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Comparison of benefit from l-dopa in Parkinsonism with increase of amine metabolites in the CSF
  1. R. B. Godwin-Austen1,
  2. B. D. Kantamaneni,
  3. G. Curzon
  1. Institute of Neurology, The National Hospital, Queen Square, London

    Abstract

    Homovanillic acid (HVA) and 5-hydroxy indole acetic acid (5-HIAA) concentrations have been estimated in the cerebrospinal fluid (CSF) of 16 and 18 patients respectively with Parkinsonism both before and during treatment with l-dopa. The rise of HVA correlated with dose of l-dopa. An increase of HVA concentration to less than 0·10 μg/ml. was associated with little or no clinical improvement. The five patients with the greatest increase of HVA concentration/g l-dopa showed little or no improvement from treatment and four of these patients had normal pre-treatment HVA and 5-HIAA. In those patients who responded well to l-dopa the CSF HVA/g l-dopa was intermediate between that of these two groups. It is suggested that change in HVA content of CSF during l-dopa treatment might be of value in the prediction of response to l-dopa.

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    Footnotes

    • 1 Reprint requests to R.B.G-A, Department of Neurology, Derbyshire Royal Infirmary, Derby.

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