{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T10:25:04Z","timestamp":1794219904464,"version":"4.8.0"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n \n The aim of this study was to evaluate associations between the corpus callosum angle (CCA), corpus callosum splenial angle (CCSA), and resistance to CSF outflow (R\n out<\/jats:sub>\n ) with neuropsychological performance in patients who had suspected idiopathic normal pressure hydrocephalus (iNPH), and to assess their predictive value for diagnosis and postoperative cognitive outcomes following ventriculoperitoneal shunt placement.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n This prospective observational study included 74 patients (39 male, mean age 73.6 years) who were evaluated for iNPH between 2019 and 2022 at a single institution. All patients underwent MRI-based measurement of the CCA and CCSA, the Katzman test for R\n out<\/jats:sub>\n , and a comprehensive neuropsychological battery. Patients were grouped by CCA size (< 90\u00b0, 91\u00b0\u2013109\u00b0, and > 110\u00b0), CCSA size (< 60\u00b0, 61\u00b0\u201379\u00b0, and > 80\u00b0), and R\n out<\/jats:sub>\n (\u2265 12 mm Hg and < 12 mm Hg). Group comparisons were performed using nonparametric tests, and logistic regression was applied to identify neuropsychological predictors of elevated R\n out<\/jats:sub>\n .\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Lower CCA values were associated with trends toward poorer performance in imitation apraxia, visual gnosis, and Mini-Mental State Examination (MMSE) scores, although none reached statistical significance after correction for multiple comparisons. Elevated R\n out<\/jats:sub>\n (\u2265 12 mm Hg) was significantly associated with better MMSE scores (adjusted p = 0.029), while other domains, including symbolic apraxia, rhythm reproduction, and confrontation naming, showed consistent trends but without statistical significance after correction. A logistic regression model that incorporated MMSE and rhythm reproduction predicted elevated R\n out<\/jats:sub>\n with 93.5% sensitivity and an area under the curve of 0.86. Postoperative cognitive improvements were modest and variable; however, long-term follow-up revealed sustained functional gains in selected patients, particularly those with elevated R\n out<\/jats:sub>\n and preserved preoperative cognitive function.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n \n CCA and R\n out<\/jats:sub>\n were independently associated with distinct cognitive profiles in patients with suspected iNPH. In particular, R\n out<\/jats:sub>\n demonstrated predictive value for preserved global cognition. Integrating anatomical, physiological, and neuropsychological markers might enhance diagnostic accuracy and improve patient selection for ventriculoperitoneal shunt placement.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.12.jns251883","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T02:06:43Z","timestamp":1777082803000},"page":"796-809","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal detection of idiopathic normal pressure hydrocephalus: neuropsychological assessment, radiological correlates of corpus callosum morphology, and CSF outflow resistance"],"prefix":"10.3171","volume":"145","author":[{"given":"Vicente","family":"Vanaclocha","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of Valencia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Navarro-Peris","sequence":"additional","affiliation":[{"name":"Department of Neuropsychology, Hospital Universitario Virgen de Candelaria, Tenerife;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieves","family":"Saiz-Sapena","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, General University Hospital of Valencia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Tercero-Atencia","sequence":"additional","affiliation":[{"name":"Department of Statistics, Fundaci\u00f3n Investigaci\u00f3n Hospital General Universitario de Valencia, Spain; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyre","family":"Vanaclocha","sequence":"additional","affiliation":[{"name":"Medius Klinik, Ostfildern-Ruit Klinik f\u00fcr Urologie, Ostfildern, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl 5","key":"b1","series-title":"Psychiatr Danub","first-page":"737","article-title":"Idiopathic normal pressure hydrocephalus (Hakim-Adams Syndrome): clinical symptoms, diagnosis and treatment","volume":"31","author":"Gavrilov GV","year":"2019","unstructured":"Gavrilov GV, Gaydar BV, Svistov DV, Idiopathic normal pressure hydrocephalus (Hakim-Adams Syndrome): clinical symptoms, diagnosis and treatment. 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