CSF studies in violent offenders - II. Blood-brain barrier dysfunction without concurrent inflammation or structure degeneration

Cerebral dysfunction without corresponding structural pathology has been re ported in brain imaging studies of violent offenders. Biochemical markers i n the CSF reflect various types of CNS pathology, such as blood-brain barri er dysfunction (CSF/S albumin ratio), infectious or inflammatory processes (IgG and IgM indices), neuronal or axonal degeneration (CSF-tau protein) an d synaptic de- or regeneration (CSF-growth associated protein-43 (GAP-43)). We compared these CSF markers in 19 non-psychotic perpetrators of severe v iolent crimes undergoing pretrial forensic psychiatric investigation and 19 age- and sex-matched controls. Index subjects had significantly higher alb umin ratios (p = 0.002), indicating abnormal vascular permeability as part of the complex CNS dysfunction previously reported in violent offenders. Ax is I disorders, including substance abuse or current medication, did not ex plain this finding. Since Ig-indices, CSF-tau protein or CSF-GAP-43 were no t increased, there was no support for inflammation or neuronal/ synaptic de generation as etiological factors to CNS dysfunction in this category of su bjects.