Search

Normal pressure hydrocephalus (NPH) is a treatable neurological disorder affecting elderly people with the prevalence increasing with age. NPH is caused by abnormal cerebrospinal fluid (CSF) reabsorption and manifested as a balance impairment, urinary incontinence and dementia development. These symptoms are potentially reversible if recognized early. Diagnosis of NPH is difficult and can be easily mistaken for other neurodegenerative disorders, which makes NPH one of the major misdiagnosed diseases worldwide. The aim of the study was to find out the appropriate combination of indicators, based on CSF steroids, which would contribute to a clearer NPH diagnosis. The levels of CSF cortisol, cortisone, dehydroepiandrosterone (DHEA), 7α-OH-DHEA, 7β-OH-DHEA, 7-oxo-DHEA, 16α-OH-DHEA and aldosterone (all LC-MS/MS) were determined in our patients (n=30; NPH, 65-80 years) and controls (n=10; 65-80 years). The model of orthogonal projections to latent structures (OPLS) was constructed to predict NPH. Cortisone, 7α-OH-DHEA, 7β-OH-DHEA, 7-oxo-DHEA, aldosterone, 7α-OH-DHEA /DHEA, 7-oxo-DHEA/7α-OH-DHEA, 7β-OH-DHEA/7-oxo-DHEA and 16α-OH-DHEA/DHEA in the CSF were identified as the key predictors and the model discriminated patients from controls with 100% sensitivity and 100% specificity. The suggested model would contribute to early and accurate NPH diagnosis, enabling promptly treatment of the disease., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Neuroactive steroids (dehydroepiandrosterone, pregnenolone) and their sulfates act as modulators of glutamate and gamma-aminobutyrate type A receptors in the brain The physiological ratio of these neuromodulators is maintained by two enzymes present in the brain, namely, steroid sulfatase (STS) and steroid sulfuryl transferase (SULT). Following previous determination of their activities in monkey brains, their activities were evaluated in human brain tumors. Radioimmunoassay and GC-MS were used for determination of products. Both enzyme activities were measured in the 55 most frequent human brain tumors (glioblastomas, pituitary adenomas, meningiomas, astrocytomas). Significant differences were found in STS activity among investigated types of tumors except the pair of pituitary adenomas-glioblastomas, while significant differences were found in SULT activity among investigated types of tumors. Spontaneous tendency to form clusters was revealed when both enzyme activities were taken as coordinates. Clustering indicated an individual metabolic behavior of glioblastomas and 72.7% of pituitary adenomas. Astrocytomas, meningiomas and remaining 27.3% pituitary adenomas showed similarities in both enzymes' activities. Differences in STS and SULT activity did not depend on the sex or age of subjects.