Do concentrations of neurotransmitters in lumbar CSF reflect cerebral dysfunction in depression?

Concentrations of the amines and amine metabolites dopamine (DA), noradrenaline (NA), adrenaline (A), serotonin (5-HT), homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindoleacetic acid (5-HIAA) and of the peptides, vasopressin (AVP), vasoactive intestinal polypeptide (VIP), thyrotropin releasing hormone (TRH) and cholecystokinin (CCK) were measured in lumbar cerebrospinal fluid (CSF) in patients with depression and compared with that of controls. Diagnostic classifications were performed according to ICD-9 and the Newcastle Rating Scales for Depression. The severity of depression was measured by Bech-Rafaelsen melancholia scale. Significantly decreased concentrations of CSF-A and AVP were found in as well endogenous as in non-endogenous depression, whereas reduced levels of CSF-VIP were found only in the non-endogenous group. CSF-5-HT and DA were significantly increased in endogenously depressed patients. In these studies patients with non-endogenous depression were not included. No relationship between severity of depression and concentrations of neurotransmitters was found. For most of the neurotransmitters no correlation between concentrations measured at the lumbar and at the ventricular level seems to exist. This finding indicates that measurements on CSF collected from the lumbar sack not necessarily are indicative for concentrations measured at more central levels. Although several transmitter systems most likely are disturbed in depression, results from studies on lumbar CSF should be interpreted with precaution, until further information about origin and distribution of neurotransmitters in CSF has been obtained.