Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard avenue, Toronto, ON, M5T 2S8, Canada.
Department of medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada.
Sci Rep. 2020 Jun 4;10(1):9106. doi: 10.1038/s41598-020-66154-y.
Our study aimed to: 1)investigate the diagnostic utility of CSF Aβ42, t-tau, and p-tau to differentiate normal-pressure-hydrocephalus(NPH) from Alzheimer's-disease(AD) and normal-controls; and 2)investigate if age and ventricular size affect the levels of CSF biomarkers in NPH patients. We recruited 131 participants: (a)Suspected-NPH: 72 with ventriculomegaly and clinical symptoms of NPH. These participants were then divided into two groups of 1)Probable-NPH (N = 38) and 2)Unlikely-NPH (N = 34) based on whether participants experienced gait improvement after removal of a large amount of CSF; (b)AD group: 30 participants with CSF biomarkers and cognitive symptoms consistent with AD; (c)Control-group: 29 participants who were cognitively and functionally normal. Lower levels of CSF Aβ42 and p-tau were observed in the probable-NPH compared to the normal controls(444.22 ± 163.3 vs. 1213.75 ± 556.5; and 26.05 ± 9.2 vs. 46.16 ± 13.3 pg/mL; respectively). Lower levels of CSF p-tau and t-tau were found in the probable-NPH compared to the AD(26.05 ± 9.2 vs. 114.95 ± 28.2; and 193.29 ± 92.3 vs. 822.65 ± 311.5 pg/mL; respectively) but the CSF-Aβ42 was low in both the probable-NPH and AD. CSF-Aβ42 correlated with age and Evans-index only in the probable-NPH(r = 0.460, p = 0.004; and r = -0.530, p = 0.001; respectively). Our study supports the hypothesis that age-related atrophy results in better Aβ42 clearance in the CSF because of the increase in the interstitial space.
1）探讨 CSF Aβ42、t-tau 和 p-tau 对正常压力脑积水（NPH）与阿尔茨海默病（AD）和正常对照的诊断效用；2）探讨年龄和脑室大小是否影响 NPH 患者 CSF 生物标志物的水平。我们招募了 131 名参与者：（a）疑似 NPH：72 名伴有脑室扩大和 NPH 临床症状。这些参与者随后根据是否在大量 CSF 清除后出现步态改善分为两组：1）可能的 NPH（N=38）和 2）不太可能的 NPH（N=34）；（b）AD 组：30 名 CSF 生物标志物和认知症状符合 AD 的参与者；（c）对照组：29 名认知和功能正常的参与者。与正常对照组相比，可能的 NPH 中 CSF Aβ42 和 p-tau 的水平较低（444.22±163.3 与 1213.75±556.5；26.05±9.2 与 46.16±13.3 pg/mL；分别）。与 AD 相比，可能的 NPH 中 CSF p-tau 和 t-tau 的水平较低（26.05±9.2 与 114.95±28.2；193.29±92.3 与 822.65±311.5 pg/mL；分别），但 CSF-Aβ42 在可能的 NPH 和 AD 中均较低。CSF-Aβ42 仅与年龄和 Evans 指数在可能的 NPH 中相关（r=0.460，p=0.004；r=-0.530，p=0.001；分别）。我们的研究支持以下假说，即年龄相关萎缩导致 CSF 中 Aβ42 清除增加，从而导致 Aβ42 清除增加，这是由于间质空间增加所致。
