Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to explore biochemical changes in the cerebrospinal fluid (CSF) induced by shunt surgery and the relationship between these changes and clinical improvement.</p> <p>Methods</p> <p>We...

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Main Authors: Tisell Magnus, Fredman Pam, Månsson Jan-Eric, Blennow Kaj, Tullberg Mats, Wikkelsö Carsten
Format: Article
Language:English
Published: BMC 2008-04-01
Series:Cerebrospinal Fluid Research
Online Access:http://www.cerebrospinalfluidresearch.com/content/5/1/9
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author Tisell Magnus
Fredman Pam
Månsson Jan-Eric
Blennow Kaj
Tullberg Mats
Wikkelsö Carsten
author_facet Tisell Magnus
Fredman Pam
Månsson Jan-Eric
Blennow Kaj
Tullberg Mats
Wikkelsö Carsten
author_sort Tisell Magnus
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>The aim of this study was to explore biochemical changes in the cerebrospinal fluid (CSF) induced by shunt surgery and the relationship between these changes and clinical improvement.</p> <p>Methods</p> <p>We measured clinical symptoms and analysed lumbar CSF for protein content, neurodegeneration and neurotransmission markers in patients with secondary (SNPH, n = 17) and idiopathic NPH (INPH, n = 18) before and 3 months after shunt surgery. Patients were divided into groups according to whether or not there was improvement in clinical symptoms after surgery.</p> <p>Results</p> <p>Preoperatively, the only pathological findings were elevated neurofilament protein (NFL), significantly more so in the SNPH patients than in the INPH patients, and elevated albumin content. Higher levels of NFL correlated with worse gait, balance, wakefulness and neuropsychological performance. Preoperatively, no differences were seen in any of the CSF biomarkers between patients that improved after surgery and those that did not improve. Postoperatively, a greater improvement in gait and balance performance correlated with a more pronounced reduction in NFL. Levels of albumin, albumin ratio, neuropeptide Y, vasoactive intestinal peptide and ganglioside GD3 increased significantly after shunting in both groups. In addition, Gamma amino butyric acid increased significantly in SNPH and tau in INPH.</p> <p>Conclusion</p> <p>We conclude that a number of biochemical changes occur after shunt surgery, but there are no marked differences between the SNPH and INPH patients. The results indicate that NFL may be a marker that can predict a surgically reversible state in NPH.</p>
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spelling doaj.art-f1485acb0d6a43e88752c19f38f96f792022-12-22T00:27:46ZengBMCCerebrospinal Fluid Research1743-84542008-04-0151910.1186/1743-8454-5-9Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalusTisell MagnusFredman PamMånsson Jan-EricBlennow KajTullberg MatsWikkelsö Carsten<p>Abstract</p> <p>Background</p> <p>The aim of this study was to explore biochemical changes in the cerebrospinal fluid (CSF) induced by shunt surgery and the relationship between these changes and clinical improvement.</p> <p>Methods</p> <p>We measured clinical symptoms and analysed lumbar CSF for protein content, neurodegeneration and neurotransmission markers in patients with secondary (SNPH, n = 17) and idiopathic NPH (INPH, n = 18) before and 3 months after shunt surgery. Patients were divided into groups according to whether or not there was improvement in clinical symptoms after surgery.</p> <p>Results</p> <p>Preoperatively, the only pathological findings were elevated neurofilament protein (NFL), significantly more so in the SNPH patients than in the INPH patients, and elevated albumin content. Higher levels of NFL correlated with worse gait, balance, wakefulness and neuropsychological performance. Preoperatively, no differences were seen in any of the CSF biomarkers between patients that improved after surgery and those that did not improve. Postoperatively, a greater improvement in gait and balance performance correlated with a more pronounced reduction in NFL. Levels of albumin, albumin ratio, neuropeptide Y, vasoactive intestinal peptide and ganglioside GD3 increased significantly after shunting in both groups. In addition, Gamma amino butyric acid increased significantly in SNPH and tau in INPH.</p> <p>Conclusion</p> <p>We conclude that a number of biochemical changes occur after shunt surgery, but there are no marked differences between the SNPH and INPH patients. The results indicate that NFL may be a marker that can predict a surgically reversible state in NPH.</p>http://www.cerebrospinalfluidresearch.com/content/5/1/9
spellingShingle Tisell Magnus
Fredman Pam
Månsson Jan-Eric
Blennow Kaj
Tullberg Mats
Wikkelsö Carsten
Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus
Cerebrospinal Fluid Research
title Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus
title_full Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus
title_fullStr Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus
title_full_unstemmed Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus
title_short Cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus
title_sort cerebrospinal fluid markers before and after shunting in patients with secondary and idiopathic normal pressure hydrocephalus
url http://www.cerebrospinalfluidresearch.com/content/5/1/9
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AT tullbergmats cerebrospinalfluidmarkersbeforeandaftershuntinginpatientswithsecondaryandidiopathicnormalpressurehydrocephalus
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