Alexander O'Dell
Analysis of Cerebrospinal Fluid in Normal Pressure Hydrocephalus (NPH): Evidence for Circadian Variation

SchoolUniversity of Michigan


ProgramScience


MentorStephen Dombrowski, PhD


DepartmentNeurosurgery


Research
Analysis of Cerebrospinal Fluid in Normal Pressure Hydrocephalus (NPH): Evidence for Circadian Variation
Hypothesis
The baseline vascular endothelial growth factor (VEGF) level in patients to be shunted will be higher than in those who will not be shunted. A decrease in cerebrospinal fluid (CSF) will decrease the CSF-VEGF concentration. VEGF will have a circadian variation. High levels of VEGF will correspond with poor clinical results and a decrease in VEGF concentration following drainage will show improved clinical symptoms.
Methodology
Patients diagnosed with NPH went through the NPH protocol, which includes gait, cognitive and self-scoring. The CSF samples were collected every hour for a 36-hour period and then frozen in a -80 degree freezer. The samples were then run using an R&D Systems ELISA kit. Data were compiled and analyzed.
Outcomes
Comparing our data to what the literature says, the level of VEGF in NPH patients is about the same as in patients with no neurological disorders. The level of CSF-VEGF following the 36-hour ELD is slightly lower than the VEGF level initially according to mean values. There seems to be no circadian variation in the level of VEGF over the 36-hour drainage. There is no correlation between the level of VEGF and clinical testing results.

Interpretations