Central nervous system concepts

In the central nervous system (CNS) the concept that localized microdomains of calcium are responsible for triggering vesicle fusion generally refers to neurons (Rizzuto and Pozzan 2006). Concerning glial cells although the existence of structural... 

Neuropathic pain is defined as spontaneous pain and hypersensitivity to pain associated with damage to or pathologic changes in the peripheral nervous system as in painful diabetic peripheral neuropathy (DPN), acquired immunodeficiency syndrome (AIDS), polyneuropathy, post-herpetic neuralgia (PHN) or pain originating in the central nervous system (CNS), that which occurs with spinal cord injury, multiple sclerosis, and stroke. Functional pain, a relatively newer concept, is pain sensitivity due to an abnormal processing or function of the central nervous system in response to normal stimuli. Several conditions considered to have this abnormal sensitivity or hyperresponsiveness include fibromyalgia and irritable bowel syndrome. 

Triploidy refers to cells that contain three copies of each chromosome (69 total). THploidy, which usually occurs as a result of the fertilization of an ovum by two sperm cells, is common at conception, but the vast majority of these conceptions are lost prenatally. However, about 1 in 10,000 live births is a triploid. These babies have multiple defects of the heart and central nervous system, and they do not survive. 

Trisomy 13 (Patau syndrome, 47,XY,+13 47,XX,H 13) is seen in approximately 1 in 10,000 live births. More than 90% of conceptions are lost prenatally, and more than 90% of those who survive to term do not survive to 1 year of age. Common disease features include oral-facial clefts, microphthalmia (small eyes), renal defects, and polydactyly (extra fingers). Central nervous system malformations and heart defects are common and contribute to mortality. 

Since CSF is in direct contact with the environment of the central nervous system (C NS), it is obvious that any changes in biochemical composition of brain parenchyma should be predominantly reflected in the CSF. A recent review by Reiber (2001) presents a complete concept of distinguishing diffusion of brain-derived proteins into CSF from diffusion of proteins from blood into CSF, allowing proteins that originate in the brain to be prioritized. Lumbar pimcture is an easy procedure, with a low incidence of complications. In a large study (Andreasen et al, 2001), only 4.1% of all patients experienced postlumbar headache, and an even smaller proportion of 2% was reported by Blennow et al. (1993). Thus, it is reasonable to postulate that lumbar puncture (LP) is a feasible and only moderately invasive procedure, and that CSF analysis could possibly improve current clinical and neuroimaging-based approaches to diagnosis. 

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