Idiopathic normal-pressure hydrocephalus: pathophysiology and diagnosis by CSF biomarkers.

Abstract

OBJECTIVES:

This observational study aimed to explore the pathophysiology of idiopathic normal-pressure hydrocephalus (iNPH) and to evaluate the diagnostic and prognostic value of CSF biomarkers.

METHODS:

Lumbar CSF of patients with iNPH and healthy elderly individuals (HI) and ventricular CSF (VCSF) from the patients with iNPH pre and 6 months postsurgery were analyzed by ELISA. We analyzed neurofilament light protein (NFL), myelin basic protein (MBP), a panel of β-amyloid isoforms (Aβ38, Aβ40, and Aβ42), soluble amyloid precursor protein (sAPP) isoforms sAPPα and sAPPβ, total and phosphorylated tau protein (t- and p-tau), and inflammatory markers interleukin 8, interleukin 10, and monocyte chemoattractant protein 1.

RESULTS:

NFL was elevated and amyloid precursor protein (APP)-derived proteins and tau proteins were lower in patients with iNPH than in HI. Postsurgery, there was an increase of NFL, APP-derived proteins, p-tau, and albumin in VCSF, whereas levels of MBP and t-tau had decreased. Improved patients showed a greater increase of APP-derived proteins in VCSF following shunting than did those who did not improve.

CONCLUSIONS:

We interpret our data as iNPH pathophysiology to be characterized by a reduced periventricular metabolism and axonal degeneration but no major cortical damage.

• Authors: Anna Jeppsson, Henrik Zetterberg, Kaj Blennow, Carsten Wikkelsø
• Journal: Neurology (Neurology) Vol. 80 Issue 15 Pg. 1385-92 (Apr 09 2013) ISSN: 1526-632X [Electronic] United States
• PMID: 23486875 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Amyloid beta-Peptides
• Amyloid beta-Protein Precursor
• Biomarkers
• Myelin Basic Protein
• Neurofilament Proteins
• neurofilament protein L
• tau Proteins

Topics

• Aged
• Amyloid beta-Peptides (cerebrospinal fluid)
• Amyloid beta-Protein Precursor (cerebrospinal fluid)
• Biomarkers (cerebrospinal fluid)
• Enzyme-Linked Immunosorbent Assay
• Female
• Gait Disorders, Neurologic (etiology)
• Humans
• Hydrocephalus, Normal Pressure (cerebrospinal fluid, complications, diagnosis)
• Male
• Middle Aged
• Myelin Basic Protein (cerebrospinal fluid)
• Neurofilament Proteins (cerebrospinal fluid)
• Statistics, Nonparametric
• tau Proteins (cerebrospinal fluid)