NYC Healthcare News

Research analyzes clinical connection of NPH to AD

September 03, 2015

In an effort to mirror recent research advances in AD, this study evaluated CSF biomarkers and correlated these to cortical histopathology samples and neuropsychological outcomes. An ongoing prospective longitudinal study is being conducted at the University of Virginia to include NPH patients treated at this institution, with comprehensive testing performed before and after shunting. In the first 50 consecutive patients, CSF profiling was performed for biomarkers beta-amyloid, T-tau, P-tau, APO?4 genotyping, and cortical biopsy evaluations for neuritic plaques and tau tangles. These results were analyzed in relationship to clinical progress and neuropsychological testing. The following results were noted:

???Failure to improve after shunting was closely correlated to large numbers of neuritic plaques on biopsy and increased beta-amyloid in CSF.

???The high number of plaques and tangles in frontal lobe biopsies would indicate an advanced form of AD in a significant number of patients.

???Analysis of T-tau, P-tau and beta-amyloid shows that NPH progression mirrors the changes seen in patients with AD.

"Up to 35 percent of NPH patients suffer clinical declines similar to AD patients. The likelihood and pace of this decline can be predicted using currently available CSF biomarkers, which should help reduce the number of shunt re-operations in the future. Improved screening methods are required to refine diagnosis and predict the benefits of CSF diversion. This study further elucidated that NPH is a surgically treatable form of dementia in many cases, and must be considered in the spectrum of tau-proteinopathies. Further in-depth studies are indicated," concluded Dr. Koga.

Dr. Koga and his senior colleagues at the University of Virginia are working to establish a Neurodegenerative Proteomics Laboratory and a specialized NHP Clinic to optimize and expand the treatment options for patients suffering from tau-protein dementias.

SOURCE American Association of Neurological Surgeons