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Apathy in idiopathic normal pressure hydrocephalus: A marker of reversible gait disorders
Author(s) -
Allali Gilles,
Laidet Magali,
Armand Stéphane,
Saj Arnaud,
Krack Paul,
Assal Frédéric
Publication year - 2018
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4847
Subject(s) - apathy , verbal fluency test , gait , finger tapping , medicine , physical medicine and rehabilitation , tapping , psychology , physical therapy , audiology , disease , psychiatry , cognition , neuropsychology , management , economics
Objective Apathy—the most common behavioral disturbance in idiopathic normal pressure hydrocephalus (iNPH)—is associated with poor gait, but the role of apathy on gait improvement after cerebrospinal fluid (CSF) tapping has not been studied yet. This study aims to compare gait improvement after CSF tapping in iNPH patients with and without apathy. Methods Stride time variability (STV), a marker of higher level of gait control, was measured in 33 iNPH patients (78.4 ± 5.7 years; 36.4% women) with an optoelectronic system during usual walking (single task) and during walking while dual tasking of counting and verbal fluency before and 24 hours after CSF tapping. Apathy was defined by a score ≥14 on the Starkstein apathy scale. Results Apathy was present in 60.6% of patients. Cerebrospinal fluid tapping led to greater improvement of STV (ie, decrease) during dual‐task walking (and more specifically categorical verbal fluency) in apathetic compared to nonapathetic patients (−44.7 ± 58.1% versus +4.24 ± 67.6%, respectively; P = .040), even after adjusting for age and depressive symptoms. More severe apathy was correlated with better STV improvement while dual tasking (categorical verbal fluency) after CSF tapping ( r = −0.412; P ‐value = 0.021), while it was not correlated with improvement on executive tests. Conclusions Our findings suggest that the presence of apathy is a predictor of better outcomes of gait disorders after CSF tapping in patients with iNPH.