What do the frequent CSF abnormalities in severe mental disorders mean?
By routine high standard CSF analysis as used in neurology (compare textbook Wildemann et al 2010, Springer) we found in more than 40% of therapy resiatnt cases of both, affective and schizophrenic spectrum disoders, some minor CSF abnormalities (CSF analyses performed in specialised neurological CS...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Journal of Affective Disorders Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666915323000598 |
| _version_ | 1797854487307616256 |
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| author | Prof. Dr. Karl Bechter |
| author_facet | Prof. Dr. Karl Bechter |
| author_sort | Prof. Dr. Karl Bechter |
| collection | DOAJ |
| description | By routine high standard CSF analysis as used in neurology (compare textbook Wildemann et al 2010, Springer) we found in more than 40% of therapy resiatnt cases of both, affective and schizophrenic spectrum disoders, some minor CSF abnormalities (CSF analyses performed in specialised neurological CSF laboratory under continued independent blinded quality control) including increased CSF albumin, increased cell numbers, increased immune globulin fractions, CSF specific oligoclonal bands and rarely specific antibodies (Bechter et al 2010). These findings where recently confirmed in large patient groups, investigated mainly the schizophrenic spectrum, in studies of various University clinics in Germany (Endres et al 2016a,b &2018, Rattay et al 2019, Oviedo-Salcedo et al 2021, Räuber et al 2021). When including additional non-routine CSF parameters, like neopterin (marker of the tryptophan pathway, increased CSF neopterin considered yet an established sign of neuroinflammtion in various neuroinflammatory neurological disorders) (Kühne et al 2013), or determining in addition activated CSF cells (Maxeiner et al 2009, Räuber et al 2021), or CSF cytokines (Maxeiner et al 2014, Scheiber et al 2022), the share of abnormal CSFs in such cohorts was further increased. Also, increased agent specific antibody indices were found in such patinet cohorts (Bechter et al 1995, Runge et al 2022). When summing up the CSF results from various laboratory methods applied (studies were often focused on limited number of methods applied at once beyond the routine), we found the percentage of any CSF pathologies in schizophrenic spectrum psychosis or severe depression may totally involve 70% to 100% of cases. Also autism cases may present with CSF abnormalities (Runge et al. 2020).However, there are also conflicting study results, but divergence may heavily depend from the methods used. Insofar, surely a rigorous control and further critical development of laboratory methods for CSF analysis is required in psychiatric research. Nevertheless, available evidence is strong yet, in that considerable subgroups of schizophrenic and affective spectrum disorders demonstrate minor and presumably definite CSF abnormalities, similar to CSF abnormalities known from well-defined neuroinflammatory disorders. Beyond, the overall variance of CSF abnormalities found in these psychiatric cohorts appears comparable, at least in type, to what was found in neurological disorders considered as “classical” neuroinflammatory disorders, although in such neurological disorders, not surprising, respective CSF abnormalities were usually stronger expressed. |
| first_indexed | 2024-04-09T20:07:56Z |
| format | Article |
| id | doaj.art-bb4e0cbbd324463a823b2bd7a6253d95 |
| institution | Directory Open Access Journal |
| issn | 2666-9153 |
| language | English |
| last_indexed | 2024-04-09T20:07:56Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Affective Disorders Reports |
| spelling | doaj.art-bb4e0cbbd324463a823b2bd7a6253d952023-04-01T08:51:32ZengElsevierJournal of Affective Disorders Reports2666-91532023-04-0112100520What do the frequent CSF abnormalities in severe mental disorders mean?Prof. Dr. Karl Bechter0Clinic for Psychiatry and Psychotherapy II, Ulm University, Bezirkskrankenhaus Günzburg, Lindenallee 2, D-89321, Günzburg, GermanyBy routine high standard CSF analysis as used in neurology (compare textbook Wildemann et al 2010, Springer) we found in more than 40% of therapy resiatnt cases of both, affective and schizophrenic spectrum disoders, some minor CSF abnormalities (CSF analyses performed in specialised neurological CSF laboratory under continued independent blinded quality control) including increased CSF albumin, increased cell numbers, increased immune globulin fractions, CSF specific oligoclonal bands and rarely specific antibodies (Bechter et al 2010). These findings where recently confirmed in large patient groups, investigated mainly the schizophrenic spectrum, in studies of various University clinics in Germany (Endres et al 2016a,b &2018, Rattay et al 2019, Oviedo-Salcedo et al 2021, Räuber et al 2021). When including additional non-routine CSF parameters, like neopterin (marker of the tryptophan pathway, increased CSF neopterin considered yet an established sign of neuroinflammtion in various neuroinflammatory neurological disorders) (Kühne et al 2013), or determining in addition activated CSF cells (Maxeiner et al 2009, Räuber et al 2021), or CSF cytokines (Maxeiner et al 2014, Scheiber et al 2022), the share of abnormal CSFs in such cohorts was further increased. Also, increased agent specific antibody indices were found in such patinet cohorts (Bechter et al 1995, Runge et al 2022). When summing up the CSF results from various laboratory methods applied (studies were often focused on limited number of methods applied at once beyond the routine), we found the percentage of any CSF pathologies in schizophrenic spectrum psychosis or severe depression may totally involve 70% to 100% of cases. Also autism cases may present with CSF abnormalities (Runge et al. 2020).However, there are also conflicting study results, but divergence may heavily depend from the methods used. Insofar, surely a rigorous control and further critical development of laboratory methods for CSF analysis is required in psychiatric research. Nevertheless, available evidence is strong yet, in that considerable subgroups of schizophrenic and affective spectrum disorders demonstrate minor and presumably definite CSF abnormalities, similar to CSF abnormalities known from well-defined neuroinflammatory disorders. Beyond, the overall variance of CSF abnormalities found in these psychiatric cohorts appears comparable, at least in type, to what was found in neurological disorders considered as “classical” neuroinflammatory disorders, although in such neurological disorders, not surprising, respective CSF abnormalities were usually stronger expressed.http://www.sciencedirect.com/science/article/pii/S2666915323000598 |
| spellingShingle | Prof. Dr. Karl Bechter What do the frequent CSF abnormalities in severe mental disorders mean? Journal of Affective Disorders Reports |
| title | What do the frequent CSF abnormalities in severe mental disorders mean? |
| title_full | What do the frequent CSF abnormalities in severe mental disorders mean? |
| title_fullStr | What do the frequent CSF abnormalities in severe mental disorders mean? |
| title_full_unstemmed | What do the frequent CSF abnormalities in severe mental disorders mean? |
| title_short | What do the frequent CSF abnormalities in severe mental disorders mean? |
| title_sort | what do the frequent csf abnormalities in severe mental disorders mean |
| url | http://www.sciencedirect.com/science/article/pii/S2666915323000598 |
| work_keys_str_mv | AT profdrkarlbechter whatdothefrequentcsfabnormalitiesinseverementaldisordersmean |