title: More advanced Alzheimer's disease may be associated with a decrease in cerebrospinal fluid pressure.
abstract: In a recent article, elevated cerebrospinal fluid pressure (CSFP) consistent with very early normal pressure hydrocephalus (NPH), was found in a small subset of Alzheimer's disease (AD) patients (possible AD-NPH hybrids) enrolled in a clinical trial for chronic low-flow cerebrospinal fluid drainage. Also in the same study, was another interesting finding that merits further discussion: a substantial proportion of AD patients had very low CSFP. Based on the characteristics of these subjects, we hypothesize that more advanced AD may be associated with a decrease in CSFP. Reduced CSFP among a group of AD patients could provide a clue towards a better understanding of the high rate of comorbidity reported between AD and glaucoma since it has been shown that mean CSFP is lower in subjects with primary open-angle glaucoma. This could result in an abnormally high trans-lamina cribrosa pressure difference and lead to glaucomatous damage.
authors.affiliation: Department of Psychiatry, PC Sint-Amandus, Reigerlostraat 10, 8730 Beernem, Belgium. wostyn.peter@skynet.be.
authors.forename: Peter
authors.initials: P
authors.lastname: Wostyn
authors.forename: Kurt
authors.initials: K
authors.lastname: Audenaert
authors.forename: Peter Paul
authors.initials: PP
authors.lastname: De Deyn