Plasticity in the aging brain. Reversibility of anatomic, metabolic, and cognitive deficits in normal-pressure hydrocephalus following shunt surgery
J. A. Kaye, C. L. Grady, J. V. Haxby, A. Moore and R. P. Friedland
Laboratory of Neurosciences, National Institute of Aging, National Institute of Health, Bethesda, Md.
The course of idiopathic normal-pressure hydrocephalus was studied in a
78-year-old woman with a 4-year history of progressive dementia who
underwent neuropsychologic testing, quantitative x-ray computed tomography,
magnetic resonance imaging, and positron emission tomography with
fludeoxyglucose F 18 to measure rates of regional cerebral glucose
utilization. Preshunt cognitive testing demonstrated progressive
deterioration during 2 years, and positron emission tomography showed
significant reductions in regional cerebral glucose utilization of 34% to
49% as compared with age- and sex-matched control subjects in frontal,
temporal, parietal, and whole brain regions. Periodic testing, carried out
during a 2-year period after shunt surgery, showed steady improvement in
clinical status. Parallel to the clinical changes, there was a significant
reversal in neuropsychologic test scores with increased brain volume and
increased regional cerebral glucose utilization in several brain regions.
These results documented the considerable potential for recovery of
compromised brain function in older subjects even after 4 years of
progressive brain disease.
