Annals of Indian Academy of Neurology
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REVIEW: MANAGEMENT UPDATES
Year : 2009  |  Volume : 12  |  Issue : 4  |  Page : 246-253

Cerebrospinal fluid in multiple sclerosis


Clinical and Experimental Neuroimmunology, Department of Neurology, The Ohio State University, Columbus, Ohio 43221, USA

Correspondence Address:
Kottil W Rammohan
2050 Kenny Road, Suite 2250, Columbus, Ohio 43221
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.58282

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Background: Technological advances have made it possible to examine the human cerebrospinal fluid (CSF) in a manner that was previously impossible. CSF provides a window into the changes that occur in the central nervous system (CNS) in health and disease. Through analysis of the CSF, we discern indirectly the state of health of the CNS, and correctly or incorrectly, draw conclusions regarding mechanisms of CNS injury and repair. Objective, Materials and Methods: To review the current state of knowledge of changes in the CSF in multiple sclerosis. Discussion: Establishing CSF markers that permit evaluation of the various biological processes in multiple sclerosis remains a challenge. Of all the biological processes, inflammatory markers are probably the best identified. Detection of oligoclonal immunoglobulin bands in the CSF is now established as the single most useful laboratory marker in the CSF to aid in the diagnosis of multiple sclerosis. Markers of demyelination, remyelination, neuro-axonal loss, neural repair and regeneration, and astrogliosis are only now being recognized. A good surrogate for any of these pathophysiological processes has not been defined to date. Conclusion: The goal of future research is not only to define surrogate markers in the CSF for each of the above functions, but also to extend it to other more readily accessible body fluids like blood and urine. A synopsis of the current literature in most of these areas of CSF evaluation pertaining to multiple sclerosis is presented in this article.


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