Abstract
Introduction: Idiopathic normal pressure hydrocephalus (iNPH) can be misdiagnosed with other neurodegenerative diseases, especially in the early disease stages. Considering the opportunity of the shunt surgery, iNPH should be diagnosed with accuracy. Here, we evaluate the utility of CSF biomarkers and their relationship with clinical features in the diagnosis of iNPH. Methods: We performed a multivariate analysis of the CSF levels of Aβ42, t-tau, and p-tau collected from four groups of patients: 14 iNPH, 14 progressive supranuclear palsy (PSP), 14 Alzheimer's disease (AD), 14 controls (CTL). Diagnostic accuracy of biomarkers was determined by the receiver operating characteristic curve analysis. Statistical correlation was calculated between each CSF biomarker and single clinical items of iNPH. Results: Aβ42 levels in iNPH were lower than controls, although not as low as in AD. Likewise, CSF t-tau and p-tau were lower in iNPH than in controls. Of interest, t-tau and p-tau were higher in AD than in controls and hence both t-tau and p-tau were significantly lower in iNPH than in AD. No differences were found between iNPH and PSP. CSF biomarkers levels did not correlate to clinical features of iNPH, whereas two significant correlations emerged within clinical parameters: cognitive impairment was related to gait difficulties, while ventricular enlargement correlated with continence disturbances. Conclusion: Measurement of CSF biomarker levels may be helpful in the differential diagnosis between iNPH and AD but not between iNPH and PSP. Both Aβ42 and tau levels appear unrelated to main clinical features of iNPH.
| Original language | English |
|---|---|
| Article number | 00086 |
| Journal | Frontiers in Neurology |
| Volume | 6 |
| Issue number | APR |
| DOIs | |
| Publication status | Published - 2015 |
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Keywords
- CSF biomarkers
- Idiopathic normal pressure hydrocephalus
- Progressive supranuclear palsy
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
Cite this
A clinical and biochemical analysis in the differential diagnosis of idiopathic normal pressure hydrocephalus. / Schirinzi, Tommaso; Sancesario, Giulia Maria; Ialongo, Cristiano; Imbriani, Paola; Madeo, Graziella; Toniolo, Sofia; Martorana, Alessandro; Pisani, Antonio.
In: Frontiers in Neurology, Vol. 6, No. APR, 00086, 2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A clinical and biochemical analysis in the differential diagnosis of idiopathic normal pressure hydrocephalus
AU - Schirinzi, Tommaso
AU - Sancesario, Giulia Maria
AU - Ialongo, Cristiano
AU - Imbriani, Paola
AU - Madeo, Graziella
AU - Toniolo, Sofia
AU - Martorana, Alessandro
AU - Pisani, Antonio
PY - 2015
Y1 - 2015
N2 - Introduction: Idiopathic normal pressure hydrocephalus (iNPH) can be misdiagnosed with other neurodegenerative diseases, especially in the early disease stages. Considering the opportunity of the shunt surgery, iNPH should be diagnosed with accuracy. Here, we evaluate the utility of CSF biomarkers and their relationship with clinical features in the diagnosis of iNPH. Methods: We performed a multivariate analysis of the CSF levels of Aβ42, t-tau, and p-tau collected from four groups of patients: 14 iNPH, 14 progressive supranuclear palsy (PSP), 14 Alzheimer's disease (AD), 14 controls (CTL). Diagnostic accuracy of biomarkers was determined by the receiver operating characteristic curve analysis. Statistical correlation was calculated between each CSF biomarker and single clinical items of iNPH. Results: Aβ42 levels in iNPH were lower than controls, although not as low as in AD. Likewise, CSF t-tau and p-tau were lower in iNPH than in controls. Of interest, t-tau and p-tau were higher in AD than in controls and hence both t-tau and p-tau were significantly lower in iNPH than in AD. No differences were found between iNPH and PSP. CSF biomarkers levels did not correlate to clinical features of iNPH, whereas two significant correlations emerged within clinical parameters: cognitive impairment was related to gait difficulties, while ventricular enlargement correlated with continence disturbances. Conclusion: Measurement of CSF biomarker levels may be helpful in the differential diagnosis between iNPH and AD but not between iNPH and PSP. Both Aβ42 and tau levels appear unrelated to main clinical features of iNPH.
AB - Introduction: Idiopathic normal pressure hydrocephalus (iNPH) can be misdiagnosed with other neurodegenerative diseases, especially in the early disease stages. Considering the opportunity of the shunt surgery, iNPH should be diagnosed with accuracy. Here, we evaluate the utility of CSF biomarkers and their relationship with clinical features in the diagnosis of iNPH. Methods: We performed a multivariate analysis of the CSF levels of Aβ42, t-tau, and p-tau collected from four groups of patients: 14 iNPH, 14 progressive supranuclear palsy (PSP), 14 Alzheimer's disease (AD), 14 controls (CTL). Diagnostic accuracy of biomarkers was determined by the receiver operating characteristic curve analysis. Statistical correlation was calculated between each CSF biomarker and single clinical items of iNPH. Results: Aβ42 levels in iNPH were lower than controls, although not as low as in AD. Likewise, CSF t-tau and p-tau were lower in iNPH than in controls. Of interest, t-tau and p-tau were higher in AD than in controls and hence both t-tau and p-tau were significantly lower in iNPH than in AD. No differences were found between iNPH and PSP. CSF biomarkers levels did not correlate to clinical features of iNPH, whereas two significant correlations emerged within clinical parameters: cognitive impairment was related to gait difficulties, while ventricular enlargement correlated with continence disturbances. Conclusion: Measurement of CSF biomarker levels may be helpful in the differential diagnosis between iNPH and AD but not between iNPH and PSP. Both Aβ42 and tau levels appear unrelated to main clinical features of iNPH.
KW - CSF biomarkers
KW - Idiopathic normal pressure hydrocephalus
KW - Progressive supranuclear palsy
UR - http://www.scopus.com/inward/record.url?scp=84930661214&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84930661214&partnerID=8YFLogxK
U2 - 10.3389/fneur.2015.00086
DO - 10.3389/fneur.2015.00086
M3 - Article
AN - SCOPUS:84930661214
VL - 6
JO - Frontiers in Neurology
JF - Frontiers in Neurology
SN - 1664-2295
IS - APR
M1 - 00086
ER -