Control of Renal Factors in Plasma Homovanillic Acid Measurements

To identify and control renal factors affecting plasma homovanillic acid (HVA), a dopamine metabolite and an indicator of brain dopamine activity in clinical research, nine healthy subjects were studied on 5 nonconsecutive days. First study day was the baseline and on the other days base, salt, water, or probenecid loads were given. On each day serial concentrations of HVA and serotonin metabolite 5-hyroxyindoleacetic acid (HIAA), another organic anion, in plasma were measured. Results suggested that base, salt, and water loads did not affect plasma concentrations of either metabolite. Probenecid, which partially blocks renal organic anion transport, induced similar increases in plasma HVA and HIAA. When plasma HVA:HIAA ratio was used to control for the effect of probenecid, differences between baseline and probenecid days were no longer significant. Results suggest that HVA and HIAA are similarly handled by the kidney and that simultaneously measured plasma HIAA could be used to distinguish renal influences in plasma HVA studies.     

The effect of olanzapine treatment on monoamine metabolite concentrations in the cerebrospinal fluid of schizophrenic patients.

The mechanism of action of both typical antipsychotics and the atypical antipsychotic, clozapine, may be related to the (changing) interaction of dopamine and serotonin in schizophrenia. This study examined the effect of olanzapine in schizophrenic patients on cerebrospinal fluid (CSF) metabolites of dopamine (homovanillic acid, HVA) and serotonin (5-hydroxyindoleacetic acid, 5-HIAA). Twenty-three male schizophrenic patients, who were drug-free for at least 2 weeks (mean drug-free period of 35 days +/- 43; median 16 days), underwent a lumbar puncture (LP). Patients were subsequently treated with olanzapine 10 mg/day for 6 weeks, after which the LP was repeated. CSF was assayed for HVA and 5-HIAA concentrations. Psychiatric symptoms were rated once a week. Olanzapine significantly increased HVA concentrations and the HVA/5-HIAA ratio while 5-HIAA concentrations were not altered. These changes did not significantly correlate with treatment response. A negative correlation was found between HVA concentrations and negative symptoms after olanzapine treatment. In conclusion, olanzapine treatment increases HVA concentrations and the HVA/5-HIAA ratio in CSF of schizophrenic patients, but these changes are unrelated to its clinical efficacy.     

Dynamic characteristics of dopamine, norepinephrine and serotonin metabolism in axonal endings of the rat hypothalamus and striatum during hypoxia: a study using HPLC with electrochemical detection

The metabolism of dopamine, norepinephrine and serotonin was studied in normoxic or hypobaric hypoxic rats, using HPLC with electrochemical detection. The changes in serotonin and its metabolite 5 hydroxy indolacetic acid (5 HIAA) levels in the hypoxic striatum and hypothalamus suggest an inhibition of 5 HIAA formation and a complex interaction between synthesis, release and uptake. Hypoxia caused a decrease of the striatal levels of homovanillic acid (HVA), dihydroxy 3-4 phenylacetic acid (DOPAC) [inhibition of tyrosine hydroxylase (TH) and monoamine oxidase (MAO)] and 3-methoxytyramine (3 MT) (inhibition of release). Striatal dopamine levels were increased, suggesting an increase in granular dopamine storage, with an impaired release. Hypothalamic levels of norepinephrine were decreased during hypoxia [(inhibition of TH, MAO, and dopamine beta-hydroxylase (DBH)].     

Dopamine and serotonin metabolites in rat cerebroventricular fluid following withdrawal of haloperidol or electroshock treatment

Levels of the dopamine metabolites dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) and of the major serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) were determined in the CSF of rats at various times after repeated electroshock treatment (EST) or chronic administration of haloperidol. The acidic metabolites were analyzed in 25 l CSF using HPLC with an electrochemical detector. A significant decrease in the CSF levels of DOPAC and HVA was found 4 days after the last administration of chronic haloperidol, EST, or both. The decrease in the level of the dopamine metabolites indicated a slower dopamine turnover, which might have resulted from hypersensitivity of presynaptic dopamine receptors after these treatments. Rats treated with haloperidol also showed an increase in 5-HIAA levels, possibly due to enhanced serotonin turnover. The 5-HIAA increase following haloperidol was prevented by a concurrent administration of EST, suggesting attenuation by EST of the haloperidol-induced enhancement of serotonin turnover.     

5-Hydroxyindoleacetic acid (5 HIAA) and homovanillic acid (HVA) following probenecid in acute psychotic patients treated with phenothiazines

Lumbar CSF 5 HIAA and HVA were measured following probenecid administration in acute psychotic patients before and during treatment with phenothiazines. Patients with more classical schizophrenic symptoms had higher values for 5 HIAA/HVA than other psychotics, depressives, and inmate volunteers. Prior to treatment CSF 5 HIAA, but not HVA, correlated significantly with several clinical items related to psychotic disorganization. Phenothiazine treatment produced significant increases in CSF HVA which could not be correlated with the dose of antipsychotic or antiparkinson drugs.     

Effects of apomorphine on the in vivo release of dopamine and its metabolites, studied by brain dialysis

The effect of apomorphine (0.05-0.5 mg/kg s.c.) on the release of endogenous dopamine and extracellular levels of the metabolites 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5HIAA) were examined in vivo by intracerebral dialysis. A dialysis tube was implanted stereotaxically through both caudate nuclei of rats and perfused with Ringer solution at a rate of 2 microliters/min. The amount of dopamine, DOPAC, HVA and 5HIAA in the perfusates was measured by HPLC with electrochemical detection. With the dialysis tube implanted into the striatum of anaesthetized rats it was possible to measure basal levels of dopamine and the metabolites in the perfusates; dopamine, 0.27 +/- 0.05 pmol/20 min (n = 15), DOPAC 43.3 +/- 2.57 pmol/20 min (n = 15), HVA 24.5 +/- 1.89 pmol/20 min (n = 15) and 5HIAA 13.9 +/- 1.77 pmol/20 min (n = 15). The % recoveries of the monoamines through the membrane were estimated to be 12% (dopamine), 21% (DOPAC), 23% (HVA) and 25% (5HIAA). Apomorphine 0.05-0.2 mg/kg decreased the spontaneous release of dopamine by a maximum of approximately 50%. When the dose of apomorphine was raised up to 0.5 mg/kg there was a 100% inhibition of dopamine release. Also, the extracellular levels of the metabolites DOPAC and HVA decreased following apomorphine administration; however there was no consistent change in 5HIAA. These findings indicate that the dopamine autoreceptors decrease dopamine release in vivo by 0-50% while larger decreases probably involve postsynaptic neurons engaging short- as well as long-loop reflexes.     

Effect of α-methyl fluorodopa on dopamine metabolites: Importance of conjugation and egress

The effects of D,L-α-monofluoromethyldopa (MFMD), an inhibitor of aromatic L-amino acid decarboxylase, on the metabolism of dopamine (DA) and 5-hydroxytryptamine was investigated using rat brain and cerebrospinal fluid (CSF). Vehicle or MFMD (100 mg/kg) was given p.o. and 16 h later probenecid (200 mg/kg i.p.). CSF was sampled and the rats killed immediately or after 1 h. Vehicle treated rats showed regional differences of percentage conjugation of DA metabolites: 3,4-dihydroxyphenylacetic acid (DOPAC), striatum 10%, rest of brain 45%, CSF 67%; homovanillic acid (HVA), striatum 20%, rest of brain 35%, CSF 53%. These differences and the proportionately greater increases of conjugates than of free acids after probenecid vitiate regional comparisons of DA metabolism if conjugates are not included. MFMD alone decreased neither 5HIAA (except in the striatum) nor the free DA metabolites but decreased both conjugates in CSF and conjugated DOPAC in rest of brain. The inhibitory effects of MFMD on 5HT and DA synthesis were most evident when measured by the accumulation of 5HIAA or total (DOPAC + HVA) after giving probenecid. MFMD may also inhibit amine metabolite egress and the conjugation of DOPAC and HVA.     

Cerebrospinal fluid 5-hydroxyindoleacetic acid (5HIAA) and homovanillic acid (HVA) following probenecid in unipolar depressives treated with amitriptyline

Lumbar cerebrospinal fluid 5-HIAA, HVA, and the ratio 5-HIAA/HVA were measured followed probenecid administration in eleven patints with unipolar depression before and during treatment with amitriptyline (AMI). Control values were obtained from a group of inmate volunteers. Prior to treatment CSF 5HIAA formation in the depressives was not different from controls. During treatment with AMI, CSF 5-HIAA formation decreased. One patient with psychotic symptoms prior to AMI and two patients who developed psychotic reactions on AMI showed relatively low CSF 5HIAA formation prior to antidepressant therapy. Compared to controls CSF HVA values were higher in the depressives prior to AMI therapy.     

Reduced cerebrospinal HVA concentrations and HVA/5-HIAA ratios in suicide attempters. Monoamine metabolites in 120 suicide attempters and 47 controls.

Dysfunctions of central monoaminergic systems are important elements of the leading biological hypotheses of suicide and depression. The purpose of the present paper was to study the levels and the relationships between the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), the dopamine metabolite homovanillic acid (HVA) and the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) in the cerebrospinal fluid (CSF) in 120 hospitalised suicide attempters and 47 controls (healthy volunteers or patients admitted for minor surgery). The suicide attempters showed significantly lower HVA levels (174+/-82 vs. 216+/-96 nmol/L, P=0.004), HVA/5HIAA ratios (1.6+/-0.5 vs. 2.1+/-0.6, P=0.0001) and HVA/MHPG ratios (4.2+/-2.1 vs. 4.8+/-1.7, P=0.02) than the controls. The correlations between the monoamine metabolites were markedly lower in patients than in controls. CSF 5-HIAA showed no significant differences between patients and controls (107+/-40 vs. 108+/-51 nmol/L) or between violent and non-violent attempters (112+/-58 vs. 105+/-33 nmol/L). The monoamine metabolites showed no significant differences between survivors and patients who subsequently completed suicide, or between suicide attempters subgrouped by psychiatric diagnoses. The results suggest that low HVA levels and altered relationships between the monoamine metabolites are associated with suicidal behaviour.     

Dystrobrevin-binding protein 1 gene (DTNBP1) variants associated with cerebrospinal fluid homovanillic acid and 5-hydroxyindoleacetic acid concentrations in healthy volunteers

The dystrobrevin binding protein-1 (DTNBP1) gene encodes dysbindin-1, a protein involved in neurodevelopmental and neurochemical processes related mainly to the monoamine dopamine. We investigated possible associations between eleven DTNBP1 polymorphisms and cerebrospinal fluid (CSF) concentrations of the major dopamine metabolite homovanillic acid (HVA), the major serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), and the major noradrenaline metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) in healthy human subjects (n = 132). Two polymorphisms, rs2619538 and rs760666, were nominally associated with CSF HVA and 5-HIAA concentrations, whereas a third polymorphism, rs909706, showed association only with HVA. After correction for multiple testing only the associations between rs2619538 and HVA and 5-HIAA concentrations remained significant. No significant association was found between any of the investigated DTNBP1 polymorphisms and CSF MHPG concentrations. The results suggest that genetic variation in DTNBP1 gene affects the regulation of dopamine and serotonin turnover in the central nervous system of healthy volunteers.     

CSF 5-HIAA as a predictor of treatment response in trichotillomania.

Trichotillomania is characterized by chronic hair-pulling resulting in noticeable hair loss. In a preliminary study, cerebrospinal fluid (CSF) measures in 8 medication-free, female, trichotillomania patients were compared to those of matched, normal controls. There was no difference between patients and controls in measures of CSF cortisol, 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG). CSF measures did not correlate with measures of trichotillomania symptomatology. However, degree of response to treatment with serotonin re-uptake inhibitors significantly correlated with baseline CSF 5-HIAA. This suggests that central serotonin turnover is specifically relevant to treatment response to serotonin re-uptake inhibitors in trichotillomania.     

Measurement of metabolites of dopamine and 5-hydroxytryptamine in cerebroventricular perfusates of unanesthetized, freely-moving rats: selective effects of drugs

A method was developed for measuring endogenous acid metabolites of dopamine (dihydroxyphenylacetic acid, DOPAC; homovanillic acid, HVA) and of 5-hydroxytryptamine (5-hydroxyindoleacetic acid, 5HIAA) in serial samples of cerebroventricular perfusates from unanesthetized, freely-moving rats by the use of high performance liquid chromatography with electrochemical detection. Systemic administration of probenecid increased while pargyline reduced the efflux of all of the acid metabolites. Intraperitoneal injection of L-tryptophan increased the perfusate content of 5HIAA, decreased HVA and was without effect on DOPAC. Injections of haloperidol increased the efflux of DOPAC and HVA but did not alter the efflux of 5HIAA. Administration of apomorphine decreased the concentration of all three compounds. These drug-induced changes are generally consistent with those reported to occur in brain tissues. The results indicate that this method can be employed to monitor the activity of dopamine and 5-hydroxytryptamine neurons in unanesthetized, freely-moving rats.     

REM sleep and central monoamine oxidase inhibition

Our preliminary observations on the relationship of sleep and lumbar CSF acid monoamine metabolite levels suggested a greater decrease in lumbar CSF HVA as compared to 5HIAA following clinical doses of phenelzine in the presence of virtually total REM suppression. This report on nine psychiatric patients confirms these findings in a larger sample and thus supports an inhibitory role for dopamine or other catecholamines in REM sleep mechanisms. The drug-withdrawal results indicate that the four patients with REM rebound showed increases in HVA levels compared to treatment levels, while the single patient with no REM rebound also had no increase in HVA levels.This investigation was supported in part by Research Scientist Development Award KO1 MH 70012 to D.J.K. and U.S.P.H.S. grant MH 12873. We wish to thank Angelica Rozitis, Amanda Smith, Philip Rogers and Richard McPartland for technical assistance and the nursing staff of the research unit, Connecticut Mental Health Center, whose invaluable and consistent help made this study possible.     

Relationships between CSF levels of endorphins and monoamine metabolites in chronic pain patients

This paper is one in a series, which attempts to introduce objective psychophysical and biochemical criteria for the characterization and diagnosis of chronic pain syndromes. Experimental and clinical work suggest that serotonin and endorphins are important in the sensation and expression of pain. The levels of 5-hydroxy indole acetic acid (5 HIAA), homovanillic acid (HVA) and endorphin Fraction I in the cerebrospinal fluid were therefore measured in a series of 40 patients with chronic pain. The levels of all measured variables were lower than normal in patients with pain of mainly organic origin (n=22), while patients with mainly psychogenic pain (n=18) had high levels. However, only the difference in Fraction I levels between the two categories of patients reached statistical significance. There was also a statistically significant positive correlation between 5 HIAA and Fraction I levels (in the total group, and organic pain subgroup), but the corresponding correlation between HVA and Fraction I did not reach a statistically significant level. Patients were also divided into two groups with high (n=23) and low (n=17) 5 HIAA content, respectively, according to Åsberg et al. (1976). There was a highly significant difference also in Fraction I and HVA between the two groups. The results strongly suggest an intimate relationship between 5 HT, to a lesser extent dopamine, and endorphin activity in pain perception and the reaction to pain in these patients.     

Effects of halothane anaesthesia on extracellular levels of dopamine,dihydroxyphenylacetic acid,homovanillic acid and 5-hydroxyindolacetic acid in rat striatum: a microdialysis study

Summary The effects of halothane anaesthesia on striatal extracellular levels of dopamine, dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and 5-hydroxyindolacetic acid (5HIAA) were investigated in microdialysis experiments. Induction of anaesthesia was accompanied by a rapid increase in dopamine levels and a slower increase in DOPAC and HVA. 5HIAA was not affected. The reduction of dopamine levels induced by apomorphine 0.05 mg/kg appeared with a shorter latency in conscious rats than in anaesthetised rats but the maximum decrease was unaffected by anaesthesia. The decreases in dopamine and DOPAC induced by -methyl-p-tyrosine 50 mg/kg were affected in opposite directions by halothane: the dopamine reduction was more pronounced while the DOPAC reduction was less pronounced in anaesthetized than in conscious animals. In no case was a qualitative shift in the response observed. It is concluded that halothane may influence the levels of dopamine as well as the response to dopaminergic drugs.Send offprint requests to L. Ståhle at the above address     

Decrease in dopamine,its metabolites and noradrenaline in cerebrospinal fluid of schizophrenic patients after withdrawal of long-term neuroleptic treatment

Dopamine (DA), homovanillic acid (HVA), dihydroxyphenylacetic acid (DOPAC), noradrenaline (NA), and 5-hydroxyindolacetic acid (5HIAA) were measured in cerebrospinal fluid (CSF) of 15 chronic schizophrenic patients before and 2 weeks after withdrawal of long-term neuroleptic treatment. Total neuroleptic-like activity in serum (NLA) was determined at the same times. Levels of DA and its metabolites (DOPAC and HVA) and NA were significantly reduced after the discontinuation of neuroleptic treatment. No change was observed in 5HIAA values. NLA was substantially reduced, but still remained detectable. The decrease in DA, DOPAC, and HVA all showed positive correlations with each other, and correlated negatively with NLA measured after 2 weeks. Our data implies that the decrease in DA turnover is the result of the discontinuance of DA receptor blockade, while the change in NA level is independent of it.This work was supported by the State Office for Technical Development, Hungary     

6-Hydroxydopamine and 5,7-dihydroxytryptamine selectively reduce dopamine and 5-hydroxytryptamine metabolites in cerebroventricular perfusates of rats

The efflux into the lateral cerebral ventricles of metabolites of dopamine (DA) and 5-hydroxytryptamine (5HT) was determined in unanesthetized rats bearing chronically implanted push-pull cannulae. Pretreatment with 6-hydroxydopamine (6-OHDA) reduced the basal efflux of 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), but not of 5-hydroxyindoleacetic acid (5HIAA). The haloperidol-induced increase in the efflux of DOPAC and HVA was markedly attenuated in the 6-OHDA-pretreated rats. In rats treated with 5,7-hydroxytryptamine (5,7-DHT) the basal efflux of DOPAC and HVA was unaffected, while that of 5HIAA was markedly reduced; in these animals the ability of L-tryptophan to increase the perfusate content of 5HIAA was abolished. These results indicate that metabolites of DA and 5HT appearing in cerebroventricular perfusates of rats originate from DA and 5HT neuronal terminals in the brain.     

Methyl bromide alters catecholamine and metabolite concentrations in rat brain

The effects of inhalation exposure of rats methyl bromide (MB) on dopamine (DA), homovanillic acid (HVA), norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5HT), and 5-hydroxyindoleacetic acid (5HIAA) concentrations of various brain regions (striatum, hypothalamus, frontal cortex, midbrain, and medulla oblongata) were investigated. Rats received a single 8 hr exposure to MB, and amines and metabolites were separated by a reverse-phase HPLC, and were quantified via native fluorescence. An exposure to 100 ppm MB decreased tissue levels of DA and NE in all brain areas at 0 or 2 hr following exposure. HVA and MHPG contents were significantly increased in almost all brain regions. In a second study, rats were exposed to four concentrations of MB ranging from 31-250 ppm, and monoamine and metabolite levels in brain regions measured immediately after the exposure. Again, there were dose-dependent decreases of DA and NE, and increases in HVA and MHPG. Less clear changes in 5 HT and 5HIAA contents were observed. These data suggest that alterations of catecholamine metabolism may be a factor in MB-induced neurotoxicity.     

Vasopressin in CSF and plasma in depressed suicide attempters: preliminary results.

Increased plasma arginine vasopressin (AVP) concentrations have been reported in depressed suicide attempters. Plasma AVP is primarily produced by the magnocellular system in response to increased plasma osmolality, and central AVP may be independently regulated. In the present study we investigated cerebrospinal fluid (CSF) and plasma AVP concentrations in depressed patients and controls. Nineteen drug-free depressed psychiatric inpatients (nine suicide attempters) and nine neurological control subjects underwent lumbar puncture and psychiatric evaluation. CSF and plasma concentrations of AVP, serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and cortisol were assayed. In 15 depressed patients (eight suicide attempters), the combined dexamethasone/corticotropin-releasing hormone (Dex/CRH) test was performed to examine the hypothalamic-pituitary-adrenocortical (HPA) system. There were no differences between depressed subjects and controls in all parameters measured. Suicide attempters did not differ from nonattempters. In depressed patients, plasma AVP correlated positively with cortisol. There was no relationship between CSF AVP and monoamine metabolites in CSF.     

Differential effects of clorgyline on catecholamine and indoleamine metabolites in the cerebrospinal fluid of rhesus monkeys

The effects of acute and chronic administration of clorgyline, an irreversible inhibitor of monoamine oxidase type A (MAO-A), on the deaminated metabolites of norepinephrine, dopamine and serotonin were examined in rhesus monkey cerebrospinal fluid (CSF). Acute clorgyline treatment resulted in highly significant, dose-dependent reductions in 3-methoxy-4-hydroxyphenylglycol (MHPG) of 50% (1 mg/kg) and 68% (2 mg/kg) compared to pretreatment values. Chronic clorgyline administration (0.25 to 0.5 mg/kg X 24 days) resulted in a 67% reduction in CSF MHPG. In contrast, the concentrations of 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were less affected by acute clorgyline administration, being reduced significantly only after the 2 mg/kg dose, which lowered 5-HIAA 27% and HVA 48%. Chronic clorgyline treatment had no significant effect on the CSF concentrations of HVA and 5-HIAA. These data, which suggest that MAO-A inhibition by clorgyline in vivo is more closely associated with changes in the noradrenergic than the serotonergic or dopaminergic systems in nonhuman primates, are in general agreement with the effects of clorgyline on CSF and urinary biogenic amine metabolites in man. They differ from several in vitro studies which indicate a primary role of MAO-A in the metabolism of serotonin and of MAO-B in norepinephrine degradation in primate brain. The discrepancies may reflect modulating effects of synaptic feedback mechanisms on the actions of clorgyline in vivo or perhaps a failure of CSF metabolites to adequately reflect brain amine metabolism changes. The lack of change in platelet MAO-B activity during clorgyline treatment together with the minimal changes in HVA concentrations indicate that the selective inhibitory effects of clorgyline on MAO-A were maintained during chronic administration of low drug doses.