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Volume 12 Supplement 1

Abstracts from Hydrocephalus 2015

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Exercise-induced changes of CSF vascular endothelial growth factor in adult chronic hydrocephalus patients


Vascular endothelial growth factor (VEGF) is a growth factor demonstrated to play a key role in cerebral angiogenesis and neurogenesis. It has been considered a critical component in hippocampus neurogenesis and memory formation and has been observed to increase in the rat hippocampus after exercise. In a previous study, we found increases in VEGF receptor and/or ligand in an experimental model of chronic e hydrocephalus in several brain areas and cerebrospinal fluid (CSF), suggesting a role in the adaption to chronic hypoxia. Here we investigate the ability of moderate exercise to increase CSF-VEGF levels in adult chronic hydrocephalus patients.


Lumbar CSF samples were collected from 17 normal pressure hydrocephalus (NPH) patients over 5 hours in 1-h intervals. During CSF collection, 11 patients (exercise group) underwent a standard in-room physical therapy session; 6 patients (no-exercise group) did not undergo a physical therapy session. CSF-VEGF levels were evaluated for increase related to exercise and the clinical response to CSF drainage.


CSF-VEGF levels in the exercise group demonstrated significant increases 1-3hrs post-exercise compared with the levels 1-2hrs pre-exercise (p=0.04), and also showed significantly higher levels than the no-exercise groups (p=0.03). While patients who clinically improved with CSF removal did not demonstrate an increase in CSF-VEGF levels, those who did not clinically improve had higher CSF-VEGF levels after exercise. The post-exercise CSF-VEGF level in the group that did not clinically improvement was significantly higher than both their own pre-exercise level (p=0.02) and also higher than that seen in the clinically improving group (p=0.05) after exercise.


CSF-VEGF levels can increase after moderate exercise even in elderly hydrocephalus patients. This suggests a potential benefit of exercise in benefiting some of these patients may exist via a central VEGF mechanism. Increased VEGF levels after exercise in patients who showed no improvement with CSF drainage suggest that vascular injury may play a role in this group's pathophysiology.

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Correspondence to Mark Gregory Luciano.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Luciano, M.G., Yang, J., Shanahan, K.J. et al. Exercise-induced changes of CSF vascular endothelial growth factor in adult chronic hydrocephalus patients. Fluids Barriers CNS 12 (Suppl 1), O58 (2015).

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