Influence of comorbidities in idiopathic normal pressure hydrocephalus - research and clinical care. A report of the ISHCSF task force on comorbidities in INPH

Jan Malm, Neill R Graff Radford, Masatsune Ishikawa, Bo Kristensen, Ville Leinonen, Etsuro Mori, Brian K. Owler, Mats Tullberg, Michael A. Williams, Norman R. Relkin

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Idiopathic normal pressure hydrocephalus (INPH) is a syndrome of ventriculomegaly, gait impairment, cognitive decline and incontinence that occurs in an elderly population prone to many types of comorbidities. Identification of the comorbidities is thus an important part of the clinical management of INPH patients. In 2011, a task force was appointed by the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders (ISHCSF) with the objective to compile an evidence-based expert analysis of what we know and what we need to know regarding comorbidities in INPH. This article is the final report of the task force. The expert panel conducted a comprehensive review of the literature. After weighing the evidence, the various proposals were discussed and the final document was approved by all the task force members and represents a consensus of expert opinions. Recommendations regarding the following topics are given: I. Musculoskeletal conditions; II. Urinary problems; III. Vascular disease including risk factors, Binswanger disease, and white matter hyperintensities; IV. Mild cognitive impairment and Alzheimer disease including biopsies; V. Other dementias (frontotemporal dementia, Lewy body, Parkinson); VI. Psychiatric and behavioral disorders; VII. Brain imaging; VIII. How to investigate and quantify. The task force concluded that comorbidity can be an important predictor of prognosis and post-operative outcome in INPH. Reported differences in outcomes among various INPH cohorts may be partly explained by variation in the rate and types of comorbidities at different hydrocephalus centers. Identification of comorbidities should thus be a central part of the clinical management of INPH where a detailed history, physical examination, and targeted investigations are the basis for diagnosis and grading. Future INPH research should focus on the contribution of comorbidity to overall morbidity, mortality and long-term outcomes.

Original languageEnglish (US)
Article number22
JournalFluids and Barriers of the CNS
Volume10
Issue number1
DOIs
StatePublished - Jun 10 2013

Fingerprint

Normal Pressure Hydrocephalus
Advisory Committees
Hydrocephalus
Cerebrospinal Fluid
Comorbidity
Research
Lewy Bodies
Frontotemporal Dementia
Vascular Dementia
Expert Testimony
Gait
Vascular Diseases
Neuroimaging
Physical Examination
Psychiatry
Dementia
Consensus
Alzheimer Disease
History
Morbidity

Keywords

  • Comorbidity
  • Guidelines
  • Hydrocephalus
  • Normal pressure
  • Review
  • Task force

ASJC Scopus subject areas

  • Cellular and Molecular Neuroscience
  • Neurology
  • Developmental Neuroscience

Cite this

Influence of comorbidities in idiopathic normal pressure hydrocephalus - research and clinical care. A report of the ISHCSF task force on comorbidities in INPH. / Malm, Jan; Graff Radford, Neill R; Ishikawa, Masatsune; Kristensen, Bo; Leinonen, Ville; Mori, Etsuro; Owler, Brian K.; Tullberg, Mats; Williams, Michael A.; Relkin, Norman R.

In: Fluids and Barriers of the CNS, Vol. 10, No. 1, 22, 10.06.2013.

Research output: Contribution to journalArticle

Malm, Jan ; Graff Radford, Neill R ; Ishikawa, Masatsune ; Kristensen, Bo ; Leinonen, Ville ; Mori, Etsuro ; Owler, Brian K. ; Tullberg, Mats ; Williams, Michael A. ; Relkin, Norman R. / Influence of comorbidities in idiopathic normal pressure hydrocephalus - research and clinical care. A report of the ISHCSF task force on comorbidities in INPH. In: Fluids and Barriers of the CNS. 2013 ; Vol. 10, No. 1.
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