Neuropsychological Profile of Normal Pressure Hydrocephalus: A Systematic Review of Cognitive Trajectories and Evidence-Based Assessment Tools for Surgical Management

Cognitive recovery after shunt in NPH follows a predominantly fronto-subcortical pattern, with the greatest improvements occurring within the first postoperative year. MMSE, TMT-A, TMT-B, and Digit Span represent the most reliable and informative neuropsychological tools for preoperative and postoperative evaluation and should constitute the core of a standardized NPH-specific cognitive battery. Establishing uniform testing protocols and improving methodological consistency across studies will enhance diagnostic accuracy, surgical decision-making, and long-term monitoring of this treatable condition.