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CSF biomarkers distinguish idiopathic normal pressure hydrocephalus from its mimics
Univ Gothenburg, Sweden.
Univ Gothenburg, Sweden.
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden; UCL Inst Neurol, England; UCL, England.
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2019 (English)In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 90, no 10, p. 1117-1123Article in journal (Refereed) Published
Abstract [en]

Objective To examine the differential diagnostic significance of cerebrospinal fluid (CSF) biomarkers reflecting Alzheimers disease-related amyloid beta (A beta) production and aggregation, cortical neuronal damage, tau pathology, damage to long myelinated axons and astrocyte activation, which hypothetically separates patients with idiopathic normal pressure hydrocephalus (iNPH) from patients with other neurodegenerative disorders. Methods The study included lumbar CSF samples from 82 patients with iNPH, 75 with vascular dementia, 70 with Parkinsons disease, 34 with multiple system atrophy, 34 with progressive supranuclear palsy, 15 with corticobasal degeneration, 50 with Alzheimers disease, 19 with frontotemporal lobar degeneration and 54 healthy individuals (HIs). We analysed soluble amyloid precursor protein alpha (sAPP alpha) and beta (sAPP beta), A beta species (A beta 38, A beta 40 and A beta 42), total tau (T-tau), phosphorylated tau, neurofilament light and monocyte chemoattractant protein 1 (MCP-1). Results Patients with iNPH had lower concentrations of tau and APP-derived proteins in combination with elevated MCP-1 compared with HI and the non-iNPH disorders. T-tau, A beta 40 and MCP-1 together yielded an area under the curve of 0.86, differentiating iNPH from the other disorders. A prediction algorithm consisting of T-tau, A beta 40 and MCP-1 was designed as a diagnostic tool using CSF biomarkers. Conclusions The combination of the CSF biomarkers T-tau, A beta 40 and MCP-1 separates iNPH from cognitive and movement disorders with good diagnostic sensitivity and specificity. This may have important implications for diagnosis and clinical research on disease mechanisms for iNPH.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP , 2019. Vol. 90, no 10, p. 1117-1123
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Neurology
Identifiers
URN: urn:nbn:se:liu:diva-161130DOI: 10.1136/jnnp-2019-320826ISI: 000487463400008PubMedID: 31167811OAI: oai:DiVA.org:liu-161130DiVA, id: diva2:1365805
Note

Funding Agencies|Swedish Research CouncilSwedish Research Council [2017-00915]; Swedish government; ALF [2017-04961, ALFGBG-720931, ALFGBG-720121, ALFGBG715986]; Swedish Alzheimer Foundation [F-742881]; Hjarnfonden, Sweden [FO2017-0243]; Kuopio University Hospital; Goteborg Foundation for Neurological Research

Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-12-11

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Nägga, Katarina
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Division of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of Acute Internal Medicine and Geriatrics
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