The influence of cerebrospinal fluid turnover on age-related changes in cerebrospinal fluid protein concentrations

Studies have shown that ageing and several neurological diseases of the central nervous system are often accompanied with increase in concentrations of many cerebrospinal fluid (CSF) proteins. However, few studies have actually looked into the mechanisms behind the increase in CSF protein concentrations. In this study, CSF secretion rates and turnovers were measured using the in situ perfused choroid plexus (CP) technique in a group of sheep between 1 and 10 years of age. CSF protein concentrations were determined using quantitative proteomic techniques. CSF turnover in hours correlated significantly with age, changing from 10.5 ± 2.7 h in the young to 17.1 ± 2.4 h in the old. The amount of CSF replaced per hour decreased from 2.46 ± 0.42 mL in the young to 1.17 ± 0.16 mL in the old. The age-related reduction in CSF turnover was calculated to have a concentrating effect of approximately 1.32 times in middle-aged and 2.10 times in old CSF proteins. After CSF turnover normalization, CSF albumin (a plasma-derived protein) concentration still increased significantly with age; however, both brain-derived and partially brain-derived protein concentrations in the CSF decreased with age after normalization. Regression analysis between turnovers and albumin concentrations has shown that reduced CSF turnover was the cause of increased CSF albumin concentrations with age. Therefore, CSF protein concentrations should be normalized according to their age-specific turnovers first before their concentrations can be compared logically between different ages.