Original scientific paper
https://doi.org/10.3325/cmj.2024.65.328
Biomarker changes in suspected idiopathic normalpressure hydrocephalus patients undergoing external lumbar drainage: a pilot study
Klara Brgić Mandić
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
Goran Mrak
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
Hrvoje Barić
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
Sergej Marasanov
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
Goran Šimić
; Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
Ena Španić Popovački
; Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
Marijan Klarica
; Department of Pharmacology and Croatian Institute for Brain Research, University of Zagreb, School of Medicine, Zagreb, Croatia
*
* Corresponding author.
Abstract
Aim To examine whether changes in biomarker concentrations in patients with idiopathic normal-pressure hydrocephalus (iNPH) during 72 h of external lumbar drainage
(ELD) can differentiate between responders and non-responders.
Methods Twenty patients with clinical and neuroradiological signs of iNPH underwent ELD over a period of 72
h. During this period, changes in cerebrospinal fluid (CSF)
concentrations of biomarkers (amyloid-β, total and phosphorylated tau proteins) and intracranial pressure were
monitored, and the volume of drained CSF was measured.
Changes in the concentrations of selected biomarkers at
three time points (0, 36, and 72 h) during ELD were tested
for association with changes in clinical condition.
Results Ten patients showed significant clinical improvement after ELD, quantified as a difference of two or more
points on the Mini-Mental State Examination and/or Japanese iNPH grading scale. The concentration of all tested
biomarkers increased during the first 36 h. Respondents
had higher Aβ 1-42 at all time points, with a significant difference seen after 72 h. They also had a significantly higher
Aβ1-42/Aβ1-40 ratio at all time points.
Conclusion A gradual increase in Aβ 1-42 concentration
during three-day ELD represents a possible positive prognostic factor for the placement of permanent CSF drainage
in patients with iNPH.
Keywords
Hrčak ID:
336461
URI
Publication date:
20.8.2024.
Visits: 19 *