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Pilot study to evaluate the effects of tetrahydrobiopterin on adult individuals with phenylketonuria with measurable maladaptive behaviors.
[phenylketonuria]
To
evaluate
the
effects
of
tetrahydrobiopterin
(
BH
4
)
on
maladaptive
behavior
in
patients
with
phenylketonuria
(
PKU
)
.
In
an
effort
to
determine
if
BH
4
has
any
effects
on
the
central
nervous
system
,
we
studied
10
individuals
with
PKU
and
measurable
maladaptive
behaviors
for
1
year
.
Behavioral
assessments
using
the
Vineland
Adaptive
Behavior
Scales
-
Second
Edition
and
a
PKU
Behavior
Checklist
were
obtained
at
baseline
,
6
months
,
and
at
the
end
of
the
study
.
Biochemical
measures
including
plasma
amino
acids
were
obtained
quarterly
,
and
phenylalanine
(
Phe
)
and
tyrosine
(
Tyr
)
were
obtained
monthly
.
Out
of
the
10
subjects
,
2
were
responders
to
BH
4
,
as
determined
by
a
blood
Phe
reduction
>
30
%
.
While
blood
Phe
in
the
8
nonresponders
did
not
change
significantly
throughout
the
study
,
their
Tyr
levels
were
significantly
higher
at
6
months
(
p
=
0
.
012
)
,
but
not
at
12
months
(
p
=
0
.
23
)
.
By
the
end
of
the
study
,
8
subjects
exhibited
fewer
maladaptive
behaviors
on
the
components
of
the
Vineland
Maladaptive
Behavior
Index
,
and
all
10
had
lower
total
scores
on
the
PKU
Behavior
Checklist
.
These
findings
suggest
that
there
may
be
direct
effects
of
BH
4
on
the
central
nervous
system
,
independent
of
lowering
blood
Phe
.
Diseases
Validation
Diseases presenting
"central nervous system"
symptom
22q11.2 deletion syndrome
adrenomyeloneuropathy
alexander disease
aniridia
aromatase deficiency
canavan disease
child syndrome
classical phenylketonuria
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
fabry disease
gm1 gangliosidosis
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
kabuki syndrome
kallmann syndrome
kindler syndrome
krabbe disease
lamellar ichthyosis
legionellosis
liposarcoma
malignant atrophic papulosis
monosomy 21
neonatal adrenoleukodystrophy
phenylketonuria
proteus syndrome
scrub typhus
severe combined immunodeficiency
sneddon syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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