Normal Pressure Hydrocephalus Associated with Alzheimer's Disease

Area of Science:

• Neurology
• Biomarkers
• Neurodegenerative Diseases

Background:

• Normal pressure hydrocephalus (NPH) is a condition characterized by cognitive impairment, gait disturbance, and urinary dysfunction.
• Differentiating between NPH subtypes, such as neurodegenerative and idiopathic, is crucial for effective treatment.
• Cerebrospinal fluid (CSF) biomarkers may offer insights into the underlying pathology of NPH.

Purpose of the Study:

• To investigate if neurodegenerative biomarkers in CSF can distinguish between NPH patients who respond to CSF drainage and those who do not.
• To explore the association between Alzheimer's disease (AD) biomarkers and treatment response in suspected NPH patients.

Main Methods:

• Studied 62 patients with NPH-indicative MRI findings, assessing cognitive and gait functions before and after CSF drainage.
• Measured CSF levels of S100 protein, neuron-specific enolase, β-amyloid protein, tau protein, and phospho-tau.
• Utilized ANOVA and multiple linear regression for statistical analysis.

Main Results:

• Patients with CSF profiles typical for Alzheimer's disease (n=28) showed significant cognitive and gait improvements post-CSF drainage.
• Patients without AD-like CSF profiles (n=34) did not experience significant improvements.
• Positive AD biomarkers in CSF predicted treatment response.

Conclusions:

• Findings suggest a link between Alzheimer's disease pathology and NPH.
• Supports a dichotomy of NPH into neurodegenerative and idiopathic forms.
• Idiopathic NPH may be less common than previously thought.