HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Hong, Z. Articles by Liren, C. Search for Related Content PubMed PubMed Citation Articles by Hong, Z. Articles by Liren, C. Related Collections General Clinical Chemistry

Excitatory Amino Acids in Cerebrospinal Fluid of Patients with Acute Head Injuries

¹ Chromatographic Center, Lanzhou Institute of Chemical Physics Chinese Academy of Sciences, 342 Tianshui Rd., Lanzhou, China 730000.
² Department of Neurosurgery, The Second Affiliated Hospital of Lanzhou Medical College, 80 Cuiyingmen, Lanzhou, China 730030.
³ Department of Neurosurgery, The First Affiliated Hospital of Lanzhou Medical College, 1 Donggang West Rd., Lanzhou, China 730000.

^aAuthor for correspondence. E-mail lzwzh{at}public.lz.gs.cn

Background: The excitatory amino acids (EAAs) glutamate (Glu) and aspartate (Asp) play a role in the pathogenesis of postischemic and posttraumatic brain insult. The changes of EAAs in cerebrospinal fluid (CSF) of patients with traumatic brain injury are incompletely understood.

Methods: We used reversed-phase HPLC with precolumn derivatization with o-phthalaldehyde and fluorescence detection to measure Glu and Asp in CSF of 42 patients with acute head injury and 9 control adults without neurologic diseases. We assessed the Glasgow Coma Scale (GCS) on admission, the main lesion patterns on computed tomography (CT) scan within 24 h post trauma, and the Glasgow Outcome Scale (GOS) 3 months post injury.

Results: The mean concentrations of Glu and Asp in CSF in the brain-injured group were significantly higher than those of the control group (Glu, P <0.001; Asp, P <0.05). In patients admitted within 24 h after severe injury (n = 13), peak Glu values appeared within 48 h in 11 patients (85%), and the mean value remained higher than control values at day 7 (P <0.02). The concentrations of EAAs were higher in patients with severe injuries (GCS 8) than in those with milder injuries (Glu, P <0.001; Asp, P <0.05). GCS and peak EAAs correlated negatively (Glu, r_s = -0.5706, P <0.001; Asp, r_s = -0.5503, P <0.001). The patients with focal brain contusion on initial CT scan (n = 8) had a significantly lower peak Glu value than the patients with other patterns (n = 8–15; P <0.02 to 0.001). The peak value of EAAs in the poor-outcome group (including severe disability, vegetative state, and death) was significantly higher than in the good-outcome group (good recovery and moderate disability; Glu, P <0.001; Asp, P <0.01); GOS was closely correlated to the EAA values (Glu, r_s = 0.5737, P <0.001; Asp, r_s = 0.5470, P <0.001).

Conclusions: The EAA concentrations in CSF increase after acute head injury and remain higher for at least 1 week post injury in severely injured patients. The more severe the trauma, the more obvious the excitotoxicity induced by EAAs and the worse the outcome.

The following articles in journals at HighWire Press have cited this article:

				R. Sethuraman, T. L. Lee, and S. Tachibana Simple Quantitative HPLC Method for Measuring Physiologic Amino Acids in Cerebrospinal Fluid without Pretreatment Clin. Chem., March 1, 2004; 50(3): 665 - 669. [Full Text] [PDF]

				G. Franz, R. Beer, A. Kampfl, K. Engelhardt, E. Schmutzhard, H. Ulmer, and F. Deisenhammer Amyloid beta 1-42 and tau in cerebrospinal fluid after severe traumatic brain injury Neurology, May 13, 2003; 60(9): 1457 - 1461. [Abstract] [Full Text] [PDF]