Increased Levels of Kynurenic Acid in the Cerebrospinal Fluid in Patients with Hydrocephalus.

Increased Levels of Kynurenic Acid in the Cerebrospinal Fluid in Patients with Hydrocephalus. Neurosignals. 2019;27(1):1-11 Authors: Kepplinger B, Baran H, Kronsteiner C, Reuss J Abstract BACKGROUND/AIMS: Normal pressure hydrocephalus (NPH) is a potentially reversible neurological syndrome commonly characterized by gait disturbance, urinary incontinence, and dementia. Hydrocephalus e-vacuo (He-v) is also characterized by the occurrence of dementia but does not show gait disturbance or urinary incontinence and has no evident cerebrospinal fluid (CSF) pressure elevation. Kynurenic acid (KYNA), an endogenous metabolite of the L-kynurenine (L-KYN) pathway of L-tryptophan (L-TRP) degradation, is an antagonist of glutamate Nmethyl-D-aspartic acid and alpha 7 nicotinic cholinergic receptors that has been linked to dementia. We investigated KYNA, L-KYN, and L-TRP levels in human CSF and serum during the aging process in 30 healthy control individuals. In addition, clinical parameters and L-TRP metabolites in CSF and serum were evaluated in four patients with NPH and five with He-v. METHODS: KYNA, L-KYN, and L-TRP levels in CSF and serum were determined using highperformance liquid chromatography. RESULTS: Healthy controls showed a significant decrease in serum albumin with age. Compared with their corresponding controls and unlike patients with He-v, patients with NPH (age ≤ 50 years) had significant increases in CSF protein (241%, p
Source: Neuro-Signals - Category: Neurology Authors: Tags: Neurosignals Source Type: research

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Conclusions Patients with NPH, regardless of stages of the diseases, have increased ASV values and could benefit from shunting. Decreasing ASV values of patients with FG 3 comparing with those with FG 2 support the hypothesis of decreasing compliance of brain with aging and increasing severity of small-vessel disease.
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Neuroradiology Source Type: research
We present one of the largest single-center studies, which was designed to prove efficacy of our low-pressure setting of gravitational valve at all three symptoms of iNPH and to find statistically significant cut-off time for best clinical improvement according to the duration of symptoms.MethodsSixty-one consecutive patients (mean age 74.9 ± 5.3) with iNPH were prospectively observed from the time of surgery with minimal 6 months follow-up. All patients underwent implantation of the same type of gravitational valve with the same setting—pro GAV with low opening pressure at 5 cm H2O —and were operated by...
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
Since the clinical syndrome of progressive gait disturbance, urinary incontinence, and dementia in the setting of occult hydrocephalus responsive to cerebrospinal fuid (CSF) shunting was first reported in 1965, the existence of a potentially reversible cause for a form of a dementia illness has generated extensive clinical research and numerous clinical trials. Idiopathic normal pressure hydrocephalus (iNPH) continues to be a heavily debated clinical syndrome. This paper reviews guidelines and imaging findings most often associated with iNPH and the relationship of the neuroimaging findings to some of the theories for this complex syndrome.
Source: Neurologic Clinics - Category: Neurology Authors: Source Type: research
Authors: Takeuchi T, Yajima K Abstract A total of 482 operated idiopathic normal pressure hydrocephalus (iNPH) patients were divided into those aged
Source: Neurologia Medico-Chirurgica - Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research
AbstractIdiopathic normal pressure hydrocephalus (iNPH) is a subtype of hydrocephalus that occurs more often in the elderly population. It is usually characterized by gait disturbance, dementia and urinary incontinence. Epidemiological studies indicate that 15.7 –17.8% of iNPH patients present with type-2 diabetes mellitus (DM). A review of the primary literature shows that these occurrence rates are higher than age- and cohort-matched non-iNPH controls. This suggests that this already vulnerable patient group has an increased risk for presenting with DM compared to their non-iNPH counterparts. Postoperative outcome ...
Source: Fluids and Barriers of the CNS - Category: Neuroscience Source Type: research
A 73-year-old woman was referred for an elective aortic valve replacement for severe aortic stenosis. She had preserved biventricular function, mild left ventricular hypertrophy, and no significant coronary artery disease. From her medical history, she had dyslipidemia treated with statins and idiopathic normal pressure hydrocephalus (iNPH) awaiting shunt placement (Figure 1, Figure 2). She was experiencing only mild iNPH-related symptoms, namely urinary incontinence, gait disturbances, and dementia, and she had been following up regularly with a neurologist.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Conclusions: The Portuguese version of the Grading Scale for Idiopathic Normal Pressure Hydrocephalus was successfully translated and validated for use in Brazilian patients.RESUMO Objetivos: o presente estudo valida para a l íngua portuguesa a escala de hidrocefalia de pressão normal (HPN) desenvolvida em língua inglesa como “ Escala de classifica ção para hidrocefalia de pressão normal idiopática ” . M étodos: Usando o método de Guillemin, uma versão traduzida da escala foi aplicada em 121 pacientes consecutivos com diagnóstico de hi...
Source: Arquivos de Neuro-Psiquiatria - Category: Neurology Source Type: research
Publication date: Available online 6 November 2018Source: Journal of Clinical NeuroscienceAuthor(s): Konstantin Bräutigam, Antonis Vakis, Christos TsitsipanisAbstractIdiopathic Normal Pressure Hydrocephalus (iNPH) is a frequent neuropsychiatric entity. Clinically it is characterised by Hakim’s triad: Dementia, gait disturbance and urinary incontinence. While its symptomatology is typical, the etiology and thereby physiopathology of iNPH still remain enigmatic. This review summarizes and synthesizes different etiologic conceptions and physiopathologic aspects of iNPH. A research of literature via the PubMed/MEDLI...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
DiscussionSYGRAVA is the first randomized trial to determine whether programmable ASDs reduce complications of drainage compared to fixed ASDs in patients with iNPH. The results of this study may contribute to health-technology assessment of different valve systems used for VP-shunt surgery, and determination of the future standard of care.Trial registrationInternational Standard Randomised Controlled Trial Number:ISRCTN13838310. Registered on 10 November 2016.
Source: Trials - Category: Research Source Type: clinical trials
Normal pressure hydrocephalus (NPH) is characterized by ventricular dilation, but with normal cerebrospinal fluid pressure, and it manifests by the presence of the triad: dementia, urinary incontinence and gait disorders [1]. Gait impairment is of the earliest symptoms; however, the reliability evaluation is not well-established, and no consensus has been reaching regarding variable should be analyzed and which parameters should be taken into account to accurately assess any improvement after an intervention.
Source: Gait and Posture - Category: Orthopaedics Authors: Tags: Short communication Source Type: research
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