Correlation of cerebrospinal fluid levels of transforming growth factor beta-1 with functional improvements after insertion of ventriculoperitoneal shunt for normal pressure hydrocephalus
The goal of this research is to investigate a potential CSF biomarker of NPH as a new tool for both the diagnosis of NPH and prognosis of VPS placement. Transforming growth factor-b1 (TGF-b1) is a signaling molecule involved in three fundamental activities; suppression of cell proliferation, immunosuppression, and deposition of extracellular matrix through promotion of synthesis and inhibition of degradation.8 Previously, TGF-b1 had been implicated in the development of communicating hydrocephalus secondary to pre-term infant intraventricular hemorrhage9 and adult aneurysmal sub-arachnoid hemorrhage.10, 11 Recently, an investigation demonstrated elevated levels of TGF-b1 in patients with shunt-responsive NPH compared to non-NPH patients.12 The specific aims of this research proposal are to: 1. Correlate CSF levels of TGF-b1 with the clinical response of patients diagnosed with NPH to VPS placement. 2. Correlate CSF levels of TGF-b1 with optimal VPS pressure settings.
Study Type
OBSERVATIONAL
Enrollment
21
CSF collection at time of VPS insertion
Vanderbilt University Medical Center
Nashville, Tennessee, United States
TGF beta-1 levels
Time frame: Time of Surgery
Mini-mental status exam
Time frame: Pre-operative, 3 and 12 months post-operatively
Modified barthel index
Time frame: Pre-operative, 3 and 12 months post-operatively
Tinetti mobility assessment
Time frame: Pre-operative, 3 and 12 months post-operatively
Programmable shunt setting
Time frame: Pre-operative, 3 and 12 months post-operatively
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