Cerebrospinal fluid amyloid beta and response of cognition to a tap test in idiopathic normal pressure hydrocephalus: a case-control study.

Abstract

OBJECTIVES:

To examine the relationship between cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) and tap test response to elucidate the effects of comorbidity of AD in idiopathic normal-pressure hydrocephalus (iNPH).

DESIGN:

Case-control study.

SETTING:

Osaka University Hospital.

PARTICIPANTS:

Patients with possible iNPH underwent a CSF tap test.

MEASUREMENTS:

Concentrations of amyloid beta (Aβ) 1-40, 1-42, and total tau in CSF were measured. The response of tap test was judged using Timed Up and Go test (TUG), 10-m reciprocation walking test (10MWT), Mini-Mental State Examination (MMSE), and iNPH grading scale. The ratio of Aβ1-42 to Aβ1-40 (Aβ42/40 ratio) and total tau concentration was compared between tap test-negative (iNPH-nTT) and -positive (iNPH-pTT) patients.

RESULTS:

We identified 27 patients as iNPH-nTT and 81 as iNPH-pTT. Aβ42/40 ratio was significantly lower (mean [SD] = 0.063 [0.026] vs. 0.083 [0.036], p = 0.008), and total tau in CSF was significantly higher (mean [SD] = 385.6 [237.2] vs. 293.6 [165.0], p = 0.028) in iNPH-nTT than in iNPH-pTT. Stepwise logistic regression analysis revealed that low Aβ42/40 ratio was significantly associated with the negativity of the tap test. The response of cognition was significantly related to Aβ42/40 ratio. The association between Aβ42/40 ratio and tap test response, especially in cognition, remained after adjusting for disease duration and severity at baseline.

CONCLUSIONS:

A low CSF Aβ42/40 ratio is associated with a poorer cognitive response, but not gait and urinary response, to a tap test in iNPH. Even if CSF biomarkers suggest AD comorbidity, treatment with iNPH may be effective for gait and urinary dysfunction.

• Authors: Hideki Kanemoto, Etsuro Mori, Toshihisa Tanaka, Takashi Suehiro, Kenji Yoshiyama, Yukiko Suzuki, Kyosuke Kakeda, Tamiki Wada, Koichi Hosomi, Haruhiko Kishima, Hiroaki Kazui, Mamoru Hashimoto, Manabu Ikeda
• Journal: International psychogeriatrics (Int Psychogeriatr) Vol. 35 Issue 9 Pg. 509-517 (09 2023) ISSN: 1741-203X [Electronic] England
• PMID: 34399871 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Amyloid beta-Peptides
• tau Proteins
• Biomarkers

Topics

• Humans
• Amyloid beta-Peptides (cerebrospinal fluid)
• Hydrocephalus, Normal Pressure (diagnosis, cerebrospinal fluid, complications)
• Case-Control Studies
• tau Proteins (cerebrospinal fluid)
• Postural Balance
• Time and Motion Studies
• Alzheimer Disease (complications)
• Biomarkers (cerebrospinal fluid)
• Cognition