SULFAMETHOXAZOLE-TRIMETHOPRIM DOUBLE-BLIND, PLACEBO-CONTROLLED, CROSSOVER TRIAL IN MACHADO-JOSEPH DISEASE - SULFAMETHOXAZOLE-TRIMETHOPRIM INCREASES CEREBROSPINAL-FLUID LEVEL OF BIOPTERIN

We performed a double-blind, placebo-controlled, crossover trial of su lfamethoxazole-trimethoprim (S-T) in 8 patients with Machado-Joseph di sease (MJD), and measured the blood and cerebrospinal fluid levels of biopterins, biogenic amines or metabolites, and folate. The clinical r esults were as follows; mild improvements of hyperreflexia of knee jer ks and of rigospasticity of the legs during S-T treatment period. In a ddition, S-T significantly reduced the times of 8 motor activities on the timed tests. The biochemical results showed that basal levels of a ll biopterins and homovanillic acid in the cerebrospinal fluid (CSF) w ere reduced to less than half the levels of those of controls with oth er neurological diseases. After S-T treatment, total and oxidized form of biopterins in the CSF increased significantly. Therefore, S-T may be effective to neurologic deficits through its mechanism of increasin g the level of brain biopterins.