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NeuroImage Apr 2023Humans learn through reinforcement, particularly when outcomes are unexpected. Recent research suggests similar mechanisms drive how we learn to benefit other people,... (Randomized Controlled Trial)
Randomized Controlled Trial
Humans learn through reinforcement, particularly when outcomes are unexpected. Recent research suggests similar mechanisms drive how we learn to benefit other people, that is, how we learn to be prosocial. Yet the neurochemical mechanisms underlying such prosocial computations remain poorly understood. Here, we investigated whether pharmacological manipulation of oxytocin and dopamine influence the neurocomputational mechanisms underlying self-benefitting and prosocial reinforcement learning. Using a double-blind placebo-controlled cross-over design, we administered intranasal oxytocin (24 IU), dopamine precursor l-DOPA (100 mg + 25 mg carbidopa), or placebo over three sessions. Participants performed a probabilistic reinforcement learning task with potential rewards for themselves, another participant, or no one, during functional magnetic resonance imaging. Computational models of reinforcement learning were used to calculate prediction errors (PEs) and learning rates. Participants behavior was best explained by a model with different learning rates for each recipient, but these were unaffected by either drug. On the neural level, however, both drugs blunted PE signaling in the ventral striatum and led to negative signaling of PEs in the anterior mid-cingulate cortex, dorsolateral prefrontal cortex, inferior parietal gyrus, and precentral gyrus, compared to placebo, and regardless of recipient. Oxytocin (versus placebo) administration was additionally associated with opposing tracking of self-benefitting versus prosocial PEs in dorsal anterior cingulate cortex, insula and superior temporal gyrus. These findings suggest that both l-DOPA and oxytocin induce a context-independent shift from positive towards negative tracking of PEs during learning. Moreover, oxytocin may have opposing effects on PE signaling when learning to benefit oneself versus another.
Topics: Humans; Dopamine; Learning; Levodopa; Magnetic Resonance Imaging; Oxytocin; Reinforcement, Psychology; Reward
PubMed: 36848972
DOI: 10.1016/j.neuroimage.2023.119983 -
Journal of Nuclear Medicine : Official... Jul 2021Congenital hyperinsulinism is characterized by persistent hypoglycemia due to inappropriate excess secretion of insulin resulting in hyperinsulinemic hypoglycemia. The...
Congenital hyperinsulinism is characterized by persistent hypoglycemia due to inappropriate excess secretion of insulin resulting in hyperinsulinemic hypoglycemia. The clinical course varies from mild to severe, with a significant risk for brain damage. Imaging plays a valuable role in the care of infants and children with severe hypoglycemia unresponsive to medical therapy. F-6-fluoro-l-dopa PET/CT is the method of choice for the detection and localization of a focal lesion of hyperinsulinism. Surgical resection of a focal lesion can lead to a cure with limited pancreatectomy. This article reviews the role of F-6-fluoro-l-dopa PET/CT in the management of this vulnerable population.
Topics: Congenital Hyperinsulinism; Humans; Infant; Levodopa; Positron Emission Tomography Computed Tomography
PubMed: 34230074
DOI: 10.2967/jnumed.120.246033 -
Neuroscience Research Apr 2022L-3,4-dihydroxyphenylalanine (l-DOPA) is the mainstay treatment for Parkinson's disease, but its effectiveness during early disease is marred by the eventual development...
L-3,4-dihydroxyphenylalanine (l-DOPA) is the mainstay treatment for Parkinson's disease, but its effectiveness during early disease is marred by the eventual development of l-DOPA induced dyskinesia. In hemi-parkinsonian rats, the serotonin type 3 (5-HT) antagonists ondansetron and granisetron alleviated dyskinesia induced by l-DOPA without impeding its anti-parkinsonian action; in parkinsonian marmosets, ondansetron alleviated dyskinesia and enhanced l-DOPA anti-parkinsonian action. Here, we sought to gain insight into the mechanisms governing the anti-dyskinetic action of 5-HT antagonists and measured 5-HT receptor levels across different brain, using [H]GR65630 autoradiographic binding. Brain sections were chosen from 6-hydroxydopamine (6-OHDA)-lesioned rats exhibiting abnormal involuntary movements (AIMs), as well as l-DOPA-naïve 6-OHDA and sham-lesioned animals. [H]GR65630 binding increased in the ipsilateral subthalamic nucleus of 6-OHDA-lesioned rats with mild and severe AIMs, (3-fold changes, P < 0.001). [H]GR65630 binding also increased in the ipsilateral entopeduncular nucleus and thalamus of 6-OHDA-lesioned rats with severe AIMs (75 % and 88 %, P < 0.05). AIMs scores negatively correlated with [H]GR65630 binding in the ipsilateral dorsolateral striatum and contralateral subthalamic nucleus (P < 0.05). These results suggest that alterations in 5-HT mediated neurotransmission may contribute to the pathophysiology of l-DOPA induced dyskinesia.
Topics: Animals; Antiparkinson Agents; Disease Models, Animal; Dyskinesia, Drug-Induced; Levodopa; Ondansetron; Oxidopamine; Rats; Rats, Sprague-Dawley; Serotonin; Subthalamic Nucleus
PubMed: 34954302
DOI: 10.1016/j.neures.2021.12.004 -
Ageing Research Reviews Aug 2023Parkinson's disease (PD) is the second most common neurodegenerative disorder. The degeneration of dopaminergic neurons in the midbrain is primarily responsible for... (Review)
Review
Parkinson's disease (PD) is the second most common neurodegenerative disorder. The degeneration of dopaminergic neurons in the midbrain is primarily responsible for the onset of the disease. The major challenge faced in the treatment of PD is the blood-brain barrier (BBB), which impedes the delivery of therapeutics to targeted locations. To address this issue, lipid nanosystems have been used for the precise delivery of therapeutic compounds in anti-PD therapy. In this review, we will discuss the application and clinical significance of lipid nanosystem in delivering therapeutic compounds for anti-PD treatment. These medicinal compounds include ropinirole, apomorphine, bromocriptine, astaxanthin, resveratrol, dopamine, glyceryl monooleate, levodopa, N-3,4-bis(pivaloyloxy)- dopamine and fibroblast growth factor, which have significant potential to treat PD in the early stage. This review, in a nutshell, will pave the way for researchers to develop diagnostic and potential therapeutic approaches using nanomedicine to overcome the challenges posed by the BBB in delivering therapeutic compounds for PD.
Topics: Humans; Parkinson Disease; Dopamine; Levodopa; Neurodegenerative Diseases; Lipids
PubMed: 37268112
DOI: 10.1016/j.arr.2023.101965 -
Expert Opinion on Emerging Drugs Jun 2020Prolonged treatment with L-3,4-dihydroxyphenylalanine (L-DOPA) leads to the development of uncontrolled movements (L-DOPA-induced dyskinesias (LID)) in Parkinson's... (Review)
Review
INTRODUCTION
Prolonged treatment with L-3,4-dihydroxyphenylalanine (L-DOPA) leads to the development of uncontrolled movements (L-DOPA-induced dyskinesias (LID)) in Parkinson's disease (PD). There is currently only a single approved drug for the treatment of LID, a long-acting preparation of the NMDA antagonist, amantadine, that has variable benefits and side-effects. Therefore, new treatments for LID remain an unmet in PD.
AREAS COVERED
We review the current strategies for the management of LID; the pathogenic mechanisms underlying the development of LID, which provides the rationale for clinical trials of novel targets for LID and provide a review of phase II/III trials for emerging drugs for LID, with either positive results, or ongoing studies, reported between January 2014 and December 2019.
EXPERT OPINION
There are several ongoing studies for agents that showed possible benefit at phase Ib/IIa for reducing LID. However, there are no new positive phase III double-blind randomized controlled clinical trials (DBRCT) for emerging treatments for LID. Generating better preclinical models, more precise recruitment tools and better outcome measures remain a priority. The pharmacology of drugs investigated for LID may be too selective; therefore, evaluating combinations of drugs is worthy of consideration as is the repurposing of existing drugs with multiple pharmacological targets.
Topics: Amantadine; Animals; Antiparkinson Agents; Drug Development; Drug Repositioning; Dyskinesia, Drug-Induced; Humans; Levodopa; Parkinson Disease; Randomized Controlled Trials as Topic
PubMed: 32366130
DOI: 10.1080/14728214.2020.1763954 -
Journal of the Neurological Sciences Mar 2021Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder, characterized by the dysfunction between dopaminergic and GABAergic neuronal activities. Dopamine...
PURPOSE
Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder, characterized by the dysfunction between dopaminergic and GABAergic neuronal activities. Dopamine (DA) replacement by its precursor L-dopa remains the primary treatment for PD. In this preliminary study, we test the hypotheses that GABA+ levels would be lower in PD patients than controls, and normalized by L-dopa.
METHODS
Eleven PD patients and eleven age-and gender-matched healthy controls underwent a H-MRS scan of the upper brainstem using a J-difference-edited sequence to resolve signals of GABA. PD patients did not take all dopaminergic medicines for at least twelve hours prior to the first scan, and were scanned again after resuming L -dopa (pre- and post-L-dopa). MRS data were processed using the Gannet. Differences of GABA+ (GABA, macromolecules, and homocarnosine) levels within-subject (PD: pre- and post-L-dopa) and between-subjects (HC vs. PD-pre or PD-post) were tested using linear mixed-effects models with Holm-Bonferroni correction applied to pairwise comparisons.
RESULTS
Significant increased GABA+ levels were observed in the upper brainstem of PD patients post-L-dopa compared with pre-L-dopa (p < 0.001). Patients' GABA+ levels before administration of L-dopa were significantly lower than HCs (p = 0.001). Increased GABA+ level by administration of L-dopa in PD patients (post-L-dopa) was lower compared with HCs, but not significantly (p = 0.52).
CONCLUSION
Increased GABA+ levels were present in the upper brainstem with PD patients post-L-dopa, suggesting dopaminergic therapy capable of improving dopamine may improve the GABA+ levels in the upper brainstem, thereby achieving the effect of modulating the GABAergic system in the treatment of PD.
Topics: Brain Stem; Dopamine; Humans; Levodopa; Parkinson Disease; gamma-Aminobutyric Acid
PubMed: 33548666
DOI: 10.1016/j.jns.2021.117309 -
Advances in Experimental Medicine and... 2020Parkinson's disease (PD) is a major cause of morbidity and mortality among older individuals. Several researchers have suggested that iron chelators which cross the... (Review)
Review
Parkinson's disease (PD) is a major cause of morbidity and mortality among older individuals. Several researchers have suggested that iron chelators which cross the blood-brain barrier (BBB) might have clinical efficacy in treating PD. Therefore, efforts are made not only in order to improve the effect of L-dopa but also to introduce drugs which provide anti-parkinsonian and neuroprotective effects. In this study, quercetin, a flavonoid, exhibited noticeable neuroprotective effects via iron induced-oxidative stress-dependent apoptotic pathways. Our results suggested that quercetin significantly decreased the catalepsy and exhibited neuroprotective effects in rotenone-induced Parkinson. A model of rotenone-induced Parkinsonism in rats produced the decrease in glutathione, SOD, catalase, and serum iron concentration and the increase in H2O2 and lipid peroxidation activity. Quercetin efficiently halted the deleterious toxic effects of L-dopa, revealing normalization of catalepsy and rotarod score, in addition to amelioration of neurochemical parameters, indicating benefit of both symptomatic and neuroprotective therapies. In silico molecular docking studies have also shown that quercetin could be an ideal potential drug target for aromatic L-amino acid decarboxylase and human catechol-O-methyltransferase. In conclusion, quercetin possesses strong iron-chelating abilities and could be recommended as a disease-modifying therapy when administered in combination with L-dopa, early on in the course of Parkinson's disease.
Topics: Animals; Antiparkinson Agents; Aromatic-L-Amino-Acid Decarboxylases; Catechol O-Methyltransferase; Humans; Levodopa; Molecular Docking Simulation; Parkinson Disease; Quercetin
PubMed: 32468451
DOI: 10.1007/978-3-030-32633-3_1 -
Expert Opinion on Pharmacotherapy May 2023Adenosine antagonism, i.e. of the A receptor, improves dopamine-sensitive motor behavior in patients with Parkinson's disease with oral levodopa-associated motor... (Review)
Review
INTRODUCTION
Adenosine antagonism, i.e. of the A receptor, improves dopamine-sensitive motor behavior in patients with Parkinson's disease with oral levodopa-associated motor complications. Only the xanthine derivative istradefylline is currently approved in Japan and in the US. This compound easily crosses the blood-brain barrier and shows high affinity to A receptors.
AREAS COVERED
This narrative review discusses the place of istradefylline in the current available drug portfolio for Parkinson's disease following a literature research in PubMed.
EXPERT OPINION
Istradefylline is safe and well tolerated. Its efficacy was pronounced, when patients were on a lower chronic oral levodopa regimen. Levodopa causes a homocysteine elevation, which reflects an impaired methylation potential. As a result, an upregulation of A receptor occurs and weakens the efficacy of istradefylline as modulator of dopamine effects on motor behavior in Parkinson's disease. This is the hypothetical reason why clinical trials failed, when patients were on a higher chronic levodopa regimen.A way out of this dilemma is to enable higher dosing of istradefylline and substitution of L-dopa with compounds, which do not influence the methylation capacity. Long-term trials may show these levodopa sparing and thus motor complications delaying effects of istradefylline.
Topics: Humans; Parkinson Disease; Levodopa; Adenosine A2 Receptor Antagonists; Purines; Antiparkinson Agents
PubMed: 37029952
DOI: 10.1080/14656566.2023.2201374 -
Molecular Medicine Reports Mar 2021The dopamine precursor 3,4‑dihydroxyphenyl‑ l‑alanine (L‑DOPA) is the most widely used symptomatic treatment for Parkinson's disease (PD); however, its prolonged...
The dopamine precursor 3,4‑dihydroxyphenyl‑ l‑alanine (L‑DOPA) is the most widely used symptomatic treatment for Parkinson's disease (PD); however, its prolonged use is associated with L‑DOPA‑induced dyskinesia in more than half of patients after 10 years of treatment. The present study investigated whether co‑treatment with β‑Lapachone, a natural compound, and L‑DOPA has protective effects in a 6‑hydroxydopamine (6‑OHDA)‑induced mouse model of PD. Unilateral 6‑OHDA‑lesioned mice were treated with vehicle or β‑Lapachone (10 mg/kg/day) and L‑DOPA for 11 days. Abnormal involuntary movements (AIMs) were scored on days 5 and 10. β‑Lapachone (10 mg/kg) co‑treatment with L‑DOPA decreased the AIMs score on both days 5 and 10. β‑Lapachone was demonstrated to have a beneficial effect on the axial and limb AIMs scores on day 10. There was no significant suppression in dopamine D1 receptor‑related and ERK1/2 signaling in the DA‑denervated striatum by β‑Lapachone‑cotreatment with L‑DOPA. Notably, β‑Lapachone‑cotreatment with L‑DOPA increased phosphorylation at the Ser9 site of glycogen synthase kinase 3β (GSK‑3β), indicating suppression of GSK‑3β activity in both the unlesioned and 6‑OHDA‑lesioned striata. In addition, astrocyte activation was markedly suppressed by β‑Lapachone‑cotreatment with L‑DOPA in the striatum and substantia nigra of the unilateral 6‑OHDA model. These findings suggest that β‑Lapachone cotreatment with L‑DOPA therapy may have therapeutic potential for the suppression or management of the development of L‑DOPA‑induced dyskinesia in patients with PD.
Topics: Animals; Dyskinesias; Levodopa; Male; Mice; Naphthoquinones; Oxidopamine; Parkinson Disease, Secondary
PubMed: 33495840
DOI: 10.3892/mmr.2021.11856 -
PloS One 2022Simultaneous imaging of l-dihydroxyphenylalanine (l-DOPA), dopamine (DA) and norepinephrine (NE) in the catecholamine metabolic pathway is particularly useful because...
Simultaneous imaging of l-dihydroxyphenylalanine (l-DOPA), dopamine (DA) and norepinephrine (NE) in the catecholamine metabolic pathway is particularly useful because l-DOPA is a neurophysiologically important metabolic intermediate. In this study, we found that 2,4,6-trimethylpyrillium tetrafluoroborate (TMPy) can selectively and efficiently react with target catecholamine molecules. Specifically, simultaneous visualization of DA and NE as metabolites of l-DOPA with high steric hinderance was achieved by derivatized-imaging mass spectrometry (IMS). Interestingly, l-DOPA showed strong localization in the brainstem, in contrast to the pattern of DA and NE, which co-localized with tyrosine hydroxylase (TH). In addition, to identify whether the detected molecules were endogenous or exogenous l-DOPA, mice were injected with l-DOPA deuterated in three positions (D3-l-DOPA), which was identifiable by a mass shift of 3Da. TMPy-labeled l-DOPA, DA and NE were detected at m/z 302.1, 258.1 and 274.1, while their D3 versions were detected at 305.0, 261.1 and 277.1 in mouse brain, respectively. l-DOPA and D3-l-DOPA were localized in the BS. DA and NE, and D3-DA and D3-NE, all of which are metabolites of L-DOPA and D3-l-DOPA, were localized in the striatum (STR) and locus coeruleus (LC). These findings suggest a mechanism in the brainstem that allows l-DOPA to accumulate without being metabolized to monoamines downstream of the metabolic pathway.
Topics: Animals; Catecholamines; Dopamine; Levodopa; Mass Spectrometry; Mice; Norepinephrine
PubMed: 35917331
DOI: 10.1371/journal.pone.0271697