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Postural function in idiopathic normal pressure hydrocephalus before and after shunt surgery: a controlled study using computerized dynamic posturography (EquiTest)
Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
2013 (English)In: Clinical neurology and neurosurgery (Dutch-Flemish ed. Print), ISSN 0303-8467, E-ISSN 1872-6968, Vol. 115, no 9, 1626-1631 p.Article in journal (Refereed) Published
Abstract [en]

Introduction

Postural dysfunction is one of the major features of idiopathic normal pressure hydrocephalus (iNPH). With computerized dynamic posturography (CDP) balance can be assessed objectively. The primary aim of this study was to describe the postural function in iNPH patients pre- and post-operatively in comparison with healthy individuals (HI) using CDP.

Subjects and methods

Thirty-five patients (16 M, 19 F) with a mean age of 73 (range 49–81) with iNPH, and sixteen HI (7 M, 9 F) aged 73 (62–89) were included. iNPH patients were operated on with a ventriculo-peritoneal shunt. Patients and HI were tested regarding motor function, balance and cognition. CDP, EquiTest (NeuroCom International, Clackamas, OR), was performed before and three months after shunt surgery and twice in HI, with a three-month interval.

Results

Pre-operatively, the 35 patients had poorer balance measured with the Sensory Organizing Test (SOT) score in every condition (p = 0.01 in SOT 1 and p < 0.001 in SOT 2–6) compared to the HI. The greatest difference was in test conditions measuring mainly vestibular function, where loss of balance (LOB) was frequent. Twenty patients were evaluated three months after shunt surgery and 18/20 (90%) of them were considered shunt responders, with a mean improvement of motor score of 26% (range 5–67%). There was an improvement post-operatively in the weighted composite SOT score (p < 0.05) but no significant change in any of the SOT conditions. LOB was not significantly reduced in any of the test conditions.

Conclusion

CDP showed that the patients had a poorer balance than the HI. The greatest difference was in SOT 5–6, indicating that the postural disturbance is of primarily central vestibular origin. There was a slight improvement of balance post-operatively.

Place, publisher, year, edition, pages
Elsevier , 2013. Vol. 115, no 9, 1626-1631 p.
Keyword [en]
Idiopathic normal pressbre hydrocephalus, Postural function, Computerized dynamic posturography, Shunt surgery
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-100038DOI: 10.1016/j.clineuro.2013.02.015ISI: 000324787900011OAI: oai:DiVA.org:liu-100038DiVA: diva2:659428
Available from: 2013-10-25 Created: 2013-10-25 Last updated: 2017-12-06

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Lundin, FredrikLedin, TorbjörnLeijon, Göran

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NeurologyFaculty of Health SciencesDepartment of NeurologyDivision of NeuroscienceDepartment of Otorhinolaryngology in Linköping
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Clinical neurology and neurosurgery (Dutch-Flemish ed. Print)
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