Cognitive Recovery in Normal Pressure Hydrocephalus

正常压力脑积水的认知恢复

• 批准号: 6682481
• 负责人: HEATHER L KATZEN
• 金额: $ 13.63万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6682481
• 关键词: aging; behavioral /social science research tag; brain imaging /visualization /scanning; cerebrospinal fluid pressure; clinical research; cognition; dementia; diffusion magnetic resonance imaging; gait; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; hydrocephalus; lumbar puncture; nervous system disorder therapy; neuropsychological tests; neurosurgery; patient oriented research; psychomotor function

DESCRIPTION (provided by applicant): Normal Pressure Hydrocephalus (NPH) is an age-related disorder contributing to an estimated 1-6% of all dementia in the elderly. NPH symptoms can be reversed with a ventriculo-peritoneal (VP) shunt, a mechanical device that permits drainage of excess cerebrospinal fluid (CSF). The recent advent of adjustable VP shunts that can be non-invasively reprogrammed over a wide range of pressures represents a major advance in the treatment of NPH. The adjustable shunt may allow a greater number of patients to achieve better cognitive recovery with fewer adverse outcomes by allowing gradual adjustments to intracerebral pressure that are not possible using a conventional fixed-pressure device. There is currently no published data on the neuropsychological impact of using adjustable shunts. The proposed study stands to yield results that will directly influence clinical decision-making. The long-term objectives of the current study are to define the pattern and course of cognitive recovery following shunt placement in NPH and to determine whether various shunting parameters have a differential impact on cognitive outcome. NPH patients will be implanted with a programmable valve system and will be randomized to two different shunt management groups. All patients will undergo neuropsychological testing at baseline, 10 days, three months, six months and nine months following surgery. Rate of improvement of different neuropsychological skills and the extent to which post-operative shunt pressure adjustments contribute to better cognitive and functional outcome will be examined. The study will also address the extent to which clinical response to pre-operative CSF drainage correlates with outcome following shunt placement. The candidate's near term goals are to develop research skills and expertise in the neuropsychological and biological aspects of age-related disorders affecting cognition and to establish a career as a clinical scientist. This Award would create an environment in which the candidate could focus the majority of her time on research in the area of aging and would allow her to pursue her long-range career objective, the development a fully independent research program in neurogeriatrics. New York Presbyterian Hospital-Weill Cornell Medical College (NYPH-WCMC) is a major academic medical center, an ideal environment for a developing clinical investigator. Both the environment and institutional commitment will foster the candidate's research career development and contribute to the success of the proposed research.

描述（由申请人提供）：正常压力脑积水（NPH）是一种与年龄相关的疾病，估计占老年人所有痴呆症的1-6％。 NPH症状可以用心室 - 腹膜（VP）分流器逆转，这是一种机械装置，允许流量过多的脑脊液（CSF）引流。在广泛的压力上，可调节的VP分流器的最近出现是无创重编程的，这代表了NPH治疗的重大进步。可调节的分流可以使更多的患者通过允许使用常规的固定压力装置对脑内压力进行逐步调整，从而使更多的患者获得更好的认知恢复，而不良后果较少。目前尚无有关使用可调节分流的神经心理学影响的公开数据。拟议的研究将产生直接影响临床决策的结果。 当前研究的长期目标是定义NPH分流器放置后认知恢复的模式和过程，并确定各种分流参数是否对认知结果产生了不同的影响。 NPH患者将使用可编程阀系统植入，并将其随机分为两个不同的分流管理组。所有患者将在基线，10天，三个月，六个月和九个月后进行神经心理学测试。将检查不同神经心理学技能的改善率以及术后分流压力调节的程度将有助于更好的认知和功能结果。该研究还将解决对术前CSF引流的临床反应与分流放置后的结果相关的程度。 候选人的近期目标是在影响认知的与年龄有关的疾病的神经心理学和生物学方面发展研究技能和专业知识，并建立了临床科学家的职业。该奖项将创造一个环境，使候选人可以将大部分时间的大部分时间集中在衰老领域的研究上，并使她能够追求自己的远程职业目标，这是一项完全独立的神经病毒研究计划。纽约长老会医院 - 博士康奈尔医学院（NYPH-WCMC）是一个主要的学术医疗中心，是发展临床研究者的理想环境。环境和机构承诺都将促进候选人的研究职业发展，并为拟议研究的成功做出贡献。