To clarify the function of human atrial natriuretic peptide (hANP) in the cerebrospinal fluid (CSF), we examined hANP levels in the CSF of patients with various neurological diseases. The subjects were 16 controls without neurological disease and 45 patients with neurological disease. The 45 patients with neurological disease were divided into a group of 15 patients with intracranial hypertension (IH) and a group of 30 patients with normal pressure (NP). hANP in both CSF (1-hANP) and serum (s-hANP) was measured by RIA. Patients with IH were followed up. We analyzed correlations between 1-hANP and other parameters of CSF. Increase in concentration of 1-hANP was positively correlated with intracranial pressure (ICP; r = 0.72; p < 0.01), but not with other CSF parameters or with s-hANP. The concentration of 1-hANP appeared to be increased especially over a threshold value of ICP. In a follow-up study of patients with IH, changes in 1-hANP paralleled changes in ICP in every case (r = 0.79; p < 0.01). Our findings strongly suggest that 1-hANP plays an important role in the regulation of ICP in humans.

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