- •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.
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))
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- The developmental role of serotonin: news from mouse molecular genetics.Nat. Rev. Neurosci. 2003; 4: 1002-1012
- Serotonin in pain and analgesia.Mol. Neurobiol. 2004; 30: 117-125
- Elevated platelet vesicular monoamine transporter density in untreated patients diagnosed with major depression.Psychiatry Res. 2002; 112: 251-256
- Hemiplegic migraine, seizures, progressive spastic paraparesis, mood disorder, and coma in siblings with low systemic serotonin.Cephalalgia. 2011; 31: 1580-1586
- Post-hypoxic intention myoclonus treated with 5-hydroxytryptophan and an extracerebral decarboxylase inhibitor.Acta Neurol. Scand. 1978; 57: 289-294
- Inherited disorders affecting dopamine and serotonin: critical neurotransmitters derived from aromatic amino acids.J. Nutr. 2007; 137: 1568S-1572S
- OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis.Osteoarthr. Cartil. August 2013; 21: 1042-1052
- Measurement in neurological rehabilitation.Curr. Opin. Neurol. Neurosurg. 1992; : 5(5)
- The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample.Br. J. Clin. Psychol. 2005; 44: 227-239
- Serotonin as a differentiation signal in early neurogenesis.Dev. Neurosci. 1978; 1: 15-30
- Serotonin induced increases in adult cell proliferation and neurogenesis are mediated through different and common 5-HT receptor subtypes in the dentate gyrus and the subventricular zone.Neuropsychopharmacology. 2004; 29: 450-460
- Serotonin promotes development and regeneration of spinal neurons in zebrafish.Cell Rep. 2015; 13: 924-932
- Serotonin release variations during recovery of motor function after a spinal cord injury in rats.Synapse. 2010; 64: 855-861
- The role of the serotonergic system in locomotor recovery after spinal cord injury.Front. Neural Circ. 2014; 8: 151
- Serotonin controls initiation of locomotion and afferent modulation of coordination via 5-HT7 receptors in adult rats.J. Physiol. 2016; (e-pub in advance of print): 1-20
- Motoneuron excitability: the importance of neuromodulatory inputs.Clin. Neurophysiol. 2009; 120: 2040-2054
- Serotonin affects movement gain control in the spinal cord.J. Neurosci. 2014; 34: 12690-12700
- Activity of medullary serotonergic neurons in freely moving animals.Brain Res. Brain Res. Rev. 2002; 40: 45-52
- Pharmacology of rising oral doses of 5-hydroxytryptophan with carbidopa.J. Psychopharmacol. 2008; 22: 426-433
- Human pharmacokinetics of long term 5-hydroxytryptophan combined with decarboxylase inhibitors.Eur. J. Clin. Pharmacol. 1982; 23: 81-86
Published online: April 27, 2017
Accepted: April 26, 2017
Received in revised form: April 4, 2017
Received: March 9, 2017
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