Cerebrospinal fluid analysis for diagnosis of noninflammatory, dementive and psychiatric diseases

Abstract

CSF analysis contributes to differential diagnosis of noninflammatory diseases by: 1) exclusion of a chronic or acute inflammation. 2) detection of particular brain-derived proteins, surrogate markers, corresponding to the suggested diagnosis (tumor, dementia, brain hypoxia, hemorrhage, autoimmune disease, psychiatric disease, metabolic disorder, rhinorhea, Table 1) and 3. differential cell count in CSF. Interpretation of brain-derived proteins in CSF uses absolute concentrations (in contrast to CSF/serum quotients for blood-derived proteins) and must discriminate between different sources: Neuronal or glial proteins like NSE, or tau protein are evaluated using their absolute concentrations in CSF for maximal sensitivity without reference to QAlb. The leptomeningeal proteins like beta trace or cystatin C are evaluated as absolute concentrations with reference to QAlb. As application examples we review the group of dementive and psychiatric diseases. Alzheimer's disease, Parkinson's disease dementia, Lewy-body disease and frontotemporal dementia are the major causes of neurodegenerative memory impairment and dementia. Combined analysis of Tau-Protein and Beta Amyloid 1-42 in CSF represent the classic approach, meanwhile extended with further surrogate markers. In 15% of psychiatric patients with schizophrenic or affective disorders an inflammatory process could be detected which points to a brain-organic involvement. In 24% of these patients with a psychiatric disease a moderately increased albumin quotient was observed as the only unexplained pathological sign. In psychiatric diseases it has to be regarded as a serious deficit not to make at least once a CSF analysis in the patients which could modify the diagnosis (in 6%).

Altered Cortical Functional Networks in Patients With Schizophrenia and Bipolar Disorder: A Resting-State Electroencephalographic Study

“…Particularly, the patients with longer duration of illness showed higher theta band connectivity in frontal regions compared to those with shorter duration ( 62 ). Also, according to the review of the bipolar disorder literature, increased theta power of resting-state EEG is one of the most robust findings in bipolar disorder ( 13 ). Thus, abnormal theta oscillation might have a key role in schizophrenia and bipolar disorder.…”

Schizophrenie - eine milde Enzephalitis?

“…Der Liquor wurde in der Pathogenese der schizophrenen Psychosen bisher wenig beachtet. Wenn Low Level Neuroinflammation (LLNI) einer Subgruppe schizophrener Psychosen ursächlich zugrunde liegt, müsste dies insbesondere in Liquoruntersuchungen nachzuweisen sein, da dies die sensitivste Methode zum Nach-weis von ZNS-Inflammation darstellt [123]. Die Liquordiagnostik wurde in den letzten 20 Jahren in der Neurologie wesentlich verbessert.…”

“…Lineare Formeln wurden durch hyperbolische Funktionen ersetzt und falsch positive wie falsch negative Interpretationen verringert (vgl. [123][124][125], free download www.comed-com. de).…”

Targeting Heterogeneous Findings in Neuronal Oscillations in Tinnitus: Analyzing MEG Novices and Mental Health Comorbidities

“…Another important factor, which might add to the heterogeneity of the results in the research on tinnitus, are psychological comorbidities. Those are high in tinnitus patients ( Zirke et al, 2010 ) and some comorbidities are known to have oscillatory correlates (e.g., for Depression: Jiang et al, 2016 , for bipolar disorder: Degabriele and Lagopoulos, 2009 ). In tinnitus research is a focus on identifying underlying neural circuits of tinnitus distress and depression.…”