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Surgery for Treatable Dementia Might Also Help in Alzheimer's
Date:5/4/2010

Patients may benefit from a shunt used for less common brain condition, research suggests,,

TUESDAY, May 4 (HealthDay News) -- Some people with Alzheimer's disease may be helped by a brain shunt normally used to treat another, less common neurological condition, new research suggests.

The other condition, normal pressure hydrocephalus (NPH), occurs when excess cerebrospinal fluid builds up in the ventricles, or cavities, deep within the brain. The reasons for the build-up of fluid are unknown, but it tends to occur in older people, said study author Dr. Sebastian Koga, a senior resident and surgeon in the department of neurosurgery at University of Virginia Health Science Center.

When diagnosing NPH, doctors look for three specific symptoms: difficulty walking (gait disturbances), urinary incontinence and dementia, or memory loss. The condition can often be slowed or relieved through a surgical procedure in which a shunt is implanted in the brain to drain fluid into the abdominal cavity, where it's harmlessly reabsorbed, Koga said.

In the study, Koga and his colleagues took brain biopsies from 50 patients who had been diagnosed with NPH and who had shunt surgery.

About 30 percent had also been diagnosed with other conditions, including Parkinson's-like tremors (13 percent), major depression (16 percent) and Alzheimer's (3 percent).

After the surgery, the researchers followed patients for an average of 26 months. Nearly half (47 percent) had a significant improvement in their symptoms.

But about 21 percent saw no benefit and 30 percent continued to decline rapidly, Koga said.

In analyzing the brain tissue, the researchers found that the patients most likely to not improve or to decline also had high counts of amyloid plaques and neurofibrillary tangles, the hallmarks of Alzheimer's disease.

While one possible conclusion is that these patients also had Alzheimer's, an
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