Frequent nocturnal vocalization in pure autonomic failure.

Nocturnal vocalization is frequent in Parkinson's disease patients with rapid eye movement (REM) sleep behaviour disorder (RBD). We investigated the frequency of nocturnal vocalization and other sleep problems in patients with pure autonomic failure (PAF) and compared the results with idiopathic Parkinson's disease (IPD) and dementia with Lewy bodies (DLB). We interviewed consecutive patient-caregiver pairs with PAF (n = 13), IPD (n = 200) and DLB (n = 19), and ischaemic stroke patients (controls, n = 43). Nocturnal vocalization was similarly frequent in PAF, IPD and DLB. Other dream enactments and vivid dreams also were more frequent in PAF, IPD and DLB compared with controls. Excessive night-time awakenings and daytime sleepiness were frequent in IPD but rare in PAF and controls. Clinical manifestation of sleep disturbances, at least of RBD-like symptoms including nocturnal vocalization and other dream enactments, may occur in PAF, as in IPD and DLB.

Pramipexole safely replaces ergot dopamine agonists with either rapid or slow switching.

This prospective, open-label, multicentre study examined the efficacy and safety of rapidly (overnight) or slowly (after 2 weeks of concomitant usage) switching patients with Parkinson's disease (PD) from conventional ergot dopamine agonists (DAs) to the non-ergot DA, pramipexole. Fifty-nine early-to-advanced PD patients with motor symptoms that were inadequately controlled by ergot DAs were enrolled. Patients were switched from ergot derivatives to pramipexole and evaluated every 2 weeks for 12 weeks by Hoehn and Yahr staging, Unified Parkinson's Disease Rating Scale (UPDRS) and a modified Epworth Sleepiness Scale (mESS). The UPDRS III subscores and total UPDRS scores significantly improved, independent of switching method. Adverse events, all of which were mild, occurred in 29.2% of patients. No sudden onset of excessive daytime sleepiness or significant worsening in mESS was seen. Switching patients with PD from ergot DA to pramipexole, using either a slow or rapid switching method, appeared to be well tolerated and effective, although further dose adjustment may be necessary in some patients after the switch.

Lasting changes in high affinity 3H-spiperone binding to the rat striatum and mesolimbic area after chronic methamphetamine administration: evaluation of dopaminergic and serotonergic receptor components.

The presence of high and low affinity 3H-spiperone binding sites was demonstrated in both the rat striatum and mesolimbic area. Dopaminergic receptor component was displaced by 10 microM 2-amino-6,7-dihydroxy-1,2,3,4-tetrahydronaphthalene (ADTN), and serotonergic receptor component by 0.2 microM mianserin. Dopaminergic receptor component was saturated at less than the range of ligand concentrations labeling the high-affinity binding sites. Treatment with 4 mg/kg of methamphetamine (MAP) for 14 days, followed by a 7-day drug-free period, resulted in significant changes in the maximal number of binding sites (Bmax) at the high-affinity sites (an increase in the mesolimbic area and a decrease in the striatum), but no significant changes in Bmax at the low affinity sites. The long-lasting increase in mesolimbic Bmax at the high-affinity 3H-spiperone binding site may be an underlying basis for MAP-induced behavioral hypersensitivity (reverse tolerance).

Effects of intermittent and continuous haloperidol administration on the dopaminergic system in the rat brain.

The after-effect of intermittent and of continuous treatment with haloperidol on the dopaminergic system of the rat brain was studied. Each rat was treated for 14 days with either a single daily intraperitoneal injection of haloperidol (intermittent haloperidol group) or with a subcutaneously implanted pump that released haloperidol for 14 days (continuous haloperidol group). The total amount of haloperidol administered was 28 mg/kg in each animal of both groups. On the seventh day after cessation of injections or removal of pumps, the changes in dopamine (DA) metabolism after a challenge dose of haloperidol (1 mg/kg, intraperitoneally) were noted, and the number of [3H]spiperone binding sites in the striatum were recorded. The continuous haloperidol group showed a greater tolerance response to the influence of haloperidol on stimulation of DA turnover and also showed a larger increase in the number of [3H]spiperone binding sites than the intermittent haloperidol group. It is concluded that continuously administered haloperidol exerts a stronger effect on DA transmission, which in turn produces a greater tolerance to an acute dose of haloperidol than intermittent haloperidol administration.

Does homozygosity advance the onset of dentatorubral-pallidoluysian atrophy?

We confirmed a homozygous type of relatively small expansion of CAG triplet repeats (57 repeats) in the short arm of chromosome 12 in a male patient with dentatorubral-pallidoluysian atrophy (DRPLA) by polymerase chain reaction. He showed early onset (age, 17 years) of DRPLA. There was good correlation of the age of onset with the number of triplet repeats. The homozygous state of the expansion of the triplet repeats was responsible for the early onset and severity of his DRPLA.

Temporal pattern of AP-1 DNA-binding activity in the rat hippocampus following a kindled seizure.

DNA binding by transcripton factor AP-1 was enhanced remarkably following kindling stimulation in rat amygdala. Maximum increase occurred 2 h after stimulation with return to baseline within 24 h. Supershift and western analyses revealed that 38,000 mol. wt Fos-related antigen and JunD were the main components of the evoked AP-1 complexes at the time their induction reached maximum. AP-1 induction 2 h after the last kindling stimulation was more prominent in samples from previously kindled rats than in those from non-kindled rats. This study sought to establish the role of AP-1 in plastic changes of the hippocampus associated with kindling. Male Sprague-Dawley rats were kindled from the left amygdala until they exhibited Racine15 class 5 generalized seizures. Nuclear proteins were extracted from dorsal hippocampi obtained from 0 to 24 h after final stimulations. From these, we evaluated the temporal pattern of DNA binding by AP-1 using a gel mobility-shift assay with a 32P-labelled AP-1 probe. Supershift and western analyses were added to investigate components of the seizure-evoked AP-1 complexes. Our results suggest that the basal level of AP-1 complexes is not associated with the seizure susceptibility in kindling. However, development of kindling appears to facilitate stimulus-evoked AP-1 induction, probably via plastic changes in the central nervous system. AP-1 may mediate such changes by regulating expression of certain genes.

AMPA receptors modulate dopamine release in the striatum, as measured by brain microdialysis.

The effect of 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo(f) quinoxaline (NBQX), a potent and selective antagonist of alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors, on the release of dopamine from the striatum was investigated in freely moving rats using an in vivo microdialysis technique. Perfusion with 1.0 mM AMPA increased the concentration of striatal extracellular dopamine. After systemic administration of NBQX (40 mg/kg, i.p.), dopamine levels in the striatal perfusate decreased. The AMPA-induced increase in dopamine levels was suppressed significantly by the systemic administration of NBQX (40 mg/kg, i.p.). Perfusion with tetrodotoxin (TTX, 5 microM) alone reduced the basal level of dopamine by 80%. Perfusion with 1.0 mM AMPA together with TTX produced a 3.9-fold increase in dopamine efflux from the TTX reduced basal level. However, the maximum dopamine level obtained thereby was close to the basal level of dopamine seen prior to perfusion with TTX. The present results demonstrate that AMPA receptors participate in tonic facilitative modulation of striatal extracellular level of dopamine. In addition, the results support the view that glutamatergic neurons modulate the release of dopamine via subtypes of excitatory amino acid receptors in the central nervous system.

Effect of acute and chronic administration of methamphetamine on activator protein-1 binding activities in the rat brain regions.

The activator protein-1 (AP-1) binding activities in the three brain regions (striatum, nucleus accumbens, cingulate cortex) increased after a single methamphetamine (METH, 4 mg/kg) injection and reached maximum levels after 180 min. Pretreatment with SCH 23390 (0.5 mg/kg), a selective dopamine D1 receptor antagonist, significantly inhibited the enhanced AP-1 binding activities induced by acute METH (4 mg/kg) administration. In chronic experiments, rats were pretreated with METH (4 mg/kg) or saline for 14 days. The AP-1 binding activities after a 1-week abstinence from chronic administration of MAP increased significantly in all the brain regions compared with those of the saline-treated controls, whereas after a 4-week abstinence, the AP-1 binding activity decreased significantly in the cingulate cortex, but not striatum or nucleus accumbens, compared with the saline-treated control group. A METH challenge after a 4-week abstinence period induced significantly more intense stereotypy, but lower AP-1 binding activities in all the brain regions of rats treated with repeated METH than repeated saline injections. The super-shift assay revealed that after a 1- or 4-week abstinence, there was no significant difference between the Fos-related antigens (Fras) contents of the saline- and METH-treated groups in any brain region examined, and that the Jun family protein levels of the METH-treated group increased significantly in the striatum and nucleus accumbens after a 1-, but not 4-, week abstinence. These results suggest that chronic METH administration leads to delayed decay of the induced AP-1 binding activities and Jun component levels after abstinence for up to 1 week, but results in no change in or decreases these activities and attenuates METH challenge-induced AP-1 binding activities after abstinence for 4 weeks.

Enhanced AP-1 binding in brain induced by D1 and D2 agonists in methamphetamine-sensitized rats.

The activator protein-1 (AP-1) binding activities induced by a separate challenge with SKF38393 and quinpirole after 1 weeks' abstinence from chronic methamphetamine (4 mg/kg/day, 14 days) were increased significantly in the striatum, nucleus accumbens and cingulate cortex compared with the saline-treated controls. Quinpirole-, but not SKF38393-induced AP-1 binding activities were still significantly higher after a 4-week abstinence period in the chronic methamphetamine group than in the chronic saline control group. Downward sniffing, which occurred following a quinpirole-challenge, was significantly intensified after both a 1 and 4 weeks' abstinence from chronic methamphetamine. These results indicate that chronic administration of methamphetamine induces alterations of the interactions of dopamine D1 and D2 receptors which are reflected as enhanced AP-1 binding activities.

MK-801 fails to modify the effect of methamphetamine on dopamine release in the rat striatum.

The effect of MK-801 at a dose of 0.5 mg kg-1, i.p., on methamphetamine-induced (MAP; 4 mg kg-1, i.p.) dopamine (DA) release was examined in the striatum of freely moving rats using an in-vivo microdialysis method. Combined treatment of MK-801 with MAP did not modify the MAP-induced increase in extracellular DA levels or the decrease in 3,4-dihydroxyphenylacetic acid levels. These findings suggest that MK-801 fails to modify the acute effect of MAP on DA release in the striatum. The blocking effect of MK-801 on the development of MAP-induced behavioral sensitization is unlikely to be mediated by DA neurons.

Haloperidol prevents the methamphetamine-induced apomorphine subsensitivity of dopamine metabolism in rat striatum.

Our previous experiment showed that the sensitivity of striatal dopaminergic metabolism to apomorphine was lowered after pretreating rats with methamphetamine. This study further demonstrated that haloperidol administered with methamphetamine prevented the effect of the methamphetamine pretreatment. Since gamma-butyrolactone was administered in combination with apomorphine so as to remove complications which might arise from the modification of impulse flow through the striatonigral feedback loop, it is possible that the observed effect of apomorphine upon striatal dopaminergic metabolism and its antagonism with haloperidol may be mediated by autoreceptors of dopaminergic axon terminals in rat striatum.

Kainic acid may enhance hippocampal NO generation of awake rats in a seizure stage-related fashion.

Temporal changes in kainate-induced seizure activity and hippocampal NO generation were evaluated simultaneously in conscious rats by using in vivo microdialysis and by determining the concentrations of nitrite and nitrate in perfusates. Intraperitoneal injection of kainic acid produced 'wet dog shake', focal seizure of the limbs and neck, hypersalivation, or generalized convulsion. These behavioral changes peaked at 120 min after the drug challenge and lasted for about 100 min. In contrast, the concentrations of NO metabolites, nitrite and nitrate, in the hippocampal perfusates increased rapidly and reached a plateau level at 40 min after the injection, and the level remained high for over 220 min. The increase was more marked in animals presenting severe seizures than those presenting mild ones. Pre-treatment with 25 mg/kg N(G)-nitro-L-arginine methyl ester promoted the severity of kainate-induced seizures, but it suppressed the increase in NO metabolites. These results suggest that kainic acid enhances hippocampal NO generation in a severity-related manner of the induced seizures. The enhanced NO generation upon kainate challenge appears mainly to be involved in seizure suppression.

Reduced apomorphine sensitivity of dopamine metabolism in rat striatum after repeated administration of methamphetamine.

Rats received daily injections of saline or methamphetamine (MAP; 4 mg/kg/day) for 14 days. Seven days after the completion of this regime, dopamine (DA) and 3,4-dihydroxyphenylacetic acid (DOPAC) levels were measured in the striatum following intraperitoneal injections of either saline plus gamma-butyrolactone (GBL; 750 mg/kg) or apomorphine (2 mg/kg) plus GBL. The saline plus GBL challenges produced no difference in the DA or DOPAC levels between saline- and MAP-treated rats. By contrast, the apomorphine plus GBL challenges produced higher DOPAC levels in MAP-treated rats than saline-treated rats, although they produced no difference in the DA levels between the two groups. These results indicate that apomorphine depresses the striatal DA metabolism less in MAP-treated rats than in saline-treated control rats. Repeated MAP administration might produce this effect through apomorphine subsensitivity of presynaptic DA autoreceptors.

Effects of repeated methyl levodopa administration on apomorphine sensitivity of rotational behavior and striatal Fos expression of rats with unilateral 6-OHDA lesions.

This study was designed to elucidate the mechanism to develop levodopa-induced dyskinesia in patients with Parkinson's disease. For this purpose, we administered methyl levodopa repeatedly to a rat model of Parkinson's disease with unilateral 6-hydroxydopamine (6-OHDA)-induced lesion of the nigrostriatal dopamine pathway. After a washout period, we measured apomorphine sensitivity of contralateral rotation and made parallel determination of Fos expression in the caudate-putamen and globus pallidus of the same animal. Once daily, i.p. injection of methyl levodopa plus benserazide for 10 days increased the number of rotations over time. A challenge dose of apomorphine showed enhanced rotational response in rats pretreated with methyl levodopa. Repeated administration of methyl levodopa resulted in diminished apomorphine sensitivity of Fos expression in the dopamine depleted caudate-putamen and in enhanced sensitivity in the globus pallidus of the same side. Present results may add evidence to the idea that repeated administration of levodopa develops dopaminergic sensitization mediated by augmented activation of pallidal neurons involved in D2-responsive pallidal output pathway.

Effect of MK-801 on endogenous dopamine release in vivo.

The effect of MK-801 on striatal dopamine (DA) release was investigated by using an in vivo microdialysis technique in the freely moving rat. Systemic injection of MK-801 (0.25, 0.5, 1, 2 mg/kg, i.p.) reduced the extracellular level of DA significantly and produced no change in the level of 3,4-dihydroxyphenylacetic acid. The behavioral observation, recorded simultaneously, revealed that MK-801, with smaller doses, produced ipsilateral circling toward the side with the dialysis probe. At larger doses, MK-801 predominantly evoked ataxia. These findings indicate that the behavioral effect of MK-801 may not be mediated via the release of DA.

Co-administration of either a selective D1 or D2 dopamine antagonist with methamphetamine prevents methamphetamine-induced behavioral sensitization and neurochemical change, studied by in vivo intracerebral dialysis.

Repeated administration of amphetamine or methamphetamine (MAP) causes behavioral sensitization in animals. Recently, several studies have revealed that in vivo release of dopamine from presynaptic nerve terminals of mesotelencephalic dopamine neurons is enhanced when sensitized animals are rechallenged with a psychostimulant. The present study investigated the effect of co-administration of SCH 23390 (a selective D1 dopamine receptor antagonist) or YM-09151-2 (a selective D2 dopamine receptor antagonist) prior to each MAP injection for 14 days on dopamine efflux in the striatal perfusates using in vivo dialysis. After 3 months drug abstinence, MAP challenge alone produced augmented stereotypy in the MAP group, but not in the control, the SCH 23390 + MAP or the YM-09151-2 + MAP group. In parallel with this behavioral observation, the degree to which dopamine efflux increased following the MAP challenge was significantly greater in the MAP group than that in the control, SCH 23390 + MAP group and the YM-09151-2 + MAP groups. While dopamine efflux after MAP challenge did not differ between the control and the YM-09151-2 + MAP group, it was greater in the SCH 23390 + MAP group than the control group. These results indicate that both D1 and D2 dopamine receptors play a role in the formation of behavioral sensitization, but with different mechanisms.

Cold-induced dysaesthesia in acute idiopathic polyneuritis.

Two cases are reported of cold-induced dysaesthesia occurring during an attack of acute idiopathic polyneuritis. Two similar cases found in the literature are reviewed. It is suggested that the dysaesthesia may be a localized symptom of cold sensitivity, with an initiating trigger in common with acute idiopathic polyneuritis.

Presumed venous infarction in spinal decompression sickness.

We describe the serial MR imaging findings in a patient with spinal decompression sickness. In the acute phase, the spinal cord was swollen, with increased T2 signal in the posterior part of the column; 1 month later, marked contrast enhancement was noted in the same location; and 2 months later, the swelling and T2 signal had decreased. MR imaging may facilitate the early diagnosis of spinal decompression sickness.

Hyperintense basal ganglia on T1-weighted MR images in a patient with central nervous system lupus and chorea.

We describe a patient with central nervous system lupus and choreatic movements in whom both basal ganglia showed high signal intensity on T1-weighted MR images, while the signal on T2-weighted images remained low. Within 8 months after onset, the choreatic movements had disappeared, with a corresponding decrease in the hyperintense T1 signal. The emergence of the choreatic movement disorder in this patient might have been related to the T1 hyperintensity of the basal ganglia, which, in turn, might have resulted from a vascular insult associated with central nervous system lupus.

Motor neglect following left thalamic hemorrhage: a case report.

We present a report on a patient who developed unilateral motor neglect of the right hemibody after a left thalamic hemorrhage. He presented with pure motor neglect without aphasia, ideomotor apraxia, or unilateral spatial neglect due to a lesion in the centromedian parafascicular (CMPF) and ventrolateral (VL) nuclei of the left thalamus. Although unilateral motor neglect is usually associated with right hemispheric lesions, a left thalamic lesion may also result in isolated motor neglect.