Background
Idiopathic normal pressure hydrocephalus, often abbreviated iNPH, is a brain disorder that mainly affects older adults. It is caused by an abnormal buildup of cerebrospinal fluid, which leads to enlarged brain ventricles while measured pressure may remain normal. The classic symptom triad includes gait disturbance, cognitive slowing, and urinary urgency or incontinence. Because these symptoms can overlap with other age-related conditions, diagnosis can be challenging, but the condition is important to recognize because it may improve with treatment.
At present, ventriculoperitoneal shunt surgery is the standard treatment and can improve walking and other symptoms in selected patients. However, surgery carries risks such as infection, bleeding, shunt malfunction, and the need for later revision. For that reason, interest has remained high in non-surgical treatments that might improve symptoms before surgery or reduce the need for it. Acetazolamide, a carbonic anhydrase inhibitor, lowers cerebrospinal fluid production and has been used in several neurologic and ophthalmic conditions. This study tested whether low-dose acetazolamide could improve gait in people with iNPH who were waiting for shunt surgery.
