Clinical profile of idiopathic normal pressure hydrocephalus with reduced myocardial sympathetic nerve function

IF 4.3 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI:10.1016/j.parkreldis.2026.108213

Shiho Matsubara , Shigenori Kanno , Toru Baba , Yoshiyuki Nishio , Chifumi Iseki , Nobuko Kawakami , Kazuo Kakinuma , Hayato Odagiri , Shoko Ota , Keiko Endo , Kentaro Takanami , Shin-ichiro Osawa , Tomohiro Kawaguchi , Hidenori Endo , Kyoko Suzuki

{"title":"Clinical profile of idiopathic normal pressure hydrocephalus with reduced myocardial sympathetic nerve function","authors":"Shiho Matsubara , Shigenori Kanno , Toru Baba , Yoshiyuki Nishio , Chifumi Iseki , Nobuko Kawakami , Kazuo Kakinuma , Hayato Odagiri , Shoko Ota , Keiko Endo , Kentaro Takanami , Shin-ichiro Osawa , Tomohiro Kawaguchi , Hidenori Endo , Kyoko Suzuki","doi":"10.1016/j.parkreldis.2026.108213","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Findings of reduced cardiac sympathetic nerve function and pareidolic illusions have been useful for identifying Lewy body disease (LBD). Therefore, we aimed to investigate whether these findings are associated with a high prevalence of LBD-related symptoms and poor shunt responsiveness in patients with idiopathic normal pressure hydrocephalus (iNPH).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 104 iNPH patients who underwent preoperative <sup>123</sup>I-metaiodobenzylguanidine myocardial scintigraphy and the Pareidolia test. We divided the patients into the abnormal cardiac scan (AC) group and the normal cardiac scan (NC) group. The severity of gait, cognitive, and urinary disturbances; the prevalence of parkinsonism; the prevalence of behavioral and neuropsychiatric symptoms; and performance on neuropsychological assessments were compared between the two groups. Moreover, we investigated the changes in these measures after shunt surgery in each group.</div></div><div><h3>Results</h3><div>Fifty-six (53.8 %) patients were classified into the AC group. Compared with patients in the NC group, the patients in the AC group had more frequent rigidity, resting tremor, hallucinations, and REM sleep behavior disorder, and greater deficits in attention, working memory, and visuospatial cognition. After shunt surgery, gait and urinary functions significantly improved in both groups. However, unlike in the NC group, no significant improvement in cognitive function was observed in the AC group.</div></div><div><h3>Conclusions</h3><div>Our results suggest that reduced cardiac sympathetic function in iNPH patients is linked to increased LBD-related clinical features and attenuated cognitive improvement after shunt surgery.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108213"},"PeriodicalIF":4.3000,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Parkinsonism & related disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1353802026000398","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Findings of reduced cardiac sympathetic nerve function and pareidolic illusions have been useful for identifying Lewy body disease (LBD). Therefore, we aimed to investigate whether these findings are associated with a high prevalence of LBD-related symptoms and poor shunt responsiveness in patients with idiopathic normal pressure hydrocephalus (iNPH).

Methods

We retrospectively analyzed 104 iNPH patients who underwent preoperative ¹²³I-metaiodobenzylguanidine myocardial scintigraphy and the Pareidolia test. We divided the patients into the abnormal cardiac scan (AC) group and the normal cardiac scan (NC) group. The severity of gait, cognitive, and urinary disturbances; the prevalence of parkinsonism; the prevalence of behavioral and neuropsychiatric symptoms; and performance on neuropsychological assessments were compared between the two groups. Moreover, we investigated the changes in these measures after shunt surgery in each group.

Results

Fifty-six (53.8 %) patients were classified into the AC group. Compared with patients in the NC group, the patients in the AC group had more frequent rigidity, resting tremor, hallucinations, and REM sleep behavior disorder, and greater deficits in attention, working memory, and visuospatial cognition. After shunt surgery, gait and urinary functions significantly improved in both groups. However, unlike in the NC group, no significant improvement in cognitive function was observed in the AC group.

Conclusions

Our results suggest that reduced cardiac sympathetic function in iNPH patients is linked to increased LBD-related clinical features and attenuated cognitive improvement after shunt surgery.

查看原文本刊更多论文

特发性常压脑积水伴心肌交感神经功能减退的临床分析

心脏交感神经功能减退和空想幻觉对诊断路易体病（LBD）很有帮助。因此，我们的目的是研究这些发现是否与特发性常压脑积水（iNPH）患者中lbd相关症状的高发和分流反应性差有关。方法回顾性分析104例术前行123i -偏氧苄基胍心肌显像和视错觉试验的iNPH患者。我们将患者分为心脏异常扫描组（AC）和正常心脏扫描组（NC）。步态、认知和泌尿障碍的严重程度；帕金森病的患病率；行为和神经精神症状的患病率；并比较两组在神经心理评估上的表现。此外，我们还调查了各组分流手术后这些指标的变化。结果56例（53.8%）患者归为AC组。与NC组相比，AC组患者出现更频繁的强直、静息性震颤、幻觉和REM睡眠行为障碍，并且在注意力、工作记忆和视觉空间认知方面存在更大的缺陷。分流手术后，两组患者的步态和泌尿功能均有明显改善。然而，与NC组不同，AC组的认知功能没有明显改善。结论研究结果表明，iNPH患者心脏交感功能降低与分流手术后lbd相关临床特征增加和认知改善减弱有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Parkinsonism & related disorders 医学-临床神经学

CiteScore

6.20

自引率

4.90%

发文量

292

审稿时长

39 days

期刊介绍： Parkinsonism & Related Disorders publishes the results of basic and clinical research contributing to the understanding, diagnosis and treatment of all neurodegenerative syndromes in which Parkinsonism, Essential Tremor or related movement disorders may be a feature. Regular features will include: Review Articles, Point of View articles, Full-length Articles, Short Communications, Case Reports and Letter to the Editor.