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Phenolic acid concentrations in the lumbar cerebrospinal fluid of Parkinsonian patients treated with l-dopa
  1. I. A. Pullar,
  2. June M. Weddell,
  3. R. Ahmed,
  4. F. J. Gillingham
  1. M.R.C. Brain Metabolism Unit, Department of Pharmacology, University of Edinburgh
  2. Department of Surgical Neurology, University of Edinburgh


    The acid metabolites of dopamine and 5-hydroxytryptamine were estimated in the lumbar cerebrospinal fluid (CSF) of Parkinsonian patients both before and during treatment with l-dopa, the amino acid precursor of dopamine. An attempt was made to relate clinical improvement to the biochemical results. The dopamine metabolites, 3,4-dihydroxyphenylacetic acid and homovanillic acid, showed increases related to the dose of l-dopa, the increase in homovanillic acid concentration being proportionately greater than that of 3,4-dihydroxyphenylacetic acid. The concentration of the 5-hydroxytryptamine metabolite, 5-hydroxyindol-3ylacetic acid, was unaltered by the drug. Clinical improvement, which in the early stages was evident particularly in the bradykinesia, was found to occur at doses of l-dopa greater than 1·5 g/day. Effective doses of l-dopa gave rise to concentrations of dopamine metabolites in the CSF which were greater than normal. Possible implications of these findings are discussed.

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