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

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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. tremordyskinesia 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.

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Author notes

  1. R. P. Iacono

    Present address: Clinical Neuroscience Research Group, Loma Linda University, Loma Linda, CA, USA

Authors and Affiliations

  1. Clinical Neuroscience Research Group, Loma Linda University, Loma Linda, CA, USA

    S. M. Kuniyoshi, J. R. Ahlman & G. J. Zimmerman

  2. Movement Disorders Team, Loma Linda Medical Center, Duke University Medical Center, Loma Linda, CA, USA

    R. P. Iacono

  3. Physiology Department, Loma Linda University, Loma Linda, CA, USA

    G. Maeda

  4. Spetnagel Laboratory for Cerebral Disease Research, Division of Neurosurgery, Duke University Medical Center, Loma Linda, CA, USA

    R. D. Pearlstein

Authors
  1. R. P. Iacono
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  2. S. M. Kuniyoshi
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  3. J. R. Ahlman
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  4. G. J. Zimmerman
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  5. G. Maeda
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  6. R. D. Pearlstein
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Iacono, R.P., Kuniyoshi, S.M., Ahlman, J.R. et al. Concentrations of indoleamine metabolic intermediates in the ventricular cerebrospinal fluid of advanced Parkinson's patients with severe postural instability and gait disorders. J. Neural Transmission 104, 451–459 (1997). https://doi.org/10.1007/BF01277663

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  • DOI: https://doi.org/10.1007/BF01277663

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