Cerebrospinal fluid sodium rhythms.

Michael G Harrington, Ronald M Salomon, Janice M Pogoda, Elena Oborina, Neil Okey, Benjamin Johnson, Dennis Schmidt, Alfred N Fonteh, Nathan F Dalleska
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引用次数: 50

Abstract

Background: Cerebrospinal fluid (CSF) sodium levels have been reported to rise during episodic migraine. Since migraine frequently starts in early morning or late afternoon, we hypothesized that natural sodium chronobiology may predispose susceptible persons when extracellular CSF sodium increases. Since no mammalian brain sodium rhythms are known, we designed a study of healthy humans to test if cation rhythms exist in CSF.

Methods: Lumbar CSF was collected every ten minutes at 0.1 mL/min for 24 h from six healthy participants. CSF sodium and potassium concentrations were measured by ion chromatography, total protein by fluorescent spectrometry, and osmolarity by freezing point depression. We analyzed cation and protein distributions over the 24 h period and spectral and permutation tests to identify significant rhythms. We applied the False Discovery Rate method to adjust significance levels for multiple tests and Spearman correlations to compare sodium fluctuations with potassium, protein, and osmolarity.

Results: The distribution of sodium varied much more than potassium, and there were statistically significant rhythms at 12 and 1.65 h periods. Curve fitting to the average time course of the mean sodium of all six subjects revealed the lowest sodium levels at 03.20 h and highest at 08.00 h, a second nadir at 09.50 h and a second peak at 18.10 h. Sodium levels were not correlated with potassium or protein concentration, or with osmolarity.

Conclusion: These CSF rhythms are the first reports of sodium chronobiology in the human nervous system. The results are consistent with our hypothesis that rising levels of extracellular sodium may contribute to the timing of migraine onset. The physiological importance of sodium in the nervous system suggests that these rhythms may have additional repercussions on ultradian functions.

Abstract Image

Abstract Image

Abstract Image

脑脊液钠节律
背景:有报道称脑脊液钠水平在发作性偏头痛期间升高。由于偏头痛经常在清晨或下午晚些时候开始,我们假设当细胞外CSF钠增加时,天然钠的时间生物学可能使易感人群易感。由于没有已知的哺乳动物脑钠节律,我们设计了一项健康人类的研究来测试脑脊液中是否存在阳离子节律。方法:每隔10分钟以0.1 mL/min的速度采集6例健康受试者腰椎脑脊液24 h。离子色谱法测定脑脊液钠、钾浓度,荧光光谱法测定总蛋白,凝固点下降法测定渗透压。我们分析了24小时内的阳离子和蛋白质分布以及光谱和排列测试,以确定显著的节律。我们应用错误发现率方法来调整多个测试的显著性水平,并使用Spearman相关性来比较钠与钾、蛋白质和渗透压的波动。结果:钠的分布变化明显大于钾,在12 h和1.65 h有统计学意义。对6名受试者的平均钠浓度曲线拟合显示,钠浓度在03.20 h时最低,在08.00 h时最高,在09.50 h时第二次最低点,在18.10 h时第二次高峰。钠浓度与钾、蛋白质浓度或渗透压无关。结论:这些脑脊液节律是人类神经系统中首次报道的钠时间生物学。结果与我们的假设一致,即细胞外钠水平的上升可能与偏头痛发作的时间有关。钠在神经系统中的生理重要性表明,这些节律可能对超音波功能有额外的影响。
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