Normal Pressure Hydrocephalus, Dementia and Kynurenic AcidBerthold Kepplinger1-3, Jochen Reuss2, Brenda Sedlnitzky-Semler1, Roman Sobota2,4, Pavol Kalina3 and Halina Baran1*
- Corresponding Author:
- Halina Baran, Ph.D.
Professor of Neurochemistry
Neurochemical laboratory Karl Landsteiner Research Institute for Neurochemistry
Neuropharmacology, Neurorehabilitation and Pain Treatment
Mauer, 3360 Mauer- Amstetten, Austria
E-mail: [email protected]
Received date: May 11, 2017; Accepted date: May 19, 2017; Published date: May 26, 2017
Citation: Kepplinger B, Reuss J, Sedlnitzky-Semler B, Sobota R, Kalina P, et al. (2017) Normal Pressure Hydrocephalus, Dementia and Kynurenic Acid. Int J Neurorehabilitation 4:269. doi:10.4172/2376-0281.1000269
Copyright: © 2017 Kepplinger B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A female 49 years old patient with vestibular schwannoma developed normal pressure hydrocephalus. Patient complained about gait disturbance, urinary incontinence and memory impairment. Investigation of clinical parameter and measurement of kynurenic acid in the cerebrospinal fluid (CSF) and serum in patients with normal pressure hydrocephalus and in corresponding controls (CO; N=15) were performed. Within investigated parameters significant increase of protein and IgG levels in CSF were found in patient with normal pressure hydrocephalus. Furthermore, kynurenic acid was increased in the CSF by 60% and in the serum by 40%, comparing to CO subjects. Kynurenic acid level in CO was in the CSF and serum 2.77 ± 0.23 and 53.4 ± 4.0 nM, respectively. Three lumbar punctures were applied to patient with normal pressure hydrocephalus and clinical parameters partially normalized and lowering of kynurenic acid levels in CSF and serum were observed. Patient was improving after each lumbar puncture but the effect was transient, therefore permanent CSF shunting was recommended. After that a complete remission of symptoms occurred. Revealed data indicate a significant advantage of single punctures in management of treatment for normal pressure hydrocephalus. Increase of kynurenic acid in CSF represents interesting parameter. It is questionable if occurrence of cognition impairment and/or dementia in patients with normal pressure hydrocephalus might be related to an enhancement of kynurenic acid in the CNS.