Evidence map›Paper›PMID 29710721›Full record

Observational studyJournal of Alzheimer's disease : JAD2018

Change of Amyloid-β 1-42 Toxic Conformer Ratio After Cerebrospinal Fluid Diversion Predicts Long-Term Cognitive Outcome in Patients with Idiopathic Normal Pressure Hydrocephalus.

Chihiro Akiba, Madoka Nakajima, Masakazu Miyajima, Ikuko Ogino, Yumiko Motoi, Kaito Kawamura, Satoshi Adachi, Akihide Kondo, Hidenori Sugano, Takahiko Tokuda and 2 more

Registry-linked trialOpen access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of Alzheimer's disease : JAD, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05915000 (Alterations of CSF Protein Markers as Prognostic Indicator of the Response to Cerebrospinal Fluid Shunting in Chronic Hydrocephalus in Adults), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05915000 recruitingnot on this mapstarted 2019, after this paper: background citation

Alterations of CSF Protein Markers as Prognostic Indicator of the Response to Cerebrospinal Fluid Shunting in Chronic Hydrocephalus in Adults

TypeobservationalSponsorUniversity of ValenciaRan2019 to 2029Enrolled150ConditionsBeta-amiloid and Phospho-tau Proteins in CSF, Ventricular Size After CSF Shunt, Cognitive Impairment and CSF Shunt, Motor Impairment Evolution After CSF ShuntArmsLumbar CSF protein marker determination
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

  1. Guideline
  2. Association between p-tau181 in cerebrospinal fluid and shunt response in patients with normal-pressure hydrocephalus.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Article
  8. Review
  9. Cerebrospinal Fluid Biomarkers in iNPH: A Narrative Review.Diagnostics (Basel, Switzerland) · 2022
    Review
  10. Review
  11. Observational
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Chihiro AkibaDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Madoka NakajimaDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Masakazu MiyajimaDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Ikuko OginoDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Yumiko MotoiDepartment of Neurology, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Kaito KawamuraDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Satoshi AdachiDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Akihide KondoDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Hidenori SuganoDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Takahiko TokudaDepartment of Neurology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
Kazuhiro IrieDivision of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Sakyo-ku, Kyoto, Japan.
Hajime AraiDepartment of Neurosurgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Juntendo University · JPKyoto Prefectural University of Medicine · JPKyoto University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlzheimer's disease (AD) pathology in idiopathic normal pressure hydrocephalus (iNPH) contributes to poor shunt responses. Amyloid-β 1- 42 (Aβ42) toxic conformer was recently identified with features of rapid oligomerization, strong neurotoxicity and synaptotoxicity.

objectiveThis observational study points to Aβ42 toxic conformer as a biomarker for AD pathology and for poor postoperative prognosis in patients with iNPH.

methodsThe first cohort consisted of patients with AD (n = 17) and iNPH (n = 17), and cognitively normal individuals (CN, n = 12). The second cohort, consisted of 51 patients with iNPH, was divided into two groups according to phosphorylated Tau (pTau) level (low- and high-pTau groups); the low-pTau group was further subdivided according to one-year postoperative change in Aβ42 toxic conformer ratio (%) [Aβ42 toxic conformer/Aβ42×100] (decreased- and increased-conformer subgroups). Enzyme-linked immunosorbent assay was used to measure pTau, Aβ42, and Aβ42 toxic conformer in cerebrospinal fluid. Outcomes were evaluated using neuropsychological tests one- and two-years postoperatively.

resultsIn the first cohort, Aβ42 toxic conformer ratio in the iNPH group (10.8%) was significantly higher than that in the CN group (6.3%) and significantly lower than that in the AD group (17.2%). In the second cohort, the high-pTau group showed cognitive decline two-years postoperatively compared to baseline. However, the low-pTau group showed favorable outcomes one-year postoperatively; furthermore, the increased-conformer subgroup showed cognitive decline two-years postoperatively while the decreased-conformer subgroup maintained the improvement.

conclusionsChange in Aβ42 toxic conformer ratio predicts long-term cognitive outcome in iNPH, even in the low-pTau group.

Indexed as

AgedAged, 80 and overAlzheimer DiseaseAmyloid beta-PeptidesCognition DisordersCohort StudiesFemaleHumansHydrocephalus, Normal PressureMaleMental Status ScheduleMiddle AgedPeptide FragmentsStatistics, Nonparametrictau ProteinsWhite MatterAmyloid beta-Peptidesamyloid beta-protein (1-42)Peptide Fragmentstau ProteinsAlzheimer’s diseaseamyloid clearanceamyloid-β 1-42cerebrospinal-fluid shuntingcognitive functionidiopathic normal pressure hydrocephalusoligomerphosphorylated tautoxic conformer

Identifiers

PMID29710721
PMCPMC6004932
OpenAlexW2799278621

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.