{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T21:19:42Z","timestamp":1794345582085,"version":"4.9.0"},"reference-count":43,"publisher":"BMJ","issue":"10","funder":[{"name":"Kuopio University Hospital VTR-fund"},{"DOI":"10.13039\/501100003792","name":"Hj\u00e4rnfonden","doi-asserted-by":"publisher","award":["#FO2017-0243"],"award-info":[{"award-number":["#FO2017-0243"]}],"id":[{"id":"10.13039\/501100003792","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Alzheimer Foundation","award":["#AF-742881"],"award-info":[{"award-number":["#AF-742881"]}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["#2017-00915"],"award-info":[{"award-number":["#2017-00915"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish State under the agreement between the Swedish government and the country councils, the ALF agreement","award":["2017-04961"],"award-info":[{"award-number":["2017-04961"]}]},{"name":"Swedish State under the agreement between the Swedish government and the country councils, the ALF agreement","award":["ALFBGB-720121"],"award-info":[{"award-number":["ALFBGB-720121"]}]},{"name":"Swedish State under the agreement between the Swedish government and the country councils, the ALF agreement","award":["ALFGBG-715986"],"award-info":[{"award-number":["ALFGBG-715986"]}]},{"name":"Swedish State under the agreement between the Swedish government and the country councils, the ALF agreement","award":["ALFGBG-720931"],"award-info":[{"award-number":["ALFGBG-720931"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2019,5,12]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the differential diagnostic significance of cerebrospinal fluid (CSF) biomarkers reflecting Alzheimer\u2019s disease-related amyloid \u03b2 (A\u03b2) production and aggregation, cortical neuronal damage, tau pathology, damage to long myelinated axons and astrocyte activation, which hypothetically separates patients with idiopathic normal pressure hydrocephalus (iNPH) from patients with other neurodegenerative disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included lumbar CSF samples from 82 patients with iNPH, 75 with vascular dementia, 70 with Parkinson\u2019s disease, 34 with multiple system atrophy, 34 with progressive supranuclear palsy, 15 with corticobasal degeneration, 50 with Alzheimer\u2019s disease, 19 with frontotemporal lobar degeneration and 54 healthy individuals (HIs). We analysed soluble amyloid precursor protein alpha (sAPP\u03b1) and beta (sAPP\u03b2), A\u03b2 species (A\u03b238, A\u03b240 and A\u03b242), total tau (T-tau), phosphorylated tau, neurofilament light and monocyte chemoattractant protein 1 (MCP-1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with iNPH had lower concentrations of tau and APP-derived proteins in combination with elevated MCP-1 compared with HI and the non-iNPH disorders. T-tau, A\u03b240 and MCP-1 together yielded an area under the curve of 0.86, differentiating iNPH from the other disorders. A prediction algorithm consisting of T-tau, A\u03b240 and MCP-1 was designed as a diagnostic tool using CSF biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combination of the CSF biomarkers T-tau, A\u03b240 and MCP-1 separates iNPH from cognitive and movement disorders with good diagnostic sensitivity and specificity. This may have important implications for diagnosis and clinical research on disease mechanisms for iNPH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2019-320826","type":"journal-article","created":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T17:19:10Z","timestamp":1559755150000},"page":"1117-1123","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":88,"title":["CSF biomarkers distinguish idiopathic normal pressure hydrocephalus from its mimics"],"prefix":"10.1136","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5908-1904","authenticated-orcid":false,"given":"Anna","family":"Jeppsson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Wikkels\u00f6","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaj","family":"Blennow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Zetterberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu","family":"Constantinescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M","family":"Remes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanna-Kaisa","family":"Herukka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas","family":"Rauramaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Nagga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ville","family":"Leinonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4997-5266","authenticated-orcid":false,"given":"Mats","family":"Tullberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,5]]},"reference":[{"key":"2024111107500833000_90.10.1117.1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(65)90016-X"},{"key":"2024111107500833000_90.10.1117.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-306117"},{"key":"2024111107500833000_90.10.1117.3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000342"},{"key":"2024111107500833000_90.10.1117.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2005.00451.x"},{"key":"2024111107500833000_90.10.1117.5","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1007\/s00415-017-8598-5","article-title":"Parkinsonian symptoms in normal pressure hydrocephalus: a population-based study","volume":"264","author":"Molde","year":"2017","journal-title":"J Neurol"},{"issue":"suppl_3","key":"2024111107500833000_90.10.1117.6","doi-asserted-by":"crossref","first-page":"S2-4","DOI":"10.1227\/01.NEU.0000168185.29659.C5","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin","year":"2005","journal-title":"Neurosurgery"},{"key":"2024111107500833000_90.10.1117.7","first-page":"1665","article-title":"Normal pressure hydrocephalus: vascular white matter changes on MR images must not exclude patients from shunt surgery","volume":"22","author":"Tullberg","year":"2001","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024111107500833000_90.10.1117.8","doi-asserted-by":"crossref","unstructured":"Schirinzi T , Sancesario GM , Ialongo C , et al . 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