The Parkinsonian Syndrome and its Dopamine Correlates

  • Margaret M. Hoehn
  • Thomas J. Crowley
  • Charles O. Rutledge
Part of the Advances in Experimental Medicine and Biology book series (AEMB)


The urinary excretion of free dopamine in 37 untreated parkinsonian patients correlated negatively with the severity of rigidity and akinesia (p<0.025) and with total neurologic deficit (p<0.05). In a parallel study of psychiatric patients, those with the lowest levels of urinary free dopamine before treatment were the most vul nerable to, and developed the most severe, secondary parkinsonian rigidity (p<0.005), akinesia (p<0.05), and total deficit (p<0.01) when they were subsequently treated for two weeks with trifluoperazine. In neither study was there a significant correlation between free urinary dopamine and tremor.

These studies directly associate the level of free dopamine in the urine with the severity of the parkinsonian syndrome. Therefore, although many peripheral sources contribute to urinary free dopamine, a small decrease in the level may actually reflect the severity of the disturbance of central dopamine metabolism and the known deficiency of dopamine in the neurons of the parkinsonian brain.


Psychiatric Patient Parkinsonian Patient Neurologic Deficit Score Extrapyramidal Sign Parkinsonian Sign 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abramsky, O., Carmon, A. and Lavy, S. (1971). Combined treatment with propranolol and levodopa. J. NeuroZ. Sci. 14 ,491–494.CrossRefGoogle Scholar
  2. Barbeau, A. (1969a). Parkinson’s disease as a systemic disorder. In Third Symposium on Parkinson’s Disease (Gillingham, F.J. and Donaldson, I.M.L., Eds.) pp. 66–73. E.S. Livingstone Ltd., Edinburgh and London.Google Scholar
  3. Barbeau, A. (1969b). L-dopa therapy in Parkinson’s disease: A crit ical review of nine years’ experience. Can. Med. Assoc. J. 101 ,791–800.Google Scholar
  4. Barbeau, A., Murphy, G.F. and Sourkes, T.L. (1961a). Excretion of dopamine in diseases of the basal ganglia. Science (Wash.) 133 ,1706–1707.CrossRefGoogle Scholar
  5. Barbeau, A., Sourkes, T.L. and Murphy, G.F. (1961b). Les catecholamines dans la maladie de Parkinson. In Monoamines et Systeme Neryeux CentraZ (de Ajuriaguerra, J., Ed.) pp. 247–262. Georg + Cie S.A., Geneva.Google Scholar
  6. Bernheimer, H. Birkmayer, O., Hornykiewicz, O., Jellinger, K. and Seitelberger, F. (1973). Brain dopamine and the syndromes of parkinsonism and Huntington’s chorea. Clinical, morphological and neurochemical correlations. J. NeuroZ. Sci. 20 ,415–455.CrossRefGoogle Scholar
  7. Birkmayer, W. and Hornykiewicz, O. (1961). Der L-3,4-Dioxyphenylalanin (= Dopa) - Effekt bei der Parkinson - Akinese. Weiner Klin. Wochenschr. 73 ,787–788.Google Scholar
  8. Bischoff, F. and Torres, A. (1962). Determination of urine dopamine. Clin. Chem. 8 ,370–377.PubMedGoogle Scholar
  9. Bozzi, R., Bruno, A. and Allegranza, A. (1965). Urinary metabolites of some monoamines and clinical effects under reserpine and chlorpromazine. Brit. J. Psychiat. 111 ,176–182.PubMedCrossRefGoogle Scholar
  10. Bruno, A. and Allegranza, A. (1965), The effect of haloperidol on the urinary excretion of dopamine, homovanillic and vanilmandelic acids in schizophrenics. Psychopharmacologia (Bert.) 8 ,60–66.CrossRefGoogle Scholar
  11. Carlsson, A. (1959) . The occurrence, distribution, and physiological role of catecholamines in the nervous system. Pharm. Rev. 11 ,490–493.PubMedGoogle Scholar
  12. Chase, T.N., Ng, L.K.Y. and Watanabe, A.M. (1972). Parkinson’s disease: Modification by 5-hydroxytryptophan. Neurology (Minneap.) 22 ,479–484.CrossRefGoogle Scholar
  13. Cotzias, G.C., Papavasiliou, P.S. and Gellene, R. (1969). Modifica tion of parkinsonism - Chronic treatment with L-dopa. New Eng. J. Med. 280 ,337–345.PubMedCrossRefGoogle Scholar
  14. Crane, G.E. (1974). Factors predisposing to drug-induced neurologic effects. In The Phenothiazines and Structurally Related Drugs (Forrest, I.S., Carr, C.J. and Usdin, E., Eds.) pp. 269–279. Raven Press, New York.Google Scholar
  15. Crowley, T.J., Rutledge, C.O., Hoehn, M.M., Stallings, M.A. and Sundell, S. (1976). Low urinary dopamine and prediction of phenothiazine-induced parkinsonism: A preliminary report. Am. J. Psychiat. 133 ,703–706.PubMedGoogle Scholar
  16. Ehringer, H. and Hornykiewicz, O. (1960). Verteilung von Noradrenalin und Dopamin (3-Hydroxytyramin) im Gehirn des Menschen und ihr Verhalten bei Erkrankungen des extrapyramidalen Systems. Klin. Wochenschr. 38 ,1236–1239.PubMedCrossRefGoogle Scholar
  17. Godwin-Austen, R.B., Tomlinson, E.B., Frears, C.C. and Kok, H.W.L. (1969). Effects of L-dopa in Parkinson’s disease. Lancet ii ,165–168.CrossRefGoogle Scholar
  18. Hoehn, M.M., Crowley, T.J. and Rutledge, C.O. (1976). Dopamine correlates of neurologic and psychiatric status in untreated parkinsonism. J. Neurol. Neurosurg. Psych. 39 ,941–951.CrossRefGoogle Scholar
  19. Hoeldtke, R., Rogawski, M. and Wurtman, R.J. (1974). Effect of selective destruction of central and peripheral catecholaminecontaining neurones with 6-hydroxydopamine on catecholamine excretion in the rat. Br. J. Pharm. 50 ,265–270.CrossRefGoogle Scholar
  20. Hornykiewicz, 0. (1971). Histochemistry, biochemistry, and pharmacology of brain catecholamines in extrapyramidal syndromes in man. In Monoamines Noyaux Gris Centraux et Syndrome de Parkinson (de Ajuriaguerra, J. and Gauthier, G., Eds.) pp. 143–157. Georg -I- Cie S.A., Geneva.Google Scholar
  21. Hornykiewicz, O. (1974). Metabolism of dopamine and L-dopa in human brain. Biochem. Pharmacol. 23 (Suppl.) ,917–923.CrossRefGoogle Scholar
  22. Klett, C.J. and Caffey, E. (1972). Evaluating the long-term need for antiparkinson drugs by schizophrenic patients. Arch. Gen. Psy chiat. 26 ,374–379.CrossRefGoogle Scholar
  23. Kott, E., Bornstein, B. and Eichhorn, F. (1971). Excretion of dopa metabolites. New Eng. J. Med. 284 ,395.PubMedGoogle Scholar
  24. Lloyd, K.G., Davidson, L. and Hornykiewicz, O. (1973). Metabolism of levodopa in the human brain. In Advances in Neurology. (Calne, D.B., Ed.) 3 ,pp. 173–188. Raven Press, New York.Google Scholar
  25. Owen, D.A.L. and Marsden, C.D. (1965). Effect of adrenergic ß block ade on parkinsonian tremor. Lancet ii ,1259–1262.CrossRefGoogle Scholar
  26. Post, R.M., Kotin, J., Goodwin, F.K. and Gordon, E.K. (1973). Psychomotor activity and cerebrospinal fluid amine metabolites in affective illness. Amer. J. Psychiat. 130 ,67–72.PubMedGoogle Scholar
  27. Prien, R.F., Levin, J. and Cole, J.O. (1969). High dose trifluoperazine therapy in chronic schizophrenia. Am. J. Psychiat. 126 ,305–313.PubMedGoogle Scholar
  28. Rutledge, C.O. and Hoehn, M.M. (1973). Sulphate conjugation and L-dopa treatment of parkinsonian patients. Nature 244 ,447–450.PubMedCrossRefGoogle Scholar
  29. Stadlan, E.M., Duvoisin, R. and Yahr, M.D. (1965). The pathology of parkinsonism. In Proceedings of the Fifth International Congress of Neuropathology (Lüthy, F. and Bischoff, A., Eds.) pp. 569–571. International Congress Series No. 100, Excerpta Medica, Amsterdam.Google Scholar
  30. Strian, F., Micheler, E. and Benkert, O. (1972), Tremor inhibition in parkinson syndrome after apomorphine administration under L-dopa and decarboxylase inhibitor basic therapy. Pharmakopsych. Neuro-Psychopharmakol. 5 ,198–205.Google Scholar
  31. Weil-Malherbe, H. and Van Buren, J.M. (1969). The excretion of dopamine and metabolites in Parkinson’s disease and the effect of diet thereon. J. Lab. Clin. Med. 74 ,305–318.PubMedGoogle Scholar
  32. Yahr, M.D., Duvoisin, R.C., Hoehn, M.M., Schear, M.J. and Barrett, R.E. (1968). L-dopa - its clinical effects in parkinsonism. Trans. Amer. Neurol. Assoc. 93 ,56–63.Google Scholar
  33. Yahr, M.D., Duvoisin, R.C., Schear, M.J., Barrett, R.E., and Hoehn, M.M. (1969). The treatment of parkinsonism with levodopa. Arch. Neurol. 21 ,343–354.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1977

Authors and Affiliations

  • Margaret M. Hoehn
    • 1
  • Thomas J. Crowley
    • 2
  • Charles O. Rutledge
    • 3
  1. 1.Departments of NeurologyUniversity of Colorado Medical CenterDenverUSA
  2. 2.Departments of PsychiatryUniversity of Colorado Medical CenterDenverUSA
  3. 3.Department of Pharmacology and ToxicologyUniversity of Kansas School of PharmacyLawrenceUSA

Personalised recommendations