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Predicting Development of Alzheimer's Disease in Patients with Shunted Idiopathic Normal Pressure Hydrocephalus
Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland;Univ Eastern Finland, Inst Clin Med Neurosurg, Kuopio, Finland;Kuopio Univ Hosp, NeuroCtr, Neurosurg, POB 100, FIN-70029 Kuopio, Finland.
Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland.
Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland;Kuopio Univ Hosp, NeuroCtr, Neurol, Kuopio, Finland.
Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland;Kuopio Univ Hosp, NeuroCtr, Neurol, Kuopio, Finland.
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2019 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, no 4, p. 1233-1243Article in journal (Refereed) Published
Abstract [en]

Background: Idiopathic normal pressure hydrocephalus (iNPH) patients often develop Alzheimer's disease (AD) related brain pathology. Disease State Index (DSI) is a method to combine data from various sources for differential diagnosis and progression of neurodegenerative disorders.

Objective: To apply DSI to predict clinical AD in shunted iNPH-patients in a defined population.

Methods: 335 shunted iNPH-patients (median 74 years) were followed until death (n = 185) or 6/2015 (n = 150). DSI model (including symptom profile, onset age of NPH symptoms, atrophy of medial temporal lobe in CT/MRI, cortical brain biopsy finding, and APOE genotype) was applied. Performance of DSI model was evaluated with receiver operating characteristic (ROC) curve analysis.

Results: A total of 70 (21%) patients developed clinical AD during median follow-up of 5.3 years. DSI-model predicted clinical AD with moderate effectiveness (AUC= 0.75). Significant factors were cortical biopsy (0.69), clinical symptoms (0.66), and medial temporal lobe atrophy (0.66).

Conclusion: We found increased occurrence of clinical AD in previously shunted iNPH patients as compared with general population. DSI supported the prediction of AD. Cortical biopsy during shunt insertion seems indicated for earlier diagnosis of comorbid AD.

Place, publisher, year, edition, pages
2019. Vol. 71, no 4, p. 1233-1243
Keywords [en]
Alzheimer's disease, computer-assisted diagnosis, normal pressure hydrocephalus
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-398155DOI: 10.3233/JAD-190334ISI: 000490569300016PubMedID: 31498122OAI: oai:DiVA.org:uu-398155DiVA, id: diva2:1375721
Funder
Academy of Finland, 263193EU, FP7, Seventh Framework Programme, 601055EU, FP7, Seventh Framework Programme, 611005Available from: 2019-12-05 Created: 2019-12-05 Last updated: 2019-12-10Bibliographically approved

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