CSF galanin and cognition after shunt surgery in normal pressure hydrocephalus.
BACKGROUND
"Normal" pressure hydrocephalus (NPH) is associated with injury to neurotransmitter and neuropeptide systems that recovers after surgery. This could be linked to changes in galanin, a neuropeptide with inhibitory effects on basal forebrain cognitive function.


OBJECTIVE
To examine changes in CSF galanin concentrations in patients with normal pressure hydrocephalus undergoing shunt surgery, and to investigate the relation between these changes and cognitive functioning.


METHODS
Eight patients underwent surgery for idiopathic normal pressure hydrocephalus. Lumbar CSF galanin determinations, cognitive status, and clinical status were quantified before operation and six months after. Cognition was assessed by an extensive battery of tests measuring attention, memory, speed of mental processing, visuospatial function, and frontal lobe function.


RESULTS
CSF galanin concentration decreased after surgery. This reduction correlated with improved clinical and cognitive functioning, specifically with attention and visuomotor speed, visuoconstructive and frontal functioning, and clinical status according to the NPH scale, including the sphincter and cognitive components.


CONCLUSIONS
The cognitive and clinical improvement after shunt implantation correlated with CSF galanin levels, suggesting that the distribution or function of this agent involves cerebral structures that have some potential for recovery. In this study, galanin was related to several cognitive functions that may be associated with the fronto-subcortical deficits underlying cognitive dysfunction in normal pressure hydrocephalus.
Mataró
M
M
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona Spain.
Poca
M A
MA
Del Mar Matarín
M
M
Catalan
R
R
Sahuquillo
J
J
Galard
R
R
D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D002557:Cerebrospinal Fluid Shunts; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D005625:Frontal Lobe / Q000502:physiology; D019004:Galanin / Q000134:cerebrospinal fluid*; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications* / Q000628:therapy*; D008297:Male; D008568:Memory; D008606:Mental Processes; D008875:Middle Aged; D009460:Neurologic Examination
D019004:Galanin