Effect of adrenocorticotropic hormone 4-10 on increasing cerebral cortex thickness in patients with hydrocephalus post-cerebrospinal fluid diversion

BACKGROUND: Hydrocephalus, characterized by excessive cerebrospinal fluid (CSF) accumulation in the brain’s ventricles or subarachnoid space, can cause ventricular dilation. CSF diversion reduces ventricular dilation and is linked to increased cerebral cortex thickness. Adrenocorticotropic hormone (ACTH 4-10) has potential neuroprotective effects and induces neurotrophins gene expression, notably brain-derived neurotrophic factor (BDNF). ACTH 4-10 promotes BDNF synthesis, which may improve hydrocephalus post-diversion. This study aims to evaluate the impact of ACTH 4-10 as a neuromodulator on cerebral cortex thickness in hydrocephalus patients post-CSF diversion. METHODS: A prospective cohort study was conducted over two years on congenital hydrocephalus patients aged 0-2 years who underwent CSF diversion. Subjects were divided into two groups: group I received 0.1% ACTH 4-10 intranasally post-diversion, while group II served as the control. Cerebral cortex thickness was measured using the Dicom Viewer application on head CT scans. Data were analyzed with an independent t-test using SPSS software. P value of <0.05 were considered as significant. RESULTS: A total of 20 patients were divided into two groups in this study. The difference in cerebral cortex thickness between the control and treatment groups was not significant, with a p-value of 0.656. Additionally, the increase in cerebral cortex thickness post-CSF diversion did not show significant results (P=0.652). CONCLUSIONS: There is no significant difference in cerebral cortex thickness between the control group and those administered ACTH 4-10. Therefore, ACTH 4-10 administration is not necessary for patients with congenital hydrocephalus.