Journal of Neural Transmission

, Volume 104, Issue 4, pp 451–459

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

  • R. P. Iacono
  • S. M. Kuniyoshi
  • J. R. Ahlman
  • G. J. Zimmerman
  • G. Maeda
  • R. D. Pearlstein
Parkinson's Disease and Allied Conditions

DOI: 10.1007/BF01277663

Cite this article as:
Iacono, R.P., Kuniyoshi, S.M., Ahlman, J.R. et al. J. Neural Transmission (1997) 104: 451. doi:10.1007/BF01277663

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.

Keywords

SerotoninParkinson's diseasepostural instabilitycerebrospinal fluid (CSF)

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • R. P. Iacono
    • 1
    • 2
  • S. M. Kuniyoshi
    • 1
  • J. R. Ahlman
    • 1
  • G. J. Zimmerman
    • 1
  • G. Maeda
    • 3
  • R. D. Pearlstein
    • 4
  1. 1.Clinical Neuroscience Research GroupLoma Linda UniversityLoma LindaUSA
  2. 2.Movement Disorders Team, Loma Linda Medical CenterDuke University Medical CenterLoma LindaUSA
  3. 3.Physiology DepartmentLoma Linda UniversityLoma LindaUSA
  4. 4.Spetnagel Laboratory for Cerebral Disease Research, Division of NeurosurgeryDuke University Medical CenterLoma LindaUSA