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Cerebrospinal Fluid as a Reflector of Central Cholinergic and Amino Acid Neurotransmitter Activity in Cerebellar Ataxia
Bala V. Manyam, MD;
Ezio Giacobini, PhD;
Thomas N. Ferraro, PhD;
Theodore A. Hare, PhD
Arch Neurol. 1990;47(11):1194-1199.
Abstract
• Cerebrospinal fluid (CSF) amino acid neurotransmitters, related compounds, and their precursors, choline levels, and acetycholinesterase activity were measured in the CSF of patients with cerebellar ataxia during a randomized, double-blind, crossover, placebo-controlled clinical trial of physostigmine salicylate. The CSF  -aminobutyric acid, methionine, and choline levels, adjusted for age, were significantly lower in patients with cerebellar ataxia compared with controls. Physostigmine selectively reduced the level of CSF isoleucine and elevated the levels of phosphoethanolamine. No change occurred in CSF acetylcholinesterase activity and in the levels of plasma amino compounds in patients with cerebellar ataxia when compared with controls. Median ataxia scores did not statistically differ between placebo and physostigmine nor did functional improvement occur in any of the patients.
Author Affiliations
From the Division of Neurology (Dr Manyam) and Department of Pharmacology (Dr Giacobini), Southern Illinois University School of Medicine, Springfield, and the Departments of Pharmacology (Drs Ferraro and Hare) and Neurology (Dr Ferraro), Thomas Jefferson University, Philadelphia, Pa.
Footnotes
Accepted for publication March 16, 1990.
Reprint requests to Division of Neurology, D411, Southern Illinois University School of Medicine, PO Box 19230, Springfield, IL 62794-9230 (Dr Manyam).
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