Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study

Abstract Background Neuroinflammation may be involved in the pathogenesis of idiopathic normal pressure hydrocephalus (iNPH). However, the specific changes in the peripheral inflammatory state of patients with iNPH remain unclear. Objective To explore the changes in the peripheral inflammatory state...

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Main Authors: Yang Yang, Dandan Guo, Qingchao Yang, Chenlu Yang, Jinde Liu, Heyin Liu, Wen Liu, Yuqian Liu, Yi Li, Yiming Liu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Fluids and Barriers of the CNS
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Online Access:https://doi.org/10.1186/s12987-025-00682-5
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author Yang Yang
Dandan Guo
Qingchao Yang
Chenlu Yang
Jinde Liu
Heyin Liu
Wen Liu
Yuqian Liu
Yi Li
Yiming Liu
author_facet Yang Yang
Dandan Guo
Qingchao Yang
Chenlu Yang
Jinde Liu
Heyin Liu
Wen Liu
Yuqian Liu
Yi Li
Yiming Liu
author_sort Yang Yang
collection DOAJ
description Abstract Background Neuroinflammation may be involved in the pathogenesis of idiopathic normal pressure hydrocephalus (iNPH). However, the specific changes in the peripheral inflammatory state of patients with iNPH remain unclear. Objective To explore the changes in the peripheral inflammatory state of patients with iNPH and their potential value as biomarkers of clinical diagnosis and disease severity. Methods In this cross-sectional study, 119 iNPH patients with AD-negative pathology and 200 healthy controls (HCs) were enrolled. Clinical characteristics, including the Idiopathic Normal Pressure Hydrocephalus Grading Scale (iNPHGS), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), were collected along with inflammatory parameters in the peripheral blood. Logistic regression was applied to evaluate differences in peripheral inflammatory indicators, adjusting for age, sex, and comorbidities. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the inflammatory markers. Correlations between inflammatory parameters and clinical characteristics were assessed. Results Significant differences in inflammatory parameters, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and prognostic nutritional index (PNI), were observed between iNPH patients and HCs after adjusting for age, sex and comorbidities. The combination of PNI and platelet-to-high-density lipoprotein ratio (PHR) distinguished iNPH patients from HCs most significantly (area under the curve [AUC] = 0.820). Neutrophil ratio and lymphocyte ratio were associated with clinical severity and cognitive impairment of patients with iNPH. Conclusions iNPH patients exhibit an elevated peripheral inflammatory state. Peripheral inflammatory parameters, especially neutrophil ratio and lymphocyte ratio, are associated with disease severity and cognitive impairment, suggesting their potential as therapeutic targets and offering new insights into the pathophysiology of iNPH. Additionally, the inflammatory peripheral parameters may serve as valuable and convenient method in assisting clinical diagnosis.
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spelling doaj-art-e292051d71434e7c9cdc45e646b84c122025-08-20T04:02:55ZengBMCFluids and Barriers of the CNS2045-81182025-07-0122111210.1186/s12987-025-00682-5Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional studyYang Yang0Dandan Guo1Qingchao Yang2Chenlu Yang3Jinde Liu4Heyin Liu5Wen Liu6Yuqian Liu7Yi Li8Yiming Liu9Department of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityAbstract Background Neuroinflammation may be involved in the pathogenesis of idiopathic normal pressure hydrocephalus (iNPH). However, the specific changes in the peripheral inflammatory state of patients with iNPH remain unclear. Objective To explore the changes in the peripheral inflammatory state of patients with iNPH and their potential value as biomarkers of clinical diagnosis and disease severity. Methods In this cross-sectional study, 119 iNPH patients with AD-negative pathology and 200 healthy controls (HCs) were enrolled. Clinical characteristics, including the Idiopathic Normal Pressure Hydrocephalus Grading Scale (iNPHGS), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), were collected along with inflammatory parameters in the peripheral blood. Logistic regression was applied to evaluate differences in peripheral inflammatory indicators, adjusting for age, sex, and comorbidities. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the inflammatory markers. Correlations between inflammatory parameters and clinical characteristics were assessed. Results Significant differences in inflammatory parameters, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and prognostic nutritional index (PNI), were observed between iNPH patients and HCs after adjusting for age, sex and comorbidities. The combination of PNI and platelet-to-high-density lipoprotein ratio (PHR) distinguished iNPH patients from HCs most significantly (area under the curve [AUC] = 0.820). Neutrophil ratio and lymphocyte ratio were associated with clinical severity and cognitive impairment of patients with iNPH. Conclusions iNPH patients exhibit an elevated peripheral inflammatory state. Peripheral inflammatory parameters, especially neutrophil ratio and lymphocyte ratio, are associated with disease severity and cognitive impairment, suggesting their potential as therapeutic targets and offering new insights into the pathophysiology of iNPH. Additionally, the inflammatory peripheral parameters may serve as valuable and convenient method in assisting clinical diagnosis.https://doi.org/10.1186/s12987-025-00682-5Idiopathic normal pressure hydrocephalusPeripheral inflammationCognitive impairment
spellingShingle Yang Yang
Dandan Guo
Qingchao Yang
Chenlu Yang
Jinde Liu
Heyin Liu
Wen Liu
Yuqian Liu
Yi Li
Yiming Liu
Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study
Fluids and Barriers of the CNS
Idiopathic normal pressure hydrocephalus
Peripheral inflammation
Cognitive impairment
title Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study
title_full Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study
title_fullStr Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study
title_full_unstemmed Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study
title_short Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study
title_sort peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients a cross sectional study
topic Idiopathic normal pressure hydrocephalus
Peripheral inflammation
Cognitive impairment
url https://doi.org/10.1186/s12987-025-00682-5
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