Abstract

ROCHA, Samanta et al. Cognitive improvement during the test tap in patients with normal pressure hydrocephalus. Psic., Saúde & Doenças [online]. 2016, vol.17, n.1, pp.67-73. ISSN 1645-0086.  https://doi.org/10.15309/16psd170110.

Idiopathic normal pressure hydrocephalus (INPH) is a syndrome characterized by the classic triad of gait disturbance, potentially reversible dementia (progressive mental deterioration) and urinary incontinence. The dementia can involve executive dysfunction, memory failures and bradyphrenia. The criteria for referral for ventriculoperitoneal shunting are still controversial but include the results of a spinal tap, which is performed to simulate the effect of shunting and to analyze the impact of cerebrospinal fluid (CSF) drainage on the patient’s gait. Objective: To evaluate the immediate effect of a spinal tap on the executive functions of patients with a diagnosis of probable INPH. Methods: Seventeen participants (seven men and ten women) aged 76.41+6.24 years (mean+SD) with 9.01+4.40 years (mean+SD) of schooling were selected from a group of 130 individuals tested. The neuropsychological tests of executive functions used were the Stroop test, digit span task, verbal fluency (animals and letters) (FAR) and MMSE. Patients were evaluated in three stages: before the first CSF drainage and after the first and second CSF drainages. Results: Statistical analysis showed significant differences between the pre-spinal tap and post-spinal tap results in the forward (p<0.013) and backward (p<0.037) digit span task, the animal fluency (p<0.004) and the first stage of the Stroop test (p<0.033). Significant differences were not observed in the orientation test (WMS), mental control (WMS) or MMSE. Conclusion: Of the various tests performed, executive function tests most clearly showed changes resulting from CSF drainage in patients with normal pressure hydrocephalus (NPH). The improvement appears to be related to an improvement in mental processing speed.

Keywords : cognition; normal pressure hydrocephalus; tap test.

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