We analysed albumin, IgG, IgA, IgM, oligoclonal IgG and specific antibodies in paired cerebrospinal fluid (CSF) and serum samples from patients with affective (n=24) or schizophrenic spectrum disorders (n=39). Numerical and graphical interpretation of CSF protein data was performed by Reibergrams with reference to a large control group (n= 4100).
In 41 % of the psychiatric patients (n=63) we observed CSF pathologies: 14 % displayed intrathecal humoral immune responses, 10 % slightly increased CSF cell counts (5-8/μL) and 29 % had moderate blood-CSF barrier dysfunctions, in 24 % as the only pathological sign with normal IgG, IgA and IgM concentrations in CSF (p= 0.9 testing the null hypothesis for intrathecal synthesis with reference to Qmean of the reference group). In the affective (n= 24) spectrum 20 % displayed a systemic immune reaction as detected by oligoclonal IgG. In probable 6 % of virusspecific, bacterial or autoimmune associated disorder with CNS involvement. Elevated CSF neopterin concentration in 34 % of the patients was interpreted as an increased release from astrocytes or from other glia cells.
The low level immune response and barrier dysfunctions are discussed on the base of a ME pathomechanism in subgroups of psychiatric patients. CSF analysis is shown to be a useful diagnostic tool for differential diagnosis in psychiatric diseases.