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Changes in CSF neurotransmitters in infantile spasms.
P J Langlais1, M L Wardlow, H Yamamoto
1Department of Psychology, San Diego State University, CA 92182.
Pediatric Neurology
|November 1, 1991
Summary
Infantile spasms are linked to lower brain serotonin activity. Treatment with adrenocorticotropic hormone (ACTH) for infantile spasms increased serotonin levels in responders, suggesting a role for tryptophan metabolism.
Area of Science:
- Neuroscience
- Biochemistry
- Pediatrics
Background:
- Infantile spasms are a severe epilepsy syndrome in infants.
- Neurotransmitter imbalances may contribute to infantile spasms.
- Adrenocorticotropic hormone (ACTH) is a common treatment for infantile spasms.
Purpose of the Study:
- To investigate neurotransmitter metabolite levels in cerebrospinal fluid (CSF) of infants with infantile spasms.
- To compare metabolite levels before and after ACTH treatment.
- To explore the relationship between seizure control and neurotransmitter changes.
Main Methods:
- CSF samples were collected from 7 infants with infantile spasms and 7 age-matched controls.
- High-performance liquid chromatography was used to analyze neurotransmitter metabolites.
- Metabolite concentrations were compared between patients and controls, and before and after ACTH treatment.
Main Results:
- Pretreatment CSF showed lower levels of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid, MHPG, and kynurenine in infantile spasm patients compared to controls.
- ACTH treatment led to increased 5-HIAA and decreased kynurenine in responders.
- Non-responders showed decreased 5-HIAA, and mixed changes in other metabolites.
Conclusions:
- Infantile spasms are associated with reduced serotonergic activity.
- Successful ACTH treatment correlates with increased serotonin turnover.
- Tryptophan metabolism may be disrupted in infantile spasms, potentially impacting seizure activity.