Normal Pressure Hydrocephalus (NPH) is a neurological disorder characterized by gait disturbance, urinary incontinence, and cognitive decline—known as the triad—resulting from expanded cerebrospinal fluid (CSF) ventricles with normal opening pressure. NPH is particularly interesting for BCI applications because it is one of the few potentially reversible causes of dementia, and BCI can both support patients and potentially aid in treatment monitoring[1].
Brain-computer interface technologies offer unique opportunities for NPH patients, who often present with a combination of motor, cognitive, and autonomic symptoms that respond differently to CSF diversion. The potentially reversible nature of NPH makes early BCI intervention particularly valuable for preventing irreversible damage[2].
Gait disturbance is typically the first and most responsive symptom in NPH:
Motor Imagery Systems
Balance and Fall Prevention
The unique pathophysiology of NPH suggests potential for pressure-integrated BCI:
Closed-Loop Monitoring
NPH affects subcortical white matter pathways, impacting executive function and attention:
Executive Function Training
Differential Diagnosis Support
Urinary incontinence in NPH has both neurological and mechanical components:
Bladder Monitoring Systems
Autonomic dysfunction in NPH affects blood pressure regulation:
Hemodynamic Monitoring
BCI may help predict shunt responsiveness:
BCI applications following CSF diversion:
Mori et al. Normal Pressure Hydrocephalus. Lancet Neurol. 2023. ↩︎
Hellstrom et al. Gait in NPH. Neurology. 2022. ↩︎
Pereira et al. Motor Imagery for NPH Gait. J Neurosurg. 2024. ↩︎
Matsumoto et al. Fall Prevention in NPH. Neurosurgery. 2023. ↩︎
Czosnyka et al. ICP Monitoring in NPH. J Neurol Neurosurg Psychiatry. 2023. ↩︎
Klinge et al. Cognitive Dysfunction in NPH. Alzheimers Dement. 2022. ↩︎
Japan NPH Study Group. Neural Biomarkers in NPH. Neurology. 2024. ↩︎
Sakakibara et al. Urinary Dysfunction in NPH. Neurourol Urodyn. 2023. ↩︎
Virhammar et al. Autonomic Dysfunction in NPH. Clin Auton Res. 2024. ↩︎
Tullberg et al. Shunt Response Prediction. J Neurol Neurosurg Psychiatry. 2023. ↩︎