Cerebrospinal fluid insulin-like growth factor 1 is low in acute and chronic white-matter diseases of children.

Insulin-like growth factor 1 increases both the number of oligodendrocytes and the amount of axonal myelin produced. The aim of this study was to see whether insulin-like growth factor 1 played a role in white-matter diseases of children. We studied insulin-like growth factor 1 in the cerebrospinal fluid of children with various white-matter diseases: (1) children with acute demyelinating events: acute disseminated encephalomyelitis (n = 5), acute transverse myelitis in multiple sclerosis (n = 1), and infarct of the medial cerebral artery causing secondary white-matter changes (n = 1), and (2) children with chronic diseases: delayed myelination (n = 3) and progressive leukodystrophies (n = 4). Insulin-like growth factor 1 was determined by radioimmunoassay with commercially available kits (Mediagnost, Tubingen, Germany). We found markedly lower concentrations of cerebrospinal fluid insulin-like growth factor 1 in the patients than in the 28 age-matched control children (P < .0005). Low cerebrospinal fluid insulin-like growth factor 1 can play a role in the pathology of both acute and chronic white-matter diseases of children.