CSF neurofilament and glial fibrillary acidic protein in normal pressure hydrocephalus.
We examined CSF levels of markers of neuronal degeneration and astrogliosis-the light subunit of the neurofilament triplet protein (NFL) and the glial fibrillary acidic protein (GFAP)-in 65 patients with normal pressure hydrocephalus (NPH). NFL was increased sixfold (864 +/- 1,538 [mean +/- SD] versus 156 +/- 81 ng/L; p < or = 0.001) and GFAP twofold (1,116 +/- 1,085 versus 637 +/- 295 ng/L; p < or = 0.01) in NPH patients compared with neurologically healthy age-matched controls. No correlation was found between any particular symptom or sign and GFAP levels in CSF. The levels of NFL, on the other hand, were higher in patients with severe symptoms compared with those with moderate or no symptoms. Furthermore, there was a correlation between a high level of NFL and gait disturbance, incontinence, psychometric incapability, and social dysfunction. A high preoperative NFL level was associated with favorable outcome after shunt surgery. This indicates that NFL is a marker of ongoing and possibly still-reversible axonal damage in NPH.
Tullberg
M
M
Institution of Clinical Neuroscience, University of Göteborg, Sweden.
Rosengren
L
L
Blomsterwall
E
E
Karlsson
J E
JE
Wikkelsö
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts; D005260:Female; D005684:Gait; D005904:Glial Fibrillary Acidic Protein / Q000134:cerebrospinal fluid*; D005911:Gliosis / Q000134:cerebrospinal fluid; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000134:cerebrospinal fluid* / Q000150:complications / Q000601:surgery; D008297:Male; D001523:Mental Disorders / Q000134:cerebrospinal fluid / Q000209:etiology; D008875:Middle Aged; D009410:Nerve Degeneration / Q000134:cerebrospinal fluid*; D016900:Neurofilament Proteins / Q000134:cerebrospinal fluid*; D011237:Predictive Value of Tests
D005904:Glial Fibrillary Acidic Protein; D016900:Neurofilament Proteins; C044882:neurofilament protein L