Change in plasma levels of amino acid neurotransmitters and its correlation with clinical heterogeneity in early Parkinson's disease patients

CNS Neurosci Ther. 2013 Nov;19(11):889-96. doi: 10.1111/cns.12165. Epub 2013 Aug 24.

Abstract

Background: The correlation between plasma amino acid (AA) neurotransmitters and clinical heterogeneity in early patients with Parkinson's disease (PD) is still poorly understood.

Aims: To examine the plasma levels of AA neurotransmitters in early patients with PD and to evaluate their correlation with PD subtypes.

Methods: Based on the predominant symptoms, fifty-one patients with PD were enrolled and divided into four subgroups: (1) akinetic-rigid type (ART), (2) tremor-dominant type (TDT), (3) postural instability/gait difficulty type (PIGD), and (4) mixed type (MT). Plasma levels of AA were measured by HPLC-RF, and their potential diagnostic practicality and their association with PD subtypes were evaluated by the receiver operating characteristic (ROC) and correlation analysis, respectively.

Results: Patients with PD exhibited markedly lower levels of Asp, Glu, Tau, L-ser, and lower values of Glu/GABA ratio than healthy controls. The ROC analysis revealed their high sensitivity (77.1-87.5%) and specificity (58.8-88.2%). Furthermore, the glutamic acid (Glu), γ-aminobutyric acid (GABA) level in the PIGD subtype was increased as compared with other subtypes and was negatively correlated with the ART/PIGD ratio.

Conclusion: The decrease in plasma Asp, Glu, Tau, L-ser levels, and the value of Glu/GABA ratio may be helpful for early PD diagnosis. The elevated GABA level may be the biochemical basis for the specific symptoms of PIGD PD.

Keywords: Amino acid neurotransmitter; Clinical heterogeneity; Motor subtype; Parkinson's disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amino Acids / blood*
  • Biomarkers / blood
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurotransmitter Agents / blood
  • Parkinson Disease / blood*
  • Parkinson Disease / diagnosis*
  • gamma-Aminobutyric Acid / blood*

Substances

  • Amino Acids
  • Biomarkers
  • Neurotransmitter Agents
  • gamma-Aminobutyric Acid