Clinical manifestations and neuroanatomical correlates of reversible impairment of cognitive functions in patients with normotensive hydrocephalus: Case Report
Main Article Content
Abstract
From a neuropsychological perspective, normotensive hydrocephalus NPH is characterized by cognitive impairment associated with the compression exerted by ventricular dilatation on the cingulate cortex and fronto-striatal circuits. The Rey-Osterrieth Complex Figure Test (ROCFT) is a neuropsychological assessment measure widely used by clinicians and researchers because of the wide variety of cognitive information it allows to estimate.
We present the case of young male patient with refractory structural epilepsy secondary to a childhood brain injury resulting from a metastasis of a renal tumor. Referred to Neuropsychology for behavioral changes and cognitive impairment; presenting atypical performance in the copying phase of the ROCFT.
Failures in visual integration and coding of the ROCFT copy show that, in cases of NPH, brain structures such as the cerebellum and posterior cingulum can also be compromised by the compression exerted by the cerebral hemispheres as they move due to ventricular dilatation. Failures in integration, planning, rotation and displacement of ROCFT elements have been reported in patients with secondary psychotic conditions and posterior cingulate tumors.
Failures in visual integration associated with NPH may be related to the involvement of more postero-caudal brain structures such as the cerebellum and posterior cingulum or to secondary psychosis.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Zaksaite T, Loveday C, Edginton T, Spiers HJ, Smith AD. Hydrocephalus: A neuropsychological and theoretical primer. Cortex. 2023 Mar; 160:67-99.
II. Williams MA, Nagel SJ, Luciano MG, Relkin N, Zwimpfer TJ, Katzen H, Holubkov R, Moghekar A, Wisoff JH, McKhann GM, Golomb J, Edwards RJ, Hamilton MG. The clinical spectrum of hydrocephalus in adults: report of the first 517 patients of the Adult Hydrocephalus Clinical Research Network registry. J Neurosurg. 2019 May 24;132(6):1773-1784.
III. Daou B, Klinge P, Tjoumakaris S, Rosenwasser RH, Jabbour P. Revisiting secondary normal pressure hydrocephalus: does it exist? A review. Neurosurg Focus. 2016 Sep;41(3):E6.
IV. Lilja-Lund O, Maripuu M, Kockum K, Andersson J, Lindam A, Nyberg L, Laurell K. Longitudinal neuropsychological trajectories in idiopathic normal pressure hydrocephalus: a population-based study. BMC Geriatr. 2023 Jan 16;23(1):29.
V. Hülser M, Spielmann H, Oertel J, Sippl C. Motor skills, cognitive impairment, and quality of life in normal pressure hydrocephalus: early effects of shunt placement. Acta Neurochir (Wien). 2022 Jul;164(7):1765-1775.
VI. Salvadori E, Dieci F, Caffarra P, Pantoni L. Qualitative Evaluation of the Immediate Copy of the Rey-Osterrieth Complex Figure: Comparison Between Vascular and Degenerative MCI Patients. Arch Clin Neuropsychol. 2019 Feb 1;34(1):14-23.
VII. Zhang X, Lv L, Min G, Wang Q, Zhao Y, Li Y. Overview of the Complex Figure Test and Its Clinical Application in Neuropsychiatric Disorders, Including Copying and Recall. Front Neurol. 2021 Aug 31;12:680474.
VIII. Davids RCD, Groen Y, Berg IJ, Tucha O, van Balkom I. Local-global processing approaches in older autistic adults: A matched control study using RCFT and WAIS-IV. Research in Autism Spectrum Disorders. 2020 Oct;78:101655.
IX. Bayliss, L., Cisneros Otero, M., & Ramírez-Bermúdez, J. Hidrocefalia: ¿Deterioro cognitivo reversible?. En: Ramírez-Bermúdez, J.,coordinador. Imágenes en Neuropsiquiatría: Lecciones de neurociencia clínica. 1ª ed. México: Hemisferio Izquierdo; 2022. p. 671–4.
X. Bugalho P, Alves L, Miguel R, Ribeiro O. Profile of cognitive dysfunction and relation with gait disturbance in Normal Pressure Hydrocephalus. Clin Neurol Neurosurg. 2014 Mar;118:83-8.
XI. Buckner RL, Krienen FM, Castellanos A, Diaz JC, Yeo BT. The organization of the human cerebellum estimated by intrinsic functional connectivity. J Neurophysiol. 2011 Nov;106(5):2322-45.
XII. Ramírez-Bermúdez, J., Martínez, V., López, J. C., Aviña Cervantes, C., Carrillo Mezo, R., Kerik Rotenberg, N., Díaz Meneses, I., Díaz Victoria, A. R., & Kapellmann, F. C. Indicaciones clínicas para realizar estudios de neuroimagen en pacientes con psicosis. En: Ramírez-Bermúdez, J., coordinador. Imágenes en Neuropsiquiatría: Lecciones de neurociencia clínica. 1ª ed. México: Hemisferio Izquierdo; 2022. p. 127–34.
XIII. De la Serna L. Kapellmann F. C. & Carrillo Mezo R. R-BJA. Despersonalización, deterioro cogitivo y asimbolia al dolor en una mujer con un meningioma en el cíngulo posterior. En: Ramírez-Bermúdez, J., coordinador. Imágenes en Neuropsiquiatría: Lecciones de neurociencia clínica. 1ª ed. México: Hemisferio Izquierdo; 2022. p. 659–67.
XIV. Yoshino Y, Yoshida T, Morino H, Nakamura M, Abe M, Omachi H, Inoue S, Miyoshi Y, Tachibana Y, Yamauchi N, Takeda N, Mizobuchi M, Ozaki Y, Ochi S, Iga J, Ueno SI. Prevalence of possible idiopathic normal pressure hydrocephalus in older inpatients with schizophrenia: a replication study. BMC Psychiatry. 2020 Jun 1;20(1):273.
XV. Vanhala V, Junkkari A, Korhonen VE, Kurki MI, Hiltunen M, Rauramaa T, Nerg O, Koivisto AM, Remes AM, Perälä J, Suvisaari J, Lehto SM, Viinamäki H, Soininen H, Jääskeläinen JE, Leinonen V. Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus. Neurosurgery. 2019 Apr 1;84(4):883-889.