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Idiopathic normal-pressure hydrocephalus, cerebrospinal fluid biomarkers, and the cerebrospinal fluid tap test.
J Clin Neurosci 2014; 21(8):1398-403JC

Abstract

Cerebrospinal fluid (CSF) biomarkers, including soluble amyloid β-42 (Aβ-42) and phosphorylated-tau (P-tau), reflect core pathophysiological features of Alzheimer's disease (AD). AD is frequently a concomitant pathology in older patients with idiopathic normal-pressure hydrocephalus (iNPH), and somewhat similar altered CSF dynamics exist in both AD and iNPH. We therefore investigated relationships between lumbar CSF biomarkers Aβ-42 and P-tau and clinical parameters in iNPH patients, along with differences in these biomarkers between CSF tap test (CSFTT) responders and non-responders. Thirty-one iNPH patients (14 CSFTT responders and 17 CSFTT non-responders) were included in the final analysis. We found lower CSF Aβ-42 correlated with poor cognitive performance (r=0.687, p<0.001 for Korean Mini Mental State Examination; r=0.568, p=0.001 for Frontal Assessment Battery; r=-0.439, p=0.014 for iNPH grading scale [iNPHGS] cognitive score; r=-0.588, p=0.001 for Clinical Dementia Rating Scale), and lower CSF P-tau correlated with gait dysfunction (r=-0.624, p<0.001 for Timed Up and Go Test; r=-0.652, p<0.001 for 10meter walking test; r=-0.578, p=0.001 for Gait Status Scale; r=-0.543, p=0.002 for iNPHGS gait score). In subgroup analysis, CSF P-tau/Aβ-42 ratios were significantly higher in CSFTT non-responders compared to responders (p=0.027). Two conjectures are suggested. One, CSF biomarkers may play different and characteristic roles in relation to different iNPH symptoms such as cognition and gait. Two, comorbid AD pathology in iNPH patients may affect the response to the CSFTT. Larger studies using combinations of other biomarkers associated with AD would be necessary to evaluate these hypotheses.

Authors+Show Affiliations

Department of Neurology, Kyungpook National University School of Medicine, 50 Samdeok-dong 2-ga, Jung-gu, Daegu 700-721, South Korea.Department of Neurology, Kyungpook National University School of Medicine, 50 Samdeok-dong 2-ga, Jung-gu, Daegu 700-721, South Korea.Department of Pharmacology, Kyungpook National University School of Medicine, Daegu, South Korea; Brain Science & Engineering Institute, Kyungpook National University School of Medicine, Daegu, South Korea.Department of Pharmacology, Kyungpook National University School of Medicine, Daegu, South Korea; Brain Science & Engineering Institute, Kyungpook National University School of Medicine, Daegu, South Korea.Department of Neurology, Kyungpook National University School of Medicine, 50 Samdeok-dong 2-ga, Jung-gu, Daegu 700-721, South Korea; Brain Science & Engineering Institute, Kyungpook National University School of Medicine, Daegu, South Korea. Electronic address: neuromd@knu.ac.kr.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24836892

Citation

Kang, Kyunghun, et al. "Idiopathic Normal-pressure Hydrocephalus, Cerebrospinal Fluid Biomarkers, and the Cerebrospinal Fluid Tap Test." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 21, no. 8, 2014, pp. 1398-403.
Kang K, Ko PW, Jin M, et al. Idiopathic normal-pressure hydrocephalus, cerebrospinal fluid biomarkers, and the cerebrospinal fluid tap test. J Clin Neurosci. 2014;21(8):1398-403.
Kang, K., Ko, P. W., Jin, M., Suk, K., & Lee, H. W. (2014). Idiopathic normal-pressure hydrocephalus, cerebrospinal fluid biomarkers, and the cerebrospinal fluid tap test. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 21(8), pp. 1398-403. doi:10.1016/j.jocn.2013.11.039.
Kang K, et al. Idiopathic Normal-pressure Hydrocephalus, Cerebrospinal Fluid Biomarkers, and the Cerebrospinal Fluid Tap Test. J Clin Neurosci. 2014;21(8):1398-403. PubMed PMID: 24836892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Idiopathic normal-pressure hydrocephalus, cerebrospinal fluid biomarkers, and the cerebrospinal fluid tap test. AU - Kang,Kyunghun, AU - Ko,Pan-Woo, AU - Jin,Myungwon, AU - Suk,Kyoungho, AU - Lee,Ho-Won, Y1 - 2014/05/14/ PY - 2013/08/19/received PY - 2013/09/29/revised PY - 2013/11/13/accepted PY - 2014/5/20/entrez PY - 2014/5/20/pubmed PY - 2015/3/5/medline KW - Biomarker KW - Cerebrospinal fluid KW - Normal pressure hydrocephalus KW - Phosphorylated-tau KW - Predictive value of tests KW - β amyloid SP - 1398 EP - 403 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 21 IS - 8 N2 - Cerebrospinal fluid (CSF) biomarkers, including soluble amyloid β-42 (Aβ-42) and phosphorylated-tau (P-tau), reflect core pathophysiological features of Alzheimer's disease (AD). AD is frequently a concomitant pathology in older patients with idiopathic normal-pressure hydrocephalus (iNPH), and somewhat similar altered CSF dynamics exist in both AD and iNPH. We therefore investigated relationships between lumbar CSF biomarkers Aβ-42 and P-tau and clinical parameters in iNPH patients, along with differences in these biomarkers between CSF tap test (CSFTT) responders and non-responders. Thirty-one iNPH patients (14 CSFTT responders and 17 CSFTT non-responders) were included in the final analysis. We found lower CSF Aβ-42 correlated with poor cognitive performance (r=0.687, p<0.001 for Korean Mini Mental State Examination; r=0.568, p=0.001 for Frontal Assessment Battery; r=-0.439, p=0.014 for iNPH grading scale [iNPHGS] cognitive score; r=-0.588, p=0.001 for Clinical Dementia Rating Scale), and lower CSF P-tau correlated with gait dysfunction (r=-0.624, p<0.001 for Timed Up and Go Test; r=-0.652, p<0.001 for 10meter walking test; r=-0.578, p=0.001 for Gait Status Scale; r=-0.543, p=0.002 for iNPHGS gait score). In subgroup analysis, CSF P-tau/Aβ-42 ratios were significantly higher in CSFTT non-responders compared to responders (p=0.027). Two conjectures are suggested. One, CSF biomarkers may play different and characteristic roles in relation to different iNPH symptoms such as cognition and gait. Two, comorbid AD pathology in iNPH patients may affect the response to the CSFTT. Larger studies using combinations of other biomarkers associated with AD would be necessary to evaluate these hypotheses. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/24836892/Idiopathic_normal_pressure_hydrocephalus_cerebrospinal_fluid_biomarkers_and_the_cerebrospinal_fluid_tap_test_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(14)00098-8 DB - PRIME DP - Unbound Medicine ER -