Idiopathic normal pressure hydrocephalus (iNPH) is a neuropsychiatric disease characterized by gait disturbance, cognitive dysfunction, and urinary incontinence that affects a large population of elderly people. These symptoms, especially gait disturbance, can potentially be improved by cerebrospinal fluid (CSF) drainage, which is more effective if performed at an early stage of the disease. However, the neurophysiological mechanisms of these symptoms and their recovery by CSF drainage are poorly understood. In this study, using exact low-resolution brain electromagnetic tomography-independent component analysis (eLORETA-ICA) with electroencephalography (EEG) data, we assessed activities of five EEG resting-state networks (EEG-RSNs) in 58 iNPH patients before and after drainage of CSF by lumbar puncture (CSF tapping). In addition, we assessed correlations of changes in these five EEG-RSNs activities with CSF tapping–induced changes in iNPH symptoms. The results reveal that compared with 80 healthy controls, iNPH patients had significantly decreased activities in the occipital alpha rhythm, visual perception network, and self-referential network before CSF tapping. Furthermore, CSF tapping–induced changes in occipital alpha activity correlated with changes in postural sway and frontal lobe function. Changes in visual perception network activity correlated with changes in gait speed. In addition, changes in memory perception network activity correlated with changes in Parkinsonian gait features. These results indicate a recruitment of cognitive networks in gait control, and involvement of the occipital alpha activity in cognitive dysfunction in iNPH patients. Based on these findings, eLORETA-ICA with EEG data can be considered a noninvasive, useful tool for detection of EEG-RSN activities and for understanding the neurophysiological mechanisms underlying this disease.

中文翻译：

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负责特发性正常压力脑积水步态障碍特征的 EEG 静息状态网络

特发性正常压力脑积水 (iNPH) 是一种神经精神疾病，其特征是步态障碍、认知功能障碍和尿失禁，影响大量老年人。这些症状，尤其是步态障碍，可能会通过脑脊液 (CSF) 引流得到改善，如果在疾病的早期进行引流会更有效。然而，对这些症状的神经生理机制及其通过脑脊液引流的恢复知之甚少。在这项研究中，我们使用精确的低分辨率脑电磁断层扫描独立分量分析 (eLORETA-ICA) 和脑电图 (EEG) 数据，评估了 58 名 iNPH 患者前后的五个 EEG 静息状态网络 (EEG-RSN) 的活动。通过腰椎穿刺（CSF轻敲）引流CSF。此外，我们评估了这五种 EEG-RSN 活动的变化与 CSF 敲击引起的 iNPH 症状变化的相关性。结果显示，与 80 名健康对照相比，iNPH 患者在 CSF 敲击前的枕骨 α 节律、视觉感知网络和自我参照网络活动显着减少。此外，脑脊液敲击引起的枕骨α活动的变化与姿势摇摆和额叶功能的变化相关。视觉感知网络活动的变化与步态速度的变化相关。此外，记忆感知网络活动的变化与帕金森步态特征的变化相关。这些结果表明在步态控制中招募了认知网络，以及枕骨 α 活动参与 iNPH 患者的认知功能障碍。