Asunto(s)
Enfermedades de los Ganglios Basales/líquido cefalorraquídeo , Ácido Homovanílico/líquido cefalorraquídeo , Fenilacetatos/líquido cefalorraquídeo , Atetosis/líquido cefalorraquídeo , Ventrículos Cerebrales , Corea/líquido cefalorraquídeo , Dopamina/metabolismo , Distonía Muscular Deformante/líquido cefalorraquídeo , Humanos , Enfermedad de Huntington/líquido cefalorraquídeo , Levodopa/uso terapéutico , Enfermedad de Parkinson/líquido cefalorraquídeo , Enfermedad de Parkinson/tratamiento farmacológicoRESUMEN
The concentrations of somatostatin-like immunoreactivity (SLI) in lateral ventricular fluid of patients with extrapyramidal motor disease were determined by specific radio-immunoassay. Mean SLI levels were significantly lower in patients with Parkinson's disease (mean +/- SEM); 42.9 +/- 2.9 fmol/ml) and in patients with dystonic syndromes (39.4 +/- 3.2) than in patients with benign essential tremor (65.3 +/- 9.7). The lowest levels were found in patients with athetosis (34.7 +/- 5.4). In parkinsonian patients somatostatin levels correlated with the degree of akinesia, rigidity and autonomic disturbances.
Asunto(s)
Enfermedades de los Ganglios Basales/líquido cefalorraquídeo , Somatostatina/líquido cefalorraquídeo , Adulto , Atetosis/líquido cefalorraquídeo , Enfermedades del Sistema Nervioso Autónomo/líquido cefalorraquídeo , Ventrículos Cerebrales , Distonía/líquido cefalorraquídeo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/líquido cefalorraquídeo , Rigidez Muscular/líquido cefalorraquídeo , Enfermedad de Parkinson/líquido cefalorraquídeo , RadioinmunoensayoRESUMEN
The authors present the results of examining the content of 4-hydroxy-3-methoxy-phenylacetic or homovanillic acid (the principal end metabolite of dopamine) in the ventricular fluid of patients suffering from various extrapyramidal diseases. A considerable lowering of the homovanillic acid (HVA) concentration is demonstrated in patients with parkinsonism: this reflects the degeneration of the dopamine-containing pathways and the lowering of the dopamine synthesis in the basal ganglia in that disease. The treatment with L-DOPA leads to a considerable rise of the HVA level in the ventricular fluid, the fact, that points to an intensification of dopamine metabolism in the brain, when its precursor, i.e. L-DOPA is given to the patients. In patients with deforming muscular dystonia, statistically significant differences of the HVA concentration in the cerebrospinal fluid were noted. These differences correlated with the clinical manifestations of the disease. The concentration was found to be much higher in patients with local muscular rigidity, than in those in whose clinical picture the dystonic hyperkinesis was prevalent. It is concluded that in phenotypically different forms of the deforming muscular dystonia the character of the pathology of the central dopaminergic system is also different. Patients with Huntington's chorea showed a low level of the HVA in the intraventricular fluid. It is supposed that this is an evidence of either a fall of the dopamine total content in the brain because of the degeneration of the respective neurons, or of a deterioration of cerebral dopamine catabolism because of enzymatic insufficiency. The data obtained are of importance for understanding the pathogenesis, and for developing methods of treating extrapyramidal motor disturbances.
Asunto(s)
Enfermedades de los Ganglios Basales/líquido cefalorraquídeo , Dopamina/metabolismo , Ácido Homovanílico/líquido cefalorraquídeo , Fenilacetatos/líquido cefalorraquídeo , Atetosis/líquido cefalorraquídeo , Corea/líquido cefalorraquídeo , Distonía Muscular Deformante/líquido cefalorraquídeo , Humanos , Enfermedad de Huntington/líquido cefalorraquídeo , Enfermedad de Parkinson/líquido cefalorraquídeo , Temblor/líquido cefalorraquídeoRESUMEN
In Parkinson's disease, the concentration of homovanillic acid (HVA) was reduced in lumbar CSF from patients with idiopathic Parkinsonism (n = 54, P less than 0.05) and post-encephalitic Parkinsonism (n = 19, P less than 0.01). The reduction in the concentrations of 5-hydroxyindolylacetic acid (5-HIAA) was not significant, and there was no alteration in the levels of 4-hydroxy-3-methoxyphenylethylene glycol (MHPG). Treatment with L-dopa increased the concentration of HVA in the CSF (P less than 0.05) but had no effect on the levels of 5-HIAA and MHPG. Carbidopa given in combinations with L-dopa produced similar CSF concentrations of dopa as did L-dopa alone but caused less than half the rise in HVA. Fourteen patients who became functionally independent on treatment with L-dopa had higher 5-HIAA levels than 23 patients who showed no such improvement (P less than 0.001), suggesting that intact 5-hydroxyltryptamine neurones may be important in the therapeutic response to L-dopa. In a variety of movement disorders, the levels of HVA, 5-HIAA, and MHPG were not significantly different from age-matched controls. Treatment with tetrabenazine did not significantly alter the metabolite levels in patients in whom it produced either improvement, or side effects.