Department of Psychiatry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Romanian Association for Autoimmune Encephalitis, Cluj-Napoca, Romania.
Yale J Biol Med. 2023 Mar 31;96(1):125-126. doi: 10.59249/OAMT2710. eCollection 2023 Mar.
Despite being a reliable first-hand source of data on neuronal pathology, cerebrospinal fluid (CSF) analysis remains an often-overlooked evaluation method in first-episode psychosis (FEP). In this paper, we begin by discussing the current role of CSF testing during FEP evaluation in clinical practice. Given that anti-N-methyl-D-aspartate receptor encephalitis presents with a clinical picture indistinguishable from FEP in >85% of cases, we debate the importance of testing for CSF neuronal antibodies in at least a subset of patients. Then, we continue by reviewing the most important recent studies which sought to identify potential CSF biomarkers in FEP caused by a primary psychiatric disorder. By circumventing traditional psychiatric classifications, characteristic biomarker profiles have the potential to become integral components of early diagnosis, disease stratification, treatment choice, and outcome prediction. Along these lines, we aim to provide an updated perspective on the importance of CSF investigation in FEP.
尽管脑脊液（CSF）分析是神经病理学的可靠一手数据源，但在首发精神病（FEP）中，它仍然是一种经常被忽视的评估方法。在本文中，我们首先讨论 CSF 检测在 FEP 评估中的当前作用在临床实践中。鉴于抗 N-甲基-D-天冬氨酸受体脑炎在超过 85%的病例中表现出与 FEP 无法区分的临床特征，我们争论了在至少一部分患者中检测 CSF 神经元抗体的重要性。然后，我们继续回顾最近的一些重要研究，这些研究旨在确定由原发性精神障碍引起的 FEP 中的潜在 CSF 生物标志物。通过绕过传统的精神科分类，特征性的生物标志物谱有可能成为早期诊断、疾病分层、治疗选择和预后预测的重要组成部分。基于这些观点，我们旨在提供 CSF 研究在 FEP 中的重要性的最新视角。
