HIDROCEFALIA DE PRESSÃO NORMAL: AVALIAÇÃO COGNITIVA BREVE DE ADDENBROOKE NO DIAGNÓSTICO VIA TAP TEST

Abstract

The aim of this study was to investigate the sensitivity and applicability of the Addenbrooke’s Cognitive Examination-Revised (ACE-R) in normal pressure hydrocephalus (NPH), evaluating its potential as a complementary diagnostic tool during the tap test. The study included 58 patients, comprising 22 women and 36 men, with a mean age of 72 years and an average education level of 7.3 years. Neuropsychological assessments were conducted before and after the removal of 40–50 mL of cerebrospinal fluid (CSF). Cognitive performance was analyzed using the ACE-R, and data were subjected to nonparametric statistical tests to compare pre- and post-procedure scores. The ability of the ACE-R to discriminate patients indicated for surgery was evaluated using the ROC curve. The results indicate that ACE-R scores increased significantly after the tap test (Z = -3.046; p = 0.002). The variation in ACE-R scores (DIF_ACER) was higher in the surgery-indicated group (U = 158.000; p = 0.046), suggesting that cognitive response may help predict clinical progression. The cutoff point Δ ACE-R ≥ 0.5 showed a sensitivity of 72.3% and a specificity of 54.5%. We conclude that the ACE-R demonstrated sensitivity in detecting cognitive changes after the tap test and may be a useful tool in the evaluation of NPH.