Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sweden.
Dement Geriatr Cogn Disord. 2012;34(1):61-7. doi: 10.1159/000341576. Epub 2012 Aug 22.
BACKGROUND/AIMS: Demyelination and axonal degeneration are the hallmarks of established white matter lesions (WML). The neurochemistry of ongoing WML is only partially known. We explored cerebrospinal fluid (CSF) substances as markers of brain tissue damage in relation to progression of WML rated on magnetic resonance imaging.
CSF from elderly individuals with WML was analyzed for amyloid markers, total τ, hyperphosphorylated τ, neurofilament protein light subunit, sulfatide and CSF/serum-albumin ratio. After 3 years, a follow-up magnetic resonance imaging was performed. Progression of WML was rated using the Rotterdam Progression Scale (RPS).
37 subjects (age 73.6 ± 4.6 years) were included. Subjects with more pronounced progression (RPS > 2; n = 15) had lower mean sulfatide concentration at baseline as compared to subjects with no or minimal progression (RPS 0-2; n = 22) according to univariate analyses (p = 0.009). Sulfatide was the only biomarker that predicted the RPS score according to regression analysis, explaining 18.9% of the total variance (r = 0.38, p = 0.015).
The correlation of CSF sulfatide levels and RPS scores may reflect a remyelination response to the demyelination process associated with WML. Furthermore, the results strengthen the notion that WML pathology is different from that of Alzheimer's disease.
背景/目的：脱髓鞘和轴突变性是既定的白质病变（WML）的特征。持续 WML 的神经化学仅部分已知。我们探讨了脑脊液（CSF）物质作为与磁共振成像评定的 WML 进展相关的脑损伤标志物。
分析了患有 WML 的老年人的 CSF 中的淀粉样蛋白标志物、总 τ、高磷酸化 τ、神经丝蛋白轻亚基、硫酸脑苷脂和 CSF/血清白蛋白比值。3 年后，进行了随访磁共振成像。使用鹿特丹进展量表（RPS）评定 WML 的进展。
纳入 37 名受试者（年龄 73.6 ± 4.6 岁）。根据单变量分析，与无进展或最小进展（RPS 0-2；n = 22）的受试者相比，进展更明显的受试者（RPS > 2；n = 15）基线时平均硫酸脑苷脂浓度较低（p = 0.009）。根据回归分析，硫酸脑苷脂是唯一预测 RPS 评分的生物标志物，解释了总方差的 18.9%（r = 0.38，p = 0.015）。
CSF 硫酸脑苷脂水平与 RPS 评分的相关性可能反映了与 WML 相关的脱髓鞘过程中的髓鞘再生反应。此外，结果进一步证实了 WML 病理学与阿尔茨海默病的病理学不同。
