gBOLD-CSF coupling as a noninvasive predictor of cognitive recovery after shunt surgery in Idiopathic normal pressure hydrocephalus.

gBOLD-CSF coupling was significantly weaker in iNPH than controls (p < 0.001) and correlated with worse cognition.

Preoperative coupling independently predicted postoperative ΔMini-Mental State Examination (B = - 10.92, p < 0.001).

Longitudinal analysis showed that cognitive responders exhibited a significant restoration of coupling strength postoperatively (p < 0.001), while no significant change was observed in non-responders (p = 0.292).