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Eur J Neurol. 2014 Feb;21(2):353-6. doi: 10.1111/ene.12161. Epub 2013 May 17.

Urinary profile of catecholamines and metabolites in Parkinson patients with deep brain stimulation.

Author information

1
Neurology Department, Hospital de São João, Porto, Portugal; Neurology and Neurosurgery Unit of Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Porto, Porto, Portugal; Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal.

Abstract

BACKGROUND AND PURPOSE:

Deep brain stimulation of the subthalamic nucleus (DBS-STN) is thought to continuously alter the activity of STN neurons in Parkinson's disease (PD). A chronic decrease in the levodopa dose with continuous STN stimulation may induce plastic neuronal changes.

OBJECTIVE:

The objective of this work was to study urinary excretion of catecholamines in patients with PD before and after DBS-STN.

METHODS:

Twenty-three patients were submitted to DBS-STN, and evaluated before and after surgery with respect to catecholamines and metabolites in 24-h urine measured by high-performance liquid chromatography with electrochemical detection.

RESULTS:

Of the 23 patients evaluated, a significant decrease of about 60% in the urinary excretion of L-3,4-dihydroxyphenylalanine (L-DOPA; in nmol/mg creatinine/24 h) was observed 1 week after DBS-STN. Moreover, in 17 patients with a follow-up of 8 weeks after surgery, there was a further 50% decrease in urinary L-DOPA levels, dropping to about 75% of the values before surgery. There was also a significant decrease in dopamine (DA) and 3,4-dihydroxyphenylacetic acid (DOPAC) levels 1 week after DBS-STN that was no longer present 8 weeks after. A significant increase in the DA/l-DOPA ratio was observed 1 week after surgery, with a further increase 8 weeks after surgery.

CONCLUSION:

After DBS-STN, the DA/l-DOPA ratio, an indirect measure of DA synthesis, increased. These results show that DBS-STN may improve the efficacy of oral levodopa.

KEYWORDS:

Parkinson's disease; catecholamines; deep brain stimulation; levodopa; subthalamic nucleus

PMID:
23679894
DOI:
10.1111/ene.12161
[Indexed for MEDLINE]

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