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Abstract
Elevation of total protein is the most frequent pathologic finding in the cerebrospinal
fluid (CSF) examination. It occurs in a variety of situations such as inflammation
or tumors of the central nervous system (CNS), degenerative disorders, and subarachnoid
hemorrhage, or as a result of traumatic taps. It has also been reported, for unknown
reasons, in patients with psychiatric disease. In a study of hormone changes in depression,
9 of 24 (38%) patients (13 male, 11 female) were found to have elevated CSF protein
levels (>45 mg/dl), whereas no elevations were found in healthy controls (8 male,
9 female). Eight of the patients with the elevated CSF protein levels were male (62%)
and one was female (9%). Depressed patients had significantly higher CSF protein levels
(44.7 ± 18.0 mg/dl) than controls (31.5 ± 6.0 mg/dl) (t = 3.32, df = 30.37, p = 0.002). No relationship was found between CSF protein levels and (1) the use of
medication (tricyclic antidepressants, lithium carbonate, or monoamine oxidase inhibitors)
or (2) post-dexamethasone suppression test cortisol levels. Female controls, however,
tended to have lower protein levels than male controls, whereas female patients had
significantly lower levels than male patients. Protein electrophoresis was performed
on 21 of the 41 subjects (13 patients, 8 controls). Male patients had nonsignificantly
higher absolute concentrations of CSF albumin and the globulin fractions when compared
to male controls. These differences in CSF protein do not suggest monoclonal CSF protein
production, nor are they the result of this elevated peripheral protein. They suggest
increased polyclonal production of CSF protein and/or increased blood-brain barrier
permeability in male depressed patients, and a tendency to such in female depressed
patients.
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References
- Diagnostic and Statistical Manual of Mental Disorders.3rd ed. rev. American Psychiatric Press, Washington, DC1987
- A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding.Anal Biochem. 1976; 72: 248-254
- Dementia Praecox.in: Grune & Stratton, New York1948: 105
- The schizophrenic patients with an increase of the protein content of the cerebrospinal fluid.Am J Psychiatry. 1958; 115: 545
- The group of dementia praecox patients with an increase of protein content of the cerebrospinal fluid.J Nerv Ment Dis. 1942; 95: 669-679
- Quantitative CSF IgG measurements in multiple sclerosis and other neurologic diseases: An update.Arch Neurol. 1983; 40: 409-413
- Sex differences in total protein content of cerebrospinal fluid.Acta Psychiatr Scand. 1961; 36: 76-82
- Spinal fluid changes in patients treated with ataractic drugs.Am J Psychiatry. 1960; 116: 545
- Cerebral spinal fluid.Emerg Med Clin North Am. 1986; 4: 281-296
- Interpretation of cerebrospinal fluid proteins by gel electrophoresis.Ann Clin Lab Sci. 1976; 6: 27-37
- Quantitative fractional protein determination in the cerebrospinal fluid according to Lehmann's modification of the Biuret method.Acta Psychiatr Neurol. 1947; 22: 211-239
- Cerebrospinal Fluid in Disease of the Central Nervous System.Saunders, Philadelphia1980 (chap 6)
- Body fluids III: Tapping the wealth of information in CSF.Diagn Med. 1981; (Jan/Feb): 23-33
- A rating scale for depression.J Neurol Neurosurg Psychiatry. 1960; 23: 56-62
- Pneumoencephalographic studies in mental disease.Acta Psychiat Scand. 1962; 38: 96-101
- Cerebrospinal fluid in mental disease (a study using paper electrophoresis).Dis Nerv Syst. 1963; 24: 357-360
- Abnormal cerebrospinal fluid total protein and gamma-globulin levels in 256 patients admitted to a psychiatric unit.J Neurol Sci. 1969; 9: 11-38
- Deciphering cerebrospinal fluid patterns.Diagn Med. 1980; (Mar/Apr): 23-29
- The HPA response to insulin hypoglycemia in depression.Biol Psychiatry. 1987; 22: 133-167
- The spinal tap: A new look at an old test.Ann Intern Med. 1986; 104: 840-848
- The effect of phenothiazines on cerebrospinal fluid.Int J Neuropsychiatry. 1966; 2: 223-226
- Spinal fluid changes during chlorpromazine therapy.Am J Psychiatry. 1958; 115: 167
- Cushing's syndrome. A study of fifty patients.Am J Med. 1961; 30: 129-146
- A follow-up study of non-luetic psychotic patients with abnormalities in the spinal fluid.Am J Psychiatry. 1940; 96: 1035-1041
- Schedule for Affective Disorders and Schizophrenia—Lifetime Version.Biometric Research, New York State Psychiatric Institute, New York1978
- Research diagnostic criteria. Rationale and reliability.Arch Gen Psychiatry. 1978; 35: 773-782
- Cerebrospinal fluid.in: Youmans J.P. Neurosurgery. Saunders, Philadelphia1982
- Neuropsychiatric aspects of Cushing's syndrome.Arch Neurol Psychiatry. 1952; 67: 283-309
- Der Liquor cerebrospinalis bei den sogenannten Hirnatrophien.Fortschr Neurol Psychiatr. 1957; 25: 355-364
Article info
Publication history
Received in revised form:
March 20,
1990
Received:
October 15,
1989
Identification
Copyright
© 1990 Published by Elsevier Inc.
