Objective: Early hydrocephalus and its associated conditions (intracranial pressure, size of ventricles and other neuroanatomical structures, and shunt complications) are associated with various cognitive deficits. The purpose of this study was to investigate the effect of shunt revisions (0, 1, or 2+ revisions) on cognition, specifically overall intellectual functioning (FSIQ), verbal comprehension (VCI), perceptual reasoning (PRI), working memory (WMI), and processing speed (PSI). Method: Test data from 24 Spina Bifida patients (0 shunt revisions: n = 11, 1 shunt revision, n = 7, 2+ shunt revisions: n = 6) who were referred for outpatient neuropsychological evaluation was reviewed, specifically cognitive functioning (Wechsler Intelligence Scale for Children-Fourth Edition, WISC-IV). Results: There was no statistically significant difference in FSIQ (p = 0.592), verbal comprehension (p = 0.379), perceptual reasoning (p = 0.643), working memory (p = 0.950), or processing speed (p = 0.283) by number of shunt revisions. However, descriptive statistics showed a decrease across the cognitive domains of FSIQ (Mo = 80.20 SD = 21.45, M1 = 75.86 SD = 18.24, M2+ = 70.33 SD = 11.64), VCI (Mo = 86.45 SD = 19.55, M1 = 89.00 SD = 18.27, M2+ = 75.67 SD = 13.50), PRI (Mo = 81.80 SD = 17.87, M1 = 88.67 SD = 16.01, M2+ = 77.60 SD = 9.99), WMI (Mo = 81.72 SD = 17.57, M1 = 83.42 SD = 15.99, M2+ = 80.50 SD = 15.71), and PSI (Mo = 75.72 SD = 11.73, M1 = 75.86 SD = 12.74, M2+ = 65.83 SD = 15.07) as number of shunt revisions increases. Number of shunt revisions was not correlated with any cognitive domain on the WISC-IV. Conclusion: Hydrocephalus is associated with various cognitive deficits; however, few studies to date have analyzed the effectiveness of shunt treatment in these patients. These findings suggest a trend in worsening functioning with an increase in the number of shunt revisions. Future research should utilize a larger sample size.
The Effect of Shunt Revisions on Cognitive Functioning in Individuals with Spina Bifida
R Peterson, A Quast, E Begyn, J Katzenstein; A-60
The Effect of Shunt Revisions on Cognitive Functioning in Individuals with Spina Bifida. Arch Clin Neuropsychol 2016; 31 (6): 606. doi: 10.1093/arclin/acw043.60
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