«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年01期

页码:

47-50

栏目:

临床医学

出版日期:

2020-04-06

文章信息/Info

Title:

Application of cerebrospinal fluid biomarkers in idiopathic normal pressure hydrocephalus

文章编号:

1006-8147(2020)01-0047-04

作者:

王仕勤¹; 何宇豪²; 黄 楹²

（1.巴中市中心医院神经外科中心，巴中 636000； 2.天津市环湖医院神经外科，天津 300350）

Author(s):

WANG Shi-qin¹;  HE Yu-hao¹;  HUANG Ying²

（1. Department of Neurosurgery Center, Bazhong Central Hospital，Bazhong 636000, China；2.Department of Neurosurgery, Tianjin Huanhu Hospital，Tianjin 300350, China）

关键词:

正常压力脑积水; 脑脊液; 神经丝轻链蛋白; 淀粉样蛋白-β42; tau蛋白; 水通道蛋白1

Keywords:

normal pressure hydrocephalus; cerebrospinal fluid;  neurofilament light protein; amyloid-β42;  tau protein; aquaporin 1

分类号:

R742.7

DOI:

-

文献标志码:

A

摘要:

目的：探讨特发性正常压力脑积水（iNPH）的病理生理学特点，并评估脑脊液（CSF）生物标志物的诊断和预后价值。方法：收集2016年10月-2018年6月在我院行脑室腹腔分流术的iNPH患者18例。获取手术前（术前组）及手术后6个月（术后组）的脑脊液；同时获取12例健康老年人（对照组）的脑脊液。运用酶联免疫吸附实验（ELISA）测定脑脊液生物标志物神经丝轻链蛋白（NFL），淀粉样蛋白-β42（Aβ42），总tau蛋白(T-tau)，磷酸化tau蛋白（P-tau），水通道蛋白1（AQP1）和白蛋白（Albumin）的含量。评估iNPH患者术前及术后6个月主要临床症状。结果：18例iNPH患者脑室腹腔分流术后6个月复查时，13例（72％）iNPH评分有所改善。iNPH患者术前组脑脊液中NFL和AQP1高于对照组，比值分别为1.53和1.48（P＜0.05）；而T-tau 、P-tau和Aβ42低于对照组，比值分别为0.64，0.68和0.48（P＜0.05）；两组间白蛋白水平无明显差异（P＞0.05）。iNPH患者术后组脑脊液中NFL、Aβ42、P-tau、白蛋白水平较术前组增加，对应比值为0.72, 0.62, 0.47和0.48（P＜0.05）；然而AQP1和T-tau水平较术前组下降，对应比值为2.01和1.15（P＜0.05）。结论：特发性正常压力脑积水可引起脑室周围代谢水平降低和轴突变性，但没有主要的皮质损伤。

Abstract:

Objective: This study aimed to explore the pathophysiology of idiopathic normal pressure hydrocephalus (iNPH) and to evaluate the diagnostic and prognostic value of CSF biomarkers. Methods：18 patients with iNPH who underwent ventriculoperitoneal shunt in our hospital from October 2016 to June 2018 were enrolled. Cerebrospinal fluid (CSF) was obtained before surgery (preoperative group) and 6 months after surgery (postoperative group), and CSF was collected from 12 healthy elderly individuals (control group). The levels of CSF biomarkers NFL, Aβ42, T-tau, P-tau, AQP1, and Albumin were analyzed by enzyme-linked immunosorbent assay （ELISA）. The clinical symptoms of iNPH patients before and 6 months after surgery were evaluated. Results：At 6 months after ventriculoperitoneal shunt surgery, 13 (72%) of the 18 iNPH patients had an improved iNPH score. The levels of NFL and AQP1 in the iNPH preoperative group were higher than those in the control group, the ratios were 1.53 and 1.48, respectively(P＜0.05); while the levels of T-tau, P-tau and Aβ42 were lower than the control group, the ratios were 0.64, 0.68 and 0.48, respectively (P＜0.05); there was no significant difference in albumin between the two groups (P＞0.05). The levels of NFL, Aβ42, P-tau and albumin in the iNPH postoperative group increased compared with the iNPH preoperative group, and the corresponding ratios were 0.72, 0.62, 0.47 and 0.48(P＜0.05). However, the levels of AQP1 and T-tau were decreased compared with the preoperative group, and the corresponding ratios were 2.01 and 1.15 (P＜0.05). Conclusion：The pathophysiology of iNPH is characterized by reduced periventricular metabolism and axonal degeneration but no major cortical damage.

参考文献/References:

[1] Blomsterwall E, Bilting M, Stephensen H, et al. Gait abnormality is not the only motor disturbance in normal pressure hydrocephalus[J]. Scand J Rehabil Med, 1995, 27(4):205
[2] Klinge P, Hellstr?觟m P, Tans J, et al. One-year outcome in the European multicentre study on iNPH[J]. Acta Neurol Scand, 2012, 126(3):145
[3] Marmarou A, Bergsneider M, Klinge P, et al. The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus[J].Neurosurgery, 2005, 57(3 Suppl):S17
[4] Schirinzi T, Sancesario G M, Ialongo C, et al. A clinical and biochemical analysis in the differential diagnosis of idiopathic normal pressure hydrocephalus[J]. Front Neurol, 2015, 6:86
[5] Pfanner T, Henri-Bhargava A, BorchertS. Cerebrospinal fluid biomarkers as predictors of shunt response in idiopathic normal pressure hydrocephalus: a systematic review[J]. Can J Neurol Sci, 2018, 45(1):3
[6] Hellstr?觟m P, Klinge P, Tans J, et al. A new scale for assessment of severity and outcome in iNPH[J]. ActaNeurol Scand, 2012, 126(4):229
[7] Jingami N, Asada-Utsugi M, Uemura K, et al. Idiopathic normal pressure hydrocephalus has a different cerebrospinal fluid biomarker profile from Alzheimer’s disease[J]. JAD, 2015, 45(1): 109
[8] Luikku A J, Hall A, Nerg O, et al. Multimodal analysis to predict shunt surgery outcome of 284 patients with suspected idiopathic normal pressure hydrocephalus[J]. Acta Neurochir(Wien), 2016, 158(12):2311
[9] Hong Y J, Kim M J, Jeong E, et al. Preoperative biomarkers in patients with idiopathic normal pressure hydrocephalus showing a favorable shunt surgery outcome[J]. J Neurol Sci, 2018, 387:21
[10] Tarnaris A, Toma A K, Chapman M D, et al. Use of cerebrospinal fluid amyloid-β and total tau protein to predict favorable surgical outcomes in patients with idiopathic normal pressure hydrocephalus[J]. J Neurosurg, 2011, 115(1):145
[11] Laitera T, Kurki M I, Pursiheimo J P, et al. The expression of transthyretin and amyloid-β protein precursor is altered in the brain of idiopathic normal pressure hydrocephalus patients[J]. J Alzheimers Dis, 2015, 48(4):959
[12] Patel S, Lee E B, Xie S X, et al. Phosphorylated tau/amyloid beta 1-42 ratio in ventricular cerebrospinal fluid reflects outcome in idiopathic normal pressure hydrocephalus[J]. Fluids Barriers CNS, 2012, 9(1):7
[13] Nakajima M, Miyajima M, Ogino I, et al. Cerebrospinal fluid biomarkers for prognosis of long-term cognitive treatment outcomes in patients with idiopathic normal pressure hydrocephalus[J]. J Neurol Sci, 2015,357(1/2):88
[14] Friede R L, Samorajski T. Axon caliber related to neurofilaments and microtubules in sciatic nerve fibers of rats and mice[J]. Anat Rec, 1970,167(4):379
[15] Craven C L, Baudracco I, Zetterberg H, et al.The predictive value of T-tau and AB1-42 levels in idiopathic normal pressure hydrocephalus[J]. ActaNeurochir (Wien), 2017,159(12):2293
[16] Carmona-Calero E M, Gonzalez-Toledo J M, Castaneyra-Ruiz L, et al. Expression of aquaporin-1 in the choroid plexus in communicating and non-communicating hydrocephalic rats[J]. Eur J Anat, 2015, 19(2):125
[17] Blocher J, Eckert I, Elster J, et al. Aquaporins AQP1 and AQP4 in the cerebrospinal fluid of bacterial meningitis patients[J]. Neurosci Lett, 2011, 504(1):23
[18] Tarnaris A, Toma A K, Pullen E, et al. Cognitive, biochemical, and imaging profile of patients suffering from idiopathic normal pressure hydrocephalus[J]. Alzheimers Dement, 2011, 7(5):501
[19] Momjian S, Owler B K, Czosnyka Z, et al. Pattern of white matter regional cerebral blood flow and autoregulation in normal pressure hydrocephalus[J]. Brain, 2004, 127(Pt 5):965
[20] Nakajima M, Miyajima M, Ogino I, et al. Preoperative phosphorylated Tau concentration in the cerebrospinal fluid can predict cognitive function three years after shunt surgery in patients with idiopathic normal pressure hydrocephalus[J]. J Alzheimers Dis, 2018, 66(1):319
[21] Ray B, Reyes P F, Lahiri D K. Biochemical studies in Normal Pressure Hydrocephalus (NPH) patients: change in CSF levels of amyloid precursor protein (APP), amyloid-beta (Aβ) peptide and phospho-tau[J]. J Psychiatr Res, 2011,45(4):539
[22] Kitagaki H, Mori E, Ishii K, et al. CSF spaces in idiopathic normal pressure hydrocephalus: morphology and volumetry[J]. Am J Neuroradiol, 1998,19(7):1277
[23] Street J M, Barran P E, Mackay C L, et al. Identification and proteomic profiling of exosomes in human cerebrospinal fluid[J]. J Transl Med, 2012,10:5
[24] Baird G, Montine T J, Chang J J, et al. Cerebrospinal fluid total Tau is increased in normal pressure hydrocephalus patients who undergo successful lumbar drain trials[J]. Cureus, 2017, 9(5):e1265

相似文献/References:

备注/Memo

备注/Memo:

作者简介 王仕勤（1991-），男，住院医师，硕士，研究方向：神经肿瘤；通信作者：黄楹，E-mail：Yinghuang00@aliyun.com。

常用功能

更新日期/Last Update: 2020-04-16