title: Simultaneous measurement of monoamine metabolites and 5-methyltetrahydrofolate in the cerebrospinal fluid of children.
abstract: BACKGROUND
  We describe a new method for simultaneous measurement of monoamine metabolites (3-O-methyldopa [3-OMD], 3-methoxy-4-hydroxyphenylethyleneglycol [MHPG], 5-hydroxyindoleacetic acid [5-HIAA], and homovanillic acid [HVA]) and 5-methyltetrahydrofolate (5-MTHF) and its use on cerebrospinal fluid (CSF) samples from pediatric patients.
  
  
  METHODS
  Monoamine metabolites and 5-MTHF were measured by high-performance liquid chromatography with fluorescence detection. CSF samples were prospectively collected from children according to a standardized collection protocol in which the first 1-ml fraction was used for analysis.
  
  
  RESULTS
  Monoamine metabolites and 5-MTHF were separated within 10min. They showed linearity from the limit of detection to 1024nmol/l. The limit of quantification of each metabolite was sufficiently low for the CSF sample assay. In 42 CSF samples after excluding cases with possibly altered neurotransmitter profiles, the concentrations of 3-OMD, MHPG, 5-HIAA, HVA, and 5-MTHF showed significant age dependence and their ranges were comparable with the reference values in the literature. The metabolite profiles of aromatic l-amino acid decarboxylase deficiency, Segawa disease, and folate receptor α defect by this method were compatible with those in the literature.
  
  
  CONCLUSIONS
  This method is a simple means of measuring CSF monoamine metabolites and 5-MTHF, and is especially useful for laboratories not equipped with electrochemical detectors.
authors.affiliation: Department of Child Neurology, Okayama University Hospital, Okayama, Japan. Electronic address: takiyama@okayama-u.ac.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akiyama
authors.affiliation: Department of Child Neurology, Okayama University Hospital, Okayama, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Child Neurology, Okayama University Hospital, Okayama, Japan; Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hanaoka
authors.affiliation: Department of Child Neurology, Okayama University Hospital, Okayama, Japan; Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shibata
authors.affiliation: Department of Child Neurology, Okayama University Hospital, Okayama, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Akiyama
authors.affiliation: Department of Pediatrics, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Tsuyusaki
authors.affiliation: Division of Neurology, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Kubota
authors.affiliation: Department of Child Neurology, Okayama University Hospital, Okayama, Japan; Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Harumi
authors.initials: H
authors.lastname: Yoshinaga
authors.affiliation: Department of Child Neurology, Okayama University Hospital, Okayama, Japan; Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Kobayashi
mesh_terms: D001142:Aromatic-L-Amino-Acid Decarboxylases / Q000134:cerebrospinal fluid / Q000172:deficiency; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives* / Q000134:cerebrospinal fluid; D020821:Dystonic Disorders / Q000134:cerebrospinal fluid; D005453:Fluorescence; D058975:Folate Receptor 1 / Q000134:cerebrospinal fluid / Q000172:deficiency / Q000235:genetics; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid*; D057230:Limit of Detection; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid*; D019150:Neuroaxonal Dystrophies / Q000134:cerebrospinal fluid; D012016:Reference Values; D015203:Reproducibility of Results; D013763:Tetrahydrofolates / Q000134:cerebrospinal fluid*; D014443:Tyrosine / Q000031:analogs & derivatives
chemical_list: C548696:FOLR1 protein, human; D058975:Folate Receptor 1; D013763:Tetrahydrofolates; D014443:Tyrosine; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D004295:Dihydroxyphenylalanine; D001142:Aromatic-L-Amino-Acid Decarboxylases; C000595218:DDC protein, human; C005984:5-methyltetrahydrofolate; C008404:3-methoxytyrosine; D006719:Homovanillic Acid
keywords: 3-O-methyldopa; 3-methoxy-4-hydroxyphenylethyleneglycol; 5-hydroxyindoleacetic acid; 5-methyltetrahydrofolate; Aromatic l-amino acid decarboxylase deficiency; Cerebral folate deficiency; Folate receptor α defect; Homovanillic acid; Neurotransmitters