More advanced Alzheimer's disease may be associated with a decrease in cerebrospinal fluid pressure

Peter Wostyn,Kurt Audenaert,Peter Paul De Deyn

doi:10.1186/1743-8454-6-14

Abstract

In a recent article, elevated cerebrospinal fluid pressure (CSFP) consistent with very early normal pressure hydrocephalus (NPH), was found in a small subset of Alzheimer's disease (AD) patients (possible AD-NPH hybrids) enrolled in a clinical trial for chronic low-flow cerebrospinal fluid drainage. Also in the same study, was another interesting finding that merits further discussion: a substantial proportion of AD patients had very low CSFP. Based on the characteristics of these subjects, we hypothesize that more advanced AD may be associated with a decrease in CSFP. Reduced CSFP among a group of AD patients could provide a clue towards a better understanding of the high rate of comorbidity reported between AD and glaucoma since it has been shown that mean CSFP is lower in subjects with primary open-angle glaucoma. This could result in an abnormally high trans-lamina cribrosa pressure difference and lead to glaucomatous damage.

Highlights

Reduced cerebrospinal fluid pressure (CSFP) among a group of Alzheimer's disease (AD) patients could provide a clue towards a better understanding of the high rate of comorbidity reported between AD and glaucoma since it has been shown that mean CSFP is lower in subjects with primary open-angle glaucoma
In a recent article published in Cerebrospinal Fluid Research, Silverberg et al reported elevated cerebrospinal fluid pressure (CSFP), consistent with very early normal pressure hydrocephalus (NPH), in a small subset of Alzheimer's disease (AD) patients enrolled in a clinical trial of chronic low-flow cerebrospinal fluid (CSF) drainage [1]
There was no significant difference between intraocular pressures (IOPs) in AD patients with open-angle glaucoma (OAG) and without OAG, and almost all AD patients with OAG showed normal tension

Summary

Introduction

In a recent article published in Cerebrospinal Fluid Research, Silverberg et al reported elevated cerebrospinal fluid pressure (CSFP), consistent with very early normal pressure hydrocephalus (NPH), in a small subset of Alzheimer's disease (AD) patients enrolled in a clinical trial of chronic low-flow cerebrospinal fluid (CSF) drainage [1]. This ADelevated CSFP group provided further support for the existence of an AD-NPH hybrid and CSF circulatory failure. CSFP among patients with AD could shed new light on the link between AD and glaucoma [2,3]

Discussion

Findings

Conclusion