Naumann M, Götz M, Reiners K, Lange K W, Riederer P
Department of Neurology, University of Würzburg, Federal Republic of Germany.
J Neural Transm (Vienna). 1996;103(8-9):1083-91. doi: 10.1007/BF01291793.
While several radiological findings point towards the basal ganglia as a possible anatomical site of the lesion in dystonia patients the biochemical basis of the disorder is still unknown. 5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) levels-the respective metabolites of serotonin and dopamine-were measured in lumbar cerebrospinal fluid (lCSF) of 15 patients with idiopathic adult-onset focal dystonia and in lCSF of 11 controls. 100 microliters lCSF were analyzed for 5-HIAA and HVA by reversed-phase HPLC with electrochemical detection. 5-HIAA levels were significantly reduced in dystonia patients (11.4 micrograms/ml) compared to controls (18.4 ng/ml) (p < 0.02). HVA levels in dystonia patients (30.3 ng/ml) were below control values (41.6 ng/ml) but this finding did not reach statistical significance. Decreased lCSF levels of 5-HIAA suggest an impaired serotonin metabolism in patients with idiopathic adult-onset dystonia. This observation may provide a biochemical basis for a more specific pharmacotherapy in dystonia patients.
虽然多项放射学检查结果表明基底神经节可能是肌张力障碍患者病变的解剖部位，但该疾病的生化基础仍不清楚。对15例特发性成人起病局灶性肌张力障碍患者的腰段脑脊液（lCSF）和11例对照者的lCSF进行了5-羟吲哚乙酸（5-HIAA）和高香草酸（HVA）水平的检测，5-HIAA和HVA分别是血清素和多巴胺的代谢产物。采用反相高效液相色谱电化学检测法对100微升lCSF中的5-HIAA和HVA进行分析。与对照组（18.4纳克/毫升）相比，肌张力障碍患者的5-HIAA水平显著降低（11.4微克/毫升）（p<0.02）。肌张力障碍患者的HVA水平（30.3纳克/毫升）低于对照值（41.6纳克/毫升），但这一结果未达到统计学意义。特发性成人起病肌张力障碍患者lCSF中5-HIAA水平降低表明血清素代谢受损。这一观察结果可能为肌张力障碍患者更具针对性的药物治疗提供生化基础。
