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Published Online First: 13 February 2007. doi:10.1136/jnnp.2006.088450
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:760-763
Copyright © 2007 by the BMJ Publishing Group Ltd.
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SHORT REPORT

Post-surgical changes in brain metabolism detected by magnetic resonance spectroscopy in normal pressure hydrocephalus: results of a pilot study

María del Mar Matarín1, Roser Pueyo1, María Antonia Poca2, Carles Falcón3, María Mataró1, Núria Bargalló4, Juan Sahuquillo2, Carme Junqué3

1 Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain
2 Department of Neurosurgery, Vall d’Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
3 August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
4 Department of Neuroradiology, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain

Correspondence to:
Correspondence to:
Dr M A Poca
Neurosurgery Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; 26382app{at}comb.es


ABSTRACT
Background: Adult normal pressure hydrocephalus (NPH) is one of the few potentially treatable causes of dementia. Some morphological and functional abnormalities attributed to hydrocephalus improve following treatment.

Objectives: We focused on analysis of changes in cerebral metabolites using proton magnetic resonance spectroscopy (1H-MRS) after NPH treatment, and its clinical and cognitive correlation.

Methods: 1H-MRS, neuropsychological and clinical status examinations were performed before and 6 months after shunting in 12 adults with idiopathic NPH. We obtained N-acetyl-aspartate (NAA), choline (Cho), myoinositol (MI) and creatine (Cr) values.

Results: After surgery, NAA/Cr was significantly increased. Moreover, NAA/Cr values were related to cognitive deterioration.

Conclusion: MRS could be a marker of neuronal dysfunction in NPH.

Abbreviations: Cr, creatine; Cho, choline; 1H-MRS, proton magnetic resonance spectroscopy; MI, myoinositol; MMSE, Mini-Mental State Examination; NAA, N-acetyl-aspartate; NPH, normal pressure hydrocephalus






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