Biomarkers in Normal Pressure Hydrocephalus: A Systematic Review
Anderson Corin1, Gabriel Semione2, Carlos Ferreira3, Joao Ramos3, Leonardo Oliveira4, Romualdo Filho5, Maria Fernanda Santana6, Isabela Leal7, Savio Batista8, Raphael Bertani9
1Federal University of Pelotas, 2University of West of Santa Catarina, 3Federal University of Paraíba, 4State University of Ponta Grossa, 5Federal University of Roraima, 6University Center of Várzea Grande, 7Faculty of Medical Sciences of the Santa Casa de São Paulo, 8UFRJ, 9University of São Paulo
Objective:

This study aims to identify biomarkers for Normal Pressure Hydrocephalus (NPH) through a short review of current human studies, emphasizing their physiological relevance and potential clinical applications.


Background:

Normal Pressure Hydrocephalus is a neurological disorder characterized by the classic triad of gait disturbances, cognitive impairment, and urinary incontinence. NPH is classified as idiopathic (iNPH), with no identifiable predisposing factors, or secondary, resulting from conditions such as trauma, hemorrhage, or infections. Despite its clinical significance, diagnosing NPH remains challenging due to symptom overlap with other neurodegenerative conditions. To address this diagnostic gap, establishing reliable biomarkers could enhance diagnostic accuracy and guide treatment strategies.


Design/Methods:

In accordance with PRISMA guidelines, the authors systematically searched the Embase, PubMed, Scopus, Cochrane, and Web of Science databases for literature on biomarkers in NPH. Only articles published in English that discussed biomarkers in clinical studies involving NPH patients were included. 


Results:

A total of 109 articles were included in the final analysis. The most common biomarkers found were Neurofilament protein light, Tau proteins (T-tau, P-tau), Beta-amyloid 1–42 (Aβ42, Aβ38, Aβ40), Myelin basic protein, Soluble amyloid precursor protein (isoforms α and β), Monocyte chemoattractant protein 1, Leucine-rich alpha-2-glycoprotein-1, Plasma chitinase 3-like 1, Glial fibrillary acidic protein, Receptor expressed on myeloid cells 2, S100B, Neuronal pentraxin-2, TNF-α, Interleukins (IL-8, IL-10), Lipocalin-type prostaglandin D synthase, and Aquaporins (AQP1, AQP4). 


Conclusions:

Biomarkers as predictors of disease severity, complications, and prognosis could significantly enhance NPH management. They have shown potential relevance for diagnosis and monitoring disease progression. Although there are some gaps related to accuracy, several biomarkers are demonstrating promising results and could improve patient outcomes in the near future.


10.1212/WNL.0000000000208861
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.