Urinary noradrenaline and serotonin metabolites in drug-free Parkinson patients and the effect of L-dopa treatment

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Abstract
3-Methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyIAA (5-HIAA), homovanillic acid (HVA) and cAMP were estimated in the morning urine of 41 drug-free parkinsonian patients and 25 hospitalized controls. In 29 patients, the estimations were repeated after 2 wk treatment with L-dopa plus decarboxylase inhibitor. Drug-free patients excreted more MHPG and less 5-HIAA than controls. The difference from controls was significant for MHPG, only for the subgroup of patients with akinesia as the main symptom (P = 0.001) and for 5-HIAA only for the tremor subgroup (P = 0.03). Treatment with L-dopa plus decarboxylase inihbitor for 2 wk increased the MHPG excretion significantly only for the akinesia subgroup, where the pretreatment MHPG values were high, while there was no change in MHPG excretion in the tremor and the rigidity subgroups. The treatment caused no change in the 5-HIAA excretion in the tremor subgroup, where the pretreatment values were low, while in the rigidity and akinesia subgroups 5-HIAA excretion was significantly decreased. There were considerable differences among the subgroups of parkinsonian patients regarding the metabolism of dopamine, noradrenaline[norepinephrine] and serotonin.