Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People's Republic of China.
Diagnosis and Treatment Center for Hydrocephalus, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People's Republic of China.
Clin Interv Aging. 2021 Jan 15;16:139-153. doi: 10.2147/CIA.S290709. eCollection 2021.
Idiopathic normal pressure hydrocephalus (iNPH) is a rare neurological disorder with no clear prevalence factors and is a significant danger to the elderly. The intracranial glymphatic system is the internal environment that maintains brain survival and metabolism, and thus fluid exchange changes in the glymphatic system under various pathological conditions can provide important insights into the pathogenesis and differential diagnosis of many neurodegenerative diseases such as iNPH. iNPH can be diagnosed using a combination of clinical symptoms, imaging findings and history, and cerebrospinal fluid biomarkers due to the glymphatic system disorder. However, only few researchers have linked the two. Shunt surgery can improve the glymphatic system disorders in iNPH patients, and the surgical approach is determined using a combination of clinical diagnosis and trials. Therefore, we have composed this review to provide a future opportunity for elucidating the pathogenesis of iNPH based on the glymphatic system, and link the glymphatic system to the diagnosis and treatment of iNPH. The review will provide new insights into the medical research of iNPH.
特发性正常压力脑积水（iNPH）是一种罕见的神经退行性疾病，其发病原因尚不明确，对老年人危害较大。脑内的糖质淋系统是维持大脑生存和代谢的内环境，因此糖质淋系统在各种病理条件下的流体交换变化可以为许多神经退行性疾病（如 iNPH）的发病机制和鉴别诊断提供重要的线索。iNPH 可以通过临床症状、影像学发现和病史以及脑脊液生物标志物等多种方法进行诊断，这些都是由于糖质淋系统紊乱所致。然而，目前仅有少数研究人员将两者联系起来。分流手术可以改善 iNPH 患者的糖质淋系统紊乱，手术方法则是根据临床诊断和试验结果综合确定的。因此，我们撰写了这篇综述，以期基于糖质淋系统阐明 iNPH 的发病机制，并将糖质淋系统与 iNPH 的诊断和治疗联系起来。该综述将为 iNPH 的医学研究提供新的思路。
