Chen Li-Jin, Tsai Sheng-Tzung, Tseng Guo-Fang
Department of Anatomy, College of Medicine, Tzu Chi University, Hualien, Taiwan.
Departments of Neurosurgery, School of Medicine, Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2022 Sep 5;35(1):18-23. doi: 10.4103/tcmj.tcmj_120_22. eCollection 2023 Jan-Mar.
Cerebrospinal fluid (CSF) and its drainage are crucial in clearing metabolic waste and maintaining the microenvironment of the central nervous system for proper functioning. Normal-pressure hydrocephalus (NPH) is a serious neurological disorder of the elderly with obstruction of CSF flow outside the cerebral ventricles, causing ventriculomegaly. The stasis of CSF in NPH compromises brain functioning. Although treatable, often with shunt implantation for drainage, the outcome depends highly on early diagnosis, which, however, is challenging. The initial symptoms of NPH are hard to be aware of and the complete symptoms overlap with those of other neurological diseases. Ventriculomegaly is not specific to NPH as well. The lack of knowledge on the initial stages in its development and throughout its progression further deters early diagnosis. Thus, we are in dire need for an appropriate animal model for researches into a more thorough understanding of its development and pathophysiology so that we can enhance the diagnosis and therapeutic strategies to improve the prognosis of NPH following treatment. With this, we review the few currently available experimental rodent NPH models for these animals are smaller in sizes, easier in maintenance, and having a rapid life cycle. Among these, a parietal convexity subarachnoid space kaolin injection adult rat model appears promising as it shows a slow onset of ventriculomegaly in association with cognitive and motor disabilities resembling the elderly NPH in humans.
脑脊液（CSF）及其引流对于清除代谢废物和维持中枢神经系统的微环境以确保其正常功能至关重要。正常压力脑积水（NPH）是一种严重的老年神经疾病，脑室外脑脊液流动受阻，导致脑室扩大。NPH中脑脊液的淤滞损害了脑功能。尽管可以治疗，通常通过植入分流管进行引流，但结果在很大程度上取决于早期诊断，然而，早期诊断具有挑战性。NPH的初始症状很难被察觉，并且其完整症状与其他神经疾病的症状重叠。脑室扩大也并非NPH所特有。对其发展初期及整个病程缺乏了解进一步阻碍了早期诊断。因此，我们迫切需要一种合适的动物模型来进行研究，以便更全面地了解其发展和病理生理学，从而能够改进诊断和治疗策略，改善NPH治疗后的预后。为此，我们回顾了目前可用的几种实验性啮齿动物NPH模型，因为这些动物体型较小，易于饲养，且生命周期较短。其中，顶叶凸面蛛网膜下腔注射高岭土的成年大鼠模型似乎很有前景，因为它显示出脑室扩大起病缓慢，并伴有类似于人类老年NPH的认知和运动障碍。
