{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:41:03Z","timestamp":1791855663402,"version":"4.3.4"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T00:00:00Z","timestamp":1657670400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T00:00:00Z","timestamp":1657670400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Normal pressure hydrocephalus (NPH) is a neurological disorder, characterized by gait- and balance disturbance, cognitive deterioration, and urinary incontinence, combined with ventricular enlargement. Gait ability, falls, cognitive status, and health-related quality of life pre and post surgery have not previously been studied at Karolinska University Hospital.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>One hundred and eighteen patients with iNPH that underwent shunt surgery at Karolinska University Hospital during the years from 2016 to 2018 were included. Results of walking tests, test for cognitive function, and self-estimated health-related quality of life, before and 3\u00a0months after surgery, were collected retrospectively as a single-center study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Walking ability, cognitive function, and health-related quality of life significantly increased 3\u00a0months after shunt surgery. A positive significant correlation was seen between a higher self-estimated quality of life and walking ability.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patients with suspected iNPH treated with shunt surgery at Karolinska University Hospital improved their walking ability and cognitive functioning 3\u00a0months after shunt surgery. A positive significant correlation was seen between a higher self-estimated quality of life and walking ability but not with increased cognitive function. We then concluded that the selection of patients for shunting maintained a high standard.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-022-05309-4","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T16:16:24Z","timestamp":1657728984000},"page":"2367-2373","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Gait, falls, cognitive function, and health-related quality of life after shunt-treated idiopathic normal pressure hydrocephalus\u2014a single-center study"],"prefix":"10.1007","volume":"164","author":[{"given":"Caroline","family":"Hallqvist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Gr\u00f6nstedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2129-5357","authenticated-orcid":false,"given":"Lisa","family":"Arvidsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,13]]},"reference":[{"key":"5309_CR1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1056\/NEJM196507152730301","volume":"273","author":"RD Adams","year":"1965","unstructured":"Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH (1965) Symptomatic occult hydrocephalus with normal cerebrospinal-fluid pressure. N Engl J Med 273:117\u2013126. https:\/\/doi.org\/10.1056\/NEJM196507152730301","journal-title":"N Engl J Med"},{"key":"5309_CR2","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.jns.2018.05.022","volume":"391","author":"S Agerskov","year":"2018","unstructured":"Agerskov S, Hellstr\u00f6m P, Andr\u00e9n K, Koll\u00e9n L, Wikkels\u00f6 C, Tullberg M (2018) The phenotype of idiopathic normal pressure hydrocephalus\u2014a single-center study of 429 patients. J Neurol Sci 391:54\u201360. https:\/\/doi.org\/10.1016\/j.jns.2018.05.022","journal-title":"J Neurol Sci"},{"key":"5309_CR3","doi-asserted-by":"publisher","first-page":"194","DOI":"10.25122\/jml-2019-1004","volume":"12","author":"D Baltateanu","year":"2019","unstructured":"Baltateanu D, Ciobanu I, Berteanu M (2019) The effects of ventriculoperitoneal shunt on gait performance. J Med Life 12:194\u2013198. https:\/\/doi.org\/10.25122\/jml-2019-1004","journal-title":"J Med Life"},{"key":"5309_CR4","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1093\/ageing\/26.1.15","volume":"26","author":"RW Bohannon","year":"1997","unstructured":"Bohannon RW (1997) Comfortable and maximum walking speed of adults aged 20\u201379 years: reference values and determinants. Age Ageing 26:15\u201319. https:\/\/doi.org\/10.1093\/ageing\/26.1.15","journal-title":"Age Ageing"},{"key":"5309_CR5","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1519\/00139143-200608000-00004","volume":"29","author":"RW Bohannon","year":"2006","unstructured":"Bohannon RW (2006) Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther 29:64\u201368","journal-title":"J Geriatr Phys Ther"},{"key":"5309_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2045-8118-11-19","volume":"11","author":"PK Eide","year":"2014","unstructured":"Eide PK, Pripp AH (2014) Increased prevalence of cardiovascular disease in idiopathic normal pressure hydrocephalus patients compared to a population-based cohort from the HUNT3 survey. Fluids Barriers CNS 11:1\u20136. https:\/\/doi.org\/10.1186\/2045-8118-11-19","journal-title":"Fluids Barriers CNS"},{"key":"5309_CR7","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1007\/s11136-020-02688-y","volume":"30","author":"Y-S Feng","year":"2021","unstructured":"Feng Y-S, Kohlmann T, Janssen MF, Buchholz I (2021) Psychometric properties of the EQ-5D-5L: a systematic review of the literature. Qual Life Res 30:647\u2013673. https:\/\/doi.org\/10.1007\/s11136-020-02688-y","journal-title":"Qual Life Res"},{"key":"5309_CR8","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","volume":"12","author":"MF Folstein","year":"1975","unstructured":"Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. J Psychiatr Res 12:189\u2013198. https:\/\/doi.org\/10.1016\/0022-3956(75)90026-6","journal-title":"J Psychiatr Res"},{"key":"5309_CR9","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1007\/s11136-015-1164-7","volume":"25","author":"MA Garcia-Gordillo","year":"2016","unstructured":"Garcia-Gordillo MA, Adsuar JC, Olivares PR (2016) Normative values of EQ-5D-5L: in a Spanish representative population sample from Spanish Health Survey, 2011. Qual Life Res 25:1313\u20131321. https:\/\/doi.org\/10.1007\/s11136-015-1164-7","journal-title":"Qual Life Res"},{"key":"5309_CR10","first-page":"737","volume":"31","author":"GV Gavrilov","year":"2019","unstructured":"Gavrilov GV, Gaydar BV, Svistov DV, Korovin AE, Samarcev IN, Churilov LP, Tovpeko DV (2019) Idiopathic normal pressure hydrocephalus (Hakim-Adams syndrome): clinical symptoms, diagnosis and treatment. Psychiatr Danub 31:737\u2013744","journal-title":"Psychiatr Danub"},{"key":"5309_CR11","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1111\/j.1365-2753.2007.00917.x","volume":"14","author":"JE Graham","year":"2008","unstructured":"Graham JE, Ostir GV, Fisher SR, Ottenbacher KJ (2008) Assessing walking speed in clinical research: a systematic review. J Eval Clin Pract 14:552\u2013562. https:\/\/doi.org\/10.1111\/j.1365-2753.2007.00917.x","journal-title":"J Eval Clin Pract"},{"key":"5309_CR12","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1007\/s10198-019-01054-1","volume":"20","author":"T Grochtdreis","year":"2019","unstructured":"Grochtdreis T, Dams J, K\u00f6nig H-H, Konnopka A (2019) Health-related quality of life measured with the EQ-5D-5L: estimation of normative index values based on a representative German population sample and value set. Eur J Health Econ 20:933\u2013944. https:\/\/doi.org\/10.1007\/s10198-019-01054-1","journal-title":"Eur J Health Econ"},{"key":"5309_CR13","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-022-05149-2","author":"M H\u00fclser","year":"2022","unstructured":"H\u00fclser M, Spielmann H, Oertel J, Sippl C (2022) Motor skills, cognitive impairment, and quality of life in normal pressure hydrocephalus: early effects of shunt placement. Acta Neurochir. https:\/\/doi.org\/10.1007\/s00701-022-05149-2","journal-title":"Acta Neurochir"},{"key":"5309_CR14","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1093\/neuros\/nyz297","volume":"86","author":"H Israelsson","year":"2020","unstructured":"Israelsson H, Eklund A, Malm J (2020) Cerebrospinal fluid shunting improves long-term quality of life in idiopathic normal pressure hydrocephalus. Neurosurgery 86:574\u2013582. https:\/\/doi.org\/10.1093\/neuros\/nyz297","journal-title":"Neurosurgery"},{"key":"5309_CR15","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2020.7.FOCUS20466","volume":"49","author":"H Israelsson","year":"2020","unstructured":"Israelsson H, Larsson J, Eklund A, Malm J (2020) Risk factors, comorbidities, quality of life, and complications after surgery in idiopathic normal pressure hydrocephalus: review of the INPH-CRasH study. Neurosurg Focus 49:E8. https:\/\/doi.org\/10.3171\/2020.7.FOCUS20466","journal-title":"Neurosurg Focus"},{"key":"5309_CR16","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1016\/j.jalz.2017.01.013","volume":"13","author":"D Jaraj","year":"2017","unstructured":"Jaraj D, Wikkels\u00f8 C, Rabiei K, Marlow T, Jensen C, \u00d6stling S, Skoog I (2017) Mortality and risk of dementia in normal-pressure hydrocephalus: a population study. Alzheimers Dement 13:850\u2013857. https:\/\/doi.org\/10.1016\/j.jalz.2017.01.013","journal-title":"Alzheimers Dement"},{"key":"5309_CR17","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1111\/ene.12755","volume":"22","author":"A Junkkari","year":"2015","unstructured":"Junkkari A, Sintonen H, Nerg O, Koivisto AM, Roine RP, Viinam\u00e4ki H, Soininen H, J\u00e4\u00e4skel\u00e4inen JE, Leinonen V (2015) Health-related quality of life in patients with idiopathic normal pressure hydrocephalus. Eur J Neurol 22:1391\u20131399. https:\/\/doi.org\/10.1111\/ene.12755","journal-title":"Eur J Neurol"},{"key":"5309_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00701-019-04135-5","volume":"162","author":"D Krahulik","year":"2020","unstructured":"Krahulik D, Vaverka M, Hrabalek L, Hampl M, Halaj M, Jablonsky J, Langova K (2020) Ventriculoperitoneal shunt in treating of idiopathic normal pressure hydrocephalus-single-center study. Acta Neurochir (Wien) 162:1\u20137. https:\/\/doi.org\/10.1007\/s00701-019-04135-5","journal-title":"Acta Neurochir (Wien)"},{"key":"5309_CR19","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1093\/neuros\/nyab094","volume":"89","author":"J Larsson","year":"2021","unstructured":"Larsson J, Israelsson H, Eklund A, Lundin-Olsson L, Malm J (2021) Falls and fear of falling in shunted idiopathic normal pressure hydrocephalus-the idiopathic normal pressure hydrocephalus comorbidity and risk factors associated with hydrocephalus study. Neurosurgery 89:122\u2013128. https:\/\/doi.org\/10.1093\/neuros\/nyab094","journal-title":"Neurosurgery"},{"key":"5309_CR20","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.clineuro.2016.02.013","volume":"143","author":"A Liu","year":"2016","unstructured":"Liu A, Sankey EW, Jusu\u00e9-Torres I, Patel MA, Elder BD, Goodwin CR, Hoffberger J, Lu J, Rigamonti D (2016) Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg 143:34\u201338. https:\/\/doi.org\/10.1016\/j.clineuro.2016.02.013","journal-title":"Clin Neurol Neurosurg"},{"key":"5309_CR21","doi-asserted-by":"publisher","first-page":"105385","DOI":"10.1016\/j.clineuro.2019.105385","volume":"183","author":"Y Nikaido","year":"2019","unstructured":"Nikaido Y, Urakami H, Akisue T, Okada Y, Katsuta N, Kawami Y, Ikeji T, Kuroda K, Hinoshita T, Ohno H, Kajimoto Y, Saura R (2019) Associations among falls, gait variability, and balance function in idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg 183:105385. https:\/\/doi.org\/10.1016\/j.clineuro.2019.105385","journal-title":"Clin Neurol Neurosurg"},{"key":"5309_CR22","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","volume":"39","author":"D Podsiadlo","year":"1991","unstructured":"Podsiadlo D, Richardson S (1991) The timed \u201cUp & Go\u201d: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142\u2013148. https:\/\/doi.org\/10.1111\/j.1532-5415.1991.tb01616.x","journal-title":"J Am Geriatr Soc"},{"key":"5309_CR23","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1136\/jnnp.2007.123620","volume":"79","author":"S Pujari","year":"2008","unstructured":"Pujari S, Kharkar S, Metellus P, Shuck J, Williams MA, Rigamonti D (2008) Normal pressure hydrocephalus: long-term outcome after shunt surgery. J Neurol Neurosurg Psychiatry 79:1282\u20131286. https:\/\/doi.org\/10.1136\/jnnp.2007.123620","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"5309_CR24","doi-asserted-by":"publisher","first-page":"281","DOI":"10.2176\/nmc.oa.2018-0318","volume":"59","author":"T Takeuchi","year":"2019","unstructured":"Takeuchi T, Yajima K (2019) Long-term 4 years follow-up study of 482 patients who underwent shunting for idiopathic normal pressure hydrocephalus -course of symptoms and shunt efficacy rates compared by age group-. Neurol Med Chir (Tokyo) 59:281\u2013286. https:\/\/doi.org\/10.2176\/nmc.oa.2018-0318","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"5309_CR25","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1111\/j.1532-5415.1992.tb01992.x","volume":"40","author":"TN Tombaugh","year":"1992","unstructured":"Tombaugh TN, McIntyre NJ (1992) The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 40:922\u2013935. https:\/\/doi.org\/10.1111\/j.1532-5415.1992.tb01992.x","journal-title":"J Am Geriatr Soc"},{"key":"5309_CR26","first-page":"A4911","volume":"61","author":"L Torsnes","year":"2014","unstructured":"Torsnes L, Bl\u00e5fjelldal V, Poulsen FR (2014) Treatment and clinical outcome in patients with idiopathic normal pressure hydrocephalus\u2013a systematic review. Dan Med J 61:A4911","journal-title":"Dan Med J"},{"key":"5309_CR27","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1111\/ane.13182","volume":"141","author":"V Zaccaria","year":"2020","unstructured":"Zaccaria V, Bacigalupo I, Gervasi G, Canevelli M, Corbo M, Vanacore N, Lacorte E (2020) A systematic review on the epidemiology of normal pressure hydrocephalus. Acta Neurol Scand 141:101\u2013114. https:\/\/doi.org\/10.1111\/ane.13182","journal-title":"Acta Neurol Scand"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-022-05309-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-022-05309-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-022-05309-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T07:11:51Z","timestamp":1661843511000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-022-05309-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,13]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["5309"],"URL":"https:\/\/doi.org\/10.1007\/s00701-022-05309-4","relation":{},"ISSN":["0942-0940"],"issn-type":[{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,13]]},"assertion":[{"value":"23 February 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Before undergoing shunt surgery, the patients were informed about their inclusion in the registry and that they could drop out at any time. The study was approved by the Regional ethical review board in Stockholm, DNR 2019\u201300353.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"N\/A","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}