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47/100

✓ Peer-reviewed alzhub usefulness score 47 out of 100. Tau biomarkers

Topic: Brain proteins, microglia and lab models

There are many reports about the comorbidity of NPH and other neurodegenerative diseases1–3; the primary findings in neuropathological studies of patients with NPH include amyloid plaques and hyperphosphorylated tau protein inclusions.2,4 This suggests that proteinopathy may be one of the potential causes of NPH. The results of other neurological routine examinations were all normal; these included consciousness, language, muscle strength, muscle tone, and sensory functions. Lumbar puncture revealed a normal opening pressure of 115 mm H2O and drained 30 mL of cerebrospinal fluid (CSF). As mentioned above, all tests showed significant improvement after 24 h following the tap test, with an increase of over 20%. The patient’s premortem cranial MRI results. (A-C) The patient’s MRI results at 79 years old (Evans index: 0.34). (D-F) The patient’s MRI results at 82 years old (Evans index: 0.37). MRI revealed further enlargement of her ventricles (Figure 1D-F, Evans index: 0.37). The patient significantly benefited once again from the tap test and lumbar cistern drainage. The fixed brain weighed 1145.2 g; macroscopic observation revealed marked cortical atrophy in the frontal-parietal-temporal junction area, with no evident lesions on the brain surface except for the drainage tube. Immunohistochemical staining revealed the pathology of proteinopathies. AT8 immunohistochemistry revealed neurofibrillary tangles, and the density of neuritic plaques in the same aforementioned regions (Figure 2E-H). These results indicate the presence of widespread distribution of high Alzheimer disease neuropathological change (ADNC) in the brain (NIA/AA Stage A3B3C3). Immunohistochemistry for α-synuclein demonstrated Lewy bodies in the brainstem, olfactory bulb, various cerebral cortices, hippocampus, and basal ganglia (Braak stage V; Figure 2I-L). Tap test and shunt surgery significantly improved the patient’s cognitive and motor functions, although the symptoms ultimately progressed with irreversible deterioration. NPH and other neurodegenerative diseases share some overlapping symptoms, but the neuropathological features of NPH remain poorly understood.7 Previous pathology studies of patients with NPH pointed out that vascular changes and ADNC were common in their brains.1–3 Some patients even developed corticobasal degeneration or AD during the follow-up.2 A retrospective analysis of 142 NPH patients who underwent CSF shunting surgery found that 19% of the patients had ADNC; amon

Key findings

There are many reports about the comorbidity of NPH and other neurodegenerative diseases1–3; the primary findings in neuropathological studies of patients with NPH include amyloid plaques and hyperphosphorylated tau protein inclusions.2,4 This suggests that proteinopathy may be one of the potential causes of NPH.
The results of other neurological routine examinations were all normal; these included consciousness, language, muscle strength, muscle tone, and sensory functions.
Lumbar puncture revealed a normal opening pressure of 115 mm H2O and drained 30 mL of cerebrospinal fluid (CSF).
As mentioned above, all tests showed significant improvement after 24 h following the tap test, with an increase of over 20%.
The patient’s premortem cranial MRI results.

Why it matters

This is a single autopsy case report of one person who had normal pressure hydrocephalus along with several misfolded proteins found in the brain. It cannot show that protein buildup causes normal pressure hydrocephalus or change how the condition is treated.

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Study details

Study designcohort study
Participants50
Effect size7.25%; 1.1%; or 19.2
Evidence strengthModerate

How this study scored 47/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of Neuropathology & Experimental Neurology)
Journal's citation record	2 / 4	Journal of Neuropathology & Experimental Neurology: journal h-index 239 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	1 / 4	50 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	0 / 7	Cited 0 times (OpenAlex, 2026-10-10)
Citations per year	0 / 5	0.0 citations a year over 3 year(s) since 2025
Impact for its field and year	0 / 6	Cited 0.0× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	0 / 4	Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Jing Gao: h-index 22 (OpenAlex, whole career)
Institution's track record	1 / 3	Chinese Academy of Medical Sciences & Peking Union Medical College: institution h-index 950 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 39921653)
Free to read	2 / 2	Free to read
Total	47 / 100	—

What each of these 20 components measures, and what this score is not →

Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

APA 7th

Huang, Y., Shang, L., Li, B., Wang, T., Zhang, X., Wei, J., et al. (2025). Normal pressure hydrocephalus combined with quadruple misfolded proteinopathy: An autopsy case report and a short review of literature. Journal of Neuropathology & Experimental Neurology. https://doi.org/10.1093/jnen/nlaf006

Vancouver

Huang Y, Shang L, Li B, Wang T, Zhang X, Wei J, et al. Normal pressure hydrocephalus combined with quadruple misfolded proteinopathy: An autopsy case report and a short review of literature. Journal of Neuropathology & Experimental Neurology. 2025. doi:10.1093/jnen/nlaf006. PMID: 39921653.

BibTeX

@article{huang2025-39921653,
  author  = {Huang, Yixuan and Shang, Li and Li, Bo and Wang, Tianyi and Zhang, Xiao and Wei, Junji and Mao, Chenhui and Gao, Jing},
  title   = {{Normal pressure hydrocephalus combined with quadruple misfolded proteinopathy: An autopsy case report and a short review of literature}},
  journal = {Journal of Neuropathology \& Experimental Neurology},
  year    = {2025},
  doi     = {10.1093/jnen/nlaf006},
  pmid    = {39921653},
  url     = {https://doi.org/10.1093/jnen/nlaf006}
}

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