BRAIN and NERVE－神経研究の進歩76巻2号

2024年02月発行

特集 特発性正常圧水頭症の現在

特発性正常圧水頭症の症候学

著者： 森悦朗¹²

所属機関： ¹大阪大学大学院連合小児発達学研究科行動神経学・神経精神医学寄附講座 ²東北大学

ページ範囲：P.101 - P.107

文献概要

特発性正常圧水頭症は,高齢者に,歩行障害,認知症,尿失禁の,いわゆる三徴をもたらす。どの症候も,加齢に伴う機能低下として,あるいは高齢者の神経系および非神経系疾患で生じる症状でもある。特発性正常圧水頭症においては,それぞれ失行性-失調性歩行,皮質下性認知症,切迫性尿失禁と特徴づけられるが,これらの特徴を知っておくことは臨床上重要である。本論では,特発性正常圧水頭症の症候学について解説する。

参考文献

1）厚生労働科学研究費補助金難治性疾患政策研究事業「特発性正常圧水頭症診療ガイドライン作成に関する研究」班, 日本正常圧水頭症学会（監修）: 特発性正常圧水頭症診療ガイドライン 第3版. メディカルレビュー社, 大阪, 2020

2）McGirt MJ, Woodworth G, Coon AL, Thomas G, Williams MA, et al: Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus. Neurosurgery 57: 699-705, 2005

3）Factora R, Luciano M: Normal pressure hydrocephalus: diagnosis and new approaches to treatment. Clin Geriatr Med 22: 645-657, 2006

4）Hashimoto M, Ishikawa M, Mori E, Kuwana N; Study of INPH on neurological improvement (SINPHONI): Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res 7: 18, 2010［doi: 10.1186/1743-8454-7-18］

5）Kazui H, Miyajima M, Mori E, Ishikawa M; SINPHONI-2 Investigators: Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 14: 585-594, 2015

6）Kuriyama N, Miyajima M, Nakajima M, Kurosawa M, Fukushima W, et al: Nationwide hospital-based survey of idiopathic normal pressure hydrocephalus in Japan: epidemiological and clinical characteristics. Brain Behav 7: e00635, 2017［doi: 10.1002/brb3.635］

7）Iseki C, Kawanami T, Nagasawa H, Wada M, Koyama S, et al: Asymptomatic ventriculomegaly with features of idiopathic normal pressure hydrocephalus on MRI (AVIM) in the elderly: a prospective study in a Japanese population. J Neurol Sci 277: 54-57, 2009

8）森 悦朗: 特発性正常圧水頭症の歩行障害. Brain Nerve 60: 219-224, 2008

9）Milletti D, Randi FT, Lanzino G, Hakim F, Palandri G: Gait apraxia and Hakim's disease: a historical review. Biomedicines 11: 1086, 2023［doi: 10.3390/biomedicines11041086］

10）Stolze H, Kuhtz-Buschbeck JP, Drücke H, Jöhnk K, Illert M, et al: Comparative analysis of the gait disorder of normal pressure hydrocephalus and Parkinson's disease. J Neurol Neurosurg Psychiatry 70: 289-297, 2001

11）Williams MA, Thomas G, de Lateur B, Imteyaz H, Rose JG, et al: Objective assessment of gait in normal-pressure hydrocephalus. Am J Phys Med Rehabil 87: 39-45, 2008

12）Agerskov S, Hellström P, Andrén K, Kollén L, Wikkelsö C, et al: The phenotype of idiopathic normal pressure hydrocephalus-a single center study of 429 patients. J Neurol Sci 391: 54-60, 2018

13）Hattingen E, Jurcoane A, Melber J, Blasel S, Zanella FE, et al: Diffusion tensor imaging in patients with adult chronic idiopathic hydrocephalus. Neurosurgery 66: 917-924, 2010

14）Kanno S, Abe N, Saito M, Takagi M, Nishio Y, et al: White matter involvement in idiopathic normal pressure hydrocephalus: a voxel-based diffusion tensor imaging study. J Neurol 258: 1949-1957, 2011

15）Nakayama T, Ouchi Y, Yoshikawa E, Sugihara G, Torizuka T, et al: Striatal D2 receptor availability after shunting in idiopathic normal pressure hydrocephalus. J Nucl Med 48: 1981-1986, 2007

16）Todisco M, Zangaglia R, Minafra B, Pisano P, Trifirò G, et al: Clinical outcome and striatal dopaminergic function after shunt surgery in patients with idiopathic normal pressure hydrocephalus. Neurology 96: e2861-e2873, 2021［doi: 10.1212/WNL.0000000000012064］

17）Ogino A, Kazui H, Miyoshi N, Hashimoto M, Ohkawa S, et al: Cognitive impairment in patients with idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 21: 113-119, 2006

18）Saito M, Nishio Y, Kanno S, Uchiyama M, Hayashi A, et al: Cognitive profile of idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Dis Extra 1: 202-211, 2011

19）Miyoshi N, Kazui H, Ogino A, Ishikawa M, Miyake H, et al: Association between cognitive impairment and gait disturbance in patients with idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 20: 71-76, 2005

20）Kito Y, Kazui H, Kubo Y, Yoshida T, Takaya M, et al: Neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus. Behav Neurol 21: 165-174, 2009

21）Kamohara C, Nakajima M, Kawamura K, Akiba C, Ogino I, et al: Neuropsychological tests are useful for predicting comorbidities of idiopathic normal pressure hydrocephalus. Acta Neurol Scand 142: 623-631, 2020

22）Sakakibara R, Kanda T, Sekido T, Uchiyama T, Awa Y, et al: Mechanism of bladder dysfunction in idiopathic normal pressure hydrocephalus. Neurourol Urodyn 27: 507-510, 2008

23）Krzastek SC, Bruch WM, Robinson SP, Young HF, Klausner AP: Characterization of lower urinary tract symptoms in patients with idiopathic normal pressure hydrocephalus. Neurourol Urodyn 36: 1167-1173, 2017

24）Sakakibara R, Uchida Y, Ishii K, Hashimoto M, Ishikawa M, et al; Members of SINPHONI (Study of Idiopathic Normal Pressure Hydrocephalus On Neurological Improvement): Bladder recovery relates with increased mid-cingulate perfusion after shunt surgery in idiopathic normal-pressure hydrocephalus: a single-photon emission tomography study. Int Urol Nephrol 48: 169-174, 2016

25）Nowak DA, Gumprecht H, Topka H: CSF drainage ameliorates the motor deficit in normal pressure hydrocephalus: evidence from the analysis of grasping movements. J Neurol 253: 640-647, 2006

26）Shimizu Y, Tanikawa M, Horiba M, Sahashi K, Kawashima S, et al: Clinical utility of paced finger tapping assessment in idiopathic normal pressure hydrocephalus. Front Hum Neurosci 17: 1109670, 2023［doi: 10.3389/fnhum.2023.1109670］

27）Kubo Y, Kazui H, Yoshida T, Kito Y, Kimura N, et al: Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus. Dement Geriatr Cogn Disord 25: 37-45, 2008

28）Hellström P, Klinge P, Tans J, Wikkelsø C: A new scale for assessment of severity and outcome in iNPH. Acta Neurol Scand 126: 229-237, 2012