Knowledge-base for interpretation of cerebrospinal fluid data patterns. Essentials in neurology and psychiatry

Abstract

The physiological and biophysical knowledge base for interpretations of cerebrospinal fluid (CSF) data and reference ranges are essentialfor the clinical pathologist and neurochemist. With the popular description of the CSF flow dependent barrier function, the dynamics andconcentration gradients of blood-derived, brain-derived and leptomeningeal proteins in CSF or the specificity-independent functionsof B-lymphocytes in brain also the neurologist, psychiatrist, neurosurgeon as well as the neuropharmacologist may find essentials fordiagnosis, research or development of therapies. This review may help to replace the outdated ideas like “leakage” models of the barriers, linear immunoglobulin Index Interpretations or CSF electrophoresis. Calculations, Interpretations and analytical pitfalls are describedfor albumin quotients, quantitation of immunoglobulin synthesis in Reibergrams, oligoclonal IgG, IgM analysis, the polyspecific (MRZ-)antibody reaction, the statistical treatment of CSF data and general quality assessment in the CSF laboratory. The diagnostic relevance isdocumented in an accompaning review.