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Cerebrospinal fluid analysis differentiates multiple system atrophy from Parkinson's disease

✍ Scribed by W. Farid Abdo; Daniëlle De Jong; Jan C.M. Hendriks; Martin W.I.M. Horstink; Berry P.H. Kremer; Bastiaan R. Bloem; Marcel M. Verbeek

Publisher
John Wiley and Sons
Year
2004
Tongue
English
Weight
533 KB
Volume
19
Category
Article
ISSN
0885-3185

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✦ Synopsis

Abstract

We investigated whether cerebrospinal fluid (CSF) analysis discriminates between idiopathic Parkinson's disease (PD; n = 35) and multiple system atrophy (MSA; n = 30). The median CSF concentration of the neurotransmitter metabolites 5‐hydroxyindolacetic acid (5‐HIAA) and 3‐methoxy‐4‐hydroxyphenylethyleneglycol (MHPG) was reduced significantly (49‐70%) in MSA compared to PD. In contrast, several brain‐specific proteins (tau, neuron‐specific enolase, myelin basic protein) were elevated (130–230%) in MSA compared with those in PD. A combination of CSF tau and MHPG discriminated PD from MSA (adjusted odds ratios: tau, 27.2; MHPG, 0.14). Our data suggest that the more progressive and widespread neurodegenerative nature of MSA, as compared with PD, is reflected in the composition of CSF. We propose that CSF analysis may become part of the diagnostic work‐up of patients with parkinsonian syndromes. © 2003 Movement Disorder Society

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