NEUROTRANSMITTERS IN CEREBROSPINAL-FLUID REFLECT PATHOLOGICAL ACTIVITY

The excitatory transmitters glutamate and aspartate become toxic whene ver their extracellular levels are increased because of neuronal, glia l and endothelial impairment. Taurine, a volume-regulating amino acid. is released upon excitotoxin-induced cell swelling. Our aim was to in vestigate if glutamate and aspartate in cerebrospinal fluid (CSF) reve al neuropathology in neurological patients, and if taurine unmasks glu tamate-mediated toxicity. Glutamate and aspartate are doubled in viral meningitis, acute multiple sclerosis (MS) and myelopathy compared wit h control subjects and patients with peripheral facial nerve palsy. Th ese levels do not coincide with a disturbed blood-brain barrier, as es timated by the albumin ratio, are independent of their precursors (glu tamine, asparagine) and are not associated with cell lysis. Taurine is significantly increased in meninigitis, acute MS, and myelopathy, sug gesting glutamate-mediated toxicity. Analysis of transmitters in lumba r CSF can be used to identify patients with cerebral and spinal pathol ogy who might benefit from specific receptor-modulating agents.