Cerebrospinal fluid and venous biomarkers of shunt-responsive idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis.

Autor: Thavarajasingam SG; Faculty of Medicine, Imperial College London, London, UK. sgt16@ic.ac.uk., El-Khatib M; Faculty of Medicine, Imperial College London, London, UK., Vemulapalli KV; Faculty of Medicine, Imperial College London, London, UK., Iradukunda HAS; Faculty of Medicine, Imperial College London, London, UK., Laleye J; Faculty of Medicine, Imperial College London, London, UK., Russo S; Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK., Eichhorn C; Division of Internal Medicine, University Hospital Basel, Basel, Switzerland., Eide PK; Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Jazyk: angličtina
Zdroj: Acta neurochirurgica [Acta Neurochir (Wien)] 2022 Jul; Vol. 164 (7), pp. 1719-1746. Date of Electronic Publication: 2022 Mar 01.
DOI: 10.1007/s00701-022-05154-5
Abstrakt: Background: Idiopathic normal pressure hydrocephalus (iNPH) is a neurodegenerative disease and dementia subtype involving disturbed cerebrospinal fluid (CSF) homeostasis. Patients with iNPH may improve clinically following CSF diversion through shunt surgery, but it remains a challenge to predict which patients respond to shunting. It has been proposed that CSF and blood biomarkers may be used to predict shunt response in iNPH.
Objective: To conduct a systematic review and meta-analysis to identify which CSF and venous biomarkers predict shunt-responsive iNPH most accurately.
Methods: Original studies that investigate the use of CSF and venous biomarkers to predict shunt response were searched using the following databases: Embase, MEDLINE, Scopus, PubMed, Google Scholar, and JSTOR. Included studies were assessed using the ROBINS-I tool, and eligible studies were evaluated utilising univariate meta-analyses.
Results: The study included 13 studies; seven addressed lumbar CSF levels of amyloid-β 1-42, nine studies CSF levels of Total-Tau, six studies CSF levels of Phosphorylated-Tau, and seven studies miscellaneous biomarkers, proteomics, and genotyping. A meta-analysis of six eligible studies conducted for amyloid-β 1-42, Total-Tau, and Phosphorylated-Tau demonstrated significantly increased lumbar CSF Phosphorylated-Tau (- 0.55 SMD, p = 0.04) and Total-Tau (- 0.50 SMD, p = 0.02) in shunt-non-responsive iNPH, though no differences were seen between shunt responders and non-responders for amyloid-β 1-42 (- 0.26 SMD, p = 0.55) or the other included biomarkers.
Conclusion: This meta-analysis found that lumbar CSF levels of Phosphorylated-Tau and Total-Tau are significantly increased in shunt non-responsive iNPH compared to shunt-responsive iNPH. The other biomarkers, including amyloid-β 1-42, did not significantly differentiate shunt-responsive from shunt-non-responsive iNPH. More studies on the Tau proteins examining sensitivity and specificity at different cut-off levels are needed for a robust analysis of the diagnostic efficiency of the Tau proteins.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz: