title: Cerebrospinal fluid analysis differentiates multiple system atrophy from Parkinson's disease.
abstract: We investigated whether cerebrospinal fluid (CSF) analysis discriminates between idiopathic Parkinson's disease (PD; n = 35) and multiple system atrophy (MSA; n = 30). The median CSF concentration of the neurotransmitter metabolites 5-hydroxyindolacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) was reduced significantly (49-70%) in MSA compared to PD. In contrast, several brain-specific proteins (tau, neuron-specific enolase, myelin basic protein) were elevated (130-230%) in MSA compared with those in PD. A combination of CSF tau and MHPG discriminated PD from MSA (adjusted odds ratios: tau, 27.2; MHPG, 0.14). Our data suggest that the more progressive and widespread neurodegenerative nature of MSA, as compared with PD, is reflected in the composition of CSF. We propose that CSF analysis may become part of the diagnostic work-up of patients with parkinsonian syndromes.
authors.affiliation: Department of Neurology, University Medical Center, Nijmegen, The Netherlands.
authors.forename: W Farid
authors.initials: WF
authors.lastname: Abdo
authors.forename: Daniëlle
authors.initials: D
authors.lastname: De Jong
authors.forename: Jan C M
authors.initials: JC
authors.lastname: Hendriks
authors.forename: Martin W I M
authors.initials: MW
authors.lastname: Horstink
authors.forename: Berry P H
authors.initials: BP
authors.lastname: Kremer
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.forename: Marcel M
authors.initials: MM
authors.lastname: Verbeek
mesh_terms: D000328:Adult; D000368:Aged; D001549:Benzamides; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism; D003937:Diagnosis, Differential; D004576:Electromyography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D007457:Iodine Radioisotopes; D019344:Lactic Acid / Q000134:cerebrospinal fluid; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D019578:Multiple System Atrophy / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D009243:NAD / Q000134:cerebrospinal fluid; D010300:Parkinson Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D011759:Pyrrolidines; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D001549:Benzamides; D007457:Iodine Radioisotopes; D011759:Pyrrolidines; D009243:NAD; D019344:Lactic Acid; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; C055743:3-iodo-2-hydroxy-6-methoxy-N-((1-ethyl-2-pyrrolidinyl)methyl)benzamide; D006719:Homovanillic Acid