title: Biogenic amine metabolism in juvenile neurocardiogenic syncope with dysautonomia.
abstract: OBJECTIVE
  Biogenic amine brain levels and their cerebral metabolism are frequently studied by quantitation of biogenic amine metabolites in cerebrospinal fluid (CSF) compared to age-matched controls. There is a paucity of studies in adolescents and young adults investigating the potential role of disordered cerebral biogenic amine metabolism in young patients who have dysautonomia based on abnormal head-up tilt table (HUTT).
  
  
  METHODS
  In a cohort of juvenile patients with neurocardiogenic syncope and dysautonomia documented by abnormal HUTT, biogenic amine metabolites of dopamine and serotonin were quantitated in 18 patients (15 females). HUTT testing is an effective clinical method to evaluate posturally induced physiological events in patients suspected of neurocardiogenic syncope with dysautonomia.
  
  
  RESULTS
  Levels of the dopamine metabolite (homovanillic acid: HVA) and/or the serotonin metabolite (5-hydroxyindoleacetic acid: 5HIAA) were significantly reduced in 13 patients compared to age-matched controls.
  
  
  CONCLUSIONS
  Peripheral biogenic amines and their metabolites have been extensively studied in adults with dysautonomia due to various neurodegenerative disorders (Parkinson disease, multiple system atrophy, primary autonomic failure). Our findings indicate that more than two-thirds of this cohort of young patients with dysautonomia of variable severity have a defect in cerebral biogenic amines, particularly in dopamine and serotonin metabolism.
authors.affiliation: Division of Child and Adolescent Neurology, Department of Pediatrics, The University of Texas Medical School at Houston Houston, Texas.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Butler
authors.affiliation: Division of Child and Adolescent Neurology, Department of Pediatrics, The University of Texas Medical School at Houston Houston, Texas.
authors.forename: Jeremy E
authors.initials: JE
authors.lastname: Lankford
authors.affiliation: Pediatric Research Center, Department of Pediatrics, The University of Texas Medical School at Houston Houston, Texas.
authors.forename: Syed Shahrukh
authors.initials: SS
authors.lastname: Hashmi
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, The University of Texas Medical School at Houston Houston, Texas.
authors.forename: Mohammed T
authors.initials: MT
authors.lastname: Numan