title: Correlation between intrathecal sulfatide and TNF-alpha levels in patients with vascular dementia.
abstract: 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.
authors.affiliation: Department of Rheumatology, University of Göteborg, Göteborg, Sweden. elisabeth.tarkowski@immuno.gu.se
authors.forename: E
authors.initials: E
authors.lastname: Tarkowski
authors.forename: M
authors.initials: M
authors.lastname: Tullberg
authors.forename: P
authors.initials: P
authors.lastname: Fredman
authors.forename: C
authors.initials: C
authors.lastname: Wikkelsö
mesh_terms: 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*
chemical_list: D013433:Sulfoglycosphingolipids; D014409:Tumor Necrosis Factor-alpha