Kamalian Aida, Masoudi Maryam, Foroughmand Iman, Moghekar Abhay
Neurology Department, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Neurosurg Clin N Am. 2025 Apr;36(2):207-231. doi: 10.1016/j.nec.2024.11.008. Epub 2025 Feb 5.
Idiopathic normal pressure hydrocephalus (iNPH) is a treatable condition marked by gait disturbances, cognitive decline, and urinary incontinence. Biomarkers play a crucial role in distinguishing iNPH from Alzheimer's disease (AD) and predicting shunt surgery outcomes. Aβ1-42, Aβ1-40, t-tau, and p-tau181 differentiate iNPH from AD, with iNPH showing a higher Aβ1-42/Aβ1-40 ratio and normal tau levels. Neurofilament light chain and soluble amyloid precursor protein derivatives provide prognostic insights with lower preoperative levels linked to better surgical outcomes. Elevated LRG-1 and MCP-1 in cerebrospinal fluid aid in diagnosis and predict favorable responses to shunt surgery, enhancing clinical decision making and patient care.
特发性正常压力脑积水（iNPH）是一种可治疗的疾病，其特征为步态障碍、认知衰退和尿失禁。生物标志物在区分iNPH与阿尔茨海默病（AD）以及预测分流手术结果方面起着至关重要的作用。β淀粉样蛋白1-42（Aβ1-42）、β淀粉样蛋白1-40（Aβ1-40）、总tau蛋白（t-tau）和磷酸化tau蛋白181（p-tau181）可将iNPH与AD区分开来，iNPH表现出更高的Aβ1-42/Aβ1-40比值和正常的tau蛋白水平。神经丝轻链和可溶性淀粉样前体蛋白衍生物提供预后信息，术前水平较低与更好的手术结果相关。脑脊液中富含半胱氨酸的酸性分泌蛋白61（LRG-1）和单核细胞趋化蛋白-1（MCP-1）升高有助于诊断并预测对分流手术的良好反应，从而加强临床决策和患者护理。
