title: Novel ventriculo-peritoneal shunt in Alzheimer's disease cerebrospinal fluid biomarkers.
abstract: Alzheimer's disease is an age-related dementia and its incidence is rising in developed countries as the population ages. Amyloid plaques and tau-rich neurofibrillary tangles are pathologic hallmarks of the disease. Treatment is symptomatic, consisting of compounds that block enzymatic acetylcholine degradation (acetylcholinesterase inhibitors). Cognitive benefits of the four approved antidementia drugs are typically modest and limited in duration. While Alzheimer's disease is undoubtedly multifactorial in cause, advancing age is the most important risk factor. Any robust theory of pathogenesis must account for the profound influence of age on the emergence of Alzheimer's disease. There is evidence that senescent changes in cerebrospinal fluid production, circulation, turnover and clearance of amyloid beta-peptides may be a key factor in the onset and progression of Alzheimer's disease. The effect of increasing cerebrospinal fluid circulation and turnover in Alzheimer's disease patients by implanting a novel, low-flow drainage system (COGNIshunt) has been studied and promising trends in cognitive stabilization and improvement in cerebrospinal fluid biomarkers have been found.
authors.affiliation: Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA. geralds@leland.stanford.edu
authors.forename: Gerald D
authors.initials: GD
authors.lastname: Silverberg
authors.forename: Martha
authors.initials: M
authors.lastname: Mayo
authors.forename: Thomas
authors.initials: T
authors.lastname: Saul
authors.forename: Joan
authors.initials: J
authors.lastname: Carvalho
authors.forename: Dawn
authors.initials: D
authors.lastname: McGuire
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000503:physiopathology* / Q000628:therapy*; D000818:Animals; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery*; D002986:Clinical Trials as Topic; D006801:Humans; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation* / Q000379:methods*
chemical_list: D015415:Biomarkers