Open Access Open Badges Research article

Evaluation of coexistence of Alzheimer’s disease in idiopathic normal pressure hydrocephalus using ELISA analyses for CSF biomarkers

Tae Sung Lim1, Jun Young Choi1, Sun Ah Park2, Young Chul Youn3, Hyun Young Lee4, Byung Gon Kim1, In Soo Joo1, Kyoon Huh1 and So Young Moon1*

Author Affiliations

1 Department of Neurology, School of Medicine, AjouUniversity, 5 San, Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do 442-749, Republic of Korea

2 Department of Neurology, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea

3 Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea

4 Regional Clinical Trial Center, Ajou University Medical Center, Suwon, Republic of Korea

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BMC Neurology 2014, 14:66  doi:10.1186/1471-2377-14-66

Published: 1 April 2014



We investigated levels of the β-amyloid 1–42 (Aβ42), total tau protein (T-tau) and tau phosphorylated at position threonine 181 (P-tau) in cerebrospinal fluid (CSF) of idiopathic normal pressure hydrocephalus (iNPH) patients and tried to find their clinical implications in the evaluation and treatment of iNPH.


Twenty-five possible iNPH patients were prospectively enrolled and their CSF was collected to analyze levels of Aβ42, T-tau and P-tau using ELISA method. Gait disturbance, urinary incontinence, and cognitive impairment were semi-quantified and detailed neuropsychological (NP) test was performed.


Eight iNPH patients were classified into the lower CSF Aβ42 group and 17 patients were classified into the higher CSF Aβ42 group. There was no difference in the iNPH grading score and its improvement after LP between the two groups. The lower CSF Aβ42 group showed more deficits in attention, visuospatial function and verbal memory in the baseline NP test and less improvement in phonemic categorical naming and frontal inhibitory function after LP.


Our study suggested that concomitant AD in iNPH patients might contribute to lumbar puncture or shunt unresponsiveness, especially in the field of cognitive dysfunction.

Normal pressure hydrocephalus; Alzheimer’s disease; Cerebrospinal fluid; Lumbar puncture; Neuropsychological tests