Cognition Improvement with Transcranial direct current stimulation in Postoperative Normal Pressure Hydrocephalus Patients with Programmable Pressure Valves: A Pilot Study

Introduction: The aim of this study was to investigate the impact of transcranial direct current stimulation (tDCS) on cognition in late postoperative patients who had been treated with programmable pressure valves for Normal Pressure Hydrocephalus (NPH) for at least twelve months. tDCS is a non-invasive brain stimulation technique that uses low-intensity continuous current to modulate cortical excitability and influence cognitive functions.

Methods: Neuropsychological assessments were conducted to examine cognitive profiles of 5 (five) patients before and after tDCS sessions, . Three assessments were carried out: one before treatment initiation, one three days after the 15th tDCS session, and another 30 days after the last tDCS session. Fifteen tDCS sessions were administered over three consecutive weeks. Patients completed an Adverse Effects Scale after first and fifth tDCS sessions, and a second neuropsychological assessment three days after the 15th session. Active or sham maintenance sessions were conducted four and six weeks after the second assessment, followed by a third neuropsychological evaluation 30 days after the last tDCS session. The primary outcome was assessed through post-intervention neuropsychological evaluations.

Results: The study employed a comprehensive battery of neuropsychological tests and scales to assess emotional aspects and quality of life. However, this abstract focused only on the Addenbrooke's Cognitive Examination (ACE), a brief cognitive assessment scale. The Kruskal-Wallis test and multiple Tukey comparisons were applied to the ACE scores at pre-treatment, three days post-treatment, and 30 days post-treatment.

Conclusion : Preliminary analysis of the ACE scores suggested a significant improvement in cognitive performance 30 days after tDCS treatment compared to pre-treatment scores. However, no significant differences were found between pre-treatment and three days post-treatment or between three days and 30 days post-treatment. Further research with larger samples and additional cognitive tests are warranted to confirm findings and explore the potential benefits of tDCS in such patients.