Alzheimer's Disease: Cerebral Glaucoma?

In a 1994 Medical Hypotheses paper, it was speculated that high intracranial pressure (ICP) might increase the probability of developing Alzheimer's disease (AD). A study of cerebrospinal fluid pressure (CSFP) in normal volunteers showed interindividual variations in CSFP. Some normals had what would normally be considered elevated CSFP. The hypothesis postulated that this subgroup with a high characteristic individual ICP level might be more susceptible to developing AD. The Medical Hypotheses paper further speculated that in more advanced stages of AD, such pressure factor could already be missing due to the disease process. The present article discusses recent research findings regarding CSFP distribution in AD patients that could be interpreted as support for this hypothesis. Exposure of central nervous system tissue to high pressure stress is not unique to the ICP space. Indeed, a similar situation occurs in the intraocular pressure (IOP) space in eyes with glaucoma. Interestingly, recent research has revealed similarities in the process leading to retinal ganglion cell death in glaucoma and neuronal cell death in AD. In the present paper, we raise the question of whether AD could be a cerebral form of glaucoma. Indeed, the linking of glaucoma to mechanisms of AD could reflect the anatomical and functional similarities between the IOP space and the ICP space. Further studies are warranted, however, especially to determine the possible role of high ICP in at least some cases of AD.