Assessment of low-flow CSF drainage as a treatment for AD: Results of a randomized pilot study
| العنوان: | Assessment of low-flow CSF drainage as a treatment for AD: Results of a randomized pilot study |
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| المؤلفون: | R. Winn, E. Levinthal, Dawn McGuire, Thomas Saul, Martha Mayo, Gerald D. Silverberg, Stephen L. Huhn, Daniel A. Bloch, F. Marciano, Edith V. Sullivan, S. Flitman, J. Leverenz, Steven D. Chang |
| المصدر: | Neurology. 59:1139-1145 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2002. |
| سنة النشر: | 2002 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Randomization, Pilot Projects, Neuropsychological Tests, law.invention, Central nervous system disease, Randomized controlled trial, Alzheimer Disease, Normal pressure hydrocephalus, law, medicine, Humans, Dementia, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, business.industry, Contraindications, Middle Aged, medicine.disease, Cerebrospinal Fluid Shunts, Surgery, Hydrocephalus, Clinical trial, Anesthesia, Linear Models, Female, Neurology (clinical), business, Follow-Up Studies |
| الوصف: | Objective: This prospective, randomized, controlled study was designed to investigate the safety, feasibility, and preliminary efficacy of long-term CSF drainage via a low-flow ventriculoperitoneal shunt in subjects suffering from AD. Methods: Twenty-nine subjects selected for probable AD (National Institute of Neurological and Communicative Diseases and Stroke–Alzheimer’s Disease and Related Dementias Association criteria) were screened to exclude normal pressure hydrocephalus or other etiologies of dementia and randomized to treatment (shunt) or no treatment groups. The study endpoint was the comparison of group performance on psychometric testing at quarterly intervals for 1 year. Shunted subjects had CSF withdrawn for MAP-tau and Aβ (1-42) assays at the same time intervals. Results: There was no mortality from the surgical procedure, and no patient sustained a subdural hematoma. Five notable postoperative adverse events, which resolved without permanent neurologic deficit, were reported in the shunt group. Group mean Mattis Dementia Rating Scale total scores showed little change over the year in the shunt-treatment group, in contrast to a decline in the control group ( p = 0.06). Mini-Mental State Examination mean scores supported a trend in favor of shunt treatment ( p = 0.1). There was a concomitant decrease in ventricular CSF concentrations of AD biomarkers MAP-tau and Aβ (1-42) . Conclusions: The surgical procedure and the device are reasonably safe. Adverse events were consistent with shunt procedures for hydrocephalus in this older population. The endpoint data show a trend in favor of the treated group. A larger, randomized, double-blinded, controlled, clinical trial is underway. |
| تدمد: | 1526-632X 0028-3878 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cdff3a0d4a41b829fee5bc4e32f23975 https://doi.org/10.1212/01.wnl.0000031794.42077.a1 |
| رقم الأكسشن: | edsair.doi.dedup.....cdff3a0d4a41b829fee5bc4e32f23975 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1526632X 00283878 |
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