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Brain and Nerve No to Shinkei Volume 35, Issue 5 （May 1983）

Brain and Nerve 脳と神経 35巻5号（1983年5月発行）

Japanese English

原著

舞踏様不随意運動を有する患者の髄液GABA,HVA,5HIAA濃度およびisoniazid投与の効果 LUMBAR CEREBROSPINAL FLUID LEVELS OF GABA, HVA AND 5HIAA IN VARIOUS PATIENTS WITH CHOREIC MOVEMENT AND EFFECTS WITH ISONIAZID TREATMENT 山本光利 ¹ , 大月三郎 ¹ , 三宅一政 ² , 難波玲子 ² Mitsutoshi Yamamoto ¹ , Saburo Otsuki ¹ , Kazumasa Miyake ² , Reiko Namba ² ¹岡山大学医学部神経精神科 ²国立療養所南岡山病院神経内科 ¹Department of Neuropsychiatry, Okayama University Medical School ²Department of Neurology, National Minami Okayama Hospital pp.483-488

発行日 1983年5月1日 Published Date 1983/5/1

DOI https://doi.org/10.11477/mf.1406205123

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　抄録　ハンチントン舞踏病5例，老人性舞踏病1例，chorea-acanthocytosis2例，歯状核赤核淡蒼球ルイ体萎縮の疑われる例（DRPLA）7例の合計15例の舞踏様不随意運動を有する各種の患者で髄液中のγ—amino—butyric acid （GABA），homovanillic acid （HVA），5—hydroxyindole acetic acid （5HIAA）を測定した。GABA濃度は82.7±8.3pmole／ml （mean±S．E．M．）と対照群（137.5±11.7pmole／ml）と比較し有意の低下を示した（p＜0.01）が，HVA,5HIAA客濃度は有意の差はなかった。DRPLA,chorea-acanthocytosis，老人性舞踏病のGABA濃度は全て低値であったが，ハンチントン舞踏病のそれは正常域のものが2例あった。これらのことは，舞踏様不随意運動の背景としてドパミン系がGABA系に対して優位状態にあることを示唆した。脳内GABA量を増加させる目的で，isoniazidを7例の患者にて4週間投与した。髄液GABA濃度は投与前に比較して約3.7倍に増加したがHVA,5HIAA各濃度は有意の変化はなく，舞踏様不随意運動の改善もみられなかった。Isoniazidの無効であった理由として，ドパミン系に対して変化を及ぼさなかったこと等を推測した。

In order to study r-aminobutyric acid (GABA), dopamine and serotonin metabolism in the central nervous systems of various patients with choreic movement, we investigated lumbar cerebrospinal fluid (CSF) levels of GABA, homovanillic acid (HVA), a major metabolites of dopamine, and 5-hydroxyindoleacetic acid (5 HIAA), a major metabolites of serotonin. Patients consisted of 5 cases with Huntington's chorea, one case with senile chorea, 2 cases with chorea-acanthocytosis and 7 cases with dentaterubropallidoluysian atro-phy (DRPLA). DRPLA were clinically diagnosed according to their clinical symptoms, CT-scan and autopsy finding of their family. CSF-GABA were assayed by radioreceptor assay, and CSF-HVA and 5 HIAA were measured by fluoromet-rical method.

CSF levels of GABA in patients group were 82.7±8.3 pmole/ml (mean -±S. E. M.). These values were significantly low compared to those of normal controls (137.5±11.7 pmole/ml, p <O. 01).But, CSF levels of HVA and 5 HIAA were not significantly altered. There was no significant correlation between CSF-GABA or HVA and 5-HIAA in both patients group and controls.

There was no significant correlation between these values and the severity of chorea which was evaluated by Abnormal involuntary movement scale (AIMS) of NIMH.

The next, we administered isoniazid in order to increase brain GABA levels in 7 patients with choreic movement. Isoniazid (maximum dose 600 mg/day) was administered for 4 weeks. Evaluation of chorea were assessed by AIMS. CSF levels of GABA, HVA and 5 HIAA were also investigatedbefore and after isoniazid administration. CSF levels of GABA significantly increased after isoniazid administration (about 3.7 fold, p <O. 01), but CSF levels of HVA and 5 HIAA did not show significant changes. AIMS scores were not also significantly altered.

These results suggested that patients with choreic movement had impairments of GABAergic neurons in the central nervous systems, and the increase of GABA levels showed no influences on dopaminergic or serotonergic neurons in patients with choreic movement.