Cerebrospinal fluid biomarkers for prognosis of long-term cognitive treatment outcomes in patients with idiopathic normal pressure hydrocephalus.

Abstract

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. We performed a preliminary study of CSF biomarker protein levels for cognitive outcome prognostication of two-year outcomes after shunt treated iNPH in 36 patients (13 women) with a median age of 75years (IQR 69-78). CSF biomarkers included soluble amyloid precursor proteins (sAPP, sAPPα, sAPPβ), amyloid β (Aβ)1-38, Aβ1-42 and phosphorylated tau (p-tau), lipocalin-type prostaglandin D synthase (L-PGDS)/β-trace, and cystatin C. The results clearly showed that p-tau levels (sensitivity of 71.4%, specificity of 77.8%, cut-off value of 22.0pg/mL), Aβ1-38/Aβ1-42 ratio (77.8%, 81%, 3.58), and the Aβ1-42/p-tau ratio (76%, 72.7%, 14.6) in preoperative CSF have the potential to determine postoperative prognosis. Improved cognition may be associated with the improvement in CSF circulation after LPS, which likely induces cystatin C and L-PGDS and switches synthesis from Aβ1-42 to Aβ1-38.

• Authors: Madoka Nakajima, Masakazu Miyajima, Ikuko Ogino, Chihiro Akiba, Hidenori Sugano, Takeshi Hara, Keiko Fusegi, Kostadin Karagiozov, Hajime Arai
• Journal: Journal of the neurological sciences (J Neurol Sci) Vol. 357 Issue 1-2 Pg. 88-95 (Oct 15 2015) ISSN: 1878-5883 [Electronic] Netherlands
• PMID: 26169158 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015. Published by Elsevier B.V.

Chemical References

• Amyloid beta-Peptides
• Amyloidogenic Proteins
• Biomarkers
• Cystatin C
• Lipocalins
• tau Proteins
• Intramolecular Oxidoreductases
• prostaglandin R2 D-isomerase

Topics

• Aged
• Aged, 80 and over
• Amyloid beta-Peptides (cerebrospinal fluid)
• Amyloidogenic Proteins (cerebrospinal fluid)
• Biomarkers (cerebrospinal fluid)
• Cerebrospinal Fluid Shunts
• Cognition Disorders (cerebrospinal fluid, complications, diagnosis, drug therapy)
• Cystatin C (cerebrospinal fluid)
• Female
• Humans
• Hydrocephalus, Normal Pressure (cerebrospinal fluid, complications, surgery)
• Intramolecular Oxidoreductases (cerebrospinal fluid)
• Lipocalins (cerebrospinal fluid)
• Male
• Middle Aged
• Prognosis
• Treatment Outcome
• tau Proteins (cerebrospinal fluid)