Neurotransmitters in CSF of idiopathic adult-onset dystonia: Reduced 5-HIAA levels as evidence of impaired serotonergic metabolism

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Abstract
While several radiological findings point towards the basal ganglia as a possible anatomical site of the lesion in dystonia patients the biochemical basis of the disorder is still unknown. 5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) levels — the respective metabolites of serotonin and dopamine — were measured in lumbar cerebrospinal fluid (lCSF) of 15 patients with idiopathic adult-onset focal dystonia and in lCSF of 11 controls. 100 μl lCSF were analyzed for 5-HIAA and HVA by reversed-phase HPLC with electrochemical detection. 5-HIAA levels were significantly reduced in dystonia patients (11.4μg/ml) compared to controls (18.4ng/ml) (p < 0.02). HVA levels in dystonia patients (30.3ng/ml) were below control values (41.6ng/ml) but this finding did not reach statistical significance. Decreased lCSF levels of 5-HIAA suggest an impaired serotonin metabolism in patients with idiopathic adult-onset dystonia. This observation may provide a biochemical basis for a more specific pharmacotherapy in dystonia patients.