Independence of Blood and Cerebrospinal Fluid Lactate

Posner, Jerome B.; Plum, Fred

doi:10.1001/archneur.1967.00470230044005

Cited by 145 publications

(53 citation statements)

References 13 publications

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“…The rostrocaudal gradient (RCG) of lactate was 0.82. We verified the earlier studies of Posner and Plum who found almost equal CSF lactate levels between the cisterns and lumbar thecal sac, and that of Vamosi et al who, similarly to us, found higher lumbar lactate levels when compared to cisternal levels [20,21].…”

Section: Discussionsupporting

confidence: 92%

Rostrocaudal Dynamics of CSF Biomarkers

Tarnaris

Toma

Chapman³

et al. 2010

Neurochem Res

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The rostrocaudal gradient (RCG) of markers present in cerebrospinal fluid (CSF) has not been studied adequately due to lack of appropriate control populations and ethical restrictions. The aim of this study is to understand the rostrocaudal gradient of CSF biomarkers. We contacted a study comparing CSF levels of seven biomarkers from cisternal (rostral) and lumbar (caudal) CSF obtained from patients with trigeminal neuralgia and tension-type headache. The RCGs of CSF/serum albumin ratio, 8-isoprostane. GFAP, total tau and beta amyloid protein were higher than one. The RCGs of lactate, VEGF and the heavy chain of neurofilament protein were lower than one. The study provides new values for several commonly examined markers of cisternal CSF. Knowledge of the RCG gradient of different CSF markers is important in interpreting studies reporting ventricular CSF values.

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Section: Discussionsupporting

confidence: 92%

Rostrocaudal Dynamics of CSF Biomarkers

Tarnaris

Toma

Chapman³

et al. 2010

Neurochem Res

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“…The concentration of LA in brain is dependent directly upon its rate of production. There is evidence, from patients and animal studies, that blood and CSF lactate concentrations are largely independent of each other (13,33). This is a very important characteristic of LA and offers an advantage over CSF glucose determination since CSF glucose is related to blood glucose.…”

Section: Figure 1 Csf Lactic Acid (Mmol/l) Concentration In the Studimentioning

confidence: 99%

“…Most patients with bacterial meningitis have concentrations above 3.5 mmol/L, with some values )11 mmol/L (100 mg/dL) (13,(20)(21)(22)31).…”

Section: Figure 1 Csf Lactic Acid (Mmol/l) Concentration In the Studimentioning

confidence: 99%

“…There is sub-stantial evidence, in patients and animals, that blood and CSF lactate concentrations are largely independent of each other. Thus, intravenous infusion of LA in dogs was sufficient to raise the blood concentration 6-fold, yet, failed to increase CSF concentrations (13). This is important in clinical practice because it is not necessary to collect matched plasma.…”

Section: Introductionmentioning

confidence: 97%

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Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

Almeida

Faria

Fontes

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: The differential diagnosis between bacterial and viral meningitis is not easy in some cases. Cerebrospinal fluid (CSF) analysis is essential for establishing this diagnosis. The objectives were to quantitate lactic acid (LA) concentrations in bacterial and viral meningitis, and other central nervous system (CNS) diseases in order to evaluate the diagnostic utility of CSF LA for discriminating bacterial from viral meningitis. Methods: CSF LA was measured in 139 CSF samples from seven groups: viral meningitis with classic CSF; suspicion of viral meningitis with neutrophils in CSF; bacterial meningitis; non-infectious neurological diseases; chronic meningitis; traumatic lumbar puncture (LP) and normal CSF. Results: CSF LA was higher in bacterial meningitis 8.7q5.4 mmol/L compared with viral meningitis (1.9q0.6) and the other groups (p-0.0001). CSF LA in the groups with viral meningitis was not different compared to groups with non-infectious CNS diseases and chronic meningitis. The ability of CSF LA to discriminate bacterial from viral meningitis showed a sensitivity of 80% and specificity of 97%, positive predictive value (PPV) of 94%, and negative predictive value (NPV) of 89%. Conclusions: CSF LA is a powerful test to discriminate bacterial from viral meningitis with high sensitivity,

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“…It has previously been demonstrated lactate cannot easily cross the bloodbrain barrier (Hertz andDienel, 2002 andAuer, 1986), infusing lactate intravenously does not increase CSF lactate (Alexander et al, 1962) and levels of blood and CSF lactate are regulated independently (Posner and Plum, 1967). However, others have documented that the blood-brain barrier is permeable to lactate (Dalsgaard et al, 2004, Smith et al, 2003and Oldendorf, 1973 and the lactate transporter MCT1 is expressed on endothelial cells (Gerhart et al, 1997).…”

Section: From the Bloodmentioning

confidence: 99%

Increase brain lactate in hepatic encephalopathy: Cause or consequence?

Rose

2010

Neurochemistry International

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Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome which develops as a result of liver failure or disease. Increased concentrations of brain lactate (microdialysate, cerebrospinal fluid, tissue) are commonly measured in patients with HE induced by either acute or chronic liver failure. Whether an increase in brain lactate is a cause or a consequence of HE remains undetermined. A rise in cerebral lactate may occur due to (1) blood-borne lactate (hyperlactataemia) crossing the blood-brain barrier, (2) increased glycolysis due to energy failure or impairment and (3) increased lactate production/release or decreased lactate utilization/uptake. This review explores the different reasons for lactate accumulation in the brain during liver failure and describes the possible roles of lactate in the pathogenesis of HE.

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Independence of Blood and Cerebrospinal Fluid Lactate

Cited by 145 publications

References 13 publications

Rostrocaudal Dynamics of CSF Biomarkers

Rostrocaudal Dynamics of CSF Biomarkers

Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

Increase brain lactate in hepatic encephalopathy: Cause or consequence?

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