1 research outputs found
Differentiating comorbidities and predicting prognosis in idiopathic normal pressure hydrocephalus using cerebrospinal fluid biomarkers: a review
Idiopathic normal pressure hydrocephalus (iNPH) is a condition resulting from impaired cerebrospinal fluid (CSF) absorption and excretion characterized by a triad of symptoms comprising dementia, gait disturbance (impaired
trunk balance), and urinary incontinence. CSF biomarkers
not only assist in diagnosis but are also important for analyzing the pathology and understanding appropriate treatment indications. As the neuropathological findings characteristic of iNPH have yet to be defined, there remains no
method to diagnose iNPH with 100% sensitivity and specificity. Neurotoxic proteins are assumed to be involved in
the neurological symptoms of iNPH, particularly the appearance of cognitive impairment. The symptoms of iNPH
can be reversed by improving CSF turnover through shunting. However, early diagnosis is essential as once neurodegeneration has progressed, pathological changes become
irreversible and symptom improvement is minimal, even
after shunting. Combining a variety of diagnostic methods
may lead to a more definitive diagnosis and accurate prediction of the prognosis following shunt treatment. Identifying comorbidities in iNPH using CSF biomarkers does not
contraindicate shunting-based intervention, but does limit
the improvement in symptoms it yields, and provides vital
information for predicting post-treatment prognosi