Is the blood-CSF barrier altered in disease?
OBJECTIVE
To illustrate the influence of cerebrospinal fluid (CSF) flow on lumbar CSF protein concentration and to test for an altered blood-CSF barrier permeability as additional influence.


METHODS
Consecutively hospitalized patients with normotensive hydrocephalus (n = 21) underwent lumbar puncture with CSF being sampled in sequential portions. CSF/blood quotients of albumin (QAlb) and of immunoglobulin G (QIgG) were compared intra-individually and with calculated values from a reference patient sample.


CONCLUSIONS
QAlb and QIgG of intra-individual sequential portions correlated highly with each other (median r = 0.95), suggesting lumbar CSF flow as the main thecal determinant of lumbar QAlb and QIgG variation. In addition, QIgG, relative to QAlb, was significantly lower in study patients compared with a reference patient sample (P = 0.002), implying an alteration of the blood-CSF barrier permeability as a minor determinant of QAlb and QIgG variation in study patients.
Seyfert
S
S
Department of Neurology, University Hospital Benjamin Franklin, Free University of Berlin, Berlin, Germany. seyfert@medizin.fu-berlin.de
Faulstich
A
A
D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000134:cerebrospinal fluid*; D001798:Blood Proteins / Q000032:analysis / Q000134:cerebrospinal fluid; D001812:Blood-Brain Barrier / Q000502:physiology*; D002556:Cerebrospinal Fluid Proteins / Q000097:blood / Q000134:cerebrospinal fluid; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000503:physiopathology; D007074:Immunoglobulin G / Q000097:blood* / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D043025:Oligoclonal Bands / Q000097:blood / Q000134:cerebrospinal fluid; D012709:Serum Albumin / Q000032:analysis*; D013129:Spinal Puncture; D013997:Time Factors
D000418:Albumins; D001798:Blood Proteins; D002556:Cerebrospinal Fluid Proteins; D007074:Immunoglobulin G; D043025:Oligoclonal Bands; D012709:Serum Albumin