Haoyun Xiao1,2 • Fan Hu3 • Jing Ding4 • Zheng Ye1 1 Institute of Neuroscience, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
2 University of Chinese Academy of Sciences, Beijing 100049, China
3 Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
4 Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a significant cause of the severe cognitive decline in the elderly population. There is no cure for iNPH, but cognitive symptoms can be partially alleviated through cerebrospinal fluid (CSF) diversion. In the early stages of iNPH, cognitive deficits occur primarily in the executive functions and working memory supported by frontostriatal circuits. As the disease progresses, cognition declines continuously and globally, leading to poor quality of life and daily functioning. In this review, we present recent advances in understanding the neurobiological mechanisms of cognitive impairment in iNPH, focusing on (1) abnormal CSF dynamics, (2) dysfunction of frontostriatal and entorhinal-hippocampal circuits and the default mode network, (3) abnormal neuromodulation, and (4) the presence of amyloid-β and tau pathologies.
Keywords
Idiopathic normal pressure hydrocephalus; Cognitive impairment; Cerebrospinal fluid dynamics; Frontostriatal circuits; Entorhinal-hippocampal circuits; Neuromodulation; Amyloid-β pathology; Tau pathology
