A study of the
catecholamine excretion, their precursor
DOPA and final metabolites--Homovaniline and vanilylphenylglycolic
acid in
torsion dystonia, detected certain changes which were different in patients with various clinical forms of the disease. On the basis of clinical and biochemical data 3 forms of
torsion dystonia were distinguished: 1) with a prevalence in the clinical picture of
muscle rigidity, leading to the development of pathological postures; 2) hyperkinetic forms and 3) mixed forms. In patients of the first group there was a decreased excretion of all
catecholamines. On the basis of obtained data the conclusion is made that there is a drop in the intensity of the process of dophamine synthesis and an increase of its catabolism. In the hyperkinetic form, on the contrary, there is a tendency to an increase of dophamine synthesis. It is assumed that there is a drop in the intensity of the process of
adrenaline synthesis and an increase of its catabolism. On the basis of biochemical heterogeneity of
torsion dystonia the authors recommended different approaches in treating different forms of this disease. In a prevalent
muscular rigidity the functions of the dophaminergic systems should be intensified: on the one hand, by administering precursors of dophamine
L-DOPA, on the other--by inhibiting antagonistic activity with the aid of different
cholinolytic preparations. In a hyperkinetic form a favorable effect is attained by preparations, inhibiting the dophaminergic activity (mainly preparations of the
phenothiazine and butyrophenon series).