Shunting in AD increases ventricular CSF protein levels

Background Defects in CSF circulation may impair clearance of toxic metabolites (i.e. amyloid-beta peptides – Aβ), from the brain via interstitial fluid (ISF) and so contribute to pathology in Alzheimer's disease (AD). On this view, constant drainage of CSF via a low-flow ventriculo-peritoneal shunt could facilitate clearance of toxic moieties from ISF and so slow disease progression. We tested this possibility in a prospective, randomized, double-blind controlled, multi-centre trial. We have reported elsewhere that patients with active shunts showed less cognitive decline than controls. Here, we analyse the effects of shunting on CSF protein concentrations in AD patients.