{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:35:55Z","timestamp":1793824555799,"version":"4.6.1"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective of this study was to analyze the effect of concomitant Parkinson\u2019s disease (PD) and PD dementia (PD\/PDD) on the course of idiopathic normal pressure hydrocephalus (iNPH), especially as related to the outcome of lumboperitoneal shunt (LPS) surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively analyzed patients with iNPH without accompanying disorders (iNPH alone [iNPHa]) and iNPH concomitant with PD\/PDD (iNPHc+PD\/PDD) who had presented to their department between 2010 and 2019. The diagnosis of iNPHc+PD\/PDD was established using the diagnostic criteria of the Movement Disorder Society. The effect of LPS surgery on clinical symptoms and striatum volumes was evaluated.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Thirty-three patients with iNPHa and 23 patients with iNPHc+PD\/PDD were identified. Comorbid PD\/PDD significantly worsened clinical outcome as measured by the iNPH grading scale, modified Rankin Scale (mRS), and Hoehn and Yahr (HY) scale. LPS surgery improved the iNPH score including gait disturbance (p &lt; 0.01), cognitive impairment (p = 0.02), and urinary disturbance (p &lt; 0.01) in iNPHa and improved gait disturbance (p = 0.01) and urinary disturbance (p = 0.03) in iNPHc+PD\/PDD for 1 year. Comorbid synucleinopathies maintained worse mRS scores and HY stages for 3 years, and LPS surgery extended overall survival (p = 0.003), as well as the period of sustained mRS scores (p = 0.04) and HY stages (p = 0.004) in iNPHc+PD\/PDD. Both caudate and putamen volumes were reduced in iNPHa (p &lt; 0.01) compared to those in controls and in patients with iNPHc+PD\/PDD compared to those in patients with PD\/PDD (p &lt; 0.01), and LPS surgery restored caudate volumes in both groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>These results revealed that comorbid PD\/PDD deteriorates the clinical course of iNPH and that LPS surgery is recommended regardless of this comorbidity.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.1.jns212282","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T18:27:07Z","timestamp":1647368827000},"page":"1302-1309","source":"Crossref","is-referenced-by-count":14,"title":["Effect of comorbid Parkinson\u2019s disease and Parkinson\u2019s disease dementia on the course of idiopathic normal pressure hydrocephalus"],"prefix":"10.3171","volume":"137","author":[{"given":"Anri","family":"Sakurai","sequence":"first","affiliation":[{"name":"Department of Neurology, Juntendo University School of Medicine, Tokyo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiji","family":"Tsunemi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Juntendo University School of Medicine, Tokyo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyo","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Neurology, Juntendo University School of Medicine, Tokyo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaito","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Juntendo University School of Medicine, Tokyo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madoka","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Juntendo University School of Medicine, Tokyo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Miyajima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Hattori","sequence":"additional","affiliation":[{"name":"Department of Neurology, Juntendo University School of Medicine, Tokyo;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Clin Neurol","doi-asserted-by":"publisher","first-page":"452","DOI":"10.3988\/jcn.2016.12.4.452","article-title":"Asymmetric and upper body parkinsonism in patients with idiopathic normal-pressure hydrocephalus","volume":"12","author":"Kang K","year":"2016","unstructured":"Kang K, Jeon JS, Kim T,  Asymmetric and upper body parkinsonism in patients with idiopathic normal-pressure hydrocephalus. 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