Shunt surgery to improve walking and thinking in normal pressure hydrocephalus

A Placebo-Controlled Effectiveness in INPH Shunting (PENS) Trial

NIH-funded research Johns Hopkins University · NIH-11416160

This project compares functioning versus temporarily turned-off adjustable brain shunts to help adults with iNPH improve walking and thinking.

Quick facts

Grant typeU01 cooperative agreement
Study typeNIH-funded research
Funding institutionJohns Hopkins University NIH-funded
Lab location1 site (Baltimore, United States)
Project IDNIH-11416160 on NIH RePORTER

What this research studies

I have idiopathic normal pressure hydrocephalus (iNPH), which can cause slow walking and memory problems. Everyone in the trial gets the same FDA-approved adjustable ventriculoperitoneal shunt, but some people have the valve set to work right away while others have it set to a non-working 'virtual off' position that can be changed later without more surgery. The trial is randomized and blinded and will measure change in walking speed at three months as the main outcome, with additional tests of balance and thinking. About 100 patients will be enrolled across 20 sites and all participants will eventually have the device active.

Who could benefit from this research

Good fit: Adults (21+) diagnosed with idiopathic normal pressure hydrocephalus who are considered candidates for ventriculoperitoneal shunt surgery under standard iNPH guidelines.

Not a fit: People without iNPH, those with other causes of gait or cognitive problems, or those who are not safe surgical candidates are unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, this could confirm that shunt surgery improves walking and thinking for people with iNPH and could broaden access to this treatment.

How similar studies have performed: Shunting has decades of observational support for helping iNPH patients, but this is among the first large randomized, placebo-controlled trials to test that benefit rigorously.

Where this research is happening

Baltimore, United States

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.