The Pathogenesis Based on the Glymphatic System, Diagnosis, and Treatment of Idiopathic Normal Pressure Hydrocephalus

Tan, Changwu; Wang, Xiaoqiang; Wang, Yuchang; Wang, Chuansen; Tang, Zhi; Zhang, Zhiping; Liu, Jingping; Xiao, Gelei

doi:10.2147/cia.s290709

Cited by 43 publications

(42 citation statements)

References 130 publications

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“…The glymphatic system is a sleep‐assisted CSF and interstitial fluid transport system that promotes the removal of waste from the brain parenchyma. 109 , 110 In this pathway, fluid and solutes enter the perivascular space of the artery and then diffuse into the brain parenchyma by AQP4 expressed on the endfeet of astrocytes that ensheathe the brain vasculature. 111 , 112 These substances into the brain parenchyma are collected in the perivenous spaces surrounding the large deep veins and flow into the neck lymphatic system.…”

Section: Aquaporin Regulation Treatment For Hydrocephalusmentioning

confidence: 99%

Novel therapeutics for hydrocephalus: Insights from animal models

Wang

Tan

et al. 2021

CNS Neurosci Ther

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Hydrocephalus is a cerebrospinal fluid physiological disorder that causes ventricular dilation with normal or high intracranial pressure. The current regular treatment for hydrocephalus is cerebrospinal fluid shunting, which is frequently related to failure and complications. Meanwhile, considering that the current nonsurgical treatments of hydrocephalus can only relieve the symptoms but cannot eliminate this complication caused by primary brain injuries, the exploration of more effective therapies has become the focus for many researchers. In this article, the current research status and progress of nonsurgical treatment in animal models of hydrocephalus are reviewed to provide new orientations for animal research and clinical practice.

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Section: Aquaporin Regulation Treatment For Hydrocephalusmentioning

confidence: 99%

Novel therapeutics for hydrocephalus: Insights from animal models

Wang

Tan

et al. 2021

CNS Neurosci Ther

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“…A more recent animal study of the transforming growth factor-β (TGF-β) antagonist decorin found that inhibiting TGF-β-induced subarachnoid fibrosis reduced ventricular enlargement in a rat model of juvenile communicating hydrocephalus [ 33 ]. Disordered glymphatic circulation and accumulation of macromolecules in the cerebral white matter has also been recently implicated in adult NPH [ 34 , 35 ]. These hypotheses about venous and cerebrospinal fluid circulation dynamics across the age spectrum are still emerging, but collectively support that NPH is likely not exclusively a condition of older age.…”

Section: Discussionmentioning

confidence: 99%

Reappraisal of Pediatric Normal-Pressure Hydrocephalus

Leary

Svokos

Klinge

2021

JCM

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While normal-pressure hydrocephalus (NPH) is most commonly diagnosed in older adulthood, a significant body of literature has accumulated over half a century documenting the clinical phenomenon of an NPH-like syndrome in pediatric patients. As in adult NPH, it is likely that pediatric NPH occurs due to a heterogeneous array of developmental, structural, and neurodegenerative pathologies, ultimately resulting in aberrant cerebrospinal fluid (CSF) flow and distribution within and around the brain. In this review, we aimed to systematically survey the existing clinical evidence supporting the existence of a pediatric form of NPH, dating back to the original recognition of NPH as a clinically significant subtype of communicating hydrocephalus. Leveraging emergent trends from the old and more recent published literature, we then present a modern characterization of pediatric NPH as a disorder firmly within the same disease spectrum as adult NPH, likely with overlapping etiology and pathophysiological mechanisms. Exemplary cases consistent with the diagnosis of pediatric NPH selected from the senior author’s neurosurgical practice are then presented alongside the systematic review to aid in discussion of the typical clinical and radiographic manifestations of pediatric NPH. Common co-morbidities and modern surgical treatment options are also described.

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“…A hidrocefalia de pressão normal idiopática (HPNI) é uma categoria de HPN sem causa clara, ocorrendo com maior frequência em idosos. 10,15 A HPNI não é uma entidade clínica rara. A prevalência de HPNI foi estimada em 10 por 100.000 a 22 por 100.000 em geral, com 1,30% naqueles com idade ≥ 65 anos e 5,9% naqueles com idade ≥ 80 anos.…”

Section: Introductionunclassified

“…Imagens cerebrais típicas de HPNI exibem ventriculomegalia, hiperintensidades periventriculares, fissuras Sylvianas amplas, espaço subaracnoideo estreitado e sulcos corticais em alta convexidade. 10,11 Na condição fisiológica, o fluxo do LCR tem componentes volumosos e pulsáteis.…”

Section: Introductionunclassified

Sistema Glinfático E a Fisiopatologia Da Hidrocefalia De Pressão Normal Idiopática – Estado De Arte

Kochhann¹,

Bezerra²,

Peloso³

et al. 2022

RECIMA21

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INTRODUÇÃO: A hidrocefalia de pressão normal idiopática (HPNI) é uma doença neurológica caracterizada por deficiência cognitiva, incontinência urinária e distúrbios de marcha. Com os avanços relacionados aos sistemas de imagem, a captura da função do sistema glinfático tornou-se crucial para a investigação da HPNI. Este estudo tem como objetivo relatar os principais avanços no estudo do sistema glinfático e sua função na fisiopatologia da HPNI. METODOLOGIA: O presente estudo é uma revisão integrativa da literatura, onde foi realizada uma ampla pesquisa nas principais bases de dados (Medline, Scielo, Web of Science, SCOPUS) usando os termos "sistema glinfático", "hidrocefalia de pressão normal idiopática", "neurocirurgia", combinados por operadores booleanos. RESULTADOS E DISCUSSÃO: Os resultados apresentados neste estudo mostraram-se promissores para a investigação não-invasiva de doenças neurológicas que podem ser baseadas em disfunções hidrodinâmicas cerebrais. Entretanto, outros fatores devem ser explorados. Por exemplo, a disfunção venosa cerebral profunda em pacientes com HPNI leva a uma diferença na capacidade de drenagem entre o sistema venoso superficial e profundo, o que resulta em pressão transmembrana no parênquima cerebral, acelerando o processo da doença. CONSIDERAÇÕES FINAIS: Portanto, este estudo conclui que uma investigação aprofundada das ligações entre o sistema glinfático e a fisiopatologia da HPNI pode otimizar as abordagens diagnósticas atuais e evitar o agravamento precoce da doença, com base em novas classificações, levando em conta testes de imagem e biomarcadores do líquido cefalorraquidiano.

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The Pathogenesis Based on the Glymphatic System, Diagnosis, and Treatment of Idiopathic Normal Pressure Hydrocephalus

Cited by 43 publications

References 130 publications

Novel therapeutics for hydrocephalus: Insights from animal models

Novel therapeutics for hydrocephalus: Insights from animal models

Reappraisal of Pediatric Normal-Pressure Hydrocephalus

Sistema Glinfático E a Fisiopatologia Da Hidrocefalia De Pressão Normal Idiopática – Estado De Arte

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