Cerebral blood flow and Alzheimer's disease‐related biomarkers in cerebrospinal fluid in idiopathic normal pressure hydrocephalus

2019 ◽  
Vol 19 (6) ◽  
pp. 527-538 ◽  
Author(s):  
Shingo Azuma ◽  
Hiroaki Kazui ◽  
Hideki Kanemoto ◽  
Yukiko Suzuki ◽  
Shunsuke Sato ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Blood Flow ◽  
Cerebrospinal Fluid ◽  
Cerebral Blood Flow ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus

Alzheimer’s Disease Biomarkers in Idiopathic Normal Pressure Hydrocephalus: Linking Functional Connectivity and Clinical Outcome

2021 ◽  
Vol 83 (4) ◽  
pp. 1717-1728 ◽  
Author(s):  
Giulia Bommarito ◽  
Dimitri Van De Ville ◽  
Giovanni B. Frisoni ◽  
Valentina Garibotto ◽  
Federica Ribaldi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Functional Connectivity ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Cognitive Status ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Response To Treatment ◽  
Timed Up And Go

Background: Alzheimer’s disease (AD) pathology impacts the response to treatment in patients with idiopathic normal pressure hydrocephalus (iNPH), possibly through changes in resting-state functional connectivity (rs-FC). Objective: To explore the relationship between cerebrospinal fluid biomarkers of AD and the default mode network (DMN)/hippocampal rs-FC in iNPH patients, based on their outcome after cerebrospinal fluid tap test (CSFTT), and in patients with AD. Methods: Twenty-six iNPH patients (mean age: 79.9±5.9 years; 12 females) underwent MRI and clinical assessment before and after CSFTT and were classified as responders (Resp) or not (NResp), based on the improvement at the timed up and go test and walking speed. Eleven AD patients (mean age: 70.91±5.2 years; 5 females), matched to iNPH for cognitive status, were also included. DMN and hippocampal rs-FC was related to amyloid-β42 and phosphorylated tau (pTau) levels. Results: Lower amyloid-β42 levels were associated with reduced inter- and intra-network rs-FC in NResp, and the interaction between amyloid-β42 and rs-FC was a predictor of outcome after CSFTT. The rs-FC between DMN and salience networks positively correlated to amyloid-β42 levels in both NResp and AD patients. The increase in the inter-network rs-FC after CSFTT was associated with higher pTau and lower amyloid-β42 levels in NResp, and to lower pTau levels in Resp. Conclusion: Amyloid-β42 and pTau impact on rs-FC and its changes after CSFTT in iNPH patients. The interaction between AD biomarkers and rs-FC might explain the responder status in iNPH.

Idiopathic normal pressure hydrocephalus and Alzheimer's disease in clinical practice: comorbidity and differentiation

2020 ◽  
pp. 36-43
Author(s):  
V. Yu. Lobzin ◽  
M. R.o. Alizade ◽  
A. V. Lapina ◽  
S. V. Lobzin ◽  
K. A. Kolmakova ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Brain Parenchyma ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Protein Biomarkers ◽  
Brain Functions

The idiopathic normal pressure hydrocephalus (Hakim – Adams syndrome) is characterized by the expansion of cerebrospinal cavities, which is clinically manifested by triad symptoms: cognitive impairment, impaired gait and urination. In this research the severity and modality of cognitive impairment, the pattern of gait changes and the levels of protein biomarkers of amyloidosis and neurodegeneration and neuroimaging changes was evaluated for idiopathic normal pressure hydrocephalus, Alzheimer's disease and their combination. It has been established that for patients with idiopathic normal pressure hydrocephalus the most characteristic is the dysregulatory type of disorders of higher brain functions, while for patients with a combination of Alzheimer's disease and idiopathic normal pressure hydrocephalus, mnemonic disorders are also detected. The specific changes of cerebrospinal fluid in patients with idiopathic normal pressure hydrocephalus are higher levels of amyloid beta, a decrease concentration of tau and phosphorylated tau-protein compared to patients with Alzheimer's disease. In the case of a combination of diseases (comorbidity), it was characterized by intermediate results by cerebrospinal fluid biomarkers. We also revealed patterns of transformation of moderate cognitive impairment into dementia (according to the ratio of tau/Aβ‑42 and ftau /Aβ‑42). The value of evaluating the results of magnetic resonance imaging using special techniques that evaluate both the expansion of the ventricular system and atrophy of the brain parenchyma. Comorbid patients are characterized by a combination of these processes based on the results of neuroimaging. That is why it is necessary to use complex visually analog neuroimaging scales for differential diagnosis and establishing diagnosis. Also, in the course of this work, an algorithm is proposed for mandatory clinical-neuropsychological and laboratory-instrumental examination of patients with cognitive impairment in idiopathic normal pressure hydrocephalus, Alzheimer's disease and their combination.

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