Neurotransmitter testing of the urine: a comprehensive analysis

Hinz, Marty; Stein, Alvin; Trachte, George J.; Uncini, Thomas

doi:10.2147/oaju.s13370

Cited by 25 publications

(60 citation statements)

References 12 publications

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“…1 Novel statistical results of spot baseline urinary neurotransmitter testing of norepinephrine and epinephrine assays from a database accumulated by two of the authors of this paper are reported here. Urinary norepinephrine and epinephrine samples obtained on different days from the same subject were statistically analyzed using a matchedpairs t-test.…”

Section: Methodsmentioning

confidence: 98%

“…This supports the assertion that spot urinary dopamine values are not uniform or reproducible from day to day. 1 Results of the four matched-pairs t-tests shown in Table 1 reveal that there are significant differences between spot baseline urinary neurotransmitter testing performed on different days from the same subject for all four monoamines under scrutiny.…”

Section: Spot Baseline Dopamine Matched-pairs T-testmentioning

confidence: 98%

“…1 This companion paper discusses the reproducibility of spot baseline urinary norepinephrine and epinephrine assays, and explores the feasibility and validity of using spot urinary norepinephrine or epinephrine assays in subjects not suffering from a monoamine-secreting tumor as a basis for decision-making. The paper then correlates the novel spot baseline norepinephrine and epinephrine findings reported here with our earlier reports relating to spot baseline urinary serotonin and dopamine.…”

Section: Introductionmentioning

confidence: 99%

“…1,[3][4][5] The other view advocates that it is very beneficial, and that it has numerous applications in medical decision-making, including diagnostic, therapeutic, and biomarker applications. [6][7][8][9][10][11][12] The purpose of this writing is to educate medical practitioners regarding the selection of laboratory testing for neurotransmitter diseases so that they do not use invalid testing methods.…”

mentioning

confidence: 99%

“…1,[3][4][5]13 Spot baseline testing lacks reproducibility and is of no value in patients not suffering from a monoamine-secreting tumor. 1 Those who claim that spot baseline urinary neurotransmitter testing is valid assert that monoamines cross the blood-brain barrier, are filtered at the glomerulus, and simply excreted into the urine without further renal involvement. They conclude that spot baseline urinary neurotransmitter testing is a valid assay for peripheral and central nervous system neurotransmitter levels.…”

mentioning

confidence: 99%

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Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine

Hinz¹,

Stein²,

Uncini³

2011

RRU

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Background:The purpose of this paper is to present the results of statistical analysis of spot baseline urinary norepinephrine and epinephrine assays in correlation with spot baseline urinary serotonin and dopamine findings previously published by the authors. Our research indicates a need for physicians and decision-makers to understand the lack of validity of this type of spot baseline monoamine testing when using it in the decision-making process for neurotransmitter deficiency disorders. Methods: Matched-pairs t-tests were performed for a group of subjects for whom spot baseline urinary norepinephrine and epinephrine assays were performed on samples collected on different days then paired by subject. Results: The reported laboratory test results for urinary serotonin, dopamine, norepinephrine, and epinephrine, obtained on different days from the same subjects, differed significantly and were not reproducible. Conclusion: Spot baseline monoamine assays, in subjects not suffering from a monoaminesecreting tumor, such as pheochromocytoma or carcinoid syndrome, are of no value in decision-making due to this day-to-day variability and lack of reproducibility. While there have been attempts to integrate spot baseline urinary monoamine assays into treatment of peripheral or central neurotransmitter-associated disease states, diagnosis of neurotransmitter imbalances, and biomarker applications, significant differences in day-to-day reproducibility make this impossible given the known science as it exists today.

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Section: Methodsmentioning

confidence: 98%

Section: Spot Baseline Dopamine Matched-pairs T-testmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine

Hinz¹,

Stein²,

Uncini³

2011

RRU

Self Cite

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Higher Urinary Dopamine Concentration is Associated with Greater Ad Libitum Energy Intake in Humans

Basolo

Ando

Hollstein

et al. 2020

Obesity

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Objective: This study aimed to assess the relationship between dopamine, a neurotransmitter involved in feeding behavior, and ad libitum energy intake in humans. Methods: Healthy individuals (n = 158; 72 Native American, 50 white, 18 black, and 18 Hispanic participants; BMI: 33 [SD 9] kg/m 2 ; body fat: 33% [SD 9%]) were admitted for two inpatient studies investigating the determinants of ad libitum energy intake and assessed for 3 days using a highly reproducible, computerized vending machine paradigm. Urine was collected for 24 hours during eucaloric conditions prior to the ad libitum feeding period, and urinary dopamine excretion rate was quantified by high-performance liquid chromatography. Results: Urinary dopamine excretion rate was on average 346 ± 106 μg over 24 hours and was positively correlated with BMI (r = 0.28, P < 0.0001). Higher dopamine concentrations were associated with lower cognitive restraint (ρ = −0.25, P = 0.005) and greater total ad libitum energy intake (r = 0.29, P = 0.0002). However, after adjustment for anthropometrics, in black and white cohorts, higher dopamine concentrations were associated with greater total ad libitum energy intake (r = 0.70, P = 0.001 and r = 0.33, P = 0.02, respectively), whereas no associations were observed in Native American or Hispanic cohorts (all P > 0.3). Conclusions: Higher urinary dopamine concentrations are associated with greater ad libitum energy intake, indicating a role for dopamine in the reward pathway regulating human feeding behavior.Obesity (2020) 28, 953-961.

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Development and validation of a simple, rapid and sensitive LC-MS/MS method for the measurement of urinary neurotransmitters and their metabolites

et al. 2017

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Neurotransmitters play crucial roles in physiological functions and their imbalances have demonstrated association in the pathology of several diseases. The measurement of neurotransmitters possesses a great potential as a significant clinical tool. This study presents the development and validation of an LC-MS/MS method for simultaneous quantification of multi-class neurotransmitters associated with dopamine, tryptophan and glutamate-γ-aminobutyric acid pathways. A total of ten neurotransmitters and their metabolites (dopamine, epinephrine, metanephrine, tryptophan, serotonin, kynurenic acid, kynurenine, anthranilic acid, GABA, glutamic acid) were determined based on a simple and rapid 'dilute and shoot' method using minimal urine volume. The chromatographic separation was achieved using a Poroshell 120 Bonus-RP LC Column in combination with a gradient elution within an 8.5-min time frame. The method exhibited good sensitivity as the limits of quantification ranged between 0.025 and 0.075 μg/mL with acceptable matrix effects (< ± 14.5%), no carryover and good linearity (r > 0.98). The accuracy and precision for all analytes were within tolerances, at < ± 9.9% mean relative error (MRE) and < 8.6% relative standard deviation (RSD), respectively. The method was successfully applied in measuring the neurotransmitter concentrations in urine of healthy donors. Furthermore, the undertaken stability experiments indicated that acidified urine specimens allowed the analytes to be stable for prolonged durations in comparison to those untreated. The study also reveals the performance of the method is unaffected by the absence of expensive deuterated reference standards under the experimental conditions employed which further simplifies the analytical procedures and provides a significant cost saving for running the assay. Graphical abstract The quantification of multi-class neurotransitters associated with the dopamine, tryptophan and GABA-glutamate pathways using a simple 'dilute and shoot' LC-MS/MS method.

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Neurotransmitter testing of the urine: a comprehensive analysis

Cited by 25 publications

References 12 publications

Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine

Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine

Higher Urinary Dopamine Concentration is Associated with Greater Ad Libitum Energy Intake in Humans

Development and validation of a simple, rapid and sensitive LC-MS/MS method for the measurement of urinary neurotransmitters and their metabolites

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