Neuropeptides in Cerebrospinal Fluid in Normal-Pressure Hydrocephalus and Dementia

Wikkelsø, Carsten; Ekman, Rolf; Westergren, Irena; Johansson, Barbro

doi:10.1159/000116653

Cited by 27 publications

(28 citation statements)

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“…However, little effort has been made to fi nd methods that can distinguish iNPH from other dementing illnesses. Potential diagnostic markers for distinguishing iNPH from other dementing illnesses that have been examined include tau protein and neuropeptides in the CSF [44][45][46] and reduced cerebral blood fl ow in the white matter or the frontal lobe [34,35] , but the usefulness of these markers has not been confi rmed. Recently, MRI has been reported to be useful for distinguishing iNPH from AD [7,8] .…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment in Patients with Idiopathic Normal Pressure Hydrocephalus

Oginö

Kazui

Miyoshi

et al. 2006

Dement Geriatr Cogn Disord

108

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Cognitive impairment in patients with idiopathic normal pressure hydrocephalous (iNPH) has not been clearly documented. We performed standardized neuropsychological assessments of 21 patients with iNPH and of 42 patients with Alzheimer’s disease (AD) matched to the patients with iNPH 2:1 by age, sex, and Mini-Mental State Examination score. Compared with the AD group, the iNPH group scored significantly higher on the orientation subtest of the Alzheimer’s Disease Assessment Scale and on the general memory and delayed recall subtests of the Wechsler Memory Scale-Revised (WMS-R), and significantly lower on the attention/concentration subtest of the WMS-R and on the digit span, arithmetic, block design and digit symbol substitution subtests of the Wechsler Adult Intelligence Scale-Revised. The impairment of frontal lobe functions is disproportionately severe and memory impairment is disproportionately mild in patients with iNPH compared with AD. Recognition of these features contributes to an early diagnosis, which can lead to a better prognosis.

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Section: Discussionmentioning

confidence: 99%

Cognitive Impairment in Patients with Idiopathic Normal Pressure Hydrocephalus

Oginö

Kazui

Miyoshi

et al. 2006

Dement Geriatr Cogn Disord

108

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“…Previous reports show that VIP in CSF is reduced in NPH compared with controls and that concentrations increase after shunt surgery,37 54 implying reduced VIP transmission in NPH secondary to the reduced metabolism and rCBF 2829 A speculative explanation for the higher VIP concentration in patients with SAE could be that the VIP-ergic neurons are activated to accomplish a compensatory vasodilatation.…”

Section: Discussionmentioning

confidence: 99%

“…Neuropeptide Y (NPY)36 and vasoactive intestinal peptide (VIP)37 were determined as previously described. Tau protein was determined using a sandwich enzyme linked immunosorbent assay (ELISA) constructed to measure total tau (both normal tau and PHF-tau), as described previously 38…”

Section: Methodsmentioning

confidence: 99%

CSF sulfatide distinguishes between normal pressure hydrocephalus and subcortical arteriosclerotic encephalopathy

Tullberg

Månsson²,

Fredman³

et al. 2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Objectives-To examine the CSF concentrations of molecules reflecting demyelination, neuronal and axonal degeneration, gliosis, monoaminergic neuronal function, and aminergic and peptidergic neurotransmission in a large series of patients with normal pressure hydrocephalus (NPH) or subcortical arteriosclerotic encephalopathy (SAE), to elucidate pathogenic, diagnostic, and prognostic features. Methods-CSF concentrations of glycosphingolipid (sulfatide), proteins (neurofilament triplet protein (NFL), glial fibrillary acidic protein (GFAP)), neuropeptides (vasoactive intestinal peptide (VIP), 4-aminobutyric acid (GABA)), and monoamines (homovanillic acid (HVA), 5-hydroxy-indoleacetic acid (5-HIAA), 4-hydroxy-3-methoxyphenylglycol (HMPG)) were analysed in 43 patients with NPH and 19 patients with SAE. The diagnoses of NPH and SAE were based on strict criteria and patients with NPH were subsequently operated on. Twelve clinical variables, psychometric tests measuring perceptual speed, accuracy, learning, and memory and a psychiatric evaluation were performed in all patients and before and after a shunt operation in patients with NPH. Results-The CSF sulfatide concentration was markedly increased in patients with SAE (mean 766, range 300-3800 nmol/l) compared with patients with NPH (mean 206, range 50-400 nmol/l) (p<0.001). 5-HIAA, GABA, and VIP in CSF were higher in patients with SAE than in patients with NPH. The patients with NPH with cerebrovascular aetiology had higher sulfatide concentrations and a poorer outcome after shunt surgery than patients with NPH with other aetiologies. Conclusions-The pathogenesis of the white matter changes in NPH and SAE is diVerent and ischaemic white matter changes can be a part of the NPH state. The markedly increased CSF sulfatide concentrations in patients with SAE indicate ongoing demyelination as an important pathophysiological feature of SAE. The CSF sulfatide concentration distinguished between patients with SAE and those with NPH with a sensitivity of 74% and a specificity of 94%, making it an important diagnostic marker.(J Neurol Neurosurg Psychiatry 2000;69:74-81)

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“…Thus, NFL and TNF-alpha can be markers of the reversibility of neuronal damage. 119,124) Neuropeptides including delta-sleep-inducing peptide, peptide YY and somatostatin, 132) monoamine and lactic acid, 68) and cholecystokinin 28) show low values in iNPH.…”

Section: Csf and Serum Biochemical Tests A Csf Tau Protein Monoaminmentioning

confidence: 99%

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus Guidelines From the Guidelines Committee of Idiopathic Normal Pressure Hydrocephalus, the Japanese Society of Normal Pressure Hydrocephalus

Ishikawa

Hashimoto

Kuwana

et al. 2008

Neurol. Med. Chir.(Tokyo)

198

184

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With the rapid aging of Japanese society, medical care of the elderly has become an important social issue. Among various disorders manifesting dementia, gait disturbance, and urinary incontinence in the elderly population, normal pressure hydrocephalus (NPH), especially of idiopathic type (iNPH), is becoming noteworthy. The Guidelines for management of iNPH in Japan are created in compliance with the evidence-based medicine methods and published in 2004. This English version is made to show the diagnosis and treatment of iNPH with reference to the socio-medical background in Japan and to promote the international research on iNPH. They propose three diagnostic levels; possible, probable, and definite. They indicate the diagnostic importance of high convexity tightness and dilated sylvian fissure with mild to moderate ventriculomegaly on coronal magnetic resonance imaging. The cerebrospinal fluid tap test is regarded as an important diagnostic test because of its simplicity to perform and high predictability of the shunt efficacy. The use of programmable valves at shunt surgeries is recommended. Flowcharts for diagnosis, preoperative assessment, and prevention for complications of shunt surgery are made to promote a wide use of them.

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Neuropeptides in Cerebrospinal Fluid in Normal-Pressure Hydrocephalus and Dementia

Cited by 27 publications

References 0 publications

Cognitive Impairment in Patients with Idiopathic Normal Pressure Hydrocephalus

Cognitive Impairment in Patients with Idiopathic Normal Pressure Hydrocephalus

CSF sulfatide distinguishes between normal pressure hydrocephalus and subcortical arteriosclerotic encephalopathy

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus Guidelines From the Guidelines Committee of Idiopathic Normal Pressure Hydrocephalus, the Japanese Society of Normal Pressure Hydrocephalus

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