Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus

Vanhala, Vasco; Junkkari, Antti; Korhonen, Ville; Kurki, Mitja; Hiltunen, Mikko; Rauramaa, Tuomas; Nerg, Ossi; Koivisto, Anne M.; Remes, Anne M.; Perälä, Jonna; Suvisaari, Jaana; Lehto, Soili M.; Viinamäki, Heimo; Jääskeläinen, Juha E.; Leinonen, Ville

doi:10.1093/neuros/nyy147

Cited by 19 publications

(16 citation statements)

References 45 publications

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“…In the future, we must find a way that allows SZ patients with possible iNPH to easily receive the required medical care. For these reasons, we think that the actual prevalence of iNPH in SZ patients is higher than estimated by Vanhala et al [5]. Second, we found significant changes in CT findings of DESH in addition to Evans' index between the group Fig.…”

Section: Discussioncontrasting

confidence: 45%

“…The total rate from the combined data was eight of 59 (13.6%), which is approximately 4-20 times higher than that of the Japanese general population (0.5-2.9%) [27,40,41]. Consistently, Vanhala et al [5] estimated that SZ patients were present 3 times more frequently among Finnish iNPH patients compared to the general aged population. However, this prevalence was estimated from already diagnosed iNPH patients.…”

Section: Discussionmentioning

confidence: 73%

“…Common and serious comorbidities include metabolic syndrome [2] caused by secondgeneration antipsychotics [3] and/or cognitive impairment that leads to problems with adherence to those treatments [4]. To our knowledge, only limited studies have mentioned idiopathic normal pressure hydrocephalus (iNPH) among SZ patients, including one retrospective study [5], two case reports [6,7], and one theoretical paper [8].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of possible idiopathic normal pressure hydrocephalus in older inpatients with schizophrenia: a replication study

et al. 2020

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Background: We recently reported that older patients with schizophrenia (SZ) show possible idiopathic normal pressure hydrocephalus (iNPH) more frequently than the general population. In this study, we estimated the prevalence of iNPH in a larger number of older SZ patients and explored useful examination values for diagnosis in the SZ population. Methods: We enrolled older inpatients with SZ (n = 39, mean age = 68.6 ± 7.7 years) from several psychiatric hospitals in Ehime, Japan and acquired brain imaging data using computed tomography. We evaluated three iNPH symptoms (dementia, gait disturbance, and urinary incontinence). In addition, we combined these data with our previous data to elucidate the relationship between iNPH and characteristics of SZ symptoms. Results: In total, five (12.8%) patients were diagnosed with possible iNPH. Evans' index for patients with iNPH was significantly higher than for those without iNPH (p = 0.002). The number of disproportionately enlarged subarachnoid space hydrocephalus (DESH) findings was significantly higher in patients with iNPH than in those without iNPH (p < 0.001). Using combined data, Drug-Induced Extra-pyramidal Symptoms Scale (DIEPSS) subscales of gait and bradykinesia showed an increasing trend in the SZ with iNPH group. Conclusions: We reconfirmed that older inpatients with SZ experienced possible iNPH more frequently than the general population. We should pay attention to the DIEPSS subscales of gait and bradykinesia and DESH findings in addition to the three main symptoms of iNPH and Evans' index so as to not miss SZ patients with iNPH.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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Prevalence of possible idiopathic normal pressure hydrocephalus in older inpatients with schizophrenia: a replication study

et al. 2020

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“…Depression itself is probably not an independent risk factor for the development of iNPH but more likely a result of the increased disability due to iNPH or other comorbidities that may contribute to the pathogenesis of iNPH or to the development of depression itself [60][61][62]. It might be that iNPH is associated with an extensive range of psychiatric symptoms [14,15] supported by our recent report indicating that schizophrenia is more common in the iNPH patients compared to the general population [63]. Further prospective studies regarding the symptoms of depression and iNPH are needed.…”

Section: Depressive Symptomsmentioning

confidence: 82%

Diabetes is associated with familial idiopathic normal pressure hydrocephalus: a case–control comparison with family members

Räsänen

Huovinen

Korhonen

et al. 2020

Fluids Barriers CNS

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Background The pathophysiological basis of idiopathic normal pressure hydrocephalus (iNPH) is still unclear. Previous studies have shown a familial aggregation and a potential heritability when it comes to iNPH. Our aim was to conduct a novel case-controlled comparison between familial iNPH (fNPH) patients and their elderly relatives, involving multiple different families. Methods Questionnaires and phone interviews were used for collecting the data and categorising the iNPH patients into the familial (fNPH) and the sporadic groups. Identical questionnaires were sent to the relatives of the potential fNPH patients. Venous blood samples were collected for genetic studies. The disease histories of the probable fNPH patients (n = 60) were compared with their ≥ 60-year-old relatives with no iNPH (n = 49). A modified Charlson Comorbidity Index (CCI) was used to measure the overall disease burden. Fisher’s exact test (two-tailed), the Mann–Whitney U test (two-tailed) and a multivariate binary logistic regression analysis were used to perform the statistical analyses. Results Diabetes (32% vs. 14%, p = 0.043), arterial hypertension (65.0% vs. 43%, p = 0.033), cardiac insufficiency (16% vs. 2%, p = 0.020) and depressive symptoms (32% vs. 8%, p = 0.004) were overrepresented among the probable fNPH patients compared to their non-iNPH relatives. In the age-adjusted multivariate logistic regression analysis, diabetes remained independently associated with fNPH (OR = 3.8, 95% CI 1.1–12.9, p = 0.030). Conclusions Diabetes is associated with fNPH and a possible risk factor for fNPH. Diabetes could contribute to the pathogenesis of iNPH/fNPH, which motivates to further prospective and gene-environmental studies to decipher the disease modelling of iNPH/fNPH.

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“…It is possible that also iNPH is associated with a constellation of psychiatric manifestations, including aggression, disturbances of impulse control, and even psychosis [1, 3]. Furthermore, schizophrenia is an over-represented comorbidity in iNPH [30]. The diagnostic process is further complicated by the fact that neuroradiological differential diagnoses are not clear in all cases.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of <b><i>C9ORF72</i></b> Expansion in a Large Series of Patients with Idiopathic Normal-Pressure Hydrocephalus

Korhonen

Remes

Helisalmi

et al. 2019

Dement Geriatr Cogn Disord

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Background/Aims: The C9ORF72 expansion is known to cause frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). We aim to identify the prevalence of the C9ORF72 expansion in idiopathic normal pressure hydrocephalus (iNPH). Methods: We analysed the C9ORF72 expansion in a large cohort of patients with possible iNPH (n = 487) and cognitively intact elderly controls (n = 432; age > 65 years). Results: While the C9ORF72 expansion was detected in 1.6% (n = 8/487) of cases with possible iNPH, no control subject was found to carry the mutation. The mean age at onset of symptoms of C9ORF72 expansion carriers was 59 years (range: 52–67 years), 11 years less than non-carriers (p = 0.0002). The most frequent initial/main symptom pertained to gait difficulties. Despite identified mutation, only 3 of the patients fulfilled the criteria for the FTLD-ALS spectrum. Clinically significant shunt response was detected in 6 out of 7 shunted C9ORF72 expansion carriers. Conclusion: This is the first study cohort identifying the underlying C9ORF72 expansion in patients with iNPH providing evidence for the potential comorbidity between iNPH and the FTLD-ALS spectrum. Analysis of the C9ORF72 expansion should be considered for patients with probable iNPH presenting with frontal atrophy and personality changes or other severe psychiatric symptoms.

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Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus

Cited by 19 publications

References 45 publications

Prevalence of possible idiopathic normal pressure hydrocephalus in older inpatients with schizophrenia: a replication study

Prevalence of possible idiopathic normal pressure hydrocephalus in older inpatients with schizophrenia: a replication study

Diabetes is associated with familial idiopathic normal pressure hydrocephalus: a case–control comparison with family members

Prevalence of <b><i>C9ORF72</i></b> Expansion in a Large Series of Patients with Idiopathic Normal-Pressure Hydrocephalus

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