Unresponsiveness to L-DOPA in parkinsonian patients: a study of homovanillic acid concentration in the cerebrospinal fluid.
In this study, concentrations of homovanillic acid (HVA), a principal metabolite of dopamine (DA), in the cerebrospinal fluid (CSF) were measured in 17 patients with Parkinson's disease (PD) who had been effectively treated with L-DOPA and in 8 patients clinically diagnosed as having striatonigral degeneration (SND) and for whom treatment with L-DOPA had proved ineffective. L-DOPA administration, consisting of a daily dosage of 600 mg plus 150 mg aromatic L-amino acid decarboxylase inhibitor was continued in all cases for at least 3 months. In the PD group, the HVA value was 511.6 +/- 196.5 pmol/ml and in the SND group, 144.9 +/- 83.4 pmol/ml. This remarkably low value for the SND group suggests that there may exist severe disorders in the uptake and decarboxylation of exogenous L-DOPA.
Nishi
K
K
Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
Kondo
T
T
Narabayashi
H
H
Takubo
H
H
Muramoto
S
S
Araki
H
H
D000368:Aged; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D007980:Levodopa / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D010300:Parkinson Disease / Q000134:cerebrospinal fluid / Q000188:drug therapy*
D015415:Biomarkers; D007980:Levodopa; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid