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Idiopathic normal pressure hydrocephalus

Afroditi-Despina Lalou, Virginia Levrini, Matthew Garnett, Eva Nabbanja, Dong-Joo Kim, Laurent Gergele, Anna Bjornson, Zofia Czosnyka, Marek Czosnyka
INTRODUCTION: The so-called Davson's equation relates baseline intracranial pressure (ICP) to resistance to cerebrospinal fluid outflow (Rout), formation of cerebrospinal fluid (If ) and sagittal sinus pressure (PSS ) There is a controversy over whether this fundamental equation is applicable in patients with normal pressure hydrocephalus (NPH). We investigated the relationship between Rout and ICP and also other compensatory, clinical and demographic parameters in NPH patients. METHOD: We carried out a retrospective study of 229 patients with primary NPH who had undergone constant-rate infusion studies in our hospital...
March 8, 2018: Acta Neurochirurgica
Per K Eide, Geir Ringstad
The glymphatic system plays a key role for clearance of waste solutes from the rodent brain. We recently found evidence of glymphatic circulation in the human brain when using magnetic resonance imaging (MRI) contrast agent as cerebrospinal fluid (CSF) tracer in conjunction with multiple MRI acquisitions (gMRI). The present study explored the hypothesis that reduced glymphatic clearance in entorhinal cortex (ERC) may be instrumental in idiopathic normal pressure hydrocephalus (iNPH) dementia. gMRI acquisitions were obtained over a 24-48 h time span in cognitively affected iNPH patients and non-cognitively affected patients with suspected CSF leaks...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Charlotte Selge, Florian Schoeberl, Andreas Zwergal, Georg Nuebling, Thomas Brandt, Marianne Dieterich, Roman Schniepp, Klaus Jahn
OBJECTIVE: To test whether quantitative gait analysis of gait under single- and dual-task conditions can be used for a differential diagnosis of progressive supranuclear palsy (PSP) and idiopathic normal-pressure hydrocephalus (iNPH). METHODS: In this cross-sectional study, temporal and spatial gait parameters were analyzed in 38 patients with PSP (Neurological Disorders and Stroke and Society for Progressive Supranuclear Palsy diagnostic criteria), 27 patients with iNPH (international iNPH guidelines), and 38 healthy controls...
February 21, 2018: Neurology
D C Engel, S D Adib, M U Schuhmann, C Brendle
BACKGROUND: Many radiological signs are known for the diagnosis of idiopathic normal pressure hydrocephalus (iNPH). However, there is little information about these signs in the pre-symptomatic phase. For pathophysiological investigative purposes we conducted a descriptive image analysis study on pre-symptomatic patients. METHODS: Patients that had contact with either the neurological or neurosurgical department of the university hospital Tuebingen from 2010 through 2016 with magnetic resonance images > 3 years before onset of symptoms, were included...
February 9, 2018: Fluids and Barriers of the CNS
Ippei Kitade, Ryuhei Kitai, Hiroyuki Neishi, Ken-Ichiro Kikuta, Seiichiro Shimada, Akihiko Matsumine
BACKGROUND: A few previous studies have reported a change in gait motion in idiopathic normal pressure hydrocephalus (iNPH) patients after shunt surgery compared with before shunt surgery; however, there has been no detailed quantitative investigation of gait, including kinetic and kinematic parameters. Furthermore, the relationship between gait parameters and magnetic resonance (MR) imaging has not been confirmed. RESEARCH QUESTION: We investigated the gait motion in patients with iNPH, and evaluated the relationship between kinetic gait parameters and MR imaging before and after shunt surgery...
January 12, 2018: Gait & Posture
Johan Virhammar, Katarina Laurell, Kristina Giuliana Cesarini, Elna-Marie Larsson
OBJECTIVE Postoperative decrease in ventricle size is usually not detectable either by visual assessment or by measuring the Evans index in patients with idiopathic normal pressure hydrocephalus (iNPH). The aim of the present study was to investigate whether the angle between the lateral ventricles (the callosal angle [CA]) increases and ventricular volume decreases after shunt surgery in patients with iNPH. METHODS Magnetic resonance imaging of the brain was performed before and 3 months after shunt surgery in 18 patients with iNPH...
February 2, 2018: Journal of Neurosurgery
Yuki Nagata, Akiyoshi Hirayama, Satsuki Ikeda, Aoi Shirahata, Futaba Shoji, Midori Maruyama, Mitsunori Kayano, Masahiko Bundo, Kotaro Hattori, Sumiko Yoshida, Yu-Ichi Goto, Katsuya Urakami, Tomoyoshi Soga, Kouichi Ozaki, Shumpei Niida
Background: Alzheimer's disease (AD) is a most common dementia in elderly people. Since AD symptoms resemble those of other neurodegenerative diseases, including idiopathic normal pressure hydrocephalus (iNPH), it is difficult to distinguish AD from iNPH for a precise and early diagnosis. iNPH is caused by the accumulation of cerebrospinal fluid (CSF) and involves gait disturbance, urinary incontinence, and dementia. iNPH is treatable with shunt operation which removes accumulated CSF from the brain ventricles...
2018: Biomarker Research
Sylwia Libard, Katarina Laurell, Kristina Giuliana Cesarini, Irina Alafuzoff
We had an opportunity to assess the change observed in the brain regarding Alzheimer's disease (AD)-related alterations, cell count, and inflammation that took place during a period of 21 months in a subject with a definite diagnosis of AD and idiopathic Normal Pressure Hydrocephalus (iNPH). Four neuronal markers, i.e., synaptophysin, microtubule associated protein 2, non-phosphorylated neurofilament H (SMI32), and embryonic lethal abnormal visual system proteins 3/4 HuC/HuD (HuC/HuD); three microglial markers CD68, Human Leucocytic Antigen DR, ionized calcium-binding adaptor molecule 1, glial fibrillary acidic protein (GFAP); and AD-related markers, hyperphosphorylated τ (HPτ) and amyloid-β (Aβ, Aβ40, Aβ42) were assessed...
2018: Journal of Alzheimer's Disease: JAD
Okko T Pyykkö, Ossi Nerg, Hanna-Mari Niskasaari, Timo Niskasaari, Anne M Koivisto, Mikko Hiltunen, Jussi Pihlajamäki, Tuomas Rauramaa, Maria Kojoukhova, Irina Alafuzoff, Hilkka Soininen, Juha E Jääskeläinen, Ville Leinonen
OBJECT: To investigate incidence, comorbidities, mortality, and causes of death in idiopathic normal pressure hydrocephalus (iNPH). METHODS: A cohort of 536 patients with possible NPH from a defined population with a median follow-up time of 5.1 years (range 0.04-19.9) was included in the study. Patients were evaluated by brain imaging and intraventricular pressure monitoring with a brain biopsy immunostained against amyloid-β and hyperphosphorylated tau. Hospital records were reviewed for vascular diseases and type 2 diabetes mellitus (T2DM)...
January 25, 2018: World Neurosurgery
Tommaso Schirinzi, Giulia Maria Sancesario, Giulia Di Lazzaro, Alessio D'Elia, Paola Imbriani, Simona Scalise, Antonio Pisani
Idiopathic normal pressure hydrocephalus (iNPH) is a disabling neurological disorder whose potential treatability is significantly limited by diagnostic uncertainty. In fact, typical clinical presentation occurs at late phases of disease, when CSF shunting could be ineffective. In recent years, measurement of different CSF proteins, whose concentration directly reflects neuropathological changes of CNS, has significantly improved both diagnostic timing and accuracy of neurodegenerative disease. Unfortunately iNPH lacks neuropathological hallmarks allowing the identification of specific disease biomarkers...
January 20, 2018: Journal of Neural Transmission
Sami Abu Hamdeh, Johan Virhammar, Dag Sehlin, Irina Alafuzoff, Kristina Giuliana Cesarini, Niklas Marklund
OBJECTIVE The authors conducted a study to test if the cortical brain tissue levels of soluble amyloid beta (Aβ) reflect the propensity of cortical Aβ aggregate formation and may be an additional factor predicting surgical outcome following idiopathic normal pressure hydrocephalus (iNPH) treatment. METHODS Highly selective ELISAs (enzyme-linked immunosorbent assays) were used to quantify soluble Aβ40, Aβ42, and neurotoxic Aβ oligomers/protofibrils, associated with Aβ aggregation, in cortical biopsy samples obtained in patients with iNPH (n = 20), sampled during ventriculoperitoneal (VP) shunt surgery...
January 19, 2018: Journal of Neurosurgery
Masami Goto, Osamu Abe, Shigeki Aoki, Koji Kamagata, Masaaki Hori, Tosiaki Miyati, Tsutomu Gomi, Tohoru Takeda
PURPOSE: To evaluate the error in segmented tissue images and to show the usefulness of the brain image in voxel-based morphometry (VBM) using Statistical Parametric Mapping (SPM) 12 software and 3D T1-weighted magnetic resonance images (3D-T1WIs) processed to simulate idiopathic normal pressure hydrocephalus (iNPH). MATERIALS AND METHODS: VBM analysis was performed on sagittal 3D-T1WIs obtained in 22 healthy volunteers using a 1.5T MR scanner. Regions of interest for the lateral ventricles of all subjects were carefully outlined on the original 3D-T1WIs, and two types of simulated 3D-T1WI were also prepared (non-dilated 3D-T1WI as normal control and dilated 3D-T1WI to simulate iNPH)...
January 18, 2018: Magnetic Resonance in Medical Sciences: MRMS
Maike Kuhn, Kurt-Wolfram Sühs, Manas K Akmatov, Frank Klawonn, Junxi Wang, Thomas Skripuletz, Volkhard Kaever, Martin Stangel, Frank Pessler
BACKGROUND: Varicella zoster virus (VZV) reactivation spans the spectrum from uncomplicated segmental herpes zoster to life-threatening disseminated CNS infection. Moreover, in the absence of a small animal model for this human pathogen, studies of pathogenesis at the organismal level depend on analysis of human biosamples. Changes in cerebrospinal fluid (CSF) metabolites may reflect critical aspects of host responses and end-organ damage in neuroinfection and neuroinflammation. We therefore applied a targeted metabolomics screen of CSF to three clinically distinct forms of VZV reactivation and infectious and non-infectious disease controls in order to identify biomarkers for CNS involvement in VZV reactivation...
January 17, 2018: Journal of Neuroinflammation
Yasutaka Nikaido, Toshihiro Akisue, Yoshinaga Kajimoto, Adam Tucker, Yuki Kawami, Hideyuki Urakami, Yuka Iwai, Hisatomo Sato, Tadayuki Nishiguchi, Tetsuya Hinoshita, Kenji Kuroda, Hiroshi Ohno, Ryuichi Saura
OBJECTIVES: We investigated the differences in postural control disability between idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD). PATIENTS AND METHODS: Twenty-seven iNPH patients, 20 PD patients, and 20 healthy controls (HCs) were examined using the Timed Up and Go test (TUG) and a force platform for recording the center of pressure (COP) trajectory during quiescent standing and voluntary multidirectional leaning (forward, backward, right, and left for 10 s each)...
January 10, 2018: Clinical Neurology and Neurosurgery
D Papaoikonomou, E Karypidou, P Megagiannis, F Tsolaki-Tagaraki, S Nenopoulou, O Gkatzima, Magda Tsolaki
OBJECTIVE: The role of ventriculomegaly and its interplay between various dementia entities and their pathogenesis, as well as its correlation to the levels of CSF protein markers, remains to be elucidated. Evans index (EI) is a well-established radiological marker in the diagnosis of idiopathic Normal Pressure Hydrocephalus (iNPH), assessing ventricular enlargement. However, there are no previous studies investigating the correlation between EI, age, beta amyloid (Aβ), tau and phosphorylated-tau (p-tau) proteins in the CSF...
September 2017: Hellenic Journal of Nuclear Medicine
Masaaki Hori, Kouhei Kamiya, Ryusuke Irie
No abstract text is available yet for this article.
December 2017: Neural Regeneration Research
M Hulens, W Dankaerts, I Stalmans, A Somers, G Vansant, R Rasschaert, F Bruyninckx
Fibromyalgia (FM) is a debilitating, widespread pain disorder that is assumed to originate from inappropriate pain processing in the central nervous system. Psychological and behavioral factors are both believed to underlie the pathogenesis and complicate the treatment. This hypothesis, however, has not yet been sufficiently supported by scientific evidence and accumulating evidence supports a peripheral neurological origin of the symptoms. We postulate that FM and several unexplained widespread pain syndromes are caused by chronic postural idiopathic cerebrospinal hypertension...
January 2018: Medical Hypotheses
J Andersson, M Rosell, K Kockum, L Söderström, K Laurell
Purpose: To evaluate the present diagnostic guidelines of idiopathic normal pressure hydrocephalus (iNPH) in a sample from the general population. Methods: A total of 168 individuals (93 females, 75 males), mean age 75 years (range 66-92) with and without symptoms of iNPH underwent a CT-scan of the brain, a neurological examination with assessment of the triad symptoms, i.e. gait disturbances, memory impairment and urgency incontinence. The participants were then diagnosed as "unlikely", "possible" and "probable" iNPH according to the American-European and the Japanese guidelines, respectively...
June 2017: ENeurologicalSci
Karin Kockum, Otto Lilja-Lund, Elna-Marie Larsson, Michelle Rosell, Lars Söderström, Johan Virhammar, Katarina Laurell
BACKGROUND AND PURPOSE: Despite the important role of imaging in diagnosing idiopathic normal pressure hydrocephalus (iNPH), a structured overall assessment of radiological signs is still lacking. The purpose of this study was to construct a radiological scale, composed of morphological signs of iNPH, and compare it with clinical symptoms. METHODS: In this prospective, population based study of iNPH, 168 individuals (93 females, 75 males), mean age 75 years (range 66-92 years), underwent a computed tomography (CT) of the brain and a neurological examination with assessment of clinical symptoms according to Hellström's iNPH scale...
December 27, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
P van Hoof, P Persoons
Idiopathic normal pressure hydrocephalus (INPH) is a syndrome that can be characterised by the following triad of symptoms: gait disturbances, cognitive impairment and urinary incontinence. The suspected diagnosis can be confirmed by cerebral ventriculomegaly and by a positive result of cerebrospinal fluid drainage. The frequent occurrence of comorbidity and a unflinching firm belief in the significance of the triad of clinical symptoms can hinder a correct diagnosis, leading to a delay in treatment and a poor prognosis...
2017: Tijdschrift Voor Psychiatrie
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