artifacts. With the goal of motion compensation in OI recordings and magnification of signal changes, we present a novel processing pipeline, which is based on optic flow guided denoising and gradient domain tone mapping for spatiotemporal contrast enhancement.
Functional Optical Imaging (OI) through the opened skull forms a group of Neuroimaging techniques characterized by a high temporal and spatial resolution on a meso-to macroscopic scale. State of the art OI experiments are generally difficult to execute, with a very timely surgical preparation preceding the experiment, that requires a skilled surgeon to mount a sealed imaging chamber onto the skull. The chamber reduces brain pulsation artifacts and swelling of the brain through movement restriction. In this work, we present preliminary results of a novel approach that does not rely on the usage of an imaging chamber with the goal to facilitate heavily the surgical animal preparation and to allow straightforward joint Electroencephalography - Optical Imaging recordings in the future. We carried out experiments to compare the movement restricting properties of the imaging chamber with the movement in a recording of an unconstrained and periodically irrigated brain. We used high-level image processing techniques to reduce brain pulsation artifacts and did a quantitative movement analysis of the recordings. Our results suggest that while recordings with imaging chamber show less sagittal movement, both with and without imaging chamber comprise the same lateral movements.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.