Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 410
Filter
1.
Neuropharmacology ; 52(2): 515-26, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17116309

ABSTRACT

The contribution of striatal protein kinase C (PKC) isoform changes in levodopa (L-DOPA) induced motor response complications in parkinsonian rats was investigated and the ability of tamoxifen, an antiestrogen with a partial PKC antagonist property, to prevent these response alterations in 6-hydroxydopamine (6-OHDA) lesioned rats as well as in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) treated cynomologous monkeys was studied. Following treatment of adult male rats with L-DOPA twice daily for 3 weeks, protein levels of left (lesioned) and right (intact) striatal PKC isoforms were measured. Western blot analysis showed increased protein expression of both the novel PKC epsilon isoform and the atypical PKC lambda isoform ipsilateral to the lesion (174+/-17% for epsilon, 140+/-9% for lambda, of intact striatum in 6-OHDA lesioned plus chronic L-DOPA treated animals) in acute L-DOPA treated rats. No enhancement was observed in PKC immunoreactivity for other isoforms. Tamoxifen (5.0 mg/kg p.o.) significantly attenuated the L-DOPA induced augmentation of protein expression of PKC epsilon and PKC lambda, but had no effect on immunoreactivity for other PKC isoforms. In chronic L-DOPA treated parkinsonian rats, tamoxifen prevented (5.0 mg/kg p.o.) as well as ameliorated (5.0 mg/kg p.o.) the characteristic shortening in duration of motor response to L-DOPA challenge. In MPTP lesioned primates, similar to the ameliorative effect seen in rats, tamoxifen (1 and 3 mg/kg p.o) reduced the appearance of L-DOPA induced dyskinesia by 61% and 55% respectively (p<0.05). These results suggest that changes in specific striatal PKC isoforms contribute to the pathogenesis of L-DOPA induced motor complications and further that drugs able to selectively inhibit these signaling kinases might provide adjunctive benefit in the treatment of Parkinson's disease.


Subject(s)
Antiparkinson Agents/adverse effects , Dyskinesia, Drug-Induced/drug therapy , Levodopa/adverse effects , Selective Estrogen Receptor Modulators/therapeutic use , Tamoxifen/therapeutic use , 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine , Animals , Disease Models, Animal , Drug Administration Schedule , Drug Interactions , Dyskinesia, Drug-Induced/etiology , Haplorhini , Male , Models, Biological , Nerve Tissue Proteins/metabolism , Oxidopamine , Parkinson Disease, Secondary/chemically induced , Parkinson Disease, Secondary/drug therapy , Protein Kinase C/metabolism , Rats , Rats, Sprague-Dawley , Time Factors
2.
Neuropathol Appl Neurobiol ; 32(2): 157-69, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16599944

ABSTRACT

Aberrant protein aggregation has been recognized as an important factor in the degeneration of melanized dopaminergic neurones in Parkinson's disease (PD). The constitutive (HSP73) and (heat)-inducible (HSP72) proteins of the heat shock 70 family form a major defence system against pathological protein aggregation. However, the distribution patterns of these chaperones in nigral neuromelanin-laden neurones are largely unknown. The present study determined the distribution of HSP72 and HSP73 in control and Parkinsonian substantia nigra, using immunohistochemistry. In the neuromelanin-laden neurones of controls, HSP72 was nondetectable, whereas HSP73 was weakly expressed in both the cytosol and the nucleus. Surprisingly, in PD subjects, marked nuclear HSP73, but not HSP72 immunoreactivity was observed, while cytosolic immunoreactivity of the two chaperones resembled the labelling pattern observed in controls. Furthermore, HSP73 immunoreactivity was observed in a subset of the Lewy bodies (LBs) detected in the substantia nigra of PD subjects, whereas only few of these LBs were labelled with HSP72. Interestingly, HSP72 and to a lesser extent HSP73 immunoreactivity was much stronger in nonmelanized neurones as compared with melanized neurones in this area. Thus, we conclude that the distribution pattern of HSP73 rather than HSP72 is changed in the nigral neuromelanin-laden neurones of PD subjects as compared with control subjects. The impaired ability of aged, dopaminergic neurones to express high levels of chaperones, may contribute to the preferential vulnerability of the latter cells in PD.


Subject(s)
HSP70 Heat-Shock Proteins/metabolism , Melanins/metabolism , Mesencephalon/metabolism , Neurons/metabolism , Parkinson Disease/metabolism , Aged , Blotting, Western , Female , Humans , Image Processing, Computer-Assisted , Immunohistochemistry , Lewy Bodies/metabolism , Lewy Bodies/pathology , Male , Mesencephalon/pathology , Middle Aged , Neurons/pathology , Parkinson Disease/pathology
3.
Exp Neurol ; 196(2): 422-9, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16203001

ABSTRACT

AMPA and NMDA receptors, abundantly expressed on striatal medium spiny neurons, have been implicated in the regulation of corticostriatal synaptic efficacy. To evaluate the contribution of both glutamate receptor types to the pathogenesis of motor response alterations associated with dopaminergic treatment, we studied the ability of the selective AMPA receptor antagonist GYKI-47261 and the selective NMDA receptor antagonists, MK-801 and amantadine, to mitigate these syndromes in rodent and primate models of Parkinson's disease. The effects of GYKI-47261 and amantadine (or MK-801), alone and in combination, were compared for their ability to modify dyskinesias induced by levodopa. In rats, simultaneous administration of subthreshold doses of AMPA and NMDA receptor antagonists completely normalized the wearing-off response to acute levodopa challenge produced by chronic levodopa treatment (P < 0.05). In primates, the glutamate antagonists GYKI-47261 and amantadine, co-administered at low doses (failing to alter dyskinesia scores), reduced levodopa-induced dyskinesias by 51% (P < 0.05). The simultaneous AMPA and NMDA receptor blockade acts to provide a substantially greater reduction in the response alterations induced by levodopa than inhibition of either of these receptors alone. The results suggest that mechanisms mediated by both ionotropic glutamate receptors make an independent contribution to the pathogenesis of these motor response changes and further that a combination of both drug types may provide relief from these disabling complications at lower and thus safer and more tolerable doses than required when either drug is used alone.


Subject(s)
Dopamine Agents/adverse effects , Levodopa/adverse effects , Parkinson Disease, Secondary/chemically induced , Receptors, AMPA/physiology , Receptors, N-Methyl-D-Aspartate/physiology , Amantadine/pharmacology , Animals , Antiparkinson Agents/pharmacology , Behavior, Animal , Benzazepines/pharmacology , Benzodiazepines/pharmacology , Disease Models, Animal , Dizocilpine Maleate/pharmacology , Dopamine Agonists/pharmacology , Dose-Response Relationship, Drug , Drug Interactions , Excitatory Amino Acid Antagonists/pharmacology , Haplorhini , Male , Motor Activity/drug effects , Parkinson Disease, Secondary/drug therapy , Quinpirole/pharmacology , Rats , Rats, Sprague-Dawley , Receptors, AMPA/antagonists & inhibitors , Receptors, Glutamate/physiology , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Rotarod Performance Test/methods , Time Factors
4.
Neuropharmacology ; 47(2): 184-94, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15223297

ABSTRACT

Sensitization of NMDA receptors containing the NR2B subunit has been increasingly associated with various forms of synaptic plasticity, including those implicated in the pathogenesis of extrapyramidal motor dysfunction. To determine whether activation of NR2B containing receptors contributes to the development and maintenance of levodopa-induced response changes in parkinsonian animals, we evaluated the effects of the selective NR2B antagonist CP-101,606 on these response alterations in unilateral 6-hydroxydopamine (6-OHDA) lesioned rats. Three weeks of twice-daily levodopa treatment decreased the duration of the rotational response to acute levodopa challenge. The response alteration was associated with an increase in GluR1 (S831) phosphorylation in medium spiny neurons of the dorsolateral striatum. Both the attenuated rotational response and augmented GluR1 phosphorylation were decreased by CP-101,606 treatment. These CP-101,606 effects were observed when the compound was administered either at the end of chronic levodopa treatment (ameliorative effect) or together with the twice-daily levodopa treatment for 3 weeks (preventive effect). Furthermore, concurrent administration of CP-101,606 with levodopa potentiated the ability of levodopa challenge to reverse the 6-OHDA lesion-induced contralateral forelimb movement deficit as measured in a drag test. These results suggest that activation of NR2B subunit containing NMDA receptors contributes to both the development and maintenance of levodopa-induced motor response alterations, through a mechanism that involves an increase in GluR1 phosphorylation in striatal spiny neurons.


Subject(s)
Excitatory Amino Acid Antagonists/pharmacology , Levodopa/antagonists & inhibitors , Parkinson Disease, Secondary/drug therapy , Piperidines/pharmacology , Receptors, N-Methyl-D-Aspartate/drug effects , Animals , Functional Laterality/physiology , Levodopa/pharmacology , Locomotion/drug effects , Male , Neostriatum/drug effects , Oxidopamine , Parkinson Disease, Secondary/chemically induced , Phosphorylation , Rats , Rats, Sprague-Dawley , Receptors, AMPA/metabolism , Rotation , Serine/metabolism , Stereotyped Behavior/drug effects , Sympathectomy, Chemical
5.
FASEB J ; 18(7): 932-4, 2004 May.
Article in English | MEDLINE | ID: mdl-15001552

ABSTRACT

In Parkinson's disease (PD), conformational changes in the alpha-synuclein monomer precede the formation of Lewy bodies. We examined postmortem PD and undiseased (control) substantia nigra for evidence of pathological crosslinking of alpha-synuclein by tissue transglutaminase (tTG) using immunohistochemistry, immunoprecipitation, and Western blot. Consistent with previous reports, we found that both tTG and its substrate-characteristic N(epsilon)-(gamma-glutamyl)-lysine crosslink are increased in PD nigral dopamine neurons. Furthermore, both the tTG protein and its substrate crosslink coprecipitated with alpha-synuclein in extracts of PD substantia nigra. Unexpectedly, the isodipeptide crosslink was detected in the alpha-synuclein monomer as well as in higher molecular mass oligomers of alpha-synuclein. Although the intramolecularly crosslinked alpha-synuclein monomer was present in control tissue, it was highly enriched in PD substantia nigra. Conversely, significantly less uncrosslinked alpha-synuclein remained in the postimmunoprecipitate lysate of PD tissue than in control. Crosslinked alpha-synuclein, formed at the expense of the total alpha-synuclein monomer, correlated with disease progression. These results demonstrate that much of the alpha-synuclein monomer in PD nigra is crosslinked by tTG and thus may be functionally impaired. This modification appears to be an early step in PD pathogenesis, preceding the aggregation of alpha-synuclein in Lewy bodies.


Subject(s)
GTP-Binding Proteins/physiology , Nerve Tissue Proteins/metabolism , Parkinson Disease/enzymology , Substantia Nigra/enzymology , Transglutaminases/physiology , Adult , Aged , Aged, 80 and over , Biopolymers , Dipeptides/analysis , Disease Progression , Dopamine/analysis , Female , Humans , Lewy Bodies/metabolism , Male , Middle Aged , Nerve Tissue Proteins/chemistry , Neurons/enzymology , Protein Conformation , Protein Glutamine gamma Glutamyltransferase 2 , Solubility , Structure-Activity Relationship , Synucleins , alpha-Synuclein
6.
Neurology ; 61(11 Suppl 6): S97-100, 2003 Dec 09.
Article in English | MEDLINE | ID: mdl-14663020

ABSTRACT

Research and development of the adenosine A2A receptor selective antagonist KW6002 have focused on developing a novel nondopaminergic therapy for Parkinson's disease (PD). Salient pharmacologic features of KW6002 were investigated in several animal models of PD. In rodent and primate models, KW6002 provides symptomatic relief from parkinsonian motor deficits without provoking dyskinesia or exacerbating existing dyskinesias. The major target neurons of the A2A receptor antagonist were identified as GABAergic striatopallidal medium spiny neurons. A possible mechanism of A2A receptor antagonist action in PD has been proposed based on the involvement of striatal and pallidal presynaptic A2A receptors in the "dual" modulation of GABAergic synaptic transmission. Experiments with dopamine D2 receptor knockout mice showed that A2A receptors can function and anti-PD activities of A2A antagonists can occur independent of the dopaminergic system. Clinical studies of KW6002 in patients with advanced PD with L-dopa-related motor complications yielded promising results with regard to motor symptom relief without motor side effects. The development of KW6002 represents the first time that a concept gleaned from A2A biologic research has been applied successfully to "proof of concept" clinical studies. The selective A2A antagonist should provide a novel nondopaminergic approach to PD therapy.


Subject(s)
Adenosine A2 Receptor Antagonists , Antiparkinson Agents/therapeutic use , Parkinson Disease/drug therapy , Parkinsonian Disorders/drug therapy , Purines/therapeutic use , Animals , Antiparkinson Agents/adverse effects , Clinical Trials as Topic/statistics & numerical data , Corpus Striatum/cytology , Corpus Striatum/drug effects , Corpus Striatum/metabolism , Disease Models, Animal , Drug Evaluation, Preclinical , Dyskinesia, Drug-Induced/prevention & control , Globus Pallidus/cytology , Globus Pallidus/drug effects , Globus Pallidus/metabolism , Humans , Levodopa/adverse effects , Levodopa/therapeutic use , Mice , Mice, Knockout , Motor Activity/drug effects , Neurons/drug effects , Neurons/metabolism , Oxidopamine , Parkinsonian Disorders/chemically induced , Primates , Rats , Receptor, Adenosine A2A/metabolism , Receptors, Dopamine D2/deficiency , Receptors, Dopamine D2/genetics , gamma-Aminobutyric Acid/metabolism
7.
Neurology ; 61(11 Suppl 6): S107-11, 2003 Dec 09.
Article in English | MEDLINE | ID: mdl-14663022

ABSTRACT

Improving the translation of novel findings from basic laboratory research to better therapies for neurologic disease constitutes a major challenge for the neurosciences. This brief review of aspects of the development of an adenosine A2A antagonist for use in the management of Parkinson's disease (PD) illustrates approaches to some of the relevant issues. Adenosine A2A receptors, highly expressed on striatal medium spiny neurons, signal via kinases whose aberrant activation has been linked to the appearance of parkinsonian signs after dopaminergic denervation and to the motor response complications produced by dopaminomimetic therapy. To assess the ability of A2A receptor blockade to normalize certain of these kinases and thus benefit motor dysfunction, the palliative and prophylactic effects of the selective antagonist KW6002 were first evaluated in rodent and primate models. In hemiparkinsonian rats, KW6002 reversed the intermittent L-dopa treatment-induced, protein kinase A-mediated hyperphosphorylation of striatal alpha-amino-3-hydroxy-5-methyl-4-isoxazole proprionic acid receptor GluR1 S845 residues and the concomitant shortening in motor response duration. In 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned monkeys, coadministration of KW6002 with daily apomorphine injections acted prophylactically to prevent dyskinesia onset. These and related preclinical observations guided the design of a limited, randomized, controlled, proof-of-concept study of the A2A antagonist in patients with moderately advanced PD. Although KW6002 alone or in combination with a steady-state IV infusion of optimal-dose L-dopa had no effect on parkinsonian severity, the drug potentiated the antiparkinsonian response to low-dose L-dopa with fewer dyskinesias than produced by optimal-dose L-dopa alone. KW6002 also safely prolonged the efficacy half-time of L-dopa. The results suggest that drugs capable of selectively blocking adenosine A2A receptors could confer therapeutic benefit to L-dopa-treated parkinsonian patients and warrant further evaluation in phase II studies. They also illustrate a strategy for successfully bridging a novel approach to PD therapy from an evolving research concept to pivotal clinical trials.


Subject(s)
Adenosine A2 Receptor Antagonists , Antiparkinson Agents/therapeutic use , Parkinsonian Disorders/drug therapy , Purines/therapeutic use , Animals , Antiparkinson Agents/adverse effects , Clinical Trials as Topic/statistics & numerical data , Corpus Striatum/drug effects , Corpus Striatum/metabolism , Disease Models, Animal , Dose-Response Relationship, Drug , Drug Evaluation, Preclinical , Drug Synergism , Humans , Levodopa/therapeutic use , Macaca fascicularis , Male , Motor Activity/drug effects , Neurons/drug effects , Neurons/metabolism , Parkinsonian Disorders/chemically induced , Purines/adverse effects , Rats , Rats, Sprague-Dawley , Receptors, AMPA/biosynthesis
8.
Exp Neurol ; 184(1): 285-94, 2003 Nov.
Article in English | MEDLINE | ID: mdl-14637099

ABSTRACT

Adenosine A(2A) receptors, abundantly expressed on striatal medium spiny neurons, appear to activate signaling cascades implicated in the regulation of coexpressed ionotropic glutamatergic receptors. To evaluate the contribution of adenosinergic mechanisms to the pathogenesis of the response alterations induced by dopaminergic treatment, we studied the ability of the selective adenosine A(2A) receptor antagonist KW-6002 to prevent as well as palliate these syndromes in rodent and primate models of Parkinson's disease. In rats, KW-6002 reversed the shortened motor response produced by chronic levodopa treatment while reducing levodopa-induced hyperphosphorylation at S845 residues on AMPA receptor GluR1 subunits. In primates, KW-6002 evidenced modest antiparkinsonian activity when given alone. Once-daily coadministration of KW-6002 with apomorphine prevented the development of dyskinesias, which appeared in control animals 7-10 days after initiating apomorphine treatment. Animals initially given apomorphine plus KW-6002 for 3 weeks did not begin to manifest apomorphine-induced dyskinesias until 10-12 days after discontinuing the A(2A) antagonist. These results suggest that KW-6002 can attenuate the induction as well as the expression of motor response alterations to chronic dopaminergic stimulation in parkinsonian animals, possibly by blocking A(2A) receptor-stimulated signaling pathways. Our findings strengthen the rationale for developing A(2A) antagonists as an early treatment strategy for Parkinson's disease.


Subject(s)
Adenosine A2 Receptor Antagonists , Dopamine Agonists/toxicity , Parkinson Disease, Secondary/physiopathology , 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine/antagonists & inhibitors , Animals , Antiparkinson Agents/therapeutic use , Apomorphine/toxicity , Denervation , Dyskinesia, Drug-Induced/pathology , Dyskinesia, Drug-Induced/prevention & control , Levodopa/therapeutic use , Macaca fascicularis , Male , Neurons/pathology , Oxidopamine/antagonists & inhibitors , Oxidopamine/toxicity , Parkinson Disease, Secondary/chemically induced , Parkinson Disease, Secondary/pathology , Phosphorylation , Purines/pharmacology , Rats , Rats, Sprague-Dawley , Receptors, AMPA/metabolism , Receptors, Dopamine D1/agonists , Receptors, Dopamine D2/agonists , Sympatholytics/antagonists & inhibitors , Sympatholytics/toxicity
9.
Neurology ; 61(3): 293-6, 2003 Aug 12.
Article in English | MEDLINE | ID: mdl-12913186

ABSTRACT

BACKGROUND: Observations in animal models suggest that A(2A) antagonists confer benefit by modulating dopaminergic effects on the striatal dysfunction associated with motor disability. This double-blind, placebo-controlled, proof-of-principle study evaluated the pathogenic contribution and therapeutic potential of adenosine A(2A) receptor-mediated mechanisms in Parkinson disease (PD) and levodopa-induced motor complications. METHODS: Fifteen patients with moderate to advanced PD consented to participate. All were randomized to either the selective A(2A) antagonist KW-6002 or matching placebo capsules in a 6-week dose-rising design (40 and 80 mg/day). Motor function was rated on the Unified PD Rating Scale. RESULTS: KW-6002 alone or in combination with a steady-state IV infusion of each patient's optimal levodopa dose had no effect on parkinsonian severity. At a low dose of levodopa, however, KW-6002 (80 mg) potentiated the antiparkinsonian response by 36% (p < 0.02), but with 45% less dyskinesia compared with that induced by optimal dose levodopa alone (p < 0.05). All cardinal parkinsonian signs improved, especially resting tremor. In addition, KW-6002 prolonged the efficacy half-time of levodopa by an average of 47 minutes (76%; p < 0.05). No medically important drug toxicity occurred. CONCLUSIONS: The results support the hypothesis that A(2A) receptor mechanisms contribute to symptom production in PD and that drugs able to selectively block these receptors may help palliate symptoms in levodopa-treated patients with this disorder.


Subject(s)
Adenosine A2 Receptor Antagonists , Antiparkinson Agents/therapeutic use , Parkinson Disease/drug therapy , Purines/therapeutic use , Administration, Oral , Antiparkinson Agents/administration & dosage , Antiparkinson Agents/adverse effects , Carbidopa/administration & dosage , Dose-Response Relationship, Drug , Double-Blind Method , Drug Synergism , Female , Humans , Levodopa/administration & dosage , Levodopa/adverse effects , Levodopa/therapeutic use , Male , Middle Aged , Motor Activity/drug effects , Purines/administration & dosage , Purines/adverse effects , Safety , Treatment Outcome
10.
Amino Acids ; 23(1-3): 133-9, 2002.
Article in English | MEDLINE | ID: mdl-12373527

ABSTRACT

Chronically administered levodopa to Parkinson's disease (PD) patients ultimately produces alterations in motor response. Similarly, in 6-hydroxydopamine lesioned hemi-parkinsonian rats, chronic twice-daily administration of levodopa progressively shortens the duration of contralateral turning, an index of, the wearing-off fluctuations that occur in parkinsonian patients. The pathogenesis of these response alterations involves, in part, upregulation of corticostriatal glutamatergic synaptic transmission. Changes involving kinase and phosphatase signaling pathways within striatal dopaminoceptive medium-spiny neurons now appear to contribute to increased synaptic efficacy of glutamatergic receptors in these neurons. Glutamate-mediated striatal sensitization subsequently modifies basal ganglia output in ways that favor the appearance of parkinsonian motor complications. At the molecular level, transcriptional activation of striatal CREB and cdk5 may contribute to the persistent expression of these levodopa-induced response alterations. Conceivably, a safer and more effective therapy for PD can be provided by drugs that target signaling proteins within striatal spiny neurons or those that interact extracellularly with non-dopaminergic receptors such as AMPA and NMDA, adenosine, adrenergic, opioid, and serotonergic.


Subject(s)
Corpus Striatum/physiopathology , Dyskinesia, Drug-Induced/etiology , Glutamic Acid/metabolism , Parkinson Disease/complications , Parkinson Disease/physiopathology , Animals , Antiparkinson Agents/adverse effects , Antiparkinson Agents/therapeutic use , Corpus Striatum/metabolism , Humans , Levodopa/adverse effects , Levodopa/therapeutic use , Motor Activity/physiology , Parkinson Disease/drug therapy , Receptors, Cell Surface/metabolism
11.
Neurology ; 59(5): 694-9, 2002 Sep 10.
Article in English | MEDLINE | ID: mdl-12221159

ABSTRACT

OBJECTIVE: To examine the acute effects of the NMDA receptor antagonist amantadine on motor and cognitive function in Huntington's disease (HD). BACKGROUND: Chorea in HD and in the levodopa-induced dyskinesias of PD may be clinically indistinguishable. In PD, hyperphosphorylation of NMDA receptors expressed on striatal medium spiny neurons contributes to peak-dose dyskinesias, and drugs that block these receptors can diminish chorea severity. Because these spiny neurons are the primary target of the neurodegenerative process in HD, sensitization of NMDA receptors on residual striatal neurons might also participate in the generation of motor dysfunction in HD. METHODS: To evaluate this possibility, 24 patients with HD entered a double-blind placebo-controlled crossover study of amantadine with two 2-week arms. RESULTS: Chorea scores were lower with amantadine (usually 400 mg/d) than placebo, with a median reduction in extremity chorea at rest of 36% (p = 0.04) for all 22 evaluable patients and of 56% in the 10 individuals with the highest plasma drug levels. Improvement correlated with plasma amantadine concentrations (p = 0.01) but not CAG repeat length. Parkinsonian rating scores did not worsen and there was no consistent change in cognitive measures. Adverse event profile was benign. CONCLUSIONS: Results suggest that NMDA receptor supersensitivity may contribute to the clinical expression of choreiform dyskinesias in HD and that selective antagonists at that site can safely confer palliative benefit.


Subject(s)
Amantadine/administration & dosage , Dopamine Agents/administration & dosage , Huntington Disease/drug therapy , N-Methylaspartate/antagonists & inhibitors , Adult , Aged , Amantadine/adverse effects , Chorea/drug therapy , Cognition/drug effects , Cross-Over Studies , Dopamine Agents/adverse effects , Double-Blind Method , Dyskinesia, Drug-Induced/diagnosis , Female , Humans , Male , Middle Aged , Treatment Outcome
12.
Neuropsychopharmacology ; 27(1): 92-104, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12062910

ABSTRACT

Functional coupling of regional cerebral metabolic rates for glucose measured with [18F]-Fluoro-2-deoxy-D-glucose PET was compared in 18 drug-free patients with Tourette's Syndrome (TS) and 16 age- and sex-matched control subjects. Pearson product-moment correlation matrices containing correlations between metabolic rates in regions sampled throughout the brain were generated independently for TS patients and controls and compared. Significant differences between Z-transformed correlation coefficients were used to identify group differences, and revealed that the connectivity of the ventral striatum was most severely affected in TS. Changes in the coupling of other brain areas-primary motor areas, somatosensory association areas, and insula-also appeared to differentiate TS patients and controls. Evaluation of interrelationships between cortico-striato-thalamo-cortical circuits revealed the existence of functional connections between the motor and lateral orbitofrontal circuits in both groups, however, a reversal in the pattern of these interactions differentiated TS patients and controls. In controls, activity in these circuits appeared to be negatively correlated-i.e. increased activity in one is associated with relative inactivity the other. In TS patients, on the other hand, activity in the motor and lateral orbitofrontal circuits appears to be positively coupled. These results lend further credence to the hypothesis that altered limbic-motor interactions represent a pathophysiological hallmark of this disease.


Subject(s)
Cerebral Cortex/diagnostic imaging , Cerebral Cortex/metabolism , Fluorodeoxyglucose F18 , Radiopharmaceuticals , Tomography, Emission-Computed , Tourette Syndrome/diagnostic imaging , Tourette Syndrome/metabolism , Adult , Brain Mapping/methods , Cerebral Cortex/physiopathology , Female , Humans , Male , Middle Aged , Tomography, Emission-Computed/statistics & numerical data , Tourette Syndrome/physiopathology
13.
Neurology ; 57(10): 1829-34, 2001 Nov 27.
Article in English | MEDLINE | ID: mdl-11723272

ABSTRACT

BACKGROUND: Serotoninergic transmission in the basal ganglia is known to influence dopaminergic mechanisms and motor function. OBJECTIVE: To evaluate the possibility that serotoninergic 5-HT1A autoreceptors (by regulating the release of serotonin as well as dopamine formed from exogenous levodopa) affect the response alterations complicating levodopa treatment of PD. METHODS: The 5-HT1A receptor agonist sarizotan (EMD128130) was systemically administered alone and together with levodopa to parkinsonian rats and nonhuman primates. RESULTS: In 6-hydroxydopamine-lesioned rats, sarizotan (2.5 mg/kg PO) had no effect on the acute rotational response to levodopa but did attenuate the shortening in motor response duration induced by chronic levodopa treatment. In 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned monkeys, sarizotan (2 mg/kg PO) alone had no effect on parkinsonian severity or on the antiparkinsonian response to levodopa. In contrast, the same dose of sarizotan reduced levodopa-induced choreiform dyskinesias by 91 +/- 5.9%. In both species, the motoric effects of sarizotan were blocked by the selective 5-HT1A antagonist WAY100635 (0.1 mg/kg SC), indicating that the observed sarizotan responses were probably mediated at the 5-HT1A autoreceptor. CONCLUSION: Pharmaceuticals acting to stimulate 5-HT1A receptors could prove useful in the treatment of the motor response complications in parkinsonian patients.


Subject(s)
Antiparkinson Agents/pharmacology , Motor Skills/drug effects , Parkinsonian Disorders/physiopathology , Receptors, Serotonin/drug effects , Stereotyped Behavior/drug effects , Animals , Corpus Striatum/drug effects , Corpus Striatum/physiopathology , Dose-Response Relationship, Drug , Female , Levodopa/pharmacology , Macaca fascicularis , Male , Motor Skills/physiology , Organic Chemicals , Rats , Rats, Sprague-Dawley , Receptors, Serotonin/physiology , Receptors, Serotonin, 5-HT1 , Species Specificity , Stereotyped Behavior/physiology , Substantia Nigra/drug effects , Substantia Nigra/physiopathology
15.
Clin Neuropharmacol ; 24(3): 163-9, 2001.
Article in English | MEDLINE | ID: mdl-11391128

ABSTRACT

The objective of the study was to determine the safety and efficacy of increasing doses of Rotigotine CDS in patients with advanced Parkinson's disease. The development of motor complications in Parkinson's disease has been linked to intermittent stimulation of dopamine receptors. Continuous, noninvasive, dopaminergic stimulation has not been available to date. Rotigotine CDS is a lipid-soluble D2 dopamine agonist in a transdermal delivery system that could fill this void. This inpatient study consisted of a 2-week dose escalation phase followed by a 2-week dose maintenance phase at the highest dose (80 cm2). Each individual's L-Dopa dose was back-titrated as feasible. The primary outcome measure was L-Dopa dose, and secondary outcome measures included early morning "off"-L-Dopa Unified Parkinson's Disease Rating Scale motor scores by a blinded evaluator and motor fluctuation data obtained from patient diaries ("on" without dyskinesia, "on" with dyskinesia, and "off"). Seven of 10 subjects provided data that could be evaluated. There were two administrative dropouts, and one individual was eliminated from the study because of recrudescence of hallucinations. The median daily L-Dopa dose decreased from 1,400 to 400 mg (p = 0.018, Wilcoxon test). Unified Parkinson's Disease Rating Scale motor scores were unchanged. Although diary variables improved in most individuals, only the reduction in "off" time attained statistical significance. Adverse effects were mild and consisted mainly of dopaminergic side effects and local skin reactions. The data suggest that Rotigotine CDS is an effective treatment for advanced Parkinson's disease and permits patients to substantially lower L-Dopa doses without loss of antiparkinsonian efficacy. Full-scale controlled clinical trials are warranted. In addition to potential therapeutic benefits, this drug can be used to test the hypothesis that continuous dopaminergic stimulation from the initiation of Parkinson's disease therapy will limit the development of motor complications.


Subject(s)
Antiparkinson Agents/therapeutic use , Dopamine Agonists/therapeutic use , Parkinson Disease/drug therapy , Tetrahydronaphthalenes/therapeutic use , Thiophenes/therapeutic use , Administration, Cutaneous , Adult , Aged , Antiparkinson Agents/administration & dosage , Antiparkinson Agents/adverse effects , Dopamine Agonists/administration & dosage , Dopamine Agonists/adverse effects , Double-Blind Method , Female , Humans , Levodopa/administration & dosage , Levodopa/adverse effects , Levodopa/therapeutic use , Male , Middle Aged , Tetrahydronaphthalenes/administration & dosage , Tetrahydronaphthalenes/adverse effects , Thiophenes/administration & dosage , Thiophenes/adverse effects , Treatment Outcome
16.
Mov Disord ; 16(3): 459-63, 2001 May.
Article in English | MEDLINE | ID: mdl-11391739

ABSTRACT

N-0923 is a non-ergot, dopaminergic D(2) agonist designed to be transdermally available. It has anti-parkinsonian effects when infused intravenously. An adhesive matrix patch was developed to deliver N-0923 transdermally (N-0923 TDS). In this phase II trial, we evaluated the effectiveness of various doses of N-0923 TDS at replacing levodopa. Eighty-five Parkinson's disease (PD) patients were randomized to placebo or one of four doses of N-0923 TDS for 21 days. Change in daily levodopa dose was the primary efficacy measure. Significantly greater reductions in levodopa dose were achieved as compared to placebo for the two highest doses of N-0923 TDS. Patients treated with 33.5 mg and 67 mg N-0923 TDS decreased levodopa use by 26% and 28%, vs. 7% for placebo. N-0923 TDS was safe and well tolerated.


Subject(s)
Dopamine Agonists/administration & dosage , Levodopa/administration & dosage , Parkinson Disease/drug therapy , Receptors, Dopamine D2/agonists , Tetrahydronaphthalenes/administration & dosage , Thiophenes/administration & dosage , Administration, Cutaneous , Aged , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Male , Middle Aged , Therapeutic Equivalency , Treatment Outcome
17.
Mov Disord ; 16(3): 515-20, 2001 May.
Article in English | MEDLINE | ID: mdl-11391748

ABSTRACT

Experimental evidence suggests that glutamatergic receptor blockade may improve the motor response complications associated with long-term levodopa treatment in Parkinson's disease (PD) patients. Our objective was to evaluate the acute effect of amantadine, a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) receptor, on levodopa-induced dyskinesias, and to gain further insights into the antidyskinetic mechanism of this drug. Nine PD patients with motor fluctuations and severely disabling peak of dose dyskinesias received their first morning levodopa dose, followed by a 2-hour intravenous amantadine (200 mg) or placebo infusion, on two different days. Parkinsonian symptoms and dyskinesias were assessed every 15 minutes during the infusion and for 3 hours thereafter, while patients were taking their usual oral antiparkinsonian therapy, by means of Unified Parkinson's Disease Rating Scale (UPDRS, motor examination), tapping test, and a modified Abnormal Involuntary Movement Scale (AIMS). Intravenous amantadine acutely improved levodopa-induced dyskinesias by 50%without any loss of the anti-parkinsonian benefit from levodopa. This study confirms the antidyskinetic effect of amantadine and strengthens the rationale for using antiglutamatergic drugs in the treatment of parkinsonian motor fluctuations.


Subject(s)
Amantadine/therapeutic use , Antiparkinson Agents/therapeutic use , Dopamine Agents/therapeutic use , Dyskinesia, Drug-Induced/drug therapy , Levodopa/therapeutic use , Parkinson Disease/drug therapy , Receptors, N-Methyl-D-Aspartate/metabolism , Aged , Amantadine/administration & dosage , Antiparkinson Agents/administration & dosage , Antiparkinson Agents/adverse effects , Dopamine Agents/administration & dosage , Double-Blind Method , Drug Therapy, Combination , Dyskinesia, Drug-Induced/etiology , Female , Humans , Infusions, Intravenous , Levodopa/adverse effects , Male , Middle Aged , Parkinson Disease/complications , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Remission Induction
18.
J Biol Chem ; 276(30): 28212-8, 2001 Jul 27.
Article in English | MEDLINE | ID: mdl-11337491

ABSTRACT

The close correspondence between the distribution of brain alpha-synuclein and that of muscarinic M1 and M3 receptors suggests a role for this protein in cholinergic transmission. We thus examined the effect of muscarinic stimulation on alpha-synuclein in SH-SY5Y, a human dopaminergic cell line that expresses this protein. Under basal conditions, alpha-synuclein was detected in all subcellular compartments isolated as follows: plasma membrane, cytoplasm, nucleus, and two vesicle fractions. The lipid fractions contained only a 45-kDa alpha-synuclein oligomer, whereas the cytoplasmic and nuclear fractions contained both the oligomer and the monomer. This finding suggests alpha-synuclein exists physiologically as a lipid-bound oligomer and a soluble monomer. Muscarinic stimulation by carbachol reduced the alpha-synuclein oligomer in plasma membrane over a 30-min period, with a concomitant increase of both the oligomer and the monomer in the cytoplasmic fraction. The oligomer was associated with a light vesicle fraction in cytoplasm that contains uncoated endocytotic vesicles. The carbachol-induced alteration of alpha-synuclein was blocked by atropine. Translocation of the alpha-synuclein oligomer in response to carbachol stimulation corresponds closely with the time course of ligand-stimulated muscarinic receptor endocytosis. The data suggest that the muscarine receptor stimulated release of the alpha-synuclein oligomer from plasma membrane, and its subsequent association with the endocytotic vesicle fraction may have a role in muscarine receptor endocytosis. We propose that its function may be a transient release of membrane-bound phospholipase D2 from alpha-synuclein inhibition, thus allowing this lipase to participate in muscarinic receptor endocytosis.


Subject(s)
Cell Membrane/metabolism , Cytoplasm/metabolism , Nerve Tissue Proteins/metabolism , Receptors, Muscarinic/metabolism , Annexin A2/metabolism , Blotting, Western , Carbachol/pharmacology , Cell Line , Cell Nucleus/metabolism , Cholinergic Agonists/pharmacology , Endocytosis , Humans , Lipase/metabolism , Protein Binding , Protein Transport , Synucleins , Time Factors , alpha-Synuclein
19.
J Pharmacol Exp Ther ; 297(1): 78-87, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11259530

ABSTRACT

Prostaglandin A(1) (PGA1) reportedly inhibits NF-kappaB activation and induces expression of heat shock proteins. Since both these effects could be neuroprotective, the therapeutic potential of PGA1 in neurodegenerative disorders, where excitotoxicity may contribute to pathogenesis, was evaluated in rat striatal neurons exposed to the N-methyl-D-aspartate (NMDA) receptor agonist quinolinic acid (QA). Intrastriatal administration of PGA1 (5-80 nmol) attenuated QA (60 nmol)-induced internucleosomal DNA fragmentation. The inhibitory effects of a single dose of PGA1 (80 nmol) on QA (60 nmol)-induced DNA fragmentation were observed 12 to 48 h after treatment. PGA1 (80 nmol) also attenuated QA-induced DNA fragmentation when administered up to 4 h after QA exposure. PGA1 significantly decreased the loss of D1 dopamine receptors and GAD(67) mRNA in QA-injected striatum as measured by quantitative receptor autoradiography and in situ hybridization histochemistry, suggesting that it reduced the neuronal loss induced by QA. Protection of striatal neurons against QA-induced death by PGA1 was further indicated by Nissl staining 10 days after QA administration. PGA1 (5-80 nmol) significantly inhibited QA-induced NF-kappaB activation by blocking inhibitory kappaB-alpha degradation but had no effect on activator protein-1 binding activity. PGA1 (80 nmol) treatment substantially increased 70- and 72-kDa heat shock protein levels in striatum. These results indicate that PGA1 blunts NMDA receptor-mediated neuronal apoptosis by a mechanism possibly involving the up-regulation of neuroprotective heat shock proteins and inhibition of NF-kappaB activation. In view of its potent neuroprotective activity, PGA1 could prove useful in the treatment of certain neurodegenerative disorders related to excitotoxicity.


Subject(s)
Corpus Striatum/drug effects , Prostaglandins A/pharmacology , Quinolinic Acid/toxicity , Animals , Apoptosis/drug effects , Corpus Striatum/metabolism , Corpus Striatum/pathology , DNA Fragmentation/drug effects , HSP70 Heat-Shock Proteins/biosynthesis , Male , NF-kappa B/antagonists & inhibitors , NF-kappa B/metabolism , Nucleosomes/drug effects , Rats , Rats, Sprague-Dawley
20.
Trends Neurosci ; 23(10 Suppl): S86-91, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11052225

ABSTRACT

Characteristic changes involving interactions between dopamine and glutamate in striatal medium spiny neurons now appear to contribute to symptom production in Parkinson's disease (PD). The balance between kinase and phosphatase signaling modifies the phosphorylation state of glutamate receptors and thus their synaptic strength. Sensitization of spiny-neuron NMDA and AMPA receptors alters cortical glutamatergic input to the striatum and modifies striatal GABAergic output, and thus motor function. Conceivably, the pharmacological targeting of spiny-neuron mechanisms modified in PD will provide a safer and more effective therapy.


Subject(s)
Antiparkinson Agents/pharmacology , Corpus Striatum/metabolism , Dopamine/metabolism , Glutamic Acid/metabolism , Levodopa/pharmacology , Neurons, Efferent/metabolism , Parkinsonian Disorders/metabolism , Animals , Humans , Models, Neurological , Neurons, Efferent/ultrastructure , Phosphotransferases/metabolism , Receptors, Dopamine/metabolism , Receptors, Glutamate/metabolism , Signal Transduction
SELECTION OF CITATIONS
SEARCH DETAIL
...