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The dopaminergic neurotransmitter system is associated with aggression and agitation in frontotemporal dementia. Neurochem Int 2008; 52:1052-60. [DOI: 10.1016/j.neuint.2007.10.018] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2007] [Accepted: 10/29/2007] [Indexed: 11/17/2022]
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Nilsson-Todd LK, Nordin C, Jönsson EG, Skogh E, Erhardt S. Cerebrospinal fluid kynurenic acid in male patients with schizophrenia - correlation with monoamine metabolites. Acta Neuropsychiatr 2007; 19:45-52. [PMID: 26952797 DOI: 10.1111/j.1601-5215.2006.00170.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The tryptophan metabolite kynurenic acid (KYNA) is an endogenous glutamate/nicotinic receptor antagonist. Previous studies have shown that the concentration of the compound is increased in cerebrospinal fluid (CSF) of patients with schizophrenia. Furthermore, it has been found that the CSF concentration of KYNA is positively correlated to CSF concentrations of the monoamine metabolites homovanillic acid (HVA) and 5-hydroxy indoleacetic acid (5-HIAA) in healthy control subjects. OBJECTIVES To study the correlations between KYNA and the monoamine metabolites HVA, 5-HIAA and 4-hydroxy-3-methoxyphenylglycol (HMPG) in CSF of male patients (n= 53, ranging from 20 to 48 years of age) with verified schizophrenia. METHODS CSF was obtained by lumbar puncture, and KYNA analysis was performed with an isocratic reversed-phase high-performance liquid chromatography system connected to a fluorescence detector. HVA, 5-HIAA and HMPG concentrations were measured by mass fragmentography with deuterium-labelled internal standards. RESULTS Positive intercorrelations were found between CSF KYNA, HVA and 5-HIAA, while CSF content of HMPG did not correlate to KYNA or any of the monoamine metabolites in CSF. CONCLUSION The results of this study suggest that increased KYNA formation is associated with an increased dopamine and serotonin turnover in male patients with schizophrenia.
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Affiliation(s)
- Linda K Nilsson-Todd
- 1Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Conny Nordin
- 2Department of Neuroscience and Locomotion, Psychiatry Section, Linköpings Universitet, Linköping, Sweden
| | - Erik G Jönsson
- 3Department of Clinical Neuroscience, Psychiatry Section, HUBIN Project, Karolinska Institutet and Hospital, Stockholm, Sweden
| | - Elisabeth Skogh
- 2Department of Neuroscience and Locomotion, Psychiatry Section, Linköpings Universitet, Linköping, Sweden
| | - Sophie Erhardt
- 1Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Carpenter LL, Anderson GM, Siniscalchi JM, Chappell PB, Price LH. Acute changes in cerebrospinal fluid 5-HIAA following oral paroxetine challenge in healthy humans. Neuropsychopharmacology 2003; 28:339-47. [PMID: 12589387 DOI: 10.1038/sj.npp.1300025] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A number of studies have reported decreased human lumbar cerebrospinal fluid (CSF) concentrations of the major serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA), following chronic administration of selective serotonin reuptake inhibitors (SSRIs). This decrease has been thought to be a consequence of elevated extracellular serotonin and to be mediated through terminal autoreceptor feedback inhibition of serotonin turnover. We wished to study the previously unexamined acute effects of SSRI administration on human CSF 5-HIAA. A serial lumbar puncture (LP) procedure was used to collect CSF samples before and after a single oral 40 mg dose of the SSRI paroxetine (PAR) or matching placebo in eight healthy adult humans in a randomized, double-blind fashion. CSF 5-HIAA concentrations did not change following placebo, but showed a statistically significant 27% mean increase 3 h following PAR. Our findings stand in contrast to the decreases reported for CSF 5-HIAA after chronic SSRI treatment in humans and the decreases seen in brain extracellular 5-HIAA after acute or chronic administration of SSRIs to animals.
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Affiliation(s)
- Linda L Carpenter
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI 02906, USA.
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Faull KF, Rafie R, Pascoe N, Marsh L, Pfefferbaum A. N-acetylaspartic acid (NAA) and N-acetylaspartylglutamic acid (NAAG) in human ventricular, subarachnoid, and lumbar cerebrospinal fluid. Neurochem Res 1999; 24:1249-61. [PMID: 10492520 DOI: 10.1023/a:1020973023059] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
N-Acetylaspartic and N-acetylaspartylglutamic acid concentrations in human ventricular, subarachnoid and lumbar cerebrospinal fluid were measured by combined gas chromatography-mass spectrometry using selected ion monitoring with deuterated internal standards. N-Acetylaspartate concentrations were in the range 55, 9, and 1 microM, respectively; N-acetylaspartylglutamate concentrations in the same fluids were in the range 8, 3 and 4 microM, respectively. There did not appear to be any difference in lumbar fluid concentrations of either compound between control subjects, schizophrenic patients, Alzheimer's disease patients and a pooled group of patients with neurological degeneration. Ventricular concentrations of both compounds were greatly increased in deceased patients suggesting that maintenance of their intracellular concentrations is probably energy dependent. The concentrations of these compounds in lumbar cerebrospinal fluid from living, and ventricular cerebrospinal fluid from deceased subjects were weakly correlated with one another. In lumbar fluid neither compound appeared to be correlated with age. Analysis of serially collected lumbar samples from two subjects showed a weak concentration gradient for both compounds. Neither antipsychotic medication nor the acid transport inhibitor probenecid had any effect on lumbar concentrations of either compound. Attempts to use anion exchange high pressure liquid chromatography with UV detection for measurement of the low concentrations of N-acetylaspartate found in cerebrospinal fluid from living subjects were unsuccessful.
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Affiliation(s)
- K F Faull
- Department of Chemistry & Biochemistry, UCLA, Los Angeles, CA 90095, USA.
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Cremniter D, Jamain S, Kollenbach K, Alvarez JC, Lecrubier Y, Gilton A, Jullien P, Lesieur P, Bonnet F, Spreux-Varoquaux O. CSF 5-HIAA levels are lower in impulsive as compared to nonimpulsive violent suicide attempters and control subjects. Biol Psychiatry 1999; 45:1572-9. [PMID: 10376117 DOI: 10.1016/s0006-3223(98)00382-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND We studied CSF 5-HIAA and HVA concentrations in violent suicide attempters and examined their relationship with depression, anxiety, and impulsivity. METHODS CSF 5-HIAA and HVA concentrations were determined very shortly after hospital admission and compared to those of a matched control population. Clinical evaluation was performed concomitantly; the level impulsivity was evaluated by the Impulsivity Rating Scale (IRS). RESULTS Twenty-three patients and 23 control subjects were included. According to the IRS, 14 patients were classified as impulsive, including all patients suffering from personality disorders, and 9 as nonimpulsive, with a main DSM-IIIR diagnosis of melancholia. CSF 5-HIAA concentrations in the suicide group were significantly lower than in control subjects. This difference was entirely due to the impulsive suicide attempters. There was an inverse correlation between the IRS score and CSF 5-HIAA (r = -.47, p = .02) and only a trend for HVA (r = -.41, p = .078) levels in the suicide group. CONCLUSIONS This study of a group of violent suicide attempters distinguished a subgroup of patients diagnosed with personality disorder with high impulsivity scores and a subgroup of patients with the main diagnosis of severe depression. CSF 5-HIAA was significantly lower in impulsive violent attempters than in nonimpulsive violent attempters, therefore desintangling violence from impulsivity and linking this biologic abnormality to impulsivity.
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Affiliation(s)
- D Cremniter
- Département de Psychopathologie, Centre Hospitalier Henri Mondor, Creteil, France
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Malison RT, Price LH, Berman R, van Dyck CH, Pelton GH, Carpenter L, Sanacora G, Owens MJ, Nemeroff CB, Rajeevan N, Baldwin RM, Seibyl JP, Innis RB, Charney DS. Reduced brain serotonin transporter availability in major depression as measured by [123I]-2 beta-carbomethoxy-3 beta-(4-iodophenyl)tropane and single photon emission computed tomography. Biol Psychiatry 1998; 44:1090-8. [PMID: 9836013 DOI: 10.1016/s0006-3223(98)00272-8] [Citation(s) in RCA: 302] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Prior research has suggested reductions in the density of serotonin transporter (SERT) binding sites in blood platelets and post-mortem brain tissue of depressed patients. We sought to determine whether patients with unipolar major depression have diminished SERT availability as assessed by both brainstem [123I] beta-CIT SPECT and platelet [3H]paroxetine binding. METHODS Drug-free depressed and healthy subjects were injected with 211 +/- 22 MBq [123I] beta-CIT and imaged 24 +/- 2 h later under equilibrium conditions. A ratio of specific to nonspecific brain uptake (V3" = (brainstem-occipital)/occipital), a measure proportional to the binding potential (Bmax/Kd), was used for all comparisons. RESULTS Results showed a statistically significant reduction in brainstem V3" values in depressed as compared to healthy subjects (3.1 +/- .9 vs. 3.8 +/- .8, p = .02). Platelet [3H]paroxetine binding was not altered (Bmax = 2389 +/- 484 vs. 2415 +/- 538 fmol/mg protein, p = .91) and was not significantly correlated with brainstem [123I] beta-CIT binding (r = -0.14, p = .48). CONCLUSIONS These data are the first to suggest reductions in the density of brain SERT binding sites in living depressed patients. These findings provide further support for a preeminent role for alterations in serotonergic neurons in the pathophysiology of depression.
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Affiliation(s)
- R T Malison
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06510, USA
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Sheline YI, Miller K, Bardgett ME, Csernansky JG. Higher Cerebrospinal Fluid MHPG in Subjects With Dementia of the Alzheimer Type: Relationship With Cognitive Dysfunction. THE AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY 1998. [DOI: 10.1097/00019442-199805000-00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sheline Y, Bardgett ME, Csernansky JG. Correlated reductions in cerebrospinal fluid 5-HIAA and MHPG concentrations after treatment with selective serotonin reuptake inhibitors. J Clin Psychopharmacol 1997; 17:11-4. [PMID: 9004051 DOI: 10.1097/00004714-199702000-00003] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We sought to determine whether fluvoxamine and fluoxetine, two different antidepressants with in vitro selectivity for the serotonin uptake transporter also demonstrated similar selectivity in vivo. To accomplish this, we measured cerebrospinal fluid (CSF) concentrations of 5-hydroxyindoleacetic acid (5-HIAA), 3-methoxy-4-hydroxyphenylglycol (MHPG), and homovanillic acid (HVA) before and after 6 weeks of treatment with these two drugs. Twenty-four subjects who had major depression according to DSM-III-R criteria gave written, informed consent for the collection of CSF during a double-blind comparative treatment trial of fluvoxamine (50-150 mg/day) and fluoxetine (20-80 mg/day). The symptoms of subjects were assessed clinically on a weekly basis throughout the treatment trial. CSF samples were obtained after a 7- to 14-day washout period before treatment and again at the end of treatment. CSF samples were analyzed for 5-HIAA, HVA, and MHPG using high-pressure liquid chromatography coupled to electrochemical detection. Fluvoxamine- and fluoxetine-treated patients did not differ in clinical outcome or in the CSF concentrations of monoamine metabolite levels before or after treatment. Therefore, the CSF data were pooled. Drug treatment, overall, was associated with significant decreases in 5-HIAA and MHPG and a trend toward a reduction in HVA levels. Levels of 5-HIAA, MHPG, and HVA were reduced by 57%, 48%, and 17%, respectively. In addition, the magnitude of the decreases in 5-HIAA and MHPG appeared to be correlated (r = 0.83) across the subjects, although a Spearman rank correlation indicated that outlying values had an undue effect on this relationship. These results suggest that treatment with selective serotonin reuptake inhibitors, which are selective for serotonin uptake in vitro, does not show a similarly selective effect on serotonin in vivo during treatment of patients.
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Affiliation(s)
- Y Sheline
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Affiliation(s)
- C R Cloninger
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Nisijima K, Ishiguro T. Cerebrospinal fluid levels of monoamine metabolites and gamma-aminobutyric acid in neuroleptic malignant syndrome. J Psychiatr Res 1995; 29:233-44. [PMID: 7473299 DOI: 10.1016/0022-3956(95)00007-r] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To investigate the pathophysiology of neuroleptic malignant syndrome (NMS), we measured various cerebrospinal fluid (CSF) parameters in 11 patients and compared them with 8 age-matched normal controls. Concentrations of homovanillic acid (HVA) were significantly decreased during the active phase of NMS. This finding indicates that the dopaminergic nervous system of the patients was in a state of hypofunction in this phase and supports the central dopamine blockade theory of NMS. Reduced CSF HVA levels were also found after recovery from NMS, suggesting that hypofunction of the dopaminergic system may continue subclinically. The levels of 5-HIAA were decreased in the active phase, but the change was not significant. Therefore, a relationship between the development of NMS and disturbances of serotonin metabolism remains unclear. The levels of noradrenaline and its major metabolite, 3-methoxy-4-hydroxyphenylethyleneglycol increased significantly during the active phase, but returned to normal after recovery. These results show the existence of sympathetic nervous system hyperactivity during the active phase of NMS. The levels of gamma-aminobutyric acid (GABA) were significantly lower in the patients than in the controls. These findings suggest that there is a GABAergic deficiency in NMS. Thus, our study indicates that, in addition to dopamine hypoactivity, disturbances in various neurotransmitter systems are involved in the pathophysiology of NMS.
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Affiliation(s)
- K Nisijima
- Department of Psychiatry, Jichi Medical School, Tochigi-Ken, Japan
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Faustman WO, Ringo DL, Faull KF. An association between low levels of 5-HIAA and HVA in cerebrospinal fluid and early mortality in a diagnostically mixed psychiatric sample. Br J Psychiatry 1993; 163:519-21. [PMID: 7504565 DOI: 10.1192/bjp.163.4.519] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We followed up a sample of psychiatric patients (diagnoses predominantly schizophrenia and depression) who had participated in in-patient studies of their CSF over the past 15 years. The status of 73 former patients was confirmed, of whom 12 had died. Seven of these patients died at age < or = 40, largely of suicide, homicide, or accidental causes. These seven patients had significantly lower CSF 5-HIAA and HVA than living control patients. There were significant direct correlations between age at death and both CSF 5-HIAA and HVA in the deceased patients. The results offer support for CSF monoamine metabolites relating to early death in a diagnostically diverse sample of psychiatric patients.
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Affiliation(s)
- W O Faustman
- Stanford/VA Mental Health Clinical Research Center, CA
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Benson KL, Faull KF, Zarcone VP. The effects of age and serotonergic activity on slow-wave sleep in depressive illness. Biol Psychiatry 1993; 33:842-4. [PMID: 7690599 DOI: 10.1016/0006-3223(93)90027-b] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- K L Benson
- Psychiatry Service, Department of Veterans Affairs Medical Center, Palo Alto, CA
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Hsiao JK, Potter WZ, Agren H, Owen RR, Pickar D. Clinical investigation of monoamine neurotransmitter interactions. Psychopharmacology (Berl) 1993; 112:S76-84. [PMID: 7831444 DOI: 10.1007/bf02245010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Monoamine neurotransmitter systems are widely thought to be involved in the pathophysiology of affective disorders and schizophrenia and the mechanism of action of antidepressant and antipsychotic drugs. Previous clinical studies have focused on individual monoamine function in isolation, even though a large number of preclinical studies have demonstrated that monoamine neurotransmitter systems interact with one another. In the present paper, preclinical data on monoamine neurotransmitter interactions are reviewed, and two methods for examining monoamine neurotransmitter system interactions in clinical data are presented. One of the best replicated findings in biological psychiatry is that monoamine metabolites in CSF correlate with one another. The degree of correlation may be in part a measure of the degree of interaction between the parent monoamine neurotransmitter systems. Another approach to studying interactions is the use of HVA/5HIAA and HVA/MHPG ratios as an index of interactions between 5HT-DA and NE-DA. When these methods are applied in schizophrenia, patients are found to have decreased monoamine metabolite correlations compared to normal controls. Metabolite correlations increase significantly after antipsychotic treatment, and the HVA/5HIAA and HVA/MPHG ratios also increase, suggesting that neuroleptics may act in part by strengthening interactions between monoamines. BPRS ratings are negatively correlated with HVA/5HIAA and HVA/MHPG so that patients with higher ratios have fewer symptoms, particularly after treatment. These results provide direct experimental support for hypotheses suggesting that interactions between monoamine neurotransmitters are important in schizophrenia. Some of the effects of the atypical neuroleptic, clozapine, on metabolite correlations and ratios are also discussed.
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Affiliation(s)
- J K Hsiao
- Experimental Therapeutics Branch, National Institute of Mental Health, Bethesda, MD 20892
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Faustman WO, King RJ, Faull KF, Moses JA, Benson KL, Zarcone VP, Csernansky JG. MMPI measures of impulsivity and depression correlate with CSF 5-HIAA and HVA in depression but not schizophrenia. J Affect Disord 1991; 22:235-9. [PMID: 1939932 DOI: 10.1016/0165-0327(91)90069-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Recent studies have linked impulsivity with CSF concentrations of both 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA). One work found a negative correlation between the MMPI psychopathic deviate (Pd) scale and 5-HIAA in personality disordered men (Brown et al., 1982). We found that the 5-HIAA/Pd correlation extends (P less than 0.05) to unmedicated depressed patients (n = 21). A trend was found between HVA and Pd in depression. There was no relationship between either metabolite and the Pd scale in unmedicated schizophrenics (n = 24). A significant inverse correlation was found between the MMPI depression scale and CSF HVA but not 5-HIAA in the depressed patients.
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Affiliation(s)
- W O Faustman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA 94305
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Jolkkonen J, Hartikainen P, Soikkeli R, Bissette G, Nemeroff C, Riekkinen P. A correlation study of CSF neuropeptides in Alzheimer's and Parkinson's disease. Neuropeptides 1991; 19:97-102. [PMID: 1682848 DOI: 10.1016/0143-4179(91)90138-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The concentrations of somatostatin (SRIF), vasoactive intestinal polypeptide (VIP), beta-endorphin (beta-EP), adrenocorticotropin (ACTH) and corticotropin-releasing factor (CRF) immunoreactivity were measured in cerebrospinal fluid (CSF) of patients with Alzheimer's disease (AD), patients with Parkinson's disease (PD) and controls. In order to study the mechanisms that regulate peptide levels in CSF and peptide interactions, correlations between CSF peptides were determined. Within all patient groups a number of significant correlations were shown to exist between CSF peptides. The correlations were apparently not coincidental, since there was no such relation between the concentrations of CSF peptides and CSF protein content. Neither age, sex, severity of dementia nor the presence of extrapyramidal signs could explain the number of significant correlations. These results indicate, that the correlations found between CSF peptides may be due to common regulatory mechanisms or general physiological behaviour of peptides in the CSF.
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