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Abstract
Faulty transmission in the central serotonin and catecholamine systems may be involved
in some psychiatric and neurological conditions. Central monoamine metabolism can
be studied by measuring amine metabolites in the lumbar cerebrospinal fluid (CSF),
but results to date have been inconsistent. Since most studies have analyzed lumbar
CSF, one reason for the inconsistencies may be that lumbar fluid does not reflect
brain amine metabolism. We measured 5-hydroxyindoleacetic acid (5HIAA) and homovanillic
acid (HVA) in serial CSF samples obtained in connection with pneumoencephalographic
(PEG) examinations: through seven samples of equal volume, a gradual increase was
found for both metabolites in 14 neurological patients, and the first and last fractions
were statistically significantly correlated. In addition, a small series of cisternal
CSF samples from psychiatric (depressed and alcoholic) and neurological patients were
analyzed for 5HIAA. Frequency distribution in cisternal CSF was similar to that of
lumbar values, although the levels were about twice as high, close to those found
in the last PEG fractions. There were no significant differences between patient groups
either in cisternal or lumbar CSF 5HIAA. These findings suggest that while there is
an ascending gradient, lumbar CSF samples do reflect amine metabolite concentrations
of the more central fluid. No disease-specific differences in cisternal CSF were found
which were absent in the lumbar fluid.