CSF neurotransmitter metabolites and short-term outcome of patients in coma after head injury.
The main metabolites of the neurotransmitters noradrenaline, dopamine, and serotonin, methoxy-hydroxyphenylglycol (MHPG), homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5HIAA) respectively, were estimated by HPLC with electrochemical detection in CSF samples from 24 patients in coma after head injury, 1 to 12 (mean 3.0) days from accident, and from 24 age- and sex-matched subjects undergoing myelography for possible herniated disk. Analysis of variance with age as covariate, revealed significantly elevated levels of all three metabolites in the patients group. The concentrations of 5HIAA were negatively correlated to the score in the Glasgow Coma Scale. Fourteen patients who recovered with no or minor neurological deficits, had significantly lower CSF 5HIAA levels compared to the ten patients who had a bad outcome (death), while there were no differences regarding HVA or MHPG concentrations. The possibility of a connection of the high neurotransmitter turnover during coma to the development of post-traumatic depression is discussed.
Markianos
M
M
Department of Neurosurgery, Asclepeion Hospital, Voula-Athens, Greece.
Seretis
A
A
Kotsou
S
S
Baltas
I
I
Sacharogiannis
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001925:Brain Damage, Chronic / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000401:mortality; D003128:Coma / Q000134:cerebrospinal fluid* / Q000401:mortality; D005260:Female; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000401:mortality; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000134:cerebrospinal fluid*; D011379:Prognosis; D016019:Survival Analysis
D018377:Neurotransmitter Agents; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid