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Homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and 4-hydroxy-3-methoxyphenylglycol (HMPG) were measured in the cerebrospinal fluid from patients with multiple sclerosis and from healthy volunteers. The fluid was withdrawn with the persons in the lateral recumbent position. In the controls and in 4 of the patients 10 successive samples of 2 ml each were analyzed. In the remaining patients the first 2 ml and last 2 ml of a total 20 ml were analysed. The highest values were obtained in the last portion. Patients with multiple sclerosis had significantly lower levels of 5-HIAA than controls in both the first and last CSF samples. Patients with a progressive course of prominent residual symptoms had a lower concentration of 5-HIAA and HVA than those with a relapsing course and little residual symptoms. The difference was significant for 5-HIAA.
Andersen et al. (2009) studied this question.