Value of biomarkers in the prediction of shunt responsivity in patients with normal pressure hydrocephalus

被引：0

作者：

Miroslav Cihlo ^{[1
]}

Pavel Trávníček ^{[2
]}

Alena Tichá ^{[1
]}

Radomír Hyšpler ^{[2
]}

Marta Kalousová ^{[3
]}

Svatopluk Řehák ^{[3
]}

Karel Zadrobílek ^{[4
]}

Lucie Kukrálová ^{[1
]}

Pavel Póczoš ^{[2
]}

Jan Pospíšil ^{[1
]}

Pavel Dostál ^{[2
]}

Vlasta Dostálová ^{[5
]}

机构：

[1] Charles University,Department of Neurosurgery

[2] Faculty of Medicine in Hradec Kralove,Department of Neurosurgery

[3] University Hospital Hradec Kralove,Department of Clinical Biochemistry

[4] University Hospital Hradec Kralove,Institute of Medical Biochemistry and Laboratory Diagnostics

[5] First Faculty of Medicine,Department of Anaesthesiology and Intensive Care Medicine

[6] Charles University and General University Hospital in Prague,Department of Anaesthesiology and Intensive Care Medicine

[7] Charles University,undefined

[8] Faculty of Medicine in Hradec Kralove,undefined

[9] University Hospital Hradec Kralove,undefined

来源：

Neurosurgical Review | / 48卷 / 1期

关键词：

Normal pressure hydrocephalus; Biomarkers; NfL; NfH; NSE; S100B; Tau protein; Beta-amyloid;

D O I：

10.1007/s10143-025-03581-3

中图分类号：

学科分类号：

摘要：

Preoperative differentiation between responders and non-responders to ventriculoperitoneal (VP) shunting in the treatment of normal pressure hydrocephalus (NPH) remains a significant challenge. Identifying biomarkers in presurgical assessment represents a promising approach to reducing the need for invasive cerebrospinal fluid CSF testing. In this prospective observational study, thirty adult patients were classified into Group A (responders to VP shunting) and Group B (non-responders) based on their responsiveness to invasive CSF testing. The overall clinical condition and Idiopathic NPH (iNPH) scale were assessed at baseline. Additionally, biomarker levels were compared between the two groups. Elevated levels of Neurofilament Light Chain (NfL) and Neurofilament Heavy Chain (NfH) in CSF and a reduced level of beta-amyloid Aβ42 were observed. No significant differences in biomarker levels were found between groups. Individual biomarkers demonstrated only poor predictive value (AUC = 0.37–0.53). Clinical factors were stronger predictors (AUC = 0.642–0.669), with no improvement when combined with all examined biomarkers (AUC = 0.428–0.431). No single biomarker reliably predicted confirmed postoperative shunt responsiveness among patients who underwent VP shunt placement and demonstrated clinical improvement. Clinical factors were stronger predictors, suggesting that patient history and clinical assessment (e.g., the iNPH scale) provide more reliable diagnostic information. Notably, combining biomarkers with clinical factors did not improve predictive accuracy.

引用