title: Lack of shunt response in suspected idiopathic normal pressure hydrocephalus with Alzheimer disease pathology.
abstract: To determine the impact of cortical Alzheimer disease pathology on shunt responsiveness in individuals treated for idiopathic normal pressure hydrocephalus (iNPH), 37 patients clinically diagnosed with iNPH participated in a prospective study in which performance on neurologic, psychometric, and gait measures before and 4 months after shunting was correlated with amyloid β plaques, neuritic plaques, and neurofibrillary tangles observed in cortical biopsies obtained during shunt insertion. No complications resulted from biopsy acquisition. Moderate to severe pathology was associated with worse baseline cognitive performance and diminished postoperative improvement on NPH symptom severity scales, gait measures, and cognitive instruments compared to patients lacking pathology.
authors.affiliation: Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Roy
authors.initials: R
authors.lastname: Hamilton
authors.forename: Sunil
authors.initials: S
authors.lastname: Patel
authors.forename: Edward B
authors.initials: EB
authors.lastname: Lee
authors.forename: Eric M
authors.initials: EM
authors.lastname: Jackson
authors.forename: Joanna
authors.initials: J
authors.lastname: Lopinto
authors.forename: Steven E
authors.initials: SE
authors.lastname: Arnold
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Clark
authors.forename: Anuj
authors.initials: A
authors.lastname: Basil
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Shaw
authors.forename: Sharon X
authors.initials: SX
authors.lastname: Xie
authors.forename: M Sean
authors.initials: MS
authors.lastname: Grady
authors.forename: John Q
authors.initials: JQ
authors.lastname: Trojanowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications; D016229:Amyloid beta-Peptides / Q000378:metabolism; D000704:Analysis of Variance; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D009483:Neuropsychological Tests; D058225:Plaque, Amyloid / Q000473:pathology; D017397:Prefrontal Cortex / Q000378:metabolism; D016896:Treatment Outcome; D016875:tau Proteins / Q000378:metabolism
chemical_list: D016229:Amyloid beta-Peptides; D016875:tau Proteins