Alzheimer's Disease-Related Polymorphisms in Shunt-Responsive Idiopathic Normal Pressure Hydrocephalus

J Alzheimers Dis. 2017;60(3):1077-1085. doi: 10.3233/JAD-170583.

Abstract

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a late onset, surgically treated progressive brain disease caused by impaired cerebrospinal fluid dynamics and subsequent ventriculomegaly. Comorbid Alzheimer's disease (AD) seems to be frequent in iNPH.

Objective: We aim to evaluate the role of AD-related polymorphisms in iNPH.

Methods: Overall 188 shunt-operated iNPH patients and 688 controls without diagnosed neurodegenerative disease were included into analysis. Twenty-three single-nucleotide polymorphisms (SNPs FRMD4A [rs7081208_A, rs2446581_A, rs17314229_T], CR1, BIN, CD2AP, CLU, MS4A6A, MS4A4E, PICALM, ABCA7, CD33, INPP5D, HLA_DRB5, EPHA1, PTK2B, CELF1, SORL1, FERMT2, SLC24A, DSG2, CASS4, and NME8) adjusted to APOE were analyzed between groups by using binary logistic regression analysis. Neuroradiological characteristics and AD-related changes in the right frontal cortical brain biopsies were available for further analysis.

Results: Logistic regression analysis adjusted to age, gender, and other SNPs indicated allelic variation of NME8 between iNPH patients and non-demented controls (p = 0.014). The allelic variation of NME8 was not related to the neuropathological changes in the brain biopsies of iNPH patients. However, periventricular white matter changes (p = 0.017) were more frequent in the iNPH patients with the AA-genotype, an identified risk factor of AD.

Conclusions: Our findings increase the evidence that iNPH is characterized by genetic and pathophysiological mechanisms independent from AD. Considering that NME8 plays a role in the ciliary function and displays SNP-related diversity in white matter changes, the mechanisms of NME8 in iNPH and other neurodegenerative processes are worth further study.

Keywords: Alzheimer’s disease; genetics; idiopathic normal pressure hydrocephalus; pathology; radiology.

MeSH terms

  • Aged
  • Alzheimer Disease / complications
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / genetics*
  • Alzheimer Disease / pathology
  • Brain / diagnostic imaging
  • Brain / pathology
  • Cerebrospinal Fluid Shunts*
  • Comorbidity
  • Female
  • Genetic Predisposition to Disease*
  • Humans
  • Hydrocephalus, Normal Pressure / complications
  • Hydrocephalus, Normal Pressure / genetics*
  • Hydrocephalus, Normal Pressure / pathology
  • Hydrocephalus, Normal Pressure / surgery*
  • Logistic Models
  • Male
  • Polymorphism, Single Nucleotide
  • Thioredoxins / genetics

Substances

  • NME8 protein, human
  • Thioredoxins