Graff-Radford NR. Alzheimer CSF biomarkers may be misleading in normal-pressure hydrocephalus. Neurology 2014; 83:1573-1575.
Preshunt in NPH have low Ab42 and tau protein, that improve post shunt. Author attributes to impaired clearance of these proteins in NPH, same is true for tau protein. After shunting, "room for the ICF space increases during sleep and ability for the proteins to better drain into the CSF (increases). Physicians should not rely on CSF biomarkers to look for Alz disease among patients being assessed for Alzheimer's disease.
nice clinical practical pearl. In NPH the whole idea of evaluation is to separate out bad surgical candidates from good ones by identifying Alzheimer's patients and others.