Normal‐Pressure Hydrocephalus, Sleep Apnea Syndrome, and Quality of Life in an Octagenarian

Attier-Zmudka, Jadwiga; Sérot, Jean‐Marie; Douadi, Y.; Capel, Cyrille; Bouzerar, R.; Balédent, Olivier

doi:10.1111/jgs.14422

Cited by 4 publications

(2 citation statements)

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“…It shows that altered CSF flow is associated with cognitive deficits in elderly patients, and thus suggests that treatments aiming at restoring normal CSF flow could reduce cognitive deficits. This is in accordance with a clinical observation in our practice, of a patient who recovered from debilitating neurocognitive disorders after sleep apnea treatment and ventriculoperitoneal shunting (Attier-Zmudka et al, 2016). However, this study has certain limitations.…”

Section: Discussionsupporting

confidence: 91%

“…Measurement of CSF flow as performed in this study thus presents the opportunity to better diagnose neurocognitive disorders of the elderly and offer appropriate treatment. Further, a proportion of AD patients is characterized by symptoms resembling NPH (Silverberg et al, 2002; Chakravarty, 2004), and in light of our findings, it is likely that CSF flow impairment is responsible for some cognitive impairment in these patients, who could therefore benefit from treatment (Attier-Zmudka et al, 2016).…”

Section: Discussionmentioning

confidence: 53%

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Decreased Cerebrospinal Fluid Flow Is Associated With Cognitive Deficit in Elderly Patients

Attier-Zmudka

Sérot

Valluy

et al. 2019

Front. Aging Neurosci.

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Background: Disruptions in cerebrospinal fluid (CSF) flow during aging could compromise protein clearance from the brain and contribute to the etiology of Alzheimer’s Disease (AD). Objective: To determine whether CSF flow is associated with cognitive deficit in elderly patients (>70 years). Methods: We studied 92 patients admitted to our geriatric unit for non-acute reasons using phase-contrast magnetic resonance imaging (PC-MRI) to calculate their ventricular and spinal CSF flow, and assessed their global cognitive status, memory, executive functions, and praxis. Multivariable regressions with backward selection (criterion p < 0.15) were performed to determine associations between cognitive tests and ventricular and spinal CSF flow, adjusting for depression, anxiety, and cardiovascular risk factors. Results: The cohort comprised 71 women (77%) and 21 (33%) men, aged 84.1 ± 5.2 years (range, 73–96). Net ventricular CSF flow was 52 ± 40 μL/cc (range, 0–210), and net spinal CSF flow was 500 ± 295 μL/cc (range, 0–1420). Ventricular CSF flow was associated with the number of BEC96 figures recognized (β = 0.18, CI, 0.02–0.33; p = 0.025). Spinal CSF flow was associated with the WAIS Digit Span Backward test (β = 0.06, CI, 0.01–0.12; p = 0.034), and categoric verbal fluency (β = 0.53, CI, 0.07–0.98; p = 0.024) and semantic verbal fluency (β = 0.55, CI, 0.07–1.02; p = 0.024). Conclusion: Patients with lower CSF flow had significantly worse memory, visuo-constructive capacities, and verbal fluency. Alterations in CSF flow could contribute to some of the cognitive deficit observed in patients with AD. Diagnosis and treatment of CSF flow alterations in geriatric patients with neurocognitive disorders could contribute to the prevention of their cognitive decline.

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Section: Discussionsupporting

confidence: 91%