THE IDIOPATHIC NORMAL PRESSURE HYDROCEPHALUS AND ALZHEIMER'S DISEASE IN THE PRACTICE OF A NEUROLOGIST: COMORBIDITY AND DIFFERENTIATION
In the article was evaluated clinical, neuropsychological, laboratory and neurovisual changes in idiopathic normal pressure hydrocephalus and Alzheimer's disease. The aim was to improve the diagnosis of idiopathic normal pressure hydrocephalus, Alzheimer's disease and their combination based on neuropsychological, cerebrospinal fluid and neuroimaging. There were 60 patients in our study: 20 idiopathic normal pressure hydrocephalus, 17 - Alzheimer's disease, 8 - their combinations, 15 - control. All conducted advanced neuropsychological testing. A 10 meter test and a TUG test were used to evaluate walking. Interpretation of MR-images was carried out using the following scales: iNPHRadScale, MTA, Koedam, GCA. Lumbar puncture was performed with CSF using an enzyme-linked immunosorbent assay. In the course of this study, specific features of the clinical neuropsychological, cerebrospinal fluid and neuroimaging profiles of patients with idiopathic normal pressure hydrocephalus, Alzheimer's disease and their combination were identified, which improves the quality of diagnosis and determines the direction of treatment for these diseases. Results can be used in the assessment of cognitive disorders of various origins. It is proposed to conduct an extended neuropsychological study using specific techniques that evaluate memory and attention. A special role in the diagnosis of idiopathic normal pressure hydrocephalus is played by walking disorders. That is why it is proposed to introduce into clinical practice a mandatory gait study using special tests. The value of the assessment of MR-images using several techniques is shown, which assess both dilatation of the ventricular system and atrophy of the substance of the brain. It is necessary to comprehensively apply these scales for differential diagnosis. Evaluation of biomarkers of amyloidosis and neurodegeneration coefficients are an integral aspect in differentiating these diseases. An algorithm is proposed for mandatory clinical-neuropsychological and laboratory-instrumental examination of patients with cognitive impairment in idiopathic normal pressure hydrocephalus, Alzheimer's disease and their combination (4 figs, 7 tables, bibliograp hy: 15 refs).