title: Steroid hormones in prediction of normal pressure hydrocephalus.
abstract: Normal pressure hydrocephalus (NPH) is a treatable neurological disorder affecting elderly people with the prevalence increasing with age. NPH is caused by abnormal cerebrospinal fluid (CSF) reabsorption and manifested as a balance impairment, urinary incontinence and dementia development. These symptoms are potentially reversible if recognized early. Diagnosis of NPH is difficult and can be easily mistaken for other neurodegenerative disorders, which makes NPH one of the major misdiagnosed diseases worldwide. The aim of the study was to find out the appropriate combination of indicators, based on CSF steroids, which would contribute to a clearer NPH diagnosis. The levels of CSF cortisol, cortisone, dehydroepiandrosterone (DHEA), 7α-OH-DHEA, 7β-OH-DHEA, 7-oxo-DHEA, 16α-OH-DHEA and aldosterone (all LC-MS/MS) were determined in our patients (n=30; NPH, 65-80 years) and controls (n=10; 65-80 years). The model of orthogonal projections to latent structures (OPLS) was constructed to predict NPH. Cortisone, 7α-OH-DHEA, 7β-OH-DHEA, 7-oxo-DHEA, aldosterone, 7α-OH-DHEA /DHEA, 7-oxo-DHEA/7α-OH-DHEA, 7β-OH-DHEA/7-oxo-DHEA and 16α-OH-DHEA/DHEA in the CSF were identified as the key predictors and the model discriminated patients from controls with 100% sensitivity and 100% specificity. The suggested model would contribute to early and accurate NPH diagnosis, enabling promptly treatment of the disease.
authors.affiliation: Institute of Endocrinology, Department of Steroids and Proteofactors, Narodni 8, 116 94 Prague, Czech Republic. Electronic address: lsosvorova@endo.cz.
authors.forename: Lucie
authors.initials: L
authors.lastname: Sosvorova
authors.affiliation: Institute of Endocrinology, Department of Steroids and Proteofactors, Narodni 8, 116 94 Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Hill
authors.affiliation: University Military Hospital Prague, Department of Neurosurgery, U Vojenske nemocnice 1200, 169 02 Prague, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Mohapl
authors.affiliation: Institute of Endocrinology, Department of Steroids and Proteofactors, Narodni 8, 116 94 Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Vitku
authors.affiliation: Institute of Endocrinology, Department of Steroids and Proteofactors, Narodni 8, 116 94 Prague, Czech Republic.
authors.forename: Richard
authors.initials: R
authors.lastname: Hampl
mesh_terms: D000305:Adrenal Cortex Hormones / Q000134:cerebrospinal fluid*; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000134:cerebrospinal fluid; D002853:Chromatography, Liquid; D003348:Cortisone / Q000134:cerebrospinal fluid; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D006854:Hydrocortisone / Q000134:cerebrospinal fluid; D008297:Male; D013058:Mass Spectrometry
chemical_list: D000305:Adrenal Cortex Hormones; D003687:Dehydroepiandrosterone; D000450:Aldosterone; D003348:Cortisone; D006854:Hydrocortisone
keywords: Aldosterone; Cerebrospinal fluid; Neuroactive steroids; Normal pressure hydrocephalus; Prediction