Highlights
- •Lower limb spasticity, weakness, spinal cord atrophy, systemic serotonin deficiency
- •Biological effects of serotonin in developmental and adult neurogenesis in the CNS
- •Serotonergic enhancement can benefit motor function in severe spinal cord atrophy.
Abstract
There is ample evidence of an important role of descending serotonergic projections
in modulating spinal motor neuron activation and firing, and experimental studies
suggest that 5-HT receptor stimulation can improve motor function after spinal cord
injury; however, relevant clinical data is sorely lacking. We describe two sisters
with hemiplegic migraine, low CSF and platelet serotonin levels, and progressive spastic
paraparesis associated with profound spinal cord atrophy whose lower extremity strength
and ambulation responded to a precursor replacement strategy (5-hydroxytryptophan
and carbidopa administration), an approach that may have broader applicability in
myelopathies of diverse etiology where descending serotonergic projections are compromised.
Abbreviations:
5HTP (5-hydroxytryptophan), 5HIAA (5-hydroxyindoleacidic acid), LAAD (l-amino acid decarboxylase), 5HT (serotonin (5-hydroxytryptamine))Keywords
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Article info
Publication history
Published online: April 27, 2017
Accepted:
April 26,
2017
Received in revised form:
April 4,
2017
Received:
March 9,
2017
Identification
Copyright
Crown Copyright © 2017 Published by Elsevier B.V. All rights reserved.
