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  • Title: [A study of clinical pictures and monoamine metabolism of Gilles de la Tourette syndrome].
    Author: Takano K, Ishiguro T.
    Journal: Seishin Shinkeigaku Zasshi; 1993; 95(1):1-29. PubMed ID: 7685527.
    Abstract:
    Gilles de la Tourette Syndrome (Tourette syndrome) is a movement disorder characterised by both motor and vocal (phonic) tics, accompanied by coprolalia and frequently echolalia. Since Seignot discovered that administration of haloperidol (HPL) was effective in treating Tourette syndrome, the etiology of this syndrome has been hypothesized as abnormal metabolism in neurotransmitters. We studied the clinical pictures on nine typical cases of Tourette syndrome and measured the HVA, MHPG, and 5-HIAA in their cerebrospinal fluid (CSF). Diagnosis of Tourette syndrome were made of the nine cases (all males) by DSM-III-R. All cases had symptoms of either coprolalia or echolalia. Four cases had no history of treatment with neuroleptics (untreated group) and five cases were under treatment with HPL (treated group). CSF was obtained from each subject in the morning (between 9:00-9:30 a.m.), at rest with nothing by mouth since last night and it was rapidly frozen and stored at -80 degrees C. HVA, the metabolite of dopamine, MHPG, the metabolite of norepinephrine, and 5-HIAA, the metabolite of serotonin, were analyzed by HPLC. The same analyses were made in five males who were healthy volunteer controls (control group). Comparisons were made of the HVA, MHPG and 5-HIAA levels between the three groups (untreated, treated and control group). HVA was 63.5 +/- 8.4 ng/ml in the untreated group, which was significantly higher than the 35.6 +/- 8.6 ng/ml in the controls (p < 0.05). No significant difference was found in both MHPG and 5-HIAA between the untreated and control group. No significant differences were found in HVA or MHPG between the treated group and the controls. The treated group had significantly lower 5-HIAA levels than the controls (p < 0.05). A significantly lower levels of CSF HVA were found in the treated group than in the untreated group (p < 0.05), but there were no significant differences in MHPG or 5-HIAA in the treated and untreated group. Assuming that the untreated group was most indicative of Tourette syndrome during the study, higher levels of HVA may indicate dopaminergic hyperfunction.
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