Biomarker changes in suspected idiopathic normal-pressure hydrocephalus patients undergoing external lumbar drainage: a pilot study

Scientific paper - Original scientific paper

• Author: Klara Brgić Mandić
• Author: Goran Mrak
• Author: Hrvoje Barić
• Author: Sergej Marasanov
• Author: Goran Šimić
• Author: Ena Španić Popovački
• Author: Marijan Klarica
• Author's institution: University of Zagreb; School of Medicine; (Croatian Institiute for Brain Research)
• Author's institution: University of Zagreb; School of Medicine; (Department of Anatomy and Clinical Anatomy)
• Author's institution: University of Zagreb; School of Medicine; (Department of Surgery)
• Author's institution: University of Zagreb; School of Medicine; (Department of Pharmacology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Anatomy
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Pharmacology

Abstract (english)

Aim: To examine whether changes in biomarker concentrations in patients with idiopathic normal-pressure hydrocephalus (iNPH) during 72 h of external lumbar drainage (ELD) can differentiate between responders and non-responders.

Methods: Twenty patients with clinical and neuroradiological signs of iNPH underwent ELD over a period of 72 h. During this period, changes in cerebrospinal fluid (CSF) concentrations of biomarkers (amyloid-β, total and phosphorylated tau proteins) and intracranial pressure were monitored, and the volume of drained CSF was measured. Changes in the concentrations of selected biomarkers at three time points (0, 36, and 72 h) during ELD were tested for association with changes in clinical condition.

Results: Ten patients showed significant clinical improvement after ELD, quantified as a difference of two or more points on the Mini-Mental State Examination and/or Japanese iNPH grading scale. The concentration of all tested biomarkers increased during the first 36 h. Respondents had higher Aβ 1-42 at all time points, with a significant difference seen after 72 h. They also had a significantly higher Aβ1-42/Aβ1-40 ratio at all time points.

Conclusion: A gradual increase in Aβ 1-42 concentration during three-day ELD represents a possible positive prognostic factor for the placement of permanent CSF drainage in patients with iNPH.

• Keywords (english): Aged; Aged, 80 and over; Amyloid beta-Peptides / cerebrospinal fluid; Biomarkers / cerebrospinal fluid; Drainage; Female; Humans; Hydrocephalus, Normal Pressure / cerebrospinal fluid; Hydrocephalus, Normal Pressure / diagnosis; Hydrocephalus, Normal Pressure / surgery; Intracranial Pressure; Male; Middle Aged; Peptide Fragments / cerebrospinal fluid; Pilot Projects; Spinal Puncture; tau Proteins / cerebrospinal fluid
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Croatian Medical Journal
• Numbering: vol. 65, no. 4, pp. 328-338
• p-ISSN: 0353-9504
• e-ISSN: 1332-8166
• DOI: https://doi.org/10.3325/cmj.2024.65.328
• URN:NBN: urn:nbn:hr:105:972063
• Publication: 2024-08
• Document URL: http://www.cmj.hr/2024/65/4/39219196.htm
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-09-19 08:21:22