ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2025
Degenerative pathologies on cortical biopsy, dopaminergic depletion, and shunt efficacy in iNPH.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Redefining Idiopathic Normal Pressure Hydrocephalus Using AI-Driven Brain Volumetry.Biomedicines · 2026Article
- Degenerative pathologies on cortical biopsy, dopaminergic depletion, and shunt efficacy in iNPH.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
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6 authors.
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Abstract
introductionCoexisting degenerative pathologies may influence the efficacy of ventriculoperitoneal (VP) shunting in idiopathic normal pressure hydrocephalus (iNPH).
methodsWe evaluated 58 iNPH patients who underwent VP shunting with cortical biopsy assessing pathologies including amyloid beta (Aβ). Concordance between biopsy-identified Alzheimer's pathology and amyloid positron emission tomography (PET) and the influence of magnetic resonance imaging-based iNPH indices, dopamine transporter (DAT) imaging, and biopsy pathologies on postoperative outcomes were examined.
resultsAβ pathology was found in 23 patients (39.7%) and showed high concordance with amyloid PET (95.2%). Although Aβ positivity was associated with poorer 1-year cognitive outcome, and cognitive improvement reached significance only in Aβ-negative patients, both Aβ-positive and Aβ-negative groups exhibited functional improvement after surgery. Lower anterior striatal DAT uptake was paradoxically associated with better postoperative outcomes, particularly in Aβ-positive individuals. DISCUSSION: Cortical biopsy provides information concordant with amyloid PET, and biopsy-confirmed Alzheimer's pathology and dopaminergic status influence shunt efficacy. VP shunting remains beneficial in iNPH even with degenerative comorbidities. HIGHLIGHTS: Cortical biopsy findings showed high concordance with amyloid PET in iNPH patients. AD pathology was linked to poorer cognitive and functional outcomes after surgery. VP shunting remained beneficial even in patients with comorbid AD pathology. Lower anterior striatal DAT uptake was paradoxically associated with better outcomes. Combined use of biopsy and DAT imaging may aid prognostication in iNPH management.
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