{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:45:33Z","timestamp":1791481533629,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T00:00:00Z","timestamp":1485475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["2014\u2010Nanchi\u2010General\u2010052"],"award-info":[{"award-number":["2014\u2010Nanchi\u2010General\u2010052"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>There have been no nationwide epidemiological studies of idiopathic normal pressure hydrocephalus (<jats:styled-content style=\"fixed-case\">iNPH<\/jats:styled-content>) in Japan. Therefore, a nationwide epidemiologic survey of <jats:styled-content style=\"fixed-case\">iNPH<\/jats:styled-content> was performed to determine the number of cases and clinical characteristics by sex and diagnostic level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The first survey examined the numbers of cases that met the diagnostic criteria of <jats:styled-content style=\"fixed-case\">iNPH<\/jats:styled-content> and those who underwent shunt operations in 2012. The second survey gathered patients' details to clarify their clinical background characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The estimated number of cases meeting the diagnostic criteria in 2012 was 12,900, with 6,700 undergoing shunt operations. The estimated crude prevalence was 10.2\/100,000 persons. The age of onset was in the 70s in more than 50% of both men and women. Significantly higher (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.05) frequencies of gait impairment in men and cognitive decline in women were observed as initial symptoms. At the time of definitive diagnosis, gait impairment was observed most frequently in patients with definite <jats:styled-content style=\"fixed-case\">iNPH<\/jats:styled-content> (77.7%). Hypertension was the most frequent comorbidity (40.0%), followed by diabetes mellitus (17.8%) and Alzheimer's disease (14.8%). Hypertension was observed more frequently in men, but diabetes was observed more frequently in women (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.05). An <jats:styled-content style=\"fixed-case\">LP<\/jats:styled-content> shunt was the first\u2010choice (55.1%) treatment of <jats:styled-content style=\"fixed-case\">iNPH<\/jats:styled-content>, followed by a <jats:styled-content style=\"fixed-case\">VP<\/jats:styled-content> shunt (43.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed that <jats:styled-content style=\"fixed-case\">iNPH<\/jats:styled-content> occurs most frequently in the 70s, gait impairment and cognitive decline are the most frequent initial symptoms in men and women, respectively, and hypertension and diabetes are the most frequent comorbidities in men and women, respectively.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.635","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T07:15:29Z","timestamp":1485501329000},"source":"Crossref","is-referenced-by-count":91,"title":["Nationwide hospital\u2010based survey of idiopathic normal pressure hydrocephalus in Japan: Epidemiological and clinical characteristics"],"prefix":"10.1002","volume":"7","author":[{"given":"Nagato","family":"Kuriyama","sequence":"first","affiliation":[{"name":"Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine  Kyoto Japan"},{"name":"Department of Neurology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Miyajima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madoka","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Kurosawa","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Environmental Health Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wakaba","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Public Health Osaka City University Faculty of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuko","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Hirota","sequence":"additional","affiliation":[{"name":"College of Healthcare Management  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Tamakoshi","sequence":"additional","affiliation":[{"name":"Department of Public Health Hokkaido University Graduate School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuro","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neurology and Cognitive Neuroscience Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology Yamagata University Faculty of Medicine  Yamagata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiko","family":"Tokuda","sequence":"additional","affiliation":[{"name":"Department of Neurology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Urae","sequence":"additional","affiliation":[{"name":"Mediscience Planning Inc.  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