Pathophysiological Mechanisms Underlying Idiopathic Normal Pressure Hydrocephalus: A Review of Recent Insights

Phillip A. Bonney, Robert G. Briggs, Kevin Wu, Wooseong Choi, Anadjeet Khahera, Brandon Ojogho, Xingfeng Shao, Zhen Zhao, Matthew Borzage, Danny J.J. Wang, Charles Liu, Darrin J. Lee

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


The pathophysiologic mechanisms underpinning idiopathic normal pressure hydrocephalus (iNPH), a clinically diagnosed dementia-causing disorder, continue to be explored. An increasing body of evidence implicates multiple systems in the pathogenesis of this condition, though a unifying causative etiology remains elusive. Increased knowledge of the aberrations involved has shed light on the iNPH phenotype and has helped to guide prognostication for treatment with cerebrospinal fluid diversion. In this review, we highlight the central role of the cerebrovasculature in pathogenesis, from hydrocephalus formation to cerebral blood flow derangements, blood-brain barrier breakdown, and glymphatic pathway dysfunction. We offer potential avenues for increasing our understanding of how this disease occurs.

Original languageEnglish (US)
Article number866313
JournalFrontiers in Aging Neuroscience
StatePublished - Apr 28 2022


  • blood brain barrier (BBB) breakdown
  • cerebral blood flow
  • communicating hydrocephalus
  • dementia
  • glymphatic circulation
  • idiopathic normal pressure hydrocephalus (iNPH)
  • ventriculoperitoneal (VP) shunt

ASJC Scopus subject areas

  • Aging
  • Cognitive Neuroscience


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