Neurology

Neurological diseases now affect up to one billion people worldwide. The increase in life expectancy and the ageing of the population are leading to an increase in disorders such as Alzheimer's disease, Parkinson's disease and dementia, the diagnosis and monitoring of which are a real challenge for public health.

Neurological diseases now affect up to one billion people worldwide. The increase in life expectancy and the ageing of the population are leading to an increase in disorders such as Alzheimer’s disease, Parkinson’s disease and dementia, the diagnosis and monitoring of which are a real challenge for public health.

Diagnosis: a challenge in neurology

Despite the constant evolution of scientific knowledge, diagnosis remains an important issue in the field of neurology.  Among the tools, the determination of neurological biomarkers in biological fluids such as cerebrospinal fluid (CSF) or serum is a precious asset in helping clinical diagnosis in order to orientate towards the appropriate treatment.

Brain tissue is protected by the blood-brain barrier (BBB), which controls exchanges between the central nervous system and the bloodstream. The integrity of this barrier is an important indicator in neurological diseases.

Essential markers in neurology

Albumin is one of the essential neurological biomarkers of neurophysiological status. As its synthesis is solely hepatic, the determination of albumin in the CSF associated with its serum determination (CSF/serum albumin ratio) makes it possible to verify the integrity of the blood-brain barrier.

 

The concentration of IgG in CSF and serum is also an important aid to neurological diagnosis. An increase in CSF IgG concentration may be due to an excess of IgG in the central nervous system (intrathecal synthesis), e.g. associated with multiple sclerosis, or to an abnormality in the BBB. The combination of serum and CSF IgG and albumin assays provides guidance to the appropriate diagnosis.

Another important marker in neurology is ceruloplasmin, a copper transport protein in the blood. Serum ceruloplasmin is an essential element in the diagnosis of Wilson’s disease, which manifests itself in liver, psychiatric and neurological disorders.

An increase in the concentration of beta-2-microglobulin in the CSF indicates intrathecal synthesis in cases of meningeal metastases, blood cancers (leukemia, lymphoma, etc.), multiple sclerosis or rheumatological disorders.

 

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