Is there a connection between apathy and gait improvement in patients with Normal Pressure Hydrocephalus (NPH)?

By: Aparna Srinivasan and Jenna Koschnitzky, PhD

Idiopathic NPH (iNPH) is a disorder commonly seen in older adults. These adults have enlarged ventricles with a normal cerebrospinal fluid (CSF) pressure. The three common symptoms seen in adults with iNPH include: gait disorder (difficulty walking), inability to control urination, and behavioral disturbances. Apathy, the lack of feeling, emotion, interest, and concern, is the most common form of behavioral disturbance seen in iNPH patients.

Studies done in the past have shown that shunt surgery in these patients improves both problems with walking and changes in behavior.

In a recent study out of the University of Geneva, Dr. Gilles Allali and colleagues wanted to see if the presence of apathy in patients with iNPH would predict which patients would show an improvement in gait after shunt surgery.

For this, they compared the persons manner of walking before and after 24 hours of CSF tapping in two groups of adults with iNPH. One group showed signs of apathy, and the other group did not. They found that, in the group of adults who were apathetic, there was a better improvement in their ability to walk. In other words, the more severe the apathy, the more the gait improved after CSF tapping.

According to the authors, this is the first study to report a connection between the presence of apathy and improvement in gait following shunt surgery. The main drawback of the study is that it included only a few patients.

For access to the original article, go here: https://www.ncbi.nlm.nih.gov/pubmed/29292530

Author Aparna Srinivasan will be a high school senior this fall. She enjoys playing the flute in her community orchestra and the school marching band. In the future, she hopes to pursue a career in medicine.