Another plausible explanation for the high proportion of DM comorbidities in patients with iNPH is that ventricular enlargement can cause mechanical stress-induced dysregulation of the hypothalamic-pituitary axis, resulting in dysregulation of hormonal secretion, as evidenced by decreased levels of growth hormone and insulin-like growth factor 1 in previous studies (39). The gene discussed is IGF1; the disease is diabetes mellitus.