正常压力脑积水伴发阿尔茨海默病。

Normal Pressure Hydrocephalus Associated with Alzheimer's Disease.

机构信息

Centre for Neurology and Neuropsychiatry, Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.

出版信息

Ann Neurol. 2020 Oct;88(4):703-711. doi: 10.1002/ana.25847. Epub 2020 Aug 5.

DOI:10.1002/ana.25847

PMID:32662116

Abstract

OBJECTIVE

The aim was to investigate whether neurodegenerative biomarkers in cerebrospinal fluid (CSF) differentiate patients with suspected normal pressure hydrocephalus (NPH) who respond to CSF drainage from patients who do not respond.

METHODS

Data from 62 consecutive patients who presented with magnetic resonance imaging changes indicative of NPH were studied with regard to cognitive and gait functions before and after drainage of 40-50ml of CSF. Additionally, S100 protein, neuron-specific enolase, β-amyloid protein, tau protein and phospho-tau were determined in CSF. Statistical analyses were carried out with ANOVA and multiple linear regression.

RESULTS

Patients with CSF constellations typical for Alzheimer's disease (n = 28) improved significantly in cognitive and gait-related functions after CSF drainage. In contrast, those patients without a CSF constellation typical for Alzheimer's disease (n = 34) did not improve in cognitive and gait-related functions after CSF drainage. In addition, positive CSF biomarkers for Alzheimer's disease predicted these improvements.

INTERPRETATION

Our data suggest an association between Alzheimer's disease and NPH changes, supporting the recently suggested dichotomy of a neurodegenerative NPH and a true idiopathic NPH, with the latter appearing to be rare. ANN NEUROL 2020;88:703-711.

摘要

目的

本研究旨在探讨脑脊液（CSF）中的神经退行性生物标志物是否可以区分对 CSF 引流有反应和无反应的疑似正常压力脑积水（NPH）患者。

方法

对 62 例连续就诊的患者进行前瞻性研究，这些患者的磁共振成像（MRI）改变提示有 NPH 表现，在引流 40-50ml CSF 前后对患者的认知和步态功能进行了评估。此外，还测定了 CSF 中的 S100 蛋白、神经元特异性烯醇化酶、β-淀粉样蛋白、tau 蛋白和磷酸化 tau 蛋白。采用方差分析和多元线性回归进行统计学分析。