Pyrgelis Efstratios-Stylianos, Paraskevas George P, Constantinides Vasilios C, Boufidou Fotini, Stefanis Leonidas, Kapaki Elisabeth
1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece.
Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece.
Biomedicines. 2024 Aug 20;12(8):1898. doi: 10.3390/biomedicines12081898.
Idiopathic normal-pressure hydrocephalus (iNPH) is a clinic-radiological neurological syndrome presenting with cognitive deficits, gait disturbances and urinary incontinence. It often coexists with Alzheimer's disease (AD). Due to the reversible nature of iNPH when promptly treated, a lot of studies have focused on possible biomarkers, among which are cerebrospinal fluid (CSF) biomarkers. The aim of the present study was to determine the rate of beta-amyloid pathology and AD co-pathology by measuring AD CSF biomarkers, namely, amyloid beta with 42 and 40 amino acids (Aβ42), the Aβ42/Aβ40 ratio, total Tau protein (t-Tau) and phosphorylated Tau protein at threonine 181 (p-Tau), in a cohort of iNPH patients, as well as to investigate the possible associations among CSF biomarkers and iNPH neuropsychological profiles. Fifty-three patients with iNPH were included in the present study. CSF Aβ42, Aβ40, t-Tau and p-Tau were measured in duplicate with double-sandwich ELISA assays. The neuropsychological evaluation consisted of the Mini-Mental State Examination, Frontal Assessment Battery, Five-Word Test and CLOX drawing tests 1 and 2. After statistical analysis, we found that amyloid pathology and AD co-pathology are rather common in iNPH patients and that higher values of t-Tau and p-Tau CSF levels, as well as the existence of the AD CSF profile, are associated with more severe memory impairment in the study patients. In conclusion, our study has confirmed that amyloid pathology and AD-co-pathology are rather common in iNPH patients and that CSF markers of AD pathology and t-Tau are associated with a worse memory decline in these patients.
特发性正常压力脑积水（iNPH）是一种临床-放射学神经综合征，表现为认知缺陷、步态障碍和尿失禁。它常与阿尔茨海默病（AD）共存。由于iNPH及时治疗具有可逆性，许多研究聚焦于可能的生物标志物，其中包括脑脊液（CSF）生物标志物。本研究的目的是通过测量AD脑脊液生物标志物，即含42和40个氨基酸的淀粉样β蛋白（Aβ42）、Aβ42/Aβ40比值、总tau蛋白（t-Tau）和苏氨酸181位点的磷酸化tau蛋白（p-Tau），来确定iNPH患者队列中β-淀粉样蛋白病变和AD共病变的发生率，并研究脑脊液生物标志物与iNPH神经心理学特征之间的可能关联。本研究纳入了53例iNPH患者。采用双夹心ELISA法对脑脊液Aβ42、Aβ40、t-Tau和p-Tau进行了重复测量。神经心理学评估包括简易精神状态检查、额叶评估量表、五字测试以及CLOX绘图测试1和2。经过统计分析，我们发现淀粉样蛋白病变和AD共病变在iNPH患者中相当常见，脑脊液t-Tau和p-Tau水平较高以及存在AD脑脊液特征与研究患者更严重的记忆损害相关。总之，我们的研究证实淀粉样蛋白病变和AD共病变在iNPH患者中相当常见，AD病变的脑脊液标志物和t-Tau与这些患者更严重的记忆衰退相关。
