Review

Ongoing search for diagnostic biomarkers in idiopathic normal pressure hydrocephalus

Andrew Tarnaris^*

† Author for correspondence

Department of Neurosurgery, National Hospital for Neurology & Neurosurgery, Box 32, Queen Square, London, WC1N 3BG, UK.

^*Both authors contributed equally to this work.

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Ahmed K Toma^*

Department of Neurosurgery, National Hospital for Neurology & Neurosurgery, Box 32, Queen Square, London, WC1N 3BG, UK.

^*Both authors contributed equally to this work.

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Email the corresponding author at andrewtarnaris@gmail.com

Neil D Kitchen

Department of Neurosurgery, National Hospital for Neurology & Neurosurgery, Box 32, Queen Square, London, WC1N 3BG, UK.

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Email the corresponding author at andrewtarnaris@gmail.com

Laurence D Watkins

Department of Neurosurgery, National Hospital for Neurology & Neurosurgery, Box 32, Queen Square, London, WC1N 3BG, UK.

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Email the corresponding author at andrewtarnaris@gmail.com

Published Online:15 Dec 2009https://doi.org/10.2217/bmm.09.37

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Abstract

Idiopathic normal pressure hydrocephalus is a syndrome, which typically has a clinical presentation of gait/balance disturbance, often accompanied by cognitive decline and/or urinary incontinence. Its diagnosis is based on relevant history and clinical examination, appropriate imaging findings and physiological testing. The clinical picture of idiopathic normal pressure hydrocephalus may occasionally be difficult to distinguish from that of Alzheimer’s dementia, subcortical ischemic vascular dementia and Parkinson’s disease. The aim of this article is to systematically review the literature from the last 29 years in order to identify cerebrospinal fluid (CSF) or imaging biomarkers that may aid in the diagnosis of the syndrome. The authors concluded that no CSF or imaging biomarker is currently fulfilling the criteria required to aid in the diagnosis of the condition. However, a few studies have revealed promising CSF and imaging markers that need to be verified by independent groups. The reasons that the progress in this field has been slow so far is also commented on, as well as steps required to apply the current evidence in the design of future studies within the field.

Keywords:

Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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Financial & competing interests disclosure

Ahmed Toma is supported by a grant from B Braun/Aesculap. Andrew Tarnaris was primarily responsible for the cerebrospinal fluid section and Ahmed Toma for the imaging section. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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