Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent reversible neurological disorder characterized by impaired locomotion, cognition and urinary control with ventriculomegaly. Symptoms can be relieved with cerebrospinal fluid drainage, which makes iNPH the leading cause of reversible dementia. Because of a limited understanding of pathophysiological mechanisms, unspecific symptoms and the high prevalence of comorbidity (i.e. Alzheimer's disease), iNPH is largely underdiagnosed. For these reasons, there is an urgent need for developing noninvasive quantitative biomarkers for iNPH diagnosis and prognosis. Structural and functional changes of brain circuits in relation to symptoms and treatment response are expected to deliver major advances in this direction. We review structural and functional brain connectivity findings in iNPH and complement those findings with iNPH symptom meta-analyses in healthy populations. Our goal is to reinforce our conceptualization of iNPH as to brain network mechanisms and foster the development of new hypotheses for future research and treatment options.

中文翻译：

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特发性正常压力脑积水的神经回路：大脑连接性和症状的荟萃分析的透视审查。

特发性正常压力脑积水（iNPH）是一种常见的可逆性神经系统疾病，其特征是运动能力，认知能力下降和心室肥大引起的尿液控制。脑脊液引流可缓解症状，这使iNPH成为可逆性痴呆的主要原因。由于对病理生理机制的了解有限，症状不明确以及合并症（即阿尔茨海默氏病）的患病率较高，因此iNPH的诊断不足。由于这些原因，迫切需要开发用于iNPH诊断和预后的非侵入性定量生物标记。与症状和治疗反应有关的大脑回路的结构和功能变化有望在此方向上取得重大进展。我们回顾了iNPH中结构和功能性大脑连通性的发现，并在健康人群中对这些发现进行了iNPH症状荟萃分析。我们的目标是加强关于脑网络机制的iNPH概念，并为未来的研究和治疗选择开发新的假设。