3-methoxy-4-hydroxyphenylglycol, 5-hydroxyindoleacetic acid, and homovanillic acid in human cerebrospinal fluid

Correlations between serotonin impairments and clinical indices in multiple system atrophy

BACKGROUND AND PURPOSE

Multiple system atrophy (MSA) is a neurodegenerative disease with characteristic motor and autonomic symptoms. Impaired brain serotonergic innervation can be associated with various clinical indices of MSA; however, the relationship between clinical symptoms and cerebrospinal fluid (CSF) levels of 5-hydroxyindole acetic acid (5-HIAA), a main serotonin metabolite, has not been fully elucidated.

METHODS

To compare CSF 5-HIAA levels between patients with MSA and healthy controls, we included 33 controls and 69 MSA patients with either predominant parkinsonian or cerebellar ataxia subtypes. CSF 5-HIAA levels were measured using high-performance liquid chromatography. Additionally, we investigated correlations between CSF 5-HIAA and various clinical indices in 34 MSA patients.

RESULTS

CSF 5-HIAA levels were significantly lower in MSA patients than in controls (p < 0.0001). Probable MSA patients had lower CSF 5-HIAA levels than possible MSA patients (p < 0.001). In MSA patients, CSF 5-HIAA levels were inversely correlated with scores in Parts 1, 2, and 4 of the Unified Multiple System Atrophy Rating Scale, and with systolic and diastolic blood pressure in Part 3. Structural equation modeling revealed significant paths between serotonin and clinical symptoms, and significance was highest for activities of daily living, walking, and body sway.

CONCLUSIONS

Serotonin dysfunction, as assessed by CSF 5-HIAA levels, may implicate greater MSA severity.

In-use stability of monoamine metabolites in human cerebrospinal fluid

Cerebrospinal fluid (CSF) concentrations of the monoamine metabolites homovanillic acid (HVA) and 5-hydroxyindolacetic acid (5-HIAA) are commonly used to provide information about central nervous system (CNS) dopaminergic and serotonergic activity. However, little attention has been given to the effects of sample handling on the concentrations of these compounds in human CSF. Using high-performance liquid chromatography (HPLC) with electrochemical detection, we observed that, in CSF stored at -80 degrees C, concentrations of the serotonin metabolite 5-HIAA and the dopamine metabolite HVA remained unchanged through six 1-h and six 24-h freeze-thaw cycles. Exposure to bright room light (3 h, 1,230 lux) resulted in a 5-HIAA concentration that was 96.3 +/- 2.0% of the initial and an HVA concentration that was 98.8 +/- 1.03% of initial. The pH of the CSF significantly increased during both freeze-thaw series and while maintained on ice (4 degrees C). These results demonstrate the in-use stability of 5-HIAA and HVA in human CSF under commonly-encountered laboratory conditions.

Bupropion treatment of fluoxetine-resistant chronic fatigue syndrome

Chronic fatigue syndrome (CFS) includes many symptoms of major depression. For this reason, many antidepressants have been used to treat the symptoms of this disorder. Among the more recently released antidepressants are fluoxetine and bupropion. In this open study, nine CFS patients who either could not tolerate or did not respond to fluoxetine showed significant response when administered 300 mg/day of bupropion for an 8-week period in both rating of HDRS (t = 4.80, p < 0.01) and BDI (t = 2.48, p < 0.05). Furthermore, bupropion improvement in Hamilton Depression Rating Scale correlated significantly with change in plasma homovanillic acid (HVA) (r = 0.96, p < 0.01). Plasma total methylhydroxyphenolglycol (MHPG) also increased significantly during bupropion treatment (t = 2.37, p = 0.05). Measures of T1 microsomal antibodies also decreased over treatment time; increases in natural killer cell numbers correlated inversely with change in plasma levels of free MHPG (r = -0.88, p < 0.05). Bupropion responders were more likely to have trough blood levels above 30 ng/ml (chi 2 = 3.6, p = 0.05).

Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis

OBJECTIVE

To compare the levels of biogenic amines in the cerebrospinal fluid (CSF) of primary fibromyalgia syndrome (PFS) patients with those in the CSF of controls.

METHODS

Metabolites of serotonin, norepinephrine, and dopamine were identified in CSF, using high performance liquid chromatography with coulometric detection.

RESULTS

CSF levels of metabolites from all 3 neurotransmitters were lower in PFS patients than in controls.

CONCLUSION

A low rate of turnover of several neurotransmitters supports the proposed hypothesis of a metabolic defect in PFS and suggests that the defect occurs at a neuroregulatory level.

High performance liquid chromatography as a tool in the definition of abnormalities in monoamine and tryptophan metabolites in cerebrospinal fluid from patients with neurological disorders

In this study we report the levels of 3-methoxy-4-hydroxyphenylglycol, 3,4-dihydroxyphenylacetic acid, homovallinic acid, tryptophan, 5-hydroxyindole-3-acetic acid and serotonin in lumbar cerebrospinal fluid (CSF) from patients with multiple sclerosis, cerebrovascular disease and muscular tension headache the later, as healthy controls. The separation of these substances was performed on a reversed phase column by ion pair high performance liquid chromatography and detection was made by a glassy carbon electrode set at +900 mV vs Ag+/AgCl. The whole separation was achieved within 25 min. Concentrations of all substances (10-1000 pmole/L) were linearly proportional to areas obtained. The system is sensitive, stable and reproducible. The significance of CSF levels of these metabolites from patients groups compared with healthy controls are discussed.

Catecholamines and diagnoses in children

Theoretically, noradrenergic (NA) function may be lower in subjects with undersocialized conduct disorder (CDU) and higher in subjects with anxiety/depressive disorder. To test this hypothesis, diagnostic and 24-hour urine catecholamine measures were compared between subjects with plasma dopamine-beta-hydroxylase (D beta H) activities less than 6 mumoles/min/L (low D beta H group) and greater than 15 mumoles/min/L (high D beta H group). Several measures relating to norepinephrine metabolism were lower in the low D beta H group, and the low D beta H group had more diagnoses of CDU and fewer anxiety and depressive disorder diagnoses. Comparisons between clinical and biological measures within each of the D beta H groups were also consistent with the hypothesized relationship between NA function, CDU, and anxiety/depressive disorder.

Biogenic amines and their metabolites in body fluids of normal, psychiatric and neurological subjects

The biogenic monoamines and their metabolites have been isolated, identified and quantified in human body fluids over the past forty years using a wide variety of chromatographic separation and detection techniques. This review summarizes the results of those studies on normal, psychiatric and neurological subjects. Tables of normal values and the methods used to obtain them should prove to be useful as a reference source for benchmark amine and metabolite concentrations and for successful analytical procedures for their chromatographic separation, detection and quantification. Summaries of the often contradictory results of the application of these methods to psychiatric and neurological problems are presented and may assist in the assessment of the validity of the results of experiments in this field. Finally, the individual, environmental and the methodological factors affecting the concentrations of the amines and their metabolites are discussed.

Cerebrospinal fluid parameters in healthy volunteers during serial lumbar punctures

Lumbar punctures were performed on four occasions over a 5-day period (8:30 a.m. on days 1, 3, and 5; 2:30 p.m. on day 2) on 10 normal volunteers (five of each sex; mean age, 27.7 years) to assess, with repeated sampling, the day-to-day variation of selected CSF parameters. Two subjects abstained from the lumbar puncture on day 5 due to headache after the third puncture. Lumbar CSF was analyzed for concentrations of free and total gamma-aminobutyric acid (GABA), homocarnosine, homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), total protein, albumin, and immunoglobulin (Ig)G. No significant concentration differences were found between the afternoon and next morning samples. No differences were found in concentrations of free GABA, total GABA, homocarnosine, 5-HIAA, or albumin across the study. In contrast, HVA concentrations significantly increased by day 5, whereas total protein and IgG decreased during the study. The most likely explanation for these changes involves the known concentration gradients in the CSF column.

Effects of long-term storage on the concentrations of the unconjugated acidic metabolites of the trace amines, indoleamines and catecholamines

The concentrations of urinary phenylacetic, m- and p-hydroxyphenylacetic, mandelic (MA), p-hydroxymandelic, indoleacetic, homovanillic, vanillylmandelic, 5-hydroxyindoleacetic and 3,4-dihydroxyphenylacetic (DOPAC) acids and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) and the concentrations of the above plasma acids (except MA, MHPG and DOPAC) were determined by gas chromatography-mass spectrometry with selected-ion monitoring at the time of receipt of the samples and after three, six and nine months storage at -18 degrees C. The samples were not treated in any way before storage. The concentrations of most of the urinary metabolites declined significantly (analysis of variance) over the nine-month storage period, whereas most of the plasma metabolites did not.

Catecholamines and their metabolites

The research on biosynthesis, physiology, pharmacology, regulation and degradation of catecholamines has continuously increased for more than 50 years. This is not unexpected because of the fact that catecholamines are involved in so many life processes such as nerve conduction, blood circulation and hormone regulations in health and disease. This demands that methods for their determination should be improved, and in fact during the years a number of analytical methods have been published. About 20 years ago radioenzyme techniques with thin-layer chromatographic (TLC) separation of radiolabelled catecholamine derivatives were developed which greatly contributed to our knowledge of physiological concentrations of catecholamines in biological media, particularly in plasma and brain. Radioimmune methods were successful for analysis of a number of analytes, but for catecholamines radioimmunoassays developed slowly. We believe that the greatest potential for radioimmunochemical methods lies in their ability to localize catecholamines and metabolites at the cellular and subcellular levels. With the advent of gas chromatographic-mass spectrometric (GC-MS) and high-performance liquid chromatographic (HPLC) procedures analysis of catecholamines improved greatly., The equipment for GC-MS is expensive and requires technical skillfulness, but in experienced hands a lot of new biological data have emerged. An outstanding quality with GC-MS is that the method offers the ability to identify unknown compounds and is relatively free from interferences from extraneous compounds. In comparison with GC-MS, HPLC is versatile and has gained a widespread use. Applications for research in the catecholamine field are numerous. In general, the sensitivity and specificity are satisfactory with HPLC, but it should be borne in mind that a number of pitfalls can obscure the results. This involves both sample handling, clean-up and chromatographic procedures. At present, HPLC is the most expanding field in chromatographic determination of catecholamines and their metabolites. This is particularly the case for HPLC with electrochemical detection which has revolutionized our analytical potential in this field. These chromatographic procedures continue to develop. The prerequisites for further improved methods such as capillary zone electrophoresis and combined HPLC-MS are at hand and hopefully will soon come into more general use for analysis of catecholamines in biological samples.

Selected ion monitoring analysis of monoamine metabolites in cerebrospinal fluid. Application to the study of in vivo effects of alpha 2-antagonists

The technique of isotope dilution mass spectrometry has been used for the measurement of biogenic amine metabolites in cerebrospinal fluid (CSF). CSF samples were collected from rabbits treated with alpha 2-antagonists. The aim of our study was to determine the specificity of these drugs on the central nervous noradrenergic, dopaminergic and serotonergic activity as measured by the release of corresponding monoamine metabolites. 3-Methoxy-4-hydroxyphenylethylene glycol (MHPG) and vanilmandelic acid (VMA) were used as parameters for the noradrenergic activity, whereas homovanillic acid (HVA) and 5-hydroxyindole-3-acetic acid (5-HIAA) were employed to follow the dopaminergic and serotonergic activity, respectively. For the measurement of the biogenic amine metabolites a published GCMS method has been adapted. Samples of 200 microliters CSF were processed. Following addition of deuterated internal standards and acidification, extraction was carried out with ethyl acetate. Preliminary experiments with the analysis of MHPG using diethyl ether for extraction gave rise to emulsion formation and resulted in poor recoveries for MHPG and in irreproducibility problems due to a preferential extraction of non-labelled MHPG, effects which were not observed with ethyl acetate extraction. Derivatization was done with a mixture of pentafluoropropionic anhydride/pentafluoropropanol (or hexafluoroisopropanol) in order to derivatize both hydroxyl and carboxylic acid groups. The derivatization procedure was optimized for the analysis of 5-HIAA by carrying out a second reaction step with pentafluoropropionic anhydride alone in order to complete the derivatization for the indolic NH moiety. The molecular ions of the derivatized products were selected for detection.(ABSTRACT TRUNCATED AT 250 WORDS)

Simultaneous liquid chromatographic determination of seventeen of the major monoamine neurotransmitters, precursors and metabolites. II. Assessment of human brain and cerebrospinal fluid concentrations

The optimized chromatographic method procedure presented in Part I was employed for the assessment of human brain and cerebrospinal fluid neurotransmitters levels. The optimized sample preparation and chromatographic conditions permitted a rapid (less than 25 min), sensitive and semi-automated high-performance liquid chromatographic analysis which measures all major monoamine neurotransmitters, precursors and metabolites in human brain and cerebrospinal fluid. The brain specimen was deproteinized with perchloric acid (containing Na2EDTA and sodium sulphite), the internal standard and heparin were added and the samples were sonicated, centrifuged, filtered and injected directly into the chromatographic system. Cerebrospinal fluid was handled in a similar manner except that sonication was excluded. The regional distribution of monoamine neurotransmitter concentrations in human brain and cerebrospinal fluid is presented.

Cerebrospinal fluid HVA, central brain atrophy, and clinical state in schizophrenia

In 16 patients with chronic schizophrenia, cerebrospinal fluid (CSF) concentrations of homovanillic acid (HVA) showed a significant negative correlation with computed tomographic measures of brain third ventricle size. Clinical state during a drug-free period was also significantly correlated with CSF HVA level, but not with third ventricle size when the effect of CSF HVA was partialed out. The authors propose that these findings may reflect an atrophic process involving structures around the third ventricle and a decrease in dopaminergic activity.

A semiautomated analysis method for catecholamines, indoleamines, and some prominent metabolites in microdissected regions of the nervous system: an isocratic HPLC technique employing coulometric detection and minimal sample preparation

The application of a commercially available coulometric electrochemical detector to the automated HPLC analysis of some monoamines and their metabolites in microdissected areas of the rat nervous system is described. Apart from the stability and high sensitivity of the system, other appealing features of the technique are the facile sample preparation and long-term sample storage characteristics which show minimal analyte degradation. Basal values of some regional monoamine and metabolite concentration are listed together with a brief appendix that serves as a user's guide to the operation and maintenance of the detection system.