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[CrossRef] [Google Scholar] Measurement of succinyl-carnitine and methylmalonyl-carnitine on dried blood spot by liquid chromatography-tandem mass spectrometry

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doi: 10.1371/journal.pone.0011302 138 ChappelS

This measurable deficit provides objective, biochemical proof of the mitochondrial dysfunction that patients experience, validating their symptoms and highlighting the carnitine shuttle as a primary target for therapeutic intervention

Other pharmacological options include catechol-O-methyltransferase (COMT) inhibitors like entacapone and opicapone, which extend the half-life of levodopa, do not cross the BBB at all and primarily affect peripheral metabolism, providing no direct action in the brain 59