Cerebrospinal Fluid Studies of Neurotransmitter Function in Manic and Depressive Illness

Data on a variety of chemicals measured in the CSF are summarized, assuming from the outset that they are, at best, indirect and often global estimates for the more discrete changes that are being sought and investigated.

Abstract

This Chapter reviews reported alterations in cerebrospinal fluid (CSF)-derived measures of a variety of neurotransmitter and modulator substances in patients with affective disorders. These studies are based on the assumption that measures in the CSF will provide an indirect reflection of central nervous system (CNS) processes. The data supporting this assumption have been reviewed elsewhere in this volume, as well as by Goodwin and Post,60,61 Post and Goodwin,112 and Moir et al. 96 The methodologies that involve the use of probenecid to block acid transport out of CSF in order to provide a more dynamic measure of neurotransmitter amine turnover have similarly been reviewed in Chapter 8. Both the baseline measures and those following probenecid pretreatment require considerable caution in interpretation, since for many of the neurotransmitter substances and metabolites mentioned, a contribution from the spinal cord is likely and critical transport characteristics appear to affect amine metabolite levels. However, within the context of these qualifications, many studies have documented that alterations in CSF levels can closely reflect changes occurring in CNS function. Thus, in this Chapter, we will summarize data on a variety of the chemicals measured in the CSF, assuming from the outset that they are, at best, indirect and often global estimates for the more discrete changes that are being sought and investigated.