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Laboratory Findings of NPH

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Normal Pressure Hydrocephalus

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Abstract

Considering the high occurrence of neurodegenerative comorbidities, it is rather challenging to clearly determine the precise diagnosis of normal pressure hydrocephalus (NPH), as well as to predict treatment responsiveness in these patients. Detailed investigation of cerebrospinal fluid (CSF) biomarkers potentially applicable in clinical practice might be particularly useful in the NPH diagnostic battery, together with clinical and radiological findings characteristic of the disease itself. Research has revealed a range of reliable information on the overall CSF profile in iNPH patients, although it is so far impossible to determine a single biomarker specific to NPH. The CSF profile of NPH seems to be easily differentiated from healthy controls; however, the differentiation from other neurodegenerative disorders based only on these parameters remains a challenge. The comorbidities frequently share similar (abnormally raised or abnormally decreased) concentrations of biomarkers in the CSF when compared to iNPH. Although laboratory findings of NPH are not used in current clinical practice, further research may be of great importance to better predict the NPH progression and therefore also to deliver better treatment outcomes and improved prognosis in NPH patients. This chapter summarizes up-to-date conceptions of the topic and provides relevant information discussing and introducing laboratory findings of NPH.

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Abbreviations

5-HT:

5-Hydroxytryptamine

Aβ :

 Amyloid beta

ABC :

 ATP-binding cassette

AMPA :

 α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid

AQP :

 Aquaporin

APP :

 Amyloid precursor protein

AD :

 Alzheimer’s disease

AUC :

 Area under curve

BBB :

 Blood-brain barrier

CNS :

Central nervous system

CSF :

 Cerebrospinal fluid

CTF :

 C-terminal fragments

CYP450scc :

 Cytochrome P450 cholesterol side-chain cleavage enzyme

DHEA/DHEAS :

 Dehydroepiandrosterone/dehydroepiandrosteronesulphate

FTLD :

 Frontotemporal lobe degeneration

GABA-A :

 γ-Aminobutyric acid receptor type A

HC :

 Healthy controls

HSD11B1 :

 Hydroxysteroid dehydrogenase 11-beta type 1

IDE :

 Insulin degrading enzyme

IL :

 Interleukin

iNPH :

 Idiopathic normal pressure hydrocephalus

LRG :

 Leucine-rich-α2-glycoprotein

LRR :

 Leucine-rich repeats

MAP :

 Microtubule-associated protein

MAPT :

 Microtubule-associated protein tau

MBP :

 Myelin based protein

MCI :

 Mild cognitive impairment

MCP-1 :

 Monocyte chemoattractant protein 1

MS :

 Multiple sclerosis

MSA :

 Multiple system atrophy

MTB :

 Microtubule-binding

NAS :

 Neuroactive neurosteroids

NFL :

 Neurofilament protein light

NMDA :

 N-methyl-D-aspartate

NPH :

 Normal pressure hydrocephalus

p-tau :

 Hyperphosphorylated tau

PD :

 Parkinson’s disease

PREG/PREGS :

 Pregnenolone/pregnenolonesulphate

PSP :

 Progressive supranuclear palsy

ROC :

 Receiver operating characteristic

sAPP :

 Soluble amyloid precursor protein

SD :

 Standard deviation

SIVD :

 Subcortical ischemic vascular disease

SLC :

 Solute carrier

SMD :

 Standardized mean difference

sNPH :

 Secondary normal pressure hydrocephalus

t-tau :

 Total tau

TGF-β :

 Transforming growth factor beta

TNF-α :

 Tumor necrosis factor alpha

TNF-β :

 Tumor necrosis factor beta

VD :

Vascular dementia

VDR :

Vitamin D receptor

VEGF :

Vascular endothelial growth factor

YKL-40 :

 Chitinase-3-like protein

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Funding

This chapter was supported by the Ministry of Health of the Czech Republic institutional grant no. NU23-04–00551.

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Authors and Affiliations

  1. Department of Neurosurgery, 2nd Medical Faculty, Charles University and Motol University Hospital, Prague, Czech Republic

    Adéla Bubeníková, Petr Skalický & Ondřej Bradáč

  2. Department of Neurosurgery and Neurooncology, 1st Medical Faculty, Charles University and Military University Hospital, Prague, Czech Republic

    Adéla Bubeníková, Arnošt Mládek & Ondřej Bradáč

  3. Department of Steroid Hormones and Proteofactors, Institute of Endocrinology, Prague, Czech Republic

    Ludmila Máčová

  4. Department of Cognitive Systems and Neurosciences, Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University, Prague, Czech Republic

    Arnošt Mládek

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  1. Adéla Bubeníková
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Correspondence to Ondřej Bradáč .

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    Ondrej Bradac

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Bubeníková, A., Máčová, L., Skalický, P., Mládek, A., Bradáč, O. (2023). Laboratory Findings of NPH. In: Bradac, O. (eds) Normal Pressure Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-031-36522-5_15

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