Determinants of lumbar CSF protein concentration.
OBJECTIVE
To determine factors influencing the wide variation of protein concentration in lumbar cerebrospinal fluid (CSF).


METHODS
Patient variables with potential influence on spinal CSF flow and resorption were measured in different patient settings and compared with albumin and IgG CSF/serum quotients.


RESULTS
In patients whose diagnostic lumbar puncture produces normal CSF the albumin quotient increased with body mass index (r = 0.408), abdominal circumference (r = 0.399), and body weight (r = 0.317), age-corrected with partial correlation. Body motion before lumbar puncture showed only marginal influence on albumin quotient. In patients with radiculography the albumin quotient decreased with iodine contrast medium elimination from spinal subarachnoid space (r = -0.598) and increased with narrowing of lumbosacral spinal canal (r = 0.515).


CONCLUSIONS
Correlation of albumin quotient with body mass index and related variables may be mediated by spinal CSF resorption, which should be impaired in overweight patients with elevated venous pressure. Negative correlation of albumin quotient with iodine resorption from spinal CSF supports this assumption. Correlation of albumin quotient with narrowing of lumbosacral canal should be due to slowed spinal CSF flow which does increase protein concentration. Tested variables explain part of variation of CSF protein concentration. Other variables like blood-CSF barrier permeability and pulsatile spinal CSF flow should have additional influence.
Dept. of Neurology, University Hospital Benjamin Franklin, Free University of Berlin, 12200 Berlin, Germany. seyfert@medizin.fu-berlin.de
Sepp
S
Seyfert
Volker
V
Kunzmann
Natascha
N
Schwertfeger
Hans Christian
HC
Koch
Andreas
A
Faulstich
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000134:cerebrospinal fluid*; D015992:Body Mass Index; D002556:Cerebrospinal Fluid Proteins / Q000737:chemistry*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D011843:Radiculopathy / Q000378:metabolism
D000418:Albumins; D002556:Cerebrospinal Fluid Proteins; D007074:Immunoglobulin G