Normal Pressure Hydrocephalus

A form of compensated hydrocephalus characterized clinically by a slowly progressive gait disorder (see GAIT DISORDERS, NEUROLOGIC), progressive intellectual decline, and URINARY INCONTINENCE. Spinal fluid pressure tends to be in the high normal range. This condition may result from processes which interfere with the absorption of CSF including SUBARACHNOID HEMORRHAGE, chronic MENINGITIS, and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp631-3)

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Networked: 310 relevant articles (14 outcomes, 37 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Alzheimer Disease (Alzheimer's Disease)
2.	Hyponatremia
3.	Respiratory Tract Infections (Respiratory Tract Infection)
4.	Fever (Fevers)
5.	Atrophy

Experts

1.	Leinonen, Ville: 9 articles (10/2015 - 01/2011)
2.	Rigamonti, Daniele: 9 articles (08/2015 - 09/2004)
3.	Jääskeläinen, Juha E: 7 articles (10/2015 - 01/2011)
4.	Alafuzoff, Irina: 7 articles (10/2015 - 11/2012)
5.	Williams, Michael A: 7 articles (05/2009 - 09/2004)
6.	Soininen, Hilkka: 6 articles (10/2015 - 11/2012)
7.	Hiltunen, Mikko: 6 articles (10/2015 - 11/2012)
8.	Miyajima, Masakazu: 6 articles (10/2015 - 02/2007)
9.	Nakajima, Madoka: 6 articles (10/2015 - 09/2009)
10.	Arai, Hajime: 6 articles (10/2015 - 02/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Normal Pressure Hydrocephalus:

1.	Amyloid (Amyloid Fibrils)IBA 04/01/2013 - "The primary objectives of this study were to assess the safety of [(18)F]flutemetamol injection and determine the level of association between the quantitative estimates of brain uptake of [(18)F]flutemetamol and the quantitative immunohistochemical (IHC) estimates of amyloid levels in cerebral cortex biopsies obtained during shunt placement in patients with normal pressure hydrocephalus (NPH). " 12/01/2012 - "[(18)F]Flutemetamol PET imaging and cortical biopsy histopathology for fibrillar amyloid β detection in living subjects with normal pressure hydrocephalus: pooled analysis of four studies." 04/01/2011 - "Biochemical studies in Normal Pressure Hydrocephalus (NPH) patients: change in CSF levels of amyloid precursor protein (APP), amyloid-beta (Aβ) peptide and phospho-tau." 02/01/2015 - "Analysis of the normal pressure hydrocephalus biopsies revealed no differences in the expression or splicing profiles of the studied genes between amyloid-β positive and negative patients. " 01/01/2015 - "Amyloid-β and Tau Dynamics in Human Brain Interstitial Fluid in Patients with Suspected Normal Pressure Hydrocephalus."
2.	Biological Markers (Surrogate Marker)IBA 04/01/2000 - "A biological marker for normal pressure hydrocephalus (NPH) is beneficial for evaluation of its severity and of indications for shunt operation. " 04/09/2013 - "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. " 10/15/2015 - "The prognosis of cognitive improvement after cerebrospinal fluid (CSF) shunting in idiopathic normal pressure hydrocephalus (iNPH) remains uncertain, with no reports on CSF biomarkers related to long-term cognitive prognosis. " 10/15/2015 - "Cerebrospinal fluid biomarkers for prognosis of long-term cognitive treatment outcomes in patients with idiopathic normal pressure hydrocephalus." 05/01/2015 - "Correlations between mini-mental state examination score, cerebrospinal fluid biomarkers, and pathology observed in brain biopsies of patients with normal-pressure hydrocephalus."
3.	tau Proteins (tau Protein)IBA 01/01/2003 - "Previously we found the increase of total tau protein in CSF in normal pressure hydrocephalus patients, and others reported the increase also in corticobasal degeneration and frontotemporal dementia. " 07/01/2011 - "Use of cerebrospinal fluid amyloid-β and total tau protein to predict favorable surgical outcomes in patients with idiopathic normal pressure hydrocephalus." 03/01/2004 - "Immunoreactivities of amyloid beta peptide((1-42)) and total tau protein in lumbar cerebrospinal fluid of patients with normal pressure hydrocephalus." 04/01/2000 - "Tau protein is a potential biological marker for normal pressure hydrocephalus." 02/01/2007 - "The aim of the present study was the quantitation of total tau protein (tau(T)), tau phosphorylated at threonine 181 (tau(P-181)) and beta-amyloid(1-42) (Abeta42) in the cerebrospinal fluid (CSF) of patients with idiopathic normal pressure hydrocephalus (iNPH), Alzheimer's disease (AD) and controls. "
4.	boldenone undecylenate (Equipoise)IBA 10/15/2013 - "Clinical equipoise in idiopathic normal pressure hydrocephalus: a survey of physicians on the need for randomized controlled trials assessing the efficacy of cerebrospinal fluid diversion."
5.	Acetazolamide (Diamox)FDA LinkGeneric 06/01/1997 - "We studied the cerebral blood flow (CBF) and vascular response to acetazolamide in the white matter, cortex, and thalamus of 21 patients with normal pressure hydrocephalus, comparing patients who improved clinically after shunting with those who did not. " 01/01/2015 - "The objective was to identify changes in quantitative MRI measures in patients with idiopathic normal pressure hydrocephalus (iNPH) occurring in common after oral acetazolamide (ACZ) and external lumbar drainage (ELD) interventions. " 01/01/2015 - "MRI assessment of the effects of acetazolamide and external lumbar drainage in idiopathic normal pressure hydrocephalus." 04/15/2014 - "To assess the effects of low-dose acetazolamide treatment on volumetric MRI markers and clinical outcome in idiopathic normal-pressure hydrocephalus (iNPH). " 09/01/2013 - "Preoperative acetazolamide SPECT is useful for predicting outcome of shunt operation in idiopathic normal pressure hydrocephalus patients."
6.	tranilast (N 5')IBA 06/01/1998 - "Among patients with normal pressure hydrocephalus, these differences were greater in the patients with better outcomes after shunt surgery than in the less improved group (delta v-r; 0.7 (SD 0.27) degrees C, n=7 v 0.1 (SD 0.40) degrees C, n=5, p< 0.01, delta b2-r; -0.2 (SD 0.61) degrees C, n=7 v -1.4 (0.90) degrees C, n=5, p< 0.01)." 10/01/2005 - "The group was composed of patients with CJD (n = 20), patients with other forms of dementia (n = 10), patients with motoneuron disease (n = 6), patients with normal pressure hydrocephalus (n = 5), and control subjects (n = 20). " 06/01/1998 - "Diagnosis of dementia was made through extensive examinations including MRI and PET/SPECT of the brain and based on appropriate clinical diagnostic criteria of each disorder, which included Alzheimer's disease (n = 76), frontotemporal dementia (n = 10), vascular dementia (n = 11), progressive supranuclear palsy (n = 3), corticobasal degeneration (n = 5), dementia with Lewy bodies (n = 11), and normal pressure hydrocephalus (n = 1). " 01/01/2004 - "Regional cerebral blood flow (CBF) was studied with O(15)-water positron emission tomography and anatomic region-of-interest analysis on co-registered magnetic resonance in patients with idiopathic (n = 12) and secondary (n = 5) normal pressure hydrocephalus (NPH). "
7.	PeptidesIBA 01/01/2015 - "Lumbar CSF from 32 patients with idiopathic normal pressure hydrocephalus (iNPH) (samples were obtained before and 1 year after shunting), 15 patients with AD, and 12 normal controls was analyzed for AD-related proteins and APLP1-derived Aβ-like peptides (APL1β) (a surrogate marker for Aβ). " 12/18/2002 - "Reverse-phase high pressure liquid chromatography (HPLC) fractions of a human with normal pressure hydrocephalus cerebrospinal fluid (CSF), co-migrating with NPFF-related synthetic peptides, were characterized by capillary HPLC coupled on-line to nanospray ion trap tandem mass spectrometry. " 02/01/2008 - "With regard to normal pressure hydrocephalus, evidence suggests that changes in cerebrospinal fluid circulatory dynamics ultimately may result in reduced clearance of neurotoxins, such as beta-amyloid peptides and tau protein, that play a role in the pathogenesis of Alzheimer's disease. "
8.	Ofloxacin (Levofloxacin)FDA LinkGeneric 05/01/2012 - "A caregiver of a patient with normal pressure hydrocephalus and cognitive decline repeatedly reported improvement in apathy, social interaction, and ability to perform activities of daily living after treatment with levofloxacin for upper respiratory infections. "
9.	NeurotoxinsIBA 02/01/2008 - "With regard to normal pressure hydrocephalus, evidence suggests that changes in cerebrospinal fluid circulatory dynamics ultimately may result in reduced clearance of neurotoxins, such as beta-amyloid peptides and tau protein, that play a role in the pathogenesis of Alzheimer's disease. "
10.	Butylated Hydroxytoluene (BHT)IBA 01/01/1978 - "In 4 patients with normal pressure hydrocephalus prolonged BHT turned normal after shunting, paralleled by marked clinical improvement, in contrast to previous findings in 4 patients with presenile dementia. "

Therapies and Procedures

1.	Ventriculoperitoneal Shunt 08/01/2010 - "Low pressure valves with ventriculoperitoneal shunts have been proven to lead to good outcomes in the treatment of idiopathic normal pressure hydrocephalus. " 09/01/2004 - "Patients with idiopathic normal pressure hydrocephalus who show clinical improvement (in any symptom) after lumbar drainage are likely to show significant long-term improvement in memory after ventriculoperitoneal shunt." 09/01/2004 - "This was a prospective, longitudinal study of performance on neuropsychological tests before and 6 to 12 months after insertion of a ventriculoperitoneal shunt in 10 patients with idiopathic normal pressure hydrocephalus who showed improvement in at least 1 clinical symptom with temporary lumbar drainage. " 07/01/2002 - "Volumetric measurements in the detection of reduced ventricular volume in patients with normal-pressure hydrocephalus whose clinical condition improved after ventriculoperitoneal shunt placement." 01/01/2014 - "This study reports the case of a 47 years-old Dandy Walker man, with clinical condition compatible with the diagnosis of normal pressure hydrocephalus submitted to a ventriculoperitoneal shunt with a high fixed pressure valve. "
2.	Ventriculostomy 12/01/2004 - "Even though the main indication for neuroendoscopic management of normal pressure hydrocephalus (NPH) is the presence of an aqueductal block, recent reports suggest the possible efficacy of endoscopic third ventriculostomy (ETVS) in idiopathic NPH. " 08/01/1999 - "Improvement in three out of four cases of normal pressure hydrocephalus after third ventriculostomy is reported. " 01/01/2012 - "The purpose of our study was to evaluate the results of endoscopic third ventriculostomy (ETV) in the management of patients with idiopathic normal pressure hydrocephalus (INPH). " 08/01/2015 - "We evaluated if patients with idiopathic normal pressure hydrocephalus (iNPH) showed functional improvement after primary endoscopic third ventriculostomy (ETV). " 08/01/2015 - "Functional gait outcomes for idiopathic normal pressure hydrocephalus after primary endoscopic third ventriculostomy."
3.	Aftercare (After-Treatment) 04/01/1995 - "We conclude that certain vascular conditions may allow for the maintenance of an enlarged ventricular size, and that mathematical modeling can assist in identifying factors for clinical study that may maintain normal pressure hydrocephalus even after treatment by CSF diversion." 01/01/2012 - "To describe the outcomes and complication rates in 236 patients with idiopathic normal pressure hydrocephalus (INPH) after treatment. " 05/01/2012 - "A caregiver of a patient with normal pressure hydrocephalus and cognitive decline repeatedly reported improvement in apathy, social interaction, and ability to perform activities of daily living after treatment with levofloxacin for upper respiratory infections. "
4.	Activities of Daily Living (ADL) 11/01/2009 - "Rehabilitation alone did not result in improvements in patients with chronic normal pressure hydrocephalus, but rehabilitation combined with ventriculoperitoneal shunt resulted in improvements in activities of daily living and cognitive function. " 11/01/2009 - "The aim of this study was to compare activities of daily living and cognitive function after 6 months' rehabilitation training with or without ventriculoperitoneal shunt in patients with chronic normal pressure hydrocephalus following aneurysm subarachnoid haemorrhage. " 05/01/2012 - "A caregiver of a patient with normal pressure hydrocephalus and cognitive decline repeatedly reported improvement in apathy, social interaction, and ability to perform activities of daily living after treatment with levofloxacin for upper respiratory infections. "
5.	Occupational Therapy (Therapy, Occupational) 10/01/2008 - "To examine effectiveness of standardized occupational therapy and physical therapy assessments in detecting functional changes and predicting clinical improvement in patients with suspected normal pressure hydrocephalus undergoing cerebrospinal fluid drainage. " 10/01/2008 - "Specific occupational therapy and physical therapy assessments demonstrate sensitivity to change and predictive value with patients with suspected normal pressure hydrocephalus undergoing cerebrospinal fluid drainage."