Health‐related quality‐of‐life outcome in patients with idiopathic normal‐pressure hydrocephalus – a 1‐year follow‐up study

Abstract

Less than half of the patients with iNPH experienced clinically significant favorable HRQoL outcome, partly explained by the patient's characteristics and comorbidities. The HRQoL approach reveals aspects that are important for the patient's well-being, but may also improve the quality of the outcome assessment of cerebrospinal fluid shunting. Study results may help clinicians to estimate which patients will benefit shunt surgery.

Clinical performance of fixed-pressure Sphera Duo® hydrocephalus shunt

“…The intent of current literature is to decrease complications and their consequences. The technology of shunt, its materials and the surgical techniques may decrease mechanical and infectious complications [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] .…”

“…Overdrainage can lead to slit-ventricle syndrome, which is characterized by small or slit-like ventricles, coupled with transient episodes of symptoms of raised ICP. Changes in shunt, designed to address the problem of overdrainage, include valves designed to open at different pressures and selected based upon the patient's characteristics; anti-siphoning devices to minimize the siphon effect caused by changes in posture; and valves that regulate by flow rather than by pressure differences [13][14][15][16][17][18][19] .…”

Why Does the Health-Related Quality of Life in Idiopathic Normal-Pressure Hydrocephalus Fail to Improve Despite the Favorable Clinical Outcome?

“…4 In contrast, PROs, such as Health-Related Quality of Life (HRQoL), may appreciate aspects not captured by ClinROs. [5][6][7][8][9] Recently, we published a prospective 1-year follow-up study of HRQoL outcome in patients with idiopathic normal-pressure hydrocephalus (iNPH), 9 a progressing condition of elderly patients that characteristically impairs their gait, cognition, and urinary continence. [10][11][12] The so-far unknown origin has been contemplated to cause various abnormalities in the cerebrospinal fluid (CSF) physiology and hydrodynamics, which ultimately lead to the symptoms and signs observed in patients with iNPH.…”

“…7,8 Despite of 2 decades of research, investigators have found very little common ground in choosing a HRQoL instrument for patients with dementia, determining the optimal way of administrating it, and deciding what dimensions and qualities it should or should not have. 7,8,14,15 Only little is known about HRQoL in iNPH, 9 and there are no guidelines for the measurement of HRQoL in iNPH.…”

Progress in neurology 2017–2018

“…New strategies to improve service provision with accelerated diagnosis and treatment are being employed, e.g., through telemedicine , a model that appears successful. Neurological involvement in medicine remains active across a large spectrum of presentations . Novel mutations in adult‐onset leukoencephalopathy and the spinocerebellar ataxias and the search for biomarkers in neurological disease are some examples of the involvement of neurology research across this spectrum.…”