Weiner W J, Klawans H L
J Neurol Neurosurg Psychiatry. 1973 Oct;36(5):747-52. doi: 10.1136/jnnp.36.5.747.
Lumbar cerebrospinal fluid homovanillic acid levels were estimated in 60 patients with Parkinsonism before and during levodopa treatment. There was a slight negative correlation between pretreatment CSF homovanillic acid levels and disability. There was no correlation between pretreatment homovanillic acid levels and clinical response to levodopa. Patients with high pretreatment levels did as well as those with depressed levels. High (normal or near normal) levels of CSF homovanillic acid in a patient with Parkinsonism do not necessarily indicate that the Parkinsonism will not respond to levodopa. These patients should receive the benefit of a trial of levodopa. There was also no correlation between homovanillic acid level during tratment and improvement. Patients with minimal increases in CSF homovanillic acid responded as well as those with greater elevations. Failure of levodopa to increase CSF homovanillic acid significantly does not indicate that the patient will not respond to levodopa and that levodopa should be discontinued. Other factors, such as vitamin B(6) consumption, should be investigated.
对60例帕金森病患者在左旋多巴治疗前及治疗期间测定了腰椎脑脊液高香草酸水平。治疗前脑脊液高香草酸水平与残疾程度之间存在轻微负相关。治疗前高香草酸水平与左旋多巴的临床反应之间无相关性。治疗前水平高的患者与水平低的患者效果相同。帕金森病患者脑脊液高香草酸水平高（正常或接近正常）并不一定表明帕金森病对左旋多巴无反应。这些患者应接受左旋多巴试验的益处。治疗期间高香草酸水平与改善情况之间也无相关性。脑脊液高香草酸水平升高最小的患者与升高较大的患者反应相同。左旋多巴未能显著提高脑脊液高香草酸水平并不表明患者对左旋多巴无反应，也不表明应停用左旋多巴。其他因素，如维生素B6的摄入，应进行调查。
