Concentrations of indoleamine metabolic intermediates in the ventricular cerebrospinal fluid of advanced Parkinson's patients with severe postural instability and gait disorders

Postural instability and gait disorders (PIGD) are the primary causes of disability in many but not all advanced Parkinson's disease (PD) patients. We have measured the concentrations of serotonin, 5-hydroxytryptophan (5-HTP), 5-hydroxy-3-indoleacetic acid (5-HIAA), and homovanillic acid (HVA)...

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Bibliographic Details
Published in:	Journal of Neural Transmission Vol. 104; no. 4-5; pp. 451 - 459
Main Authors:	IACONO, R. P, KUNIYOSHI, S. M, AHLMAN, J. R, ZIMMERMAN, G. J, MAEDA, G, PEARLSTEIN, R. D
Format:	Journal Article
Language:	English
Published:	Wien Springer 01-01-1997 New York, NY
Subjects:	5-Hydroxytryptophan - cerebrospinal fluid Aged Biogenic Amines - metabolism Biological and medical sciences Cerebral Ventricles - metabolism Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Gait Homovanillic Acid - cerebrospinal fluid Humans Hydroxyindoleacetic Acid - cerebrospinal fluid Indoles - metabolism Medical sciences Middle Aged Neurology Osmolar Concentration Parkinson Disease - cerebrospinal fluid Parkinson Disease - physiopathology Posture Serotonin - cerebrospinal fluid Aminoindole Human Gait disorder Nervous system diseases Serotonin Tremor Enzyme Motor system disorder Parkinson disease Lyases Cerebrospinal fluid Cerebral disorder Posture Carbon-carbon lyases Carboxy-lyases Central nervous system disease Neurotransmitter Aromatic-L-amino-acid decarboxylase Instability Degenerative disease Extrapyramidal syndrome
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Summary:	Postural instability and gait disorders (PIGD) are the primary causes of disability in many but not all advanced Parkinson's disease (PD) patients. We have measured the concentrations of serotonin, 5-hydroxytryptophan (5-HTP), 5-hydroxy-3-indoleacetic acid (5-HIAA), and homovanillic acid (HVA) in samples of ventricular cerebrospinal fluid from ten PD patients with severe disability from PIGD and from ten PD patients with tremor and levodopa induced dyskinesia as their predominant motor dysfunction. The two groups were prospectively matched for duration of disease and age. No significant differences between the two groups were found in the concentration (mean +/- SD in ng/ml, PIGD dominant vs. tremor-dyskinesia dominant) of 5-HIAA (106 +/- 50 vs. 99 +/- 34) or HVA (1,068 +/- 595 vs. 881 +/- 469). Serotonin concentration was significantly lower (0.7 +/- 0.5 vs. 1.5 +/- 0.9) and 5-HTP concentration was substantially higher (684 +/- 1,054 vs. 6 +/- 5) in the patient group with PIGD as their predominant symptoms. Thus, the distinguishing feature of patients with severe PIGD appears to be a derangement in indoleamine metabolism at the reaction step catalyzed by aromatic amino acid decarboxylase (AADC). These findings suggest that aggravation of PIGD in advanced Parkinson's may be related in part to impaired serotonergic transmission secondary to inhibition or down regulation of AADC.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0300-9564 1435-1463
DOI:	10.1007/BF01277663