Neuronal pentraxin 2 correlates with neurodegeneration but not cognition in idiopathic normal pressure hydrocephalus (iNPH).

IF 2.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia i neurochirurgia polska Pub Date : 2024-01-01 Epub Date: 2024-02-23 DOI:10.5603/pjnns.98212

Megha Patel, Yifan Zhang, Mei-Fang Xiao, Paul Worley, Abhay Moghekar

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引用次数: 0

Abstract

Aim of the study: Neuronal pentraxin-2 (NPTX2) is a synaptic protein responsible for modulating plasticity at excitatory synapses. While the role of NPTX2 as a novel synaptic biomarker in cognitive disorders has been elucidated recently, its role in idiopathic normal pressure hydrocephalus (iNPH) is not yet understood.

Clinical rationale for study: To determine if NPTX2 predicts cognition in patients with iNPH, and whether it could serve as a predictive marker for shunt outcomes.

Material and methods: 354 iNPH patients underwent cerebrospinal fluid drainage (CSF) as part of the tap test or extended lumbar drainage. Demographic and clinical measures including age, Evans Index (EI), Montreal Cognitive Assessment (MoCA) score, Functional Activities Questionnaire (FAQ) score, and baseline and post-shunt surgery Timed Up and Go (TUG) test scores were ascertained. CSF NPTX2 concentrations were measured using an ELISA. CSF β-amyloid 1-40 (Aβ1-40), β-amyloid 1-42 (Aβ1-42), and phosphorylated tau-181 (pTau-181) were measured by chemiluminescent assays. Spearman's correlation was used to determine the correlation between CSF NPTX2 concentrations and age, EI, MoCA and FAQ, TUG, Aβ1-40/Aβ1-42 ratio, and pTau-181 concentrations. Logistic regression was used to determine if CSF NPTX2 values were a predictor of short-term improvement post-CSF drainage or long-term improvement post-shunt surgery.

Results: There were 225 males and 129 females with a mean age of 77.7 years (± 7.06). Average CSF NPTX2 level in all iNPH patients was 559.97 pg/mL (± 432.87). CSF NPTX2 level in those selected for shunt surgery was 505.61 pg/mL (± 322.38). NPTX2 showed modest correlations with pTau-181 (r = 0.44, p < 0.001) with a trend for Aβ42/Aβ40 ratio (r = -0.1, p = 0.053). NPTX2 concentrations did not correlate with age (r = -0.012, p = 0.83) or MoCA score (r = 0.001, p = 0.87), but correlated negatively with FAQ (r = -0.15, p = 0.019).

Conclusions: While CSF NPTX2 values correlate with neurodegeneration, they do not correlate with cognitive or functional measures in iNPH. CSF NPTX2 cannot serve as a predictor of either short-term or long-term improvement after CSF drainage.

Clinical implications: These results suggest that synaptic degeneration is not a core feature of iNPH pathophysiology.

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神经元五肽 2 与特发性正常压力脑积水（iNPH）的神经变性相关，但与认知能力无关。

研究目的神经元五肽-2（NPTX2）是一种突触蛋白，负责调节兴奋性突触的可塑性。虽然最近已经阐明了 NPTX2 在认知障碍中作为新型突触生物标志物的作用，但它在特发性正常压力脑积水（iNPH）中的作用尚不清楚：材料与方法：354 名特发性正常压力脑积水（iNPH）患者接受了脑脊液引流术（CSF），作为水龙头试验或扩大腰椎引流术的一部分。确定了人口统计学和临床指标，包括年龄、埃文斯指数（EI）、蒙特利尔认知评估（MoCA）评分、功能活动问卷（FAQ）评分、基线和分流手术后的定时起立行走（TUG）测试评分。采用酶联免疫吸附法测定 CSF NPTX2 浓度。脑脊液中的β淀粉样蛋白1-40（Aβ1-40）、β淀粉样蛋白1-42（Aβ1-42）和磷酸化tau-181（pTau-181）通过化学发光法进行测定。Spearman 相关性用于确定 CSF NPTX2 浓度与年龄、EI、MoCA 和常见问题、TUG、Aβ1-40/Aβ1-42 比率和 pTau-181 浓度之间的相关性。采用逻辑回归法确定 CSF NPTX2 值是否可预测 CSF 引流后的短期改善或分流手术后的长期改善：男性 225 人，女性 129 人，平均年龄 77.7 岁（± 7.06）。所有 iNPH 患者的 CSF NPTX2 平均水平为 559.97 pg/mL（± 432.87）。选择进行分流手术的患者的 CSF NPTX2 水平为 505.61 pg/mL（± 322.38）。NPTX2 与 pTau-181 呈适度相关（r = 0.44，p < 0.001），与 Aβ42/Aβ40 比率呈趋势（r = -0.1，p = 0.053）。NPTX2浓度与年龄（r = -0.012，p = 0.83）或MoCA评分（r = 0.001，p = 0.87）不相关，但与常见问题（FAQ）呈负相关（r = -0.15，p = 0.019）：结论：虽然 CSF NPTX2 值与神经退行性变相关，但与 iNPH 患者的认知或功能指标无关。CSF NPTX2 不能作为 CSF 引流后短期或长期改善的预测指标：这些结果表明，突触变性并非 iNPH 病理生理学的核心特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurologia i neurochirurgia polska 医学-临床神经学

CiteScore

4.20

自引率

27.60%

发文量

128

审稿时长

6-12 weeks

期刊介绍： Polish Journal of Neurology and Neurosurgery is an official journal of the Polish Society of Neurology and the Polish Society of Neurosurgeons, aimed at publishing high quality articles within the field of clinical neurology and neurosurgery, as well as related subspecialties. For more than a century, the journal has been providing its authors and readers with the opportunity to report, discuss, and share the issues important for every-day practice and research advances in the fields related to neurology and neurosurgery.