Association between Cerebrospinal fluid pressure and cognition in Alzheimer's disease, Lewy body dimentia

Abstract

Abstract Background: The relationship between cerebrospinal fluid pressure (CSFP) and cognition has received little research attention. The purpose of this study was to explore the relationship between cerebrospinal fluid pressure and cognition in dementia patients with Alzheimer's disease (AD), patients with Lewy body dementia (LBD). Method: We included 174 participants with dementia, including 131 patients with AD, 36 patients with LBD (including dementia with Lewy bodies (DLB) and parkinson's disease dementia (PDD)). The CSFP was measured by lumbar puncture, and informant-based history, laboratory test and neuroimaging were collected, logistic and linear regression analysis were used to evaluate the associations between CSFP and cognition. Results: The mean age of the included patients was 63.23±8.9 years and the mean cerebrospinal fluid pressure was 120.89±33.36 mmH2O, 77.0% of patients had a CSFP distribution of [90-170) mmH2O. 39 patients (23.4%) had severe dementia, 78 patients (46.7%) had moderate dementia, and 50 patients (30.0%) had mild dementia. In multivariate analysis, in all participants (OR: 5.81, 95% CI: 1.38-24.37, p = 0.01) and patientswith AD (OR: 6.82, 95%: CI: 1.32-35.18, p = 0.02), the lowest quartile SCFP [50-90) mmH2O was associated with more severe dementia level compared to the highest quartile CSFP [170-210) mmH2O. In addition, there was a significant positive linear correlation between CSFP and MMSE score in all participants (r = 0.42, p ＜ 0.001, Durbin-Watson test = 1.24) and in patientswith AD (r = 0.44, p = 0.006, Durbin-Watson test = 1.20). Conclusion: In dementia patients with AD, the decrease of CSFP is related to the more serious dementia level, and CSFP have a positive relationship with MMSE score. However, no such relationship was found in patients with LBD.