CSF NEUROFILAMENT AND GLIAL FIBRILLARY ACIDIC PROTEIN IN NORMAL-PRESSURE HYDROCEPHALUS

We examined CSF levels of markers of neuronal degeneration and astrogl iosis-the light subunit of the neurofilament triplet protein (NFL) and the glial fibrillary acidic protein (GFAP)-in 65 patients with normal pressure hydrocephalus (NPH). NFL was increased sixfold (864 +/- 1,53 8 [mean +/- SD] versus 156 +/- 81 ng/L; p less than or equal to 0.001) and GFAP twofold (1,116 +/- 1,085 versus 637 +/- 295 ng/L; p less tha n or equal to 0.01) in NPH patients compared with neurologically healt hy age-matched controls. No correlation was found between any particul ar symptom or sign and GFAP levels in CSF. The levels of NFL, on the o ther hand, were higher in patients with severe symptoms compared with those with moderate or no symptoms. Furthermore, there was a correlati on between a high level of NFL and gait disturbance, incontinence, psy chometric incapability, and social dysfunction. A high preoperative NF L level was associated with favorable outcome after shunt surgery. Thi s indicates that NFL is a marker of ongoing and possibly still-reversi ble axonal damage in NPH.