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@ARTICLE{Beeke:282564,
      author       = {Beeke, M. and Sauer, C. and Petzold, J. and Schneider, S.
                      and Frenzen, K. and Donix, M. and Reiß, G. and Brandt,
                      Daniel Moritz and Haußmann, R.},
      title        = {{B}eobachtungsstudie zur {K}oinzidenz von
                      {A}lzheimer-{E}rkrankung und idiopathischem
                      {N}ormaldruckhydrozephalus: {A}nalyse von {K}oinzidenz,
                      deren {E}influss auf das {A}nsprechen im
                      {L}iquorablassversuch und zerebrovaskulärer {K}opathologie
                      | {O}bservational study on the coincidence of {A}lzheimer's
                      disease and idiopathic normal pressure hydrocephalus:
                      analysis of coincidence, the influence on response to
                      cerebrospinal fluid drainage and cerebrovascular
                      copathology},
      journal      = {Der Nervenarzt},
      volume       = {96},
      number       = {7},
      issn         = {0028-2804},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DZNE-2025-01327},
      pages        = {686 - 695},
      year         = {2025},
      abstract     = {Analysis of the frequency of comorbid Alzheimer's disease
                      in patients with suspected idiopathic normal pressure
                      hydrocephalus (iNPH) and its effects on the response to
                      cerebrospinal fluid (CSF) drainage as well as analysis of
                      the frequency of a vascular copathology in patients with
                      suspected iNPH.This was a prospective observational analysis
                      of patients with suspected iNPH who underwent
                      guideline-conform NPH routine diagnostics including CSF
                      drainage during clinical routine diagnostics between 1 July
                      2022 and 30 June 2023. Patients were recruited via the
                      departments of neurology, neurosurgery and psychiatry of the
                      University Hospital Carl Gustav Carus in Dresden. Typical
                      NPH imaging results were acquired from available magnetic
                      resonance imaging (MRI) and computed tomography (CT)
                      sectional images. Relevant sociodemographic, clinical,
                      cognitive and CSF diagnostic parameters were acquired via
                      patient chart review. The patients were categorized with
                      respect to the CSF results according to the
                      amyloid-tau-neurodegeneration (ATN) classification.During
                      the observational period 33 patients (14 female, 19 male,
                      mean age 74.6 ± 8.1 years) with suspected iNPH were
                      analyzed. Of the patients 19 $(57.6\%)$ had a complete and
                      14 $(42.4\%)$ an incomplete Hakim's triad. The difference
                      between the MoCA scores before and after CSF drainage varied
                      between patients with and without a response to CSF drainage
                      (F(1;22) = 5.725; p = 0.026). There was a trend that
                      patients with a pathological corpus callosum angle and
                      conspicuous Evans index (p = 0.052) as well as patients with
                      a pathological corpus callosum angle, Evans index and
                      complete clinical Hakim's triad (p = 0.055) more frequently
                      show a response. The mean Fazekas score was 1.7. There was
                      no correlation between the Fazekas score and response to CSF
                      drainage. In 25 patients $(75.8\%)$ biomarkers for dementia
                      and neurodegeneration were detected. According to the ATN
                      classification 20 patients $(80\%)$ were categorized as
                      A+T-, 3 $(12.0\%)$ as A+T+ and 2 $(8.0\%)$ as A-T-. Patients
                      classified as A+T+ and A+T- did not respond more often to
                      CSF drainage (p = 0.600).The combined determination of the
                      corpus callosum angle and the Evans index as well es their
                      contextualization with clinical characteristics can possibly
                      improve the prognostic evaluation regarding response to CSF
                      draínage. Especially a comorbid amyloid pathology and a
                      cerebral microangiopathy represent frequent copathologies of
                      iNPH but the influence on the response to CSF drainage
                      remains to be elucidated.},
      keywords     = {Humans / Hydrocephalus, Normal Pressure: epidemiology /
                      Hydrocephalus, Normal Pressure: therapy / Hydrocephalus,
                      Normal Pressure: diagnosis / Hydrocephalus, Normal Pressure:
                      cerebrospinal fluid / Hydrocephalus, Normal Pressure:
                      complications / Female / Male / Aged / Alzheimer Disease:
                      epidemiology / Alzheimer Disease: cerebrospinal fluid /
                      Alzheimer Disease: diagnosis / Alzheimer Disease:
                      complications / Alzheimer Disease: therapy / Aged, 80 and
                      over / Prospective Studies / Magnetic Resonance Imaging /
                      Drainage / Comorbidity / Middle Aged / Corpus callosum angle
                      (Other) / Evans index (Other) / Hakim’s triad (Other) /
                      Spinal drainage (Other) / Vascular copathology (Other)},
      cin          = {AG Falkenburger},
      ddc          = {610},
      cid          = {I:(DE-2719)1710012},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40016477},
      pmc          = {pmc:PMC12662853},
      doi          = {10.1007/s00115-025-01808-8},
      url          = {https://pub.dzne.de/record/282564},
}