NPH and Early AD Group 

Normal pressure hydrocephalus (NPH)

NPH is a poorly understood neurological disorder presenting with impaired cognitive, gate and continency functions in various combinations as well as enlarged I-IV ventricles.

NPH patients may significantly benefit of shunt surgery. The most frequent differential diagnosis is Alzheimer's disease (AD).

Neurosurgery of Kuopio University Hospital (KUH) solely serves Eastern Finnish population (see map at top left: green area).

Since 1991, our NPH protocol has included 24-hour intravenctricular pressure monitoring together with a small right frontal cortical biopsy to exclude other neurodegenerative  processes.

We are now including frontal lobe microdialysis for AD-related products as well as advanced AD imaging at
Turku PET Centre.

Kuopio NPH and AD Registry and Tissue Bank  contains clinical and long-term follow up data as well as cortical biopsy samples of over 500 patients investigated for possible NPH.

Kuopio NPH Research Group has a unique research window to NPH and AD through the cortical biopsy samples and long-term outcome data. This project is multidisciplinary approach, in which expertise from several fields of neuroscience at KUH and KU campus area as well as national and international level are combined.

Aims of research

1. Phenotype, outcome and genetics of NPH and AD in Eastern Finnish population.
2. Molecular genetics of NPH and AD in cortical biopsy samples.
3. Spectrum of AD proteins in NPH and AD brain microdialysate and CSF samples.
4. Validation of biopsy and PET diagnostics in NPH and AD.

 Selected publications

• Leinonen V, et al. Amyloid and tau proteins in cortical brain biopsy and Alzheimer's disease. Ann Neurol 2010

• Hansson Petersen CA, et al. The amyloid beta-peptide is imported into mitochondria via the TOM import machinery and localized to mitochondrial cristae. Proc Natl Acad Sci USA 2008

• Leinonen V, et al. Assessment of β-Amyloid in a frontal cortical brain biopsy specimen and by positron emission tomography with carbon 11-labeled Pittsburgh compound B. Arch Neurol 2008

• Bertram L, Hiltunen M, et al. Family-based association between Alzheimer's disease and variants in UBQLN1. N Engl J Med 2005

• Holm A, Savolainen S, Alafuzoff I. Brain biopsy prior to treatment of Alzheimer's disease. Minim Invasive Neurosurg 2003

• Savolainen S, et al. Five-year outcome of normal pressure hydrocephalus with or without a shunt: predictive value of the clinical signs, neuropsychological evaluation and infusion test. Acta Neurochir (Wien) 2002

• Savolainen S, et al. MR imaging of the hippocampus in normal pressure hydrocephalus: correlations with cortical Alzheimer's disease confirmed by pathologic analysis. AJNR Am J Neuroradiol 2000