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Treatment of Parkinson's Disease with Sodium Valproate: Clinical, Pharmacological, and Biochemical Observations

Published online by Cambridge University Press:  18 September 2015

John Nutt*
Affiliation:
Experimental Therapeutics Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland and the University of Texas Medical Branch, Galveston, Texas
Adrian Williams
Affiliation:
Experimental Therapeutics Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland and the University of Texas Medical Branch, Galveston, Texas
Charles Plotkin
Affiliation:
Experimental Therapeutics Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland and the University of Texas Medical Branch, Galveston, Texas
Nancy Eng
Affiliation:
Experimental Therapeutics Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland and the University of Texas Medical Branch, Galveston, Texas
Michael Ziegler
Affiliation:
Experimental Therapeutics Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland and the University of Texas Medical Branch, Galveston, Texas
Donald B. Calne
Affiliation:
Experimental Therapeutics Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland and the University of Texas Medical Branch, Galveston, Texas
*
University of Oregon Health Sciences Center, 3181 Southwest Sam Jackson Park Road, Portland, Oregon 97201 U.S.A.
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Summary:

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Because there is biochemical evidence of decreased GABAergic function in Parkinson's disease, sodium valproate, an inhibitor of GA BA catabolism, was administered to eight Parkinsonian patients. Valproate treatment did not significantly alter any Parkinsonian feature, but tended to increase the dyskinesia in the “on-off” patients. The increased dyskinesias were not a result of altered peripheral metabolism of L-dopa. Despite obtaining high plasma levels of valproate, no consistent alteration of CSF GABA levels could be demonstrated. Thus, in these patients, an effect of valproate on GABA metabolism is unproven, and in turn, the role of GABA in Parkinsonism and dyskinesia uncertain.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1979

References

Anzelzark, G., Horton, R.W., Meldrum, B.S., Sawaya, M.C.B. (1976). Anticonvulsant action of ethanolamine-sulphase and di-n-propylacetate and the metabolism of γ aminobutyric acid (GABA) in mice with audiogenic seizures. Biochem Pharmacol 25:413417.CrossRefGoogle Scholar
Bird, E.D., Iverson, L.L. (1974). Huntington’s chorea: post mortem measurement of glutamic acid decarboxylase, choline acetyltransferase and dopamine in basal ganglia. Brain 97:457472.CrossRefGoogle ScholarPubMed
Enna, S.J., Stern, L.Z., Wastek, G.J., Yamamura, I.Cerebrospinal fluid γ aminobutyric acid variations in neurological disorders. Arch Neurol 34:683685.CrossRefGoogle Scholar
Enna, S.J., Wood, J.H., Snyder, S.H. (1977). Gamma amino butyric acid (GABA) in human cerebrospinal fluid: Radioreceptor assay. J Neurochem 28: 11211124.CrossRefGoogle Scholar
Fahn, S. (1976). Regional distribution studies of GABA and other putative neurotransmitters and their enzymes, in Roberts, E., Chase, T.N., Tower, D.B. (eds): GABA in Nervous System Function, New York, Raven Press, pp 169186.Google Scholar
Fonnum, F., Grofova, I., Rinvik, E., Storm Mathisen, J., Walberg, F. (1974). Origin and distribution of glutamate decarboxylase in substantia nigra of the cat. Brain Res 71:7792.CrossRefGoogle ScholarPubMed
Gale, K., Guidotti, A. (1976). GABA mediated control of rat striatal tyrosine hydroxylase (TH) revealed by use of intranigral muscimol. Pharmacologist 18:131.Google Scholar
Godin, Y.Heiner, L., Mark, J., Mande, P. (1969). Effects of di-n-propylacetate, an anticonvulsive compound, on GABA metabolism. J Neurochem 16:869873.CrossRefGoogle ScholarPubMed
Harvey, P.R.P., Bradford, H.F., Davidson, A.N. (1975). The inhibitory effect of sodium n-dipropyl acetate on the degradative enzymes of the GABA shunt. FEBS Lett 52:251254.CrossRefGoogle ScholarPubMed
Hornykiewicz, O., Lloyd, K.G., Davidson, L. (1976). The GABA system, function of the basal ganglia and Parkinson’s disease, in Roberts, E., Chase, T.N., Tower, D.B. (eds): GABA in Nervous System Function, New York, Raven Press, pp 479485.Google Scholar
Huizinga, J.D., Teelken, A.W., Musciet, F.A.J., Jeuring, H.J., Wolthers, B.G. (1978). Gamma aminobutyric acid determination in human cerebrospinal fluid by massfragmentog-raphy. J. Neurochem 30:911913.CrossRefGoogle Scholar
Kupferberg, J.H. (1978). Gas-liquid chromatographic quantitation of valproic acid, in Pippenger, C.E., Penry, J.F., Kutt, H. (eds): Antiepileptic Drugs: Quantitative Analysis and Interpretation, New York, Raven Press, pp 147151.Google Scholar
Laaksonen, H., Riekkinen, P., Rinne, U.K., Sonninen, V. (1976). Brain glutamic acid decarboxylase and gamma-aminobutyric acid in Parkinson’s disease, in Birkmayer, W., Hornykiewicz, O. (eds): Advances in Parkinsonism, Basle, Editiones (Roche), pp 205209.Google Scholar
Lloyd, K.G., Mohler, H., Heitz, P., Bartholini, G. (1975). Distribution of choline acetyltransferase and glutamate decarboxylase within the substantia nigra and in other brain regions from control and parkinsonian patients. J Neurochem 25:789795.CrossRefGoogle ScholarPubMed
Lloyd, K.G., Shemin, L., Hornykiewicz, O. (1976). GABA binding in human brain specific alterations in substantia nigra of Parkinson’s. Society for Neuroscience: Abstracts, Vol 2, 789.Google Scholar
McGeer, P.L., Fibiger, H.C., Maler, L.Hattori, T., McGeer, E.G. (1974). Evidence for descending pallido-nigral GABA-containing neurons, in McDowell, F.H., Barbeau, A.B. (eds): Advances in Neurology, New York, Raven Press, pp 153163.Google Scholar
McGeer, P.L., McGeer, E.G. (1975). Evidence for glutamic acid decarboxylase-containing interneurons in the neostriatum. Brain Res 91:331335.CrossRefGoogle ScholarPubMed
McGeer, P.L.McGeer, E.G., Fibiger, H.C. (1973) Choline acetylase and glutamic acid decarboxylase in Huntington’s chorea. Neurology 23:912917.CrossRefGoogle ScholarPubMed
Neophytides, A.N., Suria, A., Chase, T.N. (1978). Cerebrospinal fluid GABA in neurological disease. Neurology 28:359.Google Scholar
Okada, Y. (1976) Role of GABA in the substantia nigra, in Roberts, E., Chase, T.N., Tower, D.B. (eds): GABA in Nervous System Function, New York, Raven Press, pp 235243.Google Scholar
Okada, Y., Nitsch-Hassler, C., Kim, J.S., Bak, I.J., Hassler, R. (1971). Role of 7 amino butyric acid (GABA) in the extrapyramidal motor system. I. Regional Distribution of GABA in rabbit, rat, guinea pig, and baboon CNS. Exp Brain Res 13:514518.CrossRefGoogle Scholar
Perry, T.L., Berry, K., Hansen, S., Diamond, S., Mok, C. (1971) Regional distribution of amino acids in human brain obtained at autopsy. J Neurochem 18:513519.CrossRefGoogle ScholarPubMed
Pinder, R.M., Brogden, R.N., Speight, T.M., Avery, G.S. (1977). Sodium valproate: a review of its pharmacological properties and therapeutic efficacy in epilepsy. Drugs 13:81123.CrossRefGoogle ScholarPubMed
Precht, W., Yoshida, M. (1971). Blockage of caudate-evoked inhibition of neurons in the substantia nigra by picrotoxin. Brain Res 32:229233.CrossRefGoogle ScholarPubMed
Price, P.A., Parkes, J.D., Marsden, C.D. (1978) Sodium valproate in the treatment of levodopa-induced dyskinesia. J Neurol Neurosurg Psychiatry 41:702706.CrossRefGoogle ScholarPubMed
Racagni, G., Bruno, F., Cattabeni, F., Maggi, A., Digiulio, A.M., Parenti, M., Groppetti, A. (1977) Functional interaction between rat substantia nigra and striatum: GABA and dopamine interrelation. Brain Res 134:353358.CrossRefGoogle ScholarPubMed
Rinne, U.K., Koskinen, V., Laaksonen, H., Lonnberg, P., Sonninen, V. (1978). GABA receptor binding in the parkinsonian brain. Life Sciences 22:225228.CrossRefGoogle ScholarPubMed
Sawaya, McB., Horton, R.W., Meldrum, B.S. (1975). Effects of anticonvulsant drugs on the cerebral enzymes metabolizing GABA. Epilepsia 16:649655.CrossRefGoogle ScholarPubMed
Simler, S., Ciesielski, L., Maitre, M., Randrianarisoa, H., Mandel, P. (1973). Effect of sodium n-dipropylacetate on audiogenic seizures and brain y aminobutyric acid level. Biochem Pharmacol 22:17011708.CrossRefGoogle Scholar
Stahl, W.L., Swanson, P.D. (1974) Biochemical abnormalities in Huntington’s chorea. Neurology 24:813819.CrossRefGoogle ScholarPubMed
Toshida, M., Rabin, A., Anderson, M. (1972). Monosynaptic inhibition of pallidal neurons by axon collaterals of caudato-nigral fibers. Exp Brain Res 15:333347.Google Scholar
Tyce, G.M., Muenter, M.D., Owen, C.A. (1970). Dihydroxyphenylalanine (DOPA) in plasma during dopa treatment of patients with Parkinson’s disease. Mayo Clinic Proc 45:438443.Google ScholarPubMed