New paper investigates CSF biomarkers for idiopathic Normal Pressure Hydrocephalus

Departmental Research Lecturer has worked with an international team of collaborators on a new paper for the journal Neurology which investigates the CSF biomarkers for idiopathic Normal Pressure Hydrocephalus - a disease that causes reversible dementia that is often tricky to differentiate from Alzheimer's Disease.

Becky explains, 'This research came about almost by accident – my team at Mass General Hospital and the Yale NIDA proteomics centre were doing a study of changes in protein levels in the cerebrospinal fluid (CSF) of people with Alzheimer’s Disease, and we included CSF from people with this neurological condition as an extra control group. 

Idiopathic normal pressure hydrocephalus (iNPH) has been described as a “reversible dementia”, as it arises from excess volumes of CSF, which can be removed to decrease cognitive symptoms. It is an interesting condition that is difficult to diagnose, and in fact there’s some controversy about whether it is a genuine medical condition at all! However, once the results came back from our analysis, it was very clear that the CSF of individuals with iNPH had a very different protein composition to people with Alzheimer’s Disease or controls. In fact, the differences were far greater than those we see in people with Alzheimer’s Disease. 

In the paper therefore, we show that there is a strong upregulation of proteins involved in immune signalling and blood coagulation, while other constitutive CSF proteins coming from neurons and metabolic processes are downregulated, perhaps diluted. We propose a panel of 12 proteins that may aid in diagnosis of this condition, while also providing evidence towards the hypothesis that iNPH is a separate clinical entity to other neurological conditions.