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Brain monoamines in metabolic (endotoxic) coma. A preliminary biochemical study in human postmortem material
Journal of Neural Transmission
|January 1, 1977
Summary
Brain monoamine levels, including dopamine (DA), serotonin (5-HT), and 5-HIAA, show distinct patterns in hepatic and uremic coma. These findings suggest common central monoamine metabolism disorders in endotoxic coma.
Area of Science:
- Neuroscience
- Biochemistry
- Toxicology
Background:
- Hepatic and uremic coma are conditions associated with toxic insults to the body.
- Alterations in central monoamine metabolism are implicated in various neurological disorders.
- Previous studies suggest a role for monoamines in hepatic encephalopathy.
Purpose of the Study:
- To investigate the levels of dopamine (DA), serotonin (5-HT), and 5-hydroxyindoleacetic acid (5-HIAA) in postmortem human brains from individuals who died in hepatic and uremic coma.
- To compare the patterns of monoamine changes in these two coma states.
- To explore the potential link between these monoamine alterations and the pathophysiology of coma.
Main Methods:
- Spectrofluorometric assays were utilized to quantify DA, 5-HT, and 5-HIAA.
- Analysis was performed on postmortem brain tissue from different brain regions.
- Samples were obtained from individuals who expired due to hepatic coma and uremic coma, with controls for comparison.
Main Results:
- Dopamine (DA) levels showed a mild general decrease (20-30%) compared to controls.
- Serotonin (5-HT) and 5-HIAA levels were markedly increased in most brain areas.
- The most significant increases in 5-HT and 5-HIAA were observed in the reticular and raphé nuclei of the brainstem and parts of the limbic system.
- Similar patterns of monoamine changes were noted in both hepatic and uremic coma, despite individual and regional variations.
Conclusions:
- The study suggests common disorders of central monoamine metabolism in endotoxic coma of different origins (hepatic and uremic).
- Increased brain 5-HT content may contribute to brain edema, a common feature in toxic coma, due to its established effect on the blood-brain barrier.
- Prominent changes in indoleamine metabolism within the reticular brainstem and limbic systems may be associated with disorders of consciousness observed in these coma states.