CATECHOLAMINES AND DOPAMINE-BETA-HYDROLAS E ACTIVITY IN BLOOD-PLASMA OF CHILDREN WITH MOTOR PATHOLOGY - THE ROLE OF CENTRAL AND PERIPHERAL MECHANISMS

Plasma catecholamine levels and serum dopamine-beta-hydrolase (DbetaH) activity were investigated using high-performance chromatography and spectrophotometry, respectively, in 32 patients aged 10-14 with variou s motor pathology. Group 1 patients (21 children with spastic diplegia and clinical signs of central catecholaminergic neuromediation defici ency received Nakom in a single daily dose 60 mg in the morning. The t reatment produced a good clinical effect. Six children of group 2 with hereditary degenerative cerebral, spinal, nervous diseases and 5 chil dren of group 3 with lower spastic paraplegia consequent to spinal cor d trauma inflicted 6-12 months: before received Nakom in a single dail y dose 30 mg in the morning for 14 days. The treatment in them resulte d in an essential decrease of pelvic dysfunctions. All the children ha d a high DOPA level in blood plasma irrespective of the group Nakom ad ministration. Pretreatment dopamine ((DA) levels were different: the l east in cerebral palsy patients ( 0.019+/-0.01 ng/ml), the highest in group 2 (p<0.05), in children with spinal cord pathology it was higher than normal and higher than in group 1 (p<0.001). Nakom treatment pro moted DA normalization in all the groups. Norepinephrine (NE) concentr ations were very low in all the patients correlating with the degenera tive process degree and did not change in response to Nakom administra tion. DbetaH activity was inhibited in all the groups, especially in t he spinal patients. Nakom increased both DbetaH activity (p<0.01) and motor activity. Thus, an increased DOPA level is plasma is not specifi c for nervous diseases. Low plasma NE reflects the degenerative proces s degree. DbetaH activity in plasma is related to motor activity and i ts enhancing is due to enzyme induction by intensification of the affe rent stream to CNS and sympathetic system under Nakom. Nakom-induced n ormalization of central catecholaminergic mechanism function improves metabolism of catecholamines and DA plasma indices, in particular.