Neurotoxicity Biomarkers as Potential Indicators of Spinal Cord Ischemia

Objectives. To study the concentration of antibodies to glutamate receptors in the serum and CSF of patients with vascular myelopathy in parallel with conventional diagnostic approaches. Materials and methods. The study group included 40 patients with vascular myelopathy: 10 patients with spinal stroke and 30 with subacute and chronic myelopathy. After application of exclusion criteria, the study group consisted of 27 patients. The reference group consisted of 30 patients with acute ischemic stroke and 30 with spondylogenic radiculopathy. The control group consisted of 15 healthy subjects. Patients underwent neurological investigations and MRI scans of the spine and spinal cord. Concentrations of antibodies to glutamate receptors (NMDA receptor NR2 fragments and AMPA/kainate receptors) were assessed by immunoenzyme analysis. Results and conclusions. Increases in titers of antibodies to NMDA receptor NR2 fragments were seen in the serum (p = 0.0001) and CSF (p = 0.0005) of patients with spinal cord ischemia as compared with the reference and control groups. Data on NR2 antibodies reliably detected myeloischemia as compared with analysis of antibodies to AMPA/kainate receptors and S100β protein. On the other hand, increased levels of antibodies to AMPA/kainate receptors were seen in patients with more severe disease, with more extensive lesions to the white matter. The authors take the view that determination of antibodies to glutamate receptors can be used in the diagnosis of vascular myelopathy and in the identification of disease severity.