Predicting the long-term course: Shunt surgery results in idiopathic normal pressure hydrocephalus-a comprehensive study.

Background: Idiopathic normal pressure hydrocephalus is a neurological disorder primarily affecting the elderly. Shunt surgery is the gold standard treatment, yet long-term outcome remains poorly investigated, especially concerning neuropsychological performance, motor skills and quality of life. This study aimed to evaluate the long-term effects of shunting in iNPH patients up to three years post-surgery.

Methods: A cohort of 30 patients with iNPH who underwent shunt placement between January 2020 and February 2021 was followed up for three years. A standardized test battery assessed neuropsychological performance, quality of life, and motor skills. The patients were tested before and one, two and three years after surgery.

Results: Motor skills, particularly lower body function, significantly improved post-surgery and remained improved even after three years. Upper body motor skills exhibited mixed results, with improvement in manual dexterity but not in finger tapping tests. Neuropsychological assessments revealed sustained improvement in certain aspects up to three years post-surgery, while a various degree of deterioration was observed in others. Quality of life, as measured by the Rankin Scale as well as Stein and Langfitt Grading, showed initial improvement post-surgery but declined over time.

Conclusion: iNPH patients demonstrate sustained improvements in motor skills, neuropsychological function and quality of life after shunt surgery. In long-term, motor skill and certain neuropsychological aspects remained improved, quality of life and some other neurocognitive aspects declined progressively over the follow up period. These findings underscore the importance of long-term follow-up and highlight the need for further research to better understand iNPH.