title: Cerebrospinal fluid biomarkers for prognosis of long-term cognitive treatment outcomes in patients with idiopathic normal pressure hydrocephalus.
abstract: The prognosis of cognitive improvement after cerebrospinal fluid (CSF) shunting in idiopathic normal pressure hydrocephalus (iNPH) remains uncertain, with no reports on CSF biomarkers related to long-term cognitive prognosis. We performed a preliminary study of CSF biomarker protein levels for cognitive outcome prognostication of two-year outcomes after shunt treated iNPH in 36 patients (13 women) with a median age of 75years (IQR 69-78). CSF biomarkers included soluble amyloid precursor proteins (sAPP, sAPPα, sAPPβ), amyloid β (Aβ)1-38, Aβ1-42 and phosphorylated tau (p-tau), lipocalin-type prostaglandin D synthase (L-PGDS)/β-trace, and cystatin C. The results clearly showed that p-tau levels (sensitivity of 71.4%, specificity of 77.8%, cut-off value of 22.0pg/mL), Aβ1-38/Aβ1-42 ratio (77.8%, 81%, 3.58), and the Aβ1-42/p-tau ratio (76%, 72.7%, 14.6) in preoperative CSF have the potential to determine postoperative prognosis. Improved cognition may be associated with the improvement in CSF circulation after LPS, which likely induces cystatin C and L-PGDS and switches synthesis from Aβ1-42 to Aβ1-38.
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: madoka66@juntendo.ac.jp.
authors.forename: Madoka
authors.initials: M
authors.lastname: Nakajima
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: mmasaka@juntendo.ac.jp.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyajima
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: i-ogino@juntendo.ac.jp.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Ogino
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: chihi-rocket@hotmail.co.jp.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Akiba
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: debo@juntendo.ac.jp.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Sugano
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: thara79nouge@gmail.com.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: keiko-fusegi@nifty.com.
authors.forename: Keiko
authors.initials: K
authors.lastname: Fusegi
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: kostadinkaragiozov@yahoo.com.
authors.forename: Kostadin
authors.initials: K
authors.lastname: Karagiozov
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8342, Japan. Electronic address: harai@juntendo.ac.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Arai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D058227:Amyloidogenic Proteins / Q000134:cerebrospinal fluid*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002557:Cerebrospinal Fluid Shunts; D003072:Cognition Disorders / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D055316:Cystatin C / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000134:cerebrospinal fluid* / Q000150:complications* / Q000601:surgery; D019746:Intramolecular Oxidoreductases / Q000134:cerebrospinal fluid*; D054834:Lipocalins / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D016229:Amyloid beta-Peptides; D058227:Amyloidogenic Proteins; D015415:Biomarkers; D055316:Cystatin C; D054834:Lipocalins; D016875:tau Proteins; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase
keywords: Amyloid beta; Biomarker; Cognitive outcome; Cystatin C; Idiopathic normal pressure hydrocephalus; Lipocalin-type prostaglandin D synthase; Lumboperitoneal shunt