The investigation regarding interactive mechanism between Alzheimer disease and ideopathic normal pressure hydrocephalus

2020 Fiscal Year Final Research Report

• Project/Area Number: 17K10310
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Psychiatric science
• Research Institution: Osaka University (2019-2020); Kumamoto University (2017-2018)
• Principal Investigator: Hashimoto Mamoru 大阪大学, 医学系研究科, 准教授 (20452881)
• Co-Investigator(Kenkyū-buntansha): 福原 竜治 熊本大学, 病院, 講師 (60346682) ; 石川 智久 熊本大学, 病院, 助教 (60419512)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: アルツハイマー病 / 特発性正常圧水頭症 / 発現機序 / DESH

Outline of Final Research Achievements

We tested the hypothesis that Alzheimer's disease (AD) pathology may contribute to the development of idiopathic normal pressure hydrocephalus (iNPH). The subjects were 461 patients with probable AD. MRI disproportionately enlarged subarachnoid-space hydrocephalus (DESH) features, which is a hallmark for iNPH on brain MRI were visually evaluated.
We found that 10.6% of patients with AD showed the MRI DESH features, which was significantly higher than those in previous Japanese community-based studies. The frequencies of gait disturbance and urinary incontinence were significantly higher in the DESH positive patients than those in the DESH negative patients. Multiple logistic regression analysis revealed that the development of the MRI DESH features was significantly associated with the presence of diabetes mellitus and the presence of periventricular white matter hyperintensities on MRI.
These findings indicate the possibility that AD pathology contributes to the development of iNPH.

Free Research Field

認知症

Academic Significance and Societal Importance of the Research Achievements

本研究結果から、アルツハイマー病（AD）患者は特発性正常圧水頭症（iNPH）を合併しやすいこと、すなわちAD病理がiNPHを誘発する可能性が示された。現在ADに対する根本的な治療方法は存在しない。しかしながら本研究結果は、脳脊髄液シャント手術や脳脊髄液循環動態の改善に作用する薬剤が、ADの病態や臨床症状の改善に有効である可能性を示唆しており、今後のAD治療薬の開発や治療介入方法を検討する上で重要な知見である。