Diagnostic and Prognostic Biomarkers of Idiopathic Normal Pressure Hydrocephalus in Cerebrospinal Fluid and Blood.

Idiopathic normal pressure hydrocephalus (iNPH) is a treatable condition marked by gait disturbances, cognitive decline, and urinary incontinence. Biomarkers play a crucial role in distinguishing iNPH from Alzheimer's disease (AD) and predicting shunt surgery outcomes. Aβ1-42, Aβ1-40, t-tau, and p-tau181 differentiate iNPH from AD, with iNPH showing a higher Aβ1-42/Aβ1-40 ratio and normal tau levels. Neurofilament light chain and soluble amyloid precursor protein derivatives provide prognostic insights with lower preoperative levels linked to better surgical outcomes. Elevated LRG-1 and MCP-1 in cerebrospinal fluid aid in diagnosis and predict favorable responses to shunt surgery, enhancing clinical decision making and patient care.