Journal
NATURE REVIEWS NEUROLOGY
Volume 11, Issue 10, Pages 567-584Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/nrneurol.2015.172
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Funding
- Wellcome Intermediate Clinical Fellowship [WT098524MA]
- Rosetrees Trust
- Gracious Heart Charity Foundation
- Medical Research Council [MR/K02342X/1]
- Great Ormond Street Hospital Children's Charities
- Actelion
- NBIA Disorders Association
- Child Brain Research
- Action Medical Research [1722] Funding Source: researchfish
- Great Ormond Street Hospital Childrens Charity [V1284, ICH1031] Funding Source: researchfish
- Medical Research Council [MR/K02342X/1] Funding Source: researchfish
- MRC [MR/K02342X/1] Funding Source: UKRI
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The monoamine neurotransmitter disorders are important genetic syndromes that cause disturbances in catecholamine (dopamine, noradrenaline and adrenaline) and serotonin homeostasis. These disorders result in aberrant monoamine synthesis, metabolism and transport. The clinical phenotypes are predominantly neurological, and symptoms resemble other childhood neurological disorders, such as dystonic or dyskinetic cerebral palsy, hypoxic ischaemic encephalopathy and movement disorders. As a consequence, monoamine neurotransmitter disorders are under-recognized and often misdiagnosed. The diagnosis of monoamine neurotransmitter disorders requires detailed clinical assessment, cerebrospinal fluid neurotransmitter analysis and further supportive diagnostic investigations. Prompt and accurate diagnosis of neurotransmitter disorders is paramount, as many are responsive to treatment. The treatment is usually mechanism-based, with the aim to reverse disturbances of monoamine synthesis and/or metabolism. Therapeutic intervention can lead to complete resolution of motor symptoms in some conditions, and considerably improve quality of life in others. In this Review, we discuss the clinical features, diagnosis and management of monoamine neurotransmitter disorders, and consider novel concepts, the latest advances in research and future prospects for therapy.
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