Cerebrospinal fluid biomarkers for normal pressure hydrocephalus

Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible disease characterized by gait disturbance, a frontal-subcortical pattern of cognitive impairment, and urinary incontinence with disproportionately enlarged ventricles. Its prevalence rises with aging. Patients with iNPH are...

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Main Authors: Derya Kaya, Ahmet Turan Isik
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Biomarkers in Neuropsychiatry
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666144623000114
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author Derya Kaya
Ahmet Turan Isik
author_facet Derya Kaya
Ahmet Turan Isik
author_sort Derya Kaya
collection DOAJ
description Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible disease characterized by gait disturbance, a frontal-subcortical pattern of cognitive impairment, and urinary incontinence with disproportionately enlarged ventricles. Its prevalence rises with aging. Patients with iNPH are treated with shunt placement, and predicting the surgical outcome is not always easy. Cerebrospinal fluid (CSF) has inevitably been an attractive matrix for biomarker identification in both the diagnosis and treatment of iNPH and the disease may have individual CSF composition changes. Additionally, in order to detect iNPH earlier, implement treatment faster, and have better therapeutic effects, the incorporation of CSF biomarkers in the diagnostic and treatment process is essential. In this review, CSF biomarkers of Alzheimer’s disease pathology, axonal damage, neuronal damage, astroglial dysfunction, myelin damage, inflammation, and extracellular matrix protein remodeling have been evaluated and tried to emphasize those of which have highly consistent findings in the studies. CSF samples collected only at a single time point may not be sufficient to identify a promising marker in such a dynamic and used to be a common comorbid condition to other neurodegenerative diseases. These confounders demonstrate the limitations of using solely biomarkers to diagnose the disease and to foresee the outcome of the shunt surgery. Therefore, CSF samples collected antemortem at different time points and biopsy-confirmed iNPH patients with and without other neurodegenerative diseases would fill the gaps in identifying a valid biomarker. Longitudinal observations of shunt responders and non-responders in multicenter with well-defined cohorts are also needed to understand iNPH-specific markers. Finally, biomarkers of a bioinformatic approach that includes micro-RNAs, extracellular vesicles, metabolomics, the microbiome, or else are warranted to identify novel and useful diagnostic and prognostic biomarker tools in iNPH.
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spelling doaj.art-18ed58ea8e13492c9ec00b58a6f330192023-12-15T07:25:59ZengElsevierBiomarkers in Neuropsychiatry2666-14462023-12-019100071Cerebrospinal fluid biomarkers for normal pressure hydrocephalusDerya Kaya0Ahmet Turan Isik1Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, 35340 Izmir, TurkeyCorrespondence to: Unit for Brain Aging and Dementia, Department of Geriatric Medicine, School of Medicine, Dokuz Eylul University, Izmir, Turkey.; Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, 35340 Izmir, TurkeyIdiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible disease characterized by gait disturbance, a frontal-subcortical pattern of cognitive impairment, and urinary incontinence with disproportionately enlarged ventricles. Its prevalence rises with aging. Patients with iNPH are treated with shunt placement, and predicting the surgical outcome is not always easy. Cerebrospinal fluid (CSF) has inevitably been an attractive matrix for biomarker identification in both the diagnosis and treatment of iNPH and the disease may have individual CSF composition changes. Additionally, in order to detect iNPH earlier, implement treatment faster, and have better therapeutic effects, the incorporation of CSF biomarkers in the diagnostic and treatment process is essential. In this review, CSF biomarkers of Alzheimer’s disease pathology, axonal damage, neuronal damage, astroglial dysfunction, myelin damage, inflammation, and extracellular matrix protein remodeling have been evaluated and tried to emphasize those of which have highly consistent findings in the studies. CSF samples collected only at a single time point may not be sufficient to identify a promising marker in such a dynamic and used to be a common comorbid condition to other neurodegenerative diseases. These confounders demonstrate the limitations of using solely biomarkers to diagnose the disease and to foresee the outcome of the shunt surgery. Therefore, CSF samples collected antemortem at different time points and biopsy-confirmed iNPH patients with and without other neurodegenerative diseases would fill the gaps in identifying a valid biomarker. Longitudinal observations of shunt responders and non-responders in multicenter with well-defined cohorts are also needed to understand iNPH-specific markers. Finally, biomarkers of a bioinformatic approach that includes micro-RNAs, extracellular vesicles, metabolomics, the microbiome, or else are warranted to identify novel and useful diagnostic and prognostic biomarker tools in iNPH.http://www.sciencedirect.com/science/article/pii/S2666144623000114Normal pressure hydrocephalusInflammationNeurofilamentAstrogliaAmyloidTau
spellingShingle Derya Kaya
Ahmet Turan Isik
Cerebrospinal fluid biomarkers for normal pressure hydrocephalus
Biomarkers in Neuropsychiatry
Normal pressure hydrocephalus
Inflammation
Neurofilament
Astroglia
Amyloid
Tau
title Cerebrospinal fluid biomarkers for normal pressure hydrocephalus
title_full Cerebrospinal fluid biomarkers for normal pressure hydrocephalus
title_fullStr Cerebrospinal fluid biomarkers for normal pressure hydrocephalus
title_full_unstemmed Cerebrospinal fluid biomarkers for normal pressure hydrocephalus
title_short Cerebrospinal fluid biomarkers for normal pressure hydrocephalus
title_sort cerebrospinal fluid biomarkers for normal pressure hydrocephalus
topic Normal pressure hydrocephalus
Inflammation
Neurofilament
Astroglia
Amyloid
Tau
url http://www.sciencedirect.com/science/article/pii/S2666144623000114
work_keys_str_mv AT deryakaya cerebrospinalfluidbiomarkersfornormalpressurehydrocephalus
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