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Brain tissue Aβ42 levels are linked to shunt response in idiopathic normal pressure hydrocephalus
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Enblad: Neurosurgery.ORCID iD: 0000-0001-6173-8357
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Enblad: Neurosurgery.ORCID iD: 0000-0001-9901-2949
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.ORCID iD: 0000-0002-9430-385
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical and experimental pathology. (Irina Alafuzoff)ORCID iD: 0000-0002-6249-569X
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2019 (English)In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 130, no 1, p. 121-129Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE The authors conducted a study to test if the cortical brain tissue levels of soluble amyloid beta (Aβ) reflect the propensity of cortical Aβ aggregate formation and may be an additional factor predicting surgical outcome following idiopathic normal pressure hydrocephalus (iNPH) treatment. METHODS Highly selective ELISAs (enzyme-linked immunosorbent assays) were used to quantify soluble Aβ40, Aβ42, and neurotoxic Aβ oligomers/protofibrils, associated with Aβ aggregation, in cortical biopsy samples obtained in patients with iNPH (n = 20), sampled during ventriculoperitoneal (VP) shunt surgery. Patients underwent pre- and postoperative (3-month) clinical assessment with a modified iNPH scale. The preoperative CSF biomarkers and the levels of soluble and insoluble Aβ species in cortical biopsy samples were analyzed for their association with a favorable outcome following the VP shunt procedure, defined as a ≥ 5-point increase in the iNPH scale. RESULTS The brain tissue levels of Aβ42 were negatively correlated with CSF Aβ42 (Spearman's r = -0.53, p < 0.05). The Aβ40, Aβ42, and Aβ oligomer/protofibril levels in cortical biopsy samples were higher in patients with insoluble cortical Aβ aggregates (p < 0.05). The preoperative CSF Aβ42 levels were similar in patients responding (n = 11) and not responding (n = 9) to VP shunt treatment at 3 months postsurgery. In contrast, the presence of cortical Aβ aggregates and high brain tissue Aβ42 levels were associated with a poor outcome following VP shunt treatment (p < 0.05). CONCLUSIONS Brain tissue measurements of soluble Aβ species are feasible. Since high Aβ42 levels in cortical biopsy samples obtained in patients with iNPH indicated a poor surgical outcome, tissue levels of Aβ species may be associated with the clinical response to shunt treatment.

Place, publisher, year, edition, pages
2019. Vol. 130, no 1, p. 121-129
Keywords [en]
AD = Alzheimer’s disease, Alzheimer’s disease, Aβ = amyloid beta, Aβ oligomers, ELISA = enzyme-linked immunosorbent assay, HPtau = hyperphosphorylated tau protein, LOD = limit of detection, LP = lumboperitoneal, MMSE = Mini-Mental State Examination, VP = ventriculoperitoneal, amyloid-β, hydrocephalus, iNPH, iNPH = idiopathic normal pressure hydrocephalus
National Category
Neurology Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
URN: urn:nbn:se:uu:diva-342227DOI: 10.3171/2017.7.JNS171005ISI: 000454604000014PubMedID: 29350601OAI: oai:DiVA.org:uu-342227DiVA, id: diva2:1183890
Funder
The Swedish Brain FoundationAvailable from: 2018-02-19 Created: 2018-02-19 Last updated: 2021-03-25Bibliographically approved

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Abu Hamdeh, SamiVirhammar, JohanSehlin, DagAlafuzoff, IrinaCesarini, Kristina GMarklund, Niklas

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