Correlation between intrathecal sulfatide and TNF-alpha levels in patients with vascular dementia.
OBJECTIVE
Subcortical vascular dementia (SVD) is associated with white matter lesions and demyelination. The aim of the present study was to examine the cerebrospinal fluid (CSF) levels of TNF-alpha, a proinflammatory cytokine mediating myelin damage, in SVD patients. The intrathecal TNF-alpha levels were related to the clinical symptoms of dementia, as well as to intrathecal levels of sulfatide, a marker of white matter degradation, and of neurofilament, a marker of neuronal degeneration.


METHODS
CSF levels of TNF-a, sulfatide and neurofilament were all analyzed by immunoenzymatic procedures in 17 patients with SVD and in 26 healthy controls.


RESULTS
The intrathecal concentration of TNF-alpha was significantly increased in SVD patients compared to healthy controls (p = 0.0001). The intrathecal levels of TNF-alpha were significantly correlated (r = 0.6, p = 0.02) to the levels of sulfatide, but not to the levels of neurofilament, (r = 0.08, NS).


CONCLUSIONS
We have demonstrated intrathecal production of TNF-alpha in SVD patients. The correlation between TNF-a and sulfatide levels in the CSF suggests that this apoptosis-inducing cytokine leads to the death of oligodendrocytes, thereby contributing to white matter degeneration, a hallmark of SVD.
Tarkowski
E
E
Department of Rheumatology, University of Göteborg, Göteborg, Sweden. elisabeth.tarkowski@immuno.gu.se
Tullberg
M
M
Fredman
P
P
Wikkelsö
C
C
D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D016022:Case-Control Studies; D015140:Dementia, Vascular / Q000134:cerebrospinal fluid* / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009474:Neurons / Q000473:pathology; D013433:Sulfoglycosphingolipids / Q000134:cerebrospinal fluid*; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid*
D013433:Sulfoglycosphingolipids; D014409:Tumor Necrosis Factor-alpha