Meningeal derived cerebrospinal fluid proteins in different forms of dementia: is a meningopathy involved in normal pressure hydrocephalus?
OBJECTIVE
In animal models and in vitro studies leptomeninges have been shown to be the origin of neurotrophic substances that support the survival and growth of neuronal cells. Because dementia is associated with neuronal loss, we investigated whether leptomeningeal dysfunction may be involved in the pathogenesis of dementia disorders.


METHODS
We analysed the cerebrospinal fluid (CSF) concentrations of the leptomeningeal derived beta trace protein, beta2 microglobulin, and cystatin C.


RESULTS
There was a statistically significant difference of the CSF beta trace protein levels among different groups. Patients with idiopathic normal pressure hydrocephalus (NPH) (17.5 (SD 4.3) mg/l) showed significantly lower CSF beta trace protein levels than patients with Alzheimer's disease (23.8 (6.2) mg/l), depression (24.2 (7.3) mg/l), and normal controls (25.3 (4.9) mg/l). To patients with vascular dementia (20.1 (5.6) mg/l) and frontotemporal dementia (21.9 (7.0) mg/l), the difference was not significant. There was no significant difference regarding the CSF and serum concentrations of beta2 microglobulin or cystatin C among the different groups.


CONCLUSIONS
We conclude that leptomeningeal dysfunction may be involved in certain types of dementia such as NPH and that reduced CSF beta trace protein levels in patients with NPH may aid in differentiating this difficult to diagnose disorder from other syndromes such as Alzheimer's disease.
Department of Neurology, University of Ulm, Germany.
J
J
Brettschneider
M W
MW
Riepe
H-F
HF
Petereit
A C
AC
Ludolph
H
H
Tumani
D000368:Aged; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis; D002556:Cerebrospinal Fluid Proteins / Q000134:cerebrospinal fluid*; D055316:Cystatin C; D015891:Cystatins / Q000134:cerebrospinal fluid*; D003704:Dementia / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D015140:Dementia, Vascular / Q000134:cerebrospinal fluid / Q000175:diagnosis; D003937:Diagnosis, Differential; D005162:Factitious Disorders / Q000134:cerebrospinal fluid / Q000175:diagnosis; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D019746:Intramolecular Oxidoreductases / Q000134:cerebrospinal fluid*; D054834:Lipocalins; D008297:Male; D008578:Meninges / Q000503:physiopathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012016:Reference Values; D001613:beta 2-Microglobulin / Q000134:cerebrospinal fluid*
C525030:CST3 protein, human; D002556:Cerebrospinal Fluid Proteins; D055316:Cystatin C; D015891:Cystatins; D054834:Lipocalins; D001613:beta 2-Microglobulin; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase