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Darrow JA, Lewis A, Gulyani S, Khingelova K, Rao A, Wang J, Zhang Y, Luciano M, Yasar S, Moghekar A. Cerebrospinal Fluid Biomarkers Predict Gait Outcomes in Idiopathic Normal Pressure Hydrocephalus. Neurol Clin Pract 2022; 12:91-101. [PMID: 35733946 PMCID: PMC9208405 DOI: 10.1212/cpj.0000000000001156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/10/2022] [Indexed: 11/15/2022]
Abstract
Background and Objectives The assessment of biomarkers in selecting patients with idiopathic normal pressure hydrocephalus (iNPH) for shunt surgery has been limited to small cohort studies and those with limited follow-up. We assessed the potential for CSF biomarkers in predicting immediate response to CSF tap test (TT) and long-term response after shunt surgery. Methods CSF was obtained from patients with iNPH referred for CSF TT after baseline assessment of cognition and gait. CSF neurofilament light (NfL), β-amyloid 42 (Aβ1–42), β-amyloid 40 (Aβ1–40), total tau (tTau), and phosphorylated tau 181 (pTau181) and leucine-rich alpha-2-glycoprotein-1 (LRG1) were measured by ELISA. The ability of these measures to predict immediate improvement following CSF TT and long-term improvement following shunt surgery was compared by univariate and adjusted multivariate regression. Results Lower NfL, pTau181, tTau, and Aβ1–40 were individually predictive of long-term improvement in gait outcomes after shunt surgery. A multivariate model of these biomarkers and MRI Evans index, adjusted for age, improved prediction (area under the receiver operating curve 0.76, 95% confidence interval 0.66–0.86). tTau, pTau181, and Aβ1–40 levels were statistically different in those whose gait improved after CSF TT compared with those who did not. Using a multivariate model, combining these markers with Evans index and transependymal flow did not significantly improve prediction of an immediate response to CSF TT. Discussion A combination of CSF biomarkers can predict improvement following shunt surgery for iNPH. However, these measures only modestly discriminate responders from nonresponders following CSF TT. The findings further suggest that abnormal CSF biomarkers in nonresponders may represent comorbid neurodegenerative pathology or a predegenerative phase that presents with an iNPH phenotype.
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Santangelo R, Cecchetti G, Bernasconi MP, Cardamone R, Barbieri A, Pinto P, Passerini G, Scomazzoni F, Comi G, Magnani G. Cerebrospinal Fluid Amyloid-β 42, Total Tau and Phosphorylated Tau are Low in Patients with Normal Pressure Hydrocephalus: Analogies and Differences with Alzheimer's Disease. J Alzheimers Dis 2018; 60:183-200. [PMID: 28826180 DOI: 10.3233/jad-170186] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Co-existence of Alzheimer's disease (AD) in normal pressure hydrocephalus (NPH) is a frequent finding, thus a common pathophysiological basis between AD and NPH has been postulated. We measured CSF amyloid-β 42 (Aβ42), total tau (t-tau), and phosphorylated tau (p-tau) concentrations in a sample of 294 patients with different types of dementia and 32 subjects without dementia. We then compared scores on neuropsychological tests of NPH patients with pathological and normal CSF Aβ42 values. Aβ42 levels were significantly lower in NPH than in control patients, with no significant differences between AD and NPH. On the contrary, t-tau and p-tau levels were significantly lower in NPH than in AD, with no differences between NPH and controls. NPH patients with pathological Aβ42 levels did not perform worse than NPH patients with normal Aβ42 levels in any cognitive domains. Our data seem to support the hypothesis of amyloid accumulation in brains of NPH patients. Nevertheless, amyloid does not seem to play a pathogenetic role in the development of cognitive deficits in NPH.
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Affiliation(s)
- Roberto Santangelo
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giordano Cecchetti
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Maria Paola Bernasconi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Rosalinda Cardamone
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Alessandra Barbieri
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Patrizia Pinto
- Department of Neurology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Francesco Scomazzoni
- Department of Neuroradiology, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
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Murakami Y, Matsumoto Y, Hoshi K, Ito H, Fuwa TJ, Yamaguchi Y, Nakajima M, Miyajima M, Arai H, Nollet K, Kato N, Nishikata R, Kuroda N, Honda T, Sakuma J, Saito K, Hashimoto Y. Rapid increase of ‘brain-type’ transferrin in cerebrospinal fluid after shunt surgery for idiopathic normal pressure hydrocephalus: a prognosis marker for cognitive recovery. J Biochem 2018; 164:205-213. [DOI: 10.1093/jb/mvy043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/01/2018] [Indexed: 01/12/2023] Open
Affiliation(s)
- Yuta Murakami
- Departments of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Yuka Matsumoto
- Departments of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Kyoka Hoshi
- Biochemistry, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Hiromi Ito
- Biochemistry, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Takashi J Fuwa
- Biochemistry, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Yoshiki Yamaguchi
- Structural Glycobiology Team, Systems Glycobiology Research Group, RIKEN-Max Planck Joint Research Center, RIKEN Global Research Cluster, Wako, Saitama, Japan
| | - Madoka Nakajima
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | | | - Hajime Arai
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | - Kenneth Nollet
- Departments of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Naho Kato
- Forensic Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Rie Nishikata
- Forensic Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Naohito Kuroda
- Forensic Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Takashi Honda
- Human Life Science, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Jun Sakuma
- Departments of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Kiyoshi Saito
- Departments of Neurosurgery, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Yasuhiro Hashimoto
- Biochemistry, Fukushima Medical University, Fukushima City, Fukushima, Japan
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Schirinzi T, Sancesario GM, Di Lazzaro G, D'Elia A, Imbriani P, Scalise S, Pisani A. Cerebrospinal fluid biomarkers profile of idiopathic normal pressure hydrocephalus. J Neural Transm (Vienna) 2018; 125:673-679. [PMID: 29353355 DOI: 10.1007/s00702-018-1842-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/08/2018] [Indexed: 01/24/2023]
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a disabling neurological disorder whose potential treatability is significantly limited by diagnostic uncertainty. In fact, typical clinical presentation occurs at late phases of disease, when CSF shunting could be ineffective. In recent years, measurement of different CSF proteins, whose concentration directly reflects neuropathological changes of CNS, has significantly improved both diagnostic timing and accuracy of neurodegenerative disease. Unfortunately iNPH lacks neuropathological hallmarks allowing the identification of specific disease biomarkers. However, neuropathology of iNPH is so rich and heterogeneous that many processes can be tracked in CSF, including Alzheimer's disease core pathology, subcortical degeneration, neuroinflammation and vascular dysfunction. Indeed, a huge number of CSF biomarkers have been analyzed in iNPH patients, but a unifying profile has not been provided yet. In this brief survey, we thus attempted to summarize the main findings in the field of iNPH CSF biomarkers, aimed at outlining a synthetic model. Although defined cut-off values for biomarkers are not available, a better knowledge of CSF characteristics may definitely assist in diagnosing the disease.
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Affiliation(s)
- Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy. .,Department of Neurosciences, IRCCS Bambino Gesù Children Hospital, Rome, Italy.
| | - Giulia Maria Sancesario
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giulia Di Lazzaro
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Alessio D'Elia
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Paola Imbriani
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Simona Scalise
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Antonio Pisani
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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Abstract
BACKGROUND The mean age of inpatients with schizophrenia has gradually increased in Japan and the risk of fracture in older schizophrenia patients is elevated. One possible cause may be idiopathic normal pressure hydrocephalus (iNPH). The present study aimed to evaluate the prevalence and symptoms of iNPH in older inpatients with schizophrenia. METHODS We prospectively examined older inpatients with schizophrenia (N = 21, mean age = 70.5 ± 5.9) in a psychiatric ward. We evaluated iNPH symptoms using the idiopathic Normal-Pressure Hydrocephalus Grading Scale (iNPHGS), Timed Up-and-Go test (TUG), Gait Status Scale (GSS), Mini-Mental State Examination (MMSE), and Neuropsychiatric Inventory (NPI). We also evaluated symptoms of schizophrenia using the Brief Psychiatric Rating Scale (BPRS) and Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). We conducted cerebrospinal fluid (CSF) tap tests for patients with possible-iNPH. RESULTS In total, three (14.3%) patients were diagnosed with possible iNPH: age, GS-Gait, GS-Cognition, TUG, 10-meter walking test, GSS, and DIEPSS were significantly increased in these compared to patients without iNPH; however, GS-Urine, MMSE, NPI, and BPRS did not differ significantly. Probable iNPH was diagnosed for two (9.5%) patients because of positive CSF tap tests. CONCLUSION The prevalence of possible and probable iNPH in older patients with schizophrenia was much higher than that reported for older people without mental illness. Of the symptoms evaluated with the tests employed, only gait disturbances, particularly walking speed, distinguished schizophrenia patients with iNPH. These findings suggest that we should pay more attention to the possibility of iNPH in older patients with schizophrenia.
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Fattahi N, Arani A, Perry A, Meyer F, Manduca A, Glaser K, Senjem ML, Ehman RL, Huston J. MR Elastography Demonstrates Increased Brain Stiffness in Normal Pressure Hydrocephalus. AJNR Am J Neuroradiol 2016; 37:462-7. [PMID: 26542235 DOI: 10.3174/ajnr.a4560] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 07/23/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Normal pressure hydrocephalus is a reversible neurologic disorder characterized by a triad of cognitive impairment, gait abnormality, and urinary incontinence that is commonly treated with ventriculoperitoneal shunt placement. However, multiple overlapping symptoms often make it difficult to differentiate normal pressure hydrocephalus from other types of dementia, and improved diagnostic techniques would help patient management. MR elastography is a novel diagnostic tool that could potentially identify patients with normal pressure hydrocephalus. The purpose of this study was to assess brain stiffness changes in patients with normal pressure hydrocephalus compared with age- and sex-matched cognitively healthy individuals. MATERIALS AND METHODS MR elastography was performed on 10 patients with normal pressure hydrocephalus and 21 age- and sex-matched volunteers with no known neurologic disorders. Image acquisition was conducted on a 3T MR imaging scanner. Shear waves with 60-Hz vibration frequency were transmitted into the brain by a pillowlike passive driver. A novel postprocessing technique resistant to noise and edge artifacts was implemented to determine regional brain stiffness. The Wilcoxon rank sum test and linear regression were used for statistical analysis. RESULTS A significant increase in stiffness was observed in the cerebrum (P = .001), occipital lobe (P < .001), parietal lobe (P = .001), and the temporal lobe (P = .02) in the normal pressure hydrocephalus group compared with healthy controls. However, no significant difference was noted in other regions of the brain, including the frontal lobe (P = .07), deep gray and white matter (P = .43), or cerebellum (P = .20). CONCLUSIONS This study demonstrates increased brain stiffness in patients with normal pressure hydrocephalus compared with age- and sex-matched healthy controls; these findings should motivate future studies investigating the use of MR elastography for this condition and the efficacy of shunt therapy.
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Affiliation(s)
- N Fattahi
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - A Arani
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - A Perry
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - F Meyer
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - A Manduca
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - K Glaser
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - M L Senjem
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - R L Ehman
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - J Huston
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota.
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Moriya M, Miyajima M, Nakajima M, Ogino I, Arai H. Impact of cerebrospinal fluid shunting for idiopathic normal pressure hydrocephalus on the amyloid cascade. PLoS One 2015; 10:e0119973. [PMID: 25821958 PMCID: PMC4379026 DOI: 10.1371/journal.pone.0119973] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 02/03/2015] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to determine whether the improvement of cerebrospinal fluid (CSF) flow dynamics by CSF shunting, can suppress the oligomerization of amyloid β-peptide (Aβ), by measuring the levels of Alzheimer’s disease (AD)-related proteins in the CSF before and after lumboperitoneal shunting. Lumbar CSF from 32 patients with idiopathic normal pressure hydrocephalus (iNPH) (samples were obtained before and 1 year after shunting), 15 patients with AD, and 12 normal controls was analyzed for AD-related proteins and APLP1-derived Aβ-like peptides (APL1β) (a surrogate marker for Aβ). We found that before shunting, individuals with iNPH had significantly lower levels of soluble amyloid precursor proteins (sAPP) and Aβ38 compared to patients with AD and normal controls. We divided the patients with iNPH into patients with favorable (improvement ≥ 1 on the modified Rankin Scale) and unfavorable (no improvement on the modified Rankin Scale) outcomes. Compared to the unfavorable outcome group, the favorable outcome group showed significant increases in Aβ38, 40, 42, and phosphorylated-tau levels after shunting. In contrast, there were no significant changes in the levels of APL1β25, 27, and 28 after shunting. After shunting, we observed positive correlations between sAPPα and sAPPβ, Aβ38 and 42, and APL1β25 and 28, with shifts from sAPPβ to sAPPα, from APL1β28 to 25, and from Aβ42 to 38 in all patients with iNPH. Our results suggest that Aβ production remained unchanged by the shunt procedure because the levels of sAPP and APL1β were unchanged. Moreover, the shift of Aβ from oligomer to monomer due to the shift of Aβ42 (easy to aggregate) to Aβ38 (difficult to aggregate), and the improvement of interstitial-fluid flow, could lead to increased Aβ levels in the CSF. Our findings suggest that the shunting procedure can delay intracerebral deposition of Aβ in patients with iNPH.
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Affiliation(s)
- Masao Moriya
- Department of Neurosurgery, Juntendo University Graduate School of medicine, Tokyo, Japan
- * E-mail:
| | - Masakazu Miyajima
- Department of Neurosurgery, Juntendo University Graduate School of medicine, Tokyo, Japan
| | - Madoka Nakajima
- Department of Neurosurgery, Juntendo University Graduate School of medicine, Tokyo, Japan
| | - Ikuko Ogino
- Department of Neurosurgery, Juntendo University Graduate School of medicine, Tokyo, Japan
| | - Hajime Arai
- Department of Neurosurgery, Juntendo University Graduate School of medicine, Tokyo, Japan
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Shahim K, Drezet JM, Martin BA, Momjian S. Ventricle equilibrium position in healthy and normal pressure hydrocephalus brains using an analytical model. J Biomech Eng 2012; 134:041007. [PMID: 22667682 DOI: 10.1115/1.4006466] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The driving force that causes enlargement of the ventricles remains unclear in case of normal pressure hydrocephalus (NPH). Both healthy and NPH brain conditions are characterized by a low transparenchymal pressure drop, typically 1 mm Hg. The present paper proposes an analytical model for normal and NPH brains using Darcy's and Biot's equations and simplifying the brain geometry to a hollow sphere with an internal and external radius. Self-consistent solutions for the large deformation problem that is associated with large ventricle dilation are presented and the notion of equilibrium or stable ventricle position is highlighted for both healthy and NPH conditions. The influence of different biomechanical parameters on the stable ventricle geometry is assessed and it is shown that both CSF seepage through the ependyma and parenchymal permeability play a key role. Although very simple, the present model is able to predict the onset and development of NPH conditions as a deviation from healthy conditions.
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Affiliation(s)
- K Shahim
- LSMX, Ecole Polytechnique,Fédérale de Lausanne, Station 12, CH-1015 Lausanne, Switzerland.
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Miyajima M, Nakajima M, Ogino I, Miyata H, Motoi Y, Arai H. Soluble amyloid precursor protein α in the cerebrospinal fluid as a diagnostic and prognostic biomarker for idiopathic normal pressure hydrocephalus. Eur J Neurol 2012; 20:236-42. [DOI: 10.1111/j.1468-1331.2012.03781.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 04/24/2012] [Indexed: 12/15/2022]
Affiliation(s)
- M. Miyajima
- Department of Neurosurgery; Juntendo University; Tokyo; Japan
| | - M. Nakajima
- Department of Neurosurgery; Juntendo University; Tokyo; Japan
| | - I. Ogino
- Department of Neurosurgery; Juntendo University; Tokyo; Japan
| | - H. Miyata
- Department of Neurosurgery; Juntendo University; Tokyo; Japan
| | - Y. Motoi
- Department of Neurology; Juntendo University; Tokyo; Japan
| | - H. Arai
- Department of Neurosurgery; Juntendo University; Tokyo; Japan
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Hussain N, Hussain MM, Ziauddin M, Triyawatanyu P, Walsh PJ. Stereoselective vinylation of aryl N-(2-pyridylsulfonyl) aldimines with 1-alkenyl-1,1-heterobimetallic reagents. Org Lett 2011; 13:6464-7. [PMID: 22085226 PMCID: PMC3237811 DOI: 10.1021/ol202766g] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vinylation of aryl N-(2-pyridylsulfonyl) aldimines with versatile 1-alkenyl-1,1-borozinc heterobimetallic reagents is disclosed. In situ hydroboration of air-stable B(pin)-alkynes followed by chemoselective transmetalation with dimethylzinc and addition to aldimines provides B(pin)-substituted allylic amines in 53-93% yield in a one-pot procedure. The addition step can be followed by either B-C bond oxidation to provide α-amino ketones (71-98% yield) or Suzuki cross-coupling to furnish trisubstituted 2-arylated (E)-allylic amines (51-73% yield).
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Affiliation(s)
- Nusrah Hussain
- P. Roy and Diana T. Vagelos Laboratories, University of Pennsylvania, Department of Chemistry, 231 South 34 Street, Philadelphia, Pennsylvania 19104-6323
| | - Mahmud M. Hussain
- P. Roy and Diana T. Vagelos Laboratories, University of Pennsylvania, Department of Chemistry, 231 South 34 Street, Philadelphia, Pennsylvania 19104-6323
| | - Muhammed Ziauddin
- P. Roy and Diana T. Vagelos Laboratories, University of Pennsylvania, Department of Chemistry, 231 South 34 Street, Philadelphia, Pennsylvania 19104-6323
| | - Plengchat Triyawatanyu
- P. Roy and Diana T. Vagelos Laboratories, University of Pennsylvania, Department of Chemistry, 231 South 34 Street, Philadelphia, Pennsylvania 19104-6323
| | - Patrick J. Walsh
- P. Roy and Diana T. Vagelos Laboratories, University of Pennsylvania, Department of Chemistry, 231 South 34 Street, Philadelphia, Pennsylvania 19104-6323
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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 Psychiatr Res 2011; 45:539-47. [PMID: 20828718 PMCID: PMC3813465 DOI: 10.1016/j.jpsychires.2010.07.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 07/13/2010] [Accepted: 07/27/2010] [Indexed: 11/22/2022]
Abstract
Normal Pressure Hydrocephalus (NPH) is one of the causes of dementia of the elderly characterized by impaired mental function, gait difficulties and urinary incontinence. Previously, it was proposed that some of the NPH patients may develop Alzheimer's disease (AD) like pathology. Aim of this study was to compare levels of different CSF biomarkers, including total secreted β-amyloid precursor protein (sAPP), sAPP-alpha form (sAPPα), amyloid-beta (Aβ) peptide, total-tau protein and hyperphosphorylated-tau protein in subjects from NPH and Non-NPH Control (NNC). CSF was collected from 23 NPH patients and 13 Non-NPH controls by lumber puncture. Western blot analysis was performed to measure levels of sAPP-total. ELISA was used separately to determine levels of sAPPα, Aβ peptide, total-tau and phospho-tau proteins. We found a significant decrease in levels of total secreted APP, sAPPα and Aβ (1-42) in the CSF sample of NPH patients vs. NNC. We did not observe any change in levels of total-tau or phospho-tau in NPH vs. NNC subjects. Notably, phospho-tau level was significantly increased in the NPH patients, who were suffering from the disease for more than one year, vs. NNC. Among five biomarkers studied, decreased sAPP, sAPPα and Aβ (1-42) levels in CSF can be molecular markers to distinguish NPH cases from NNC. Disease severity can also be assessed by increased levels of CSF phospho-tau protein and the ratio of phospho-tau to Aβ (1-42), which might be a useful tool for predicting conversion of NPH individuals to other neurodegenerative disorders including Alzheimer's disease (AD).
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Cretin B, Echaniz-Laguna A, Meyer C, Blanc F, Sellal F. [Apathy or depression? Do you have a nose for it? Four case reports of paramedian frontal tumors]. Rev Neurol (Paris) 2010; 166:704-10. [PMID: 20434745 DOI: 10.1016/j.neurol.2010.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 07/13/2009] [Accepted: 03/17/2010] [Indexed: 11/19/2022]
Abstract
We report four cases of patients with clinically isolated apathy which was mistaken for depression even though they were suffering from voluminous brain tumors. These cases remind us that rigorous clinical analysis is essential: searching for signs of organic origin or psychiatric etiology is fundamental to avoid an incorrect diagnosis. In particular, these four patients displayed anosmia, an uncommon symptom for patients suffering from depression. In addition, brain imaging is important to correctly identify the most prudent medical and/or surgical management strategy. In this short discussion, we propose an algorithm for the clinical diagnosis of apathy.
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Affiliation(s)
- B Cretin
- CNRS UMR 7191, pôle Tête-Cou-CETD, hôpitaux universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg cedex, France.
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13
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Diener HC, Johansson U, Dodick DW. Headache attributed to non-vascular intracranial disorder. HANDBOOK OF CLINICAL NEUROLOGY 2010; 97:547-587. [PMID: 20816456 DOI: 10.1016/s0072-9752(10)97050-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This chapter deals with non-vascular intracranial disorders resulting in headache. Headache attributed to high or low cerebrospinal fluid pressure is separated into headache attributed to idiopathic intracranial hypertension (IIH), headache attributed to intracranial hypertension secondary to metabolic, toxic, or hormonal causes, headache attributed to intracranial hypertension secondary to hydrocephalus, post-dural puncture headache, cerebrospinal fluid (CSF) fistula headache, headache attributed to spontaneous (or idiopathic) low CSF pressure. Headache attributed to non-infectious inflammatory disease can be caused by neurosarcoidosis, aseptic (non-infectious) meningitis or lymphocytic hypophysitis. Headache attributed to intracranial neoplasm can be caused by increased intracranial pressure or hydrocephalus caused by neoplasm or attributed directly to neoplasm or carcinomatous meningitis. Other causes of headache include hypothalamic or pituitary hyper- or hyposecretion and intrathecal injection. Headache attributed to epileptic seizure is separated into hemicrania epileptica and post-seizure headache. Finally headache attributed to Chiari malformation type I (CM1) and the syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) are described.
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Magnetic resonance imaging in the canine double-haemorrhage subarachnoid haemorrhage model. ACTA NEUROCHIRURGICA. SUPPLEMENT 2008. [PMID: 18457001 DOI: 10.1007/978-3-211-75718-5_46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
In this study, we investigated T2 weighted imaging (T2WI) and T2 values of the cortex, thalamus and cerebrospinal fluid (CSF) of the ventricles in the canine double-haemorrhage subarachnoid haemorrhage (DHSAH) model. T2 values in the cortex increased compared to prescan values from 123.07 +/- 18.72 msec on day 2 to 89.43 +/- 1.98 msec on day 7 (p < 0.05). A trend toward a temporal increase in T2 values was observed in the thalamus, but did not reach significance. The T2 values of the ventricular CSF increased by 102.2% on day 2 and 159.6% on day 7 compared to prescan values. These changes reached significance (p < 0.05) on day 7. Additionally, the ventricular size increased over the study period. Our data suggest that we can use this model to investigate acute brain injury and normal pressure hydrocephalus (NPH) after SAH.
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