Yang Yang, Guo Dandan, Yang Qingchao, Yang Chenlu, Liu Jinde, Liu Heyin, Liu Wen, Liu Yuqian, Li Yi, Liu Yiming
Department of Neurology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, Shandong, China.
Fluids Barriers CNS. 2025 Jul 8;22(1):71. doi: 10.1186/s12987-025-00682-5.
Neuroinflammation may be involved in the pathogenesis of idiopathic normal pressure hydrocephalus (iNPH). However, the specific changes in the peripheral inflammatory state of patients with iNPH remain unclear.
To explore the changes in the peripheral inflammatory state of patients with iNPH and their potential value as biomarkers of clinical diagnosis and disease severity.
In this cross-sectional study, 119 iNPH patients with AD-negative pathology and 200 healthy controls (HCs) were enrolled. Clinical characteristics, including the Idiopathic Normal Pressure Hydrocephalus Grading Scale (iNPHGS), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), were collected along with inflammatory parameters in the peripheral blood. Logistic regression was applied to evaluate differences in peripheral inflammatory indicators, adjusting for age, sex, and comorbidities. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the inflammatory markers. Correlations between inflammatory parameters and clinical characteristics were assessed.
Significant differences in inflammatory parameters, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and prognostic nutritional index (PNI), were observed between iNPH patients and HCs after adjusting for age, sex and comorbidities. The combination of PNI and platelet-to-high-density lipoprotein ratio (PHR) distinguished iNPH patients from HCs most significantly (area under the curve [AUC] = 0.820). Neutrophil ratio and lymphocyte ratio were associated with clinical severity and cognitive impairment of patients with iNPH.
iNPH patients exhibit an elevated peripheral inflammatory state. Peripheral inflammatory parameters, especially neutrophil ratio and lymphocyte ratio, are associated with disease severity and cognitive impairment, suggesting their potential as therapeutic targets and offering new insights into the pathophysiology of iNPH. Additionally, the inflammatory peripheral parameters may serve as valuable and convenient method in assisting clinical diagnosis.
神经炎症可能参与特发性正常压力脑积水（iNPH）的发病机制。然而，iNPH患者外周炎症状态的具体变化仍不清楚。
探讨iNPH患者外周炎症状态的变化及其作为临床诊断和疾病严重程度生物标志物的潜在价值。
在这项横断面研究中，纳入了119例病理检查为AD阴性的iNPH患者和200名健康对照者（HCs）。收集临床特征，包括特发性正常压力脑积水分级量表（iNPHGS）、简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA），以及外周血中的炎症参数。应用逻辑回归评估外周炎症指标的差异，并对年龄、性别和合并症进行校正。采用受试者工作特征（ROC）分析评估炎症标志物的诊断性能。评估炎症参数与临床特征之间的相关性。
在校正年龄、性别和合并症后，iNPH患者和HCs之间在炎症参数上存在显著差异，如中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和预后营养指数（PNI）。PNI与血小板与高密度脂蛋白比值（PHR）的组合对iNPH患者和HCs的区分最为显著（曲线下面积[AUC]=0.820）。中性粒细胞比例和淋巴细胞比例与iNPH患者的临床严重程度和认知障碍相关。
iNPH患者外周炎症状态升高。外周炎症参数，尤其是中性粒细胞比例和淋巴细胞比例，与疾病严重程度和认知障碍相关，提示它们作为治疗靶点的潜力，并为iNPH的病理生理学提供了新的见解。此外，外周炎症参数可能是辅助临床诊断的有价值且便捷的方法。
