Schneider J S, Gonczi Heather, Decamp Emmanuel
Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, 1020 Locust Street, 521 JAH, Philadelphia, PA 19107, USA.
Brain Res. 2003 Nov 14;990(1-2):38-44. doi: 10.1016/s0006-8993(03)03382-1.
Levodopa-induced dyskinesias (LIDs) present a major problem for the long-term management of Parkinson's disease (PD) patients. Due to the interdependence of risk factors in clinical populations, it is difficult to independently examine factors that may influence the development of LIDs. Using macaque monkeys with different types of MPTP-induced parkinsonism, the current study evaluated the degree to which rate of symptom progression, symptom severity, and response to and duration of levodopa therapy may be involved in the development of LIDs. Monkeys with acute (short-term) MPTP exposure, rapid symptom onset and short symptom duration prior to initiation of levodopa therapy developed dyskinesia between 11 and 24 days of daily levodopa administration. In contrast, monkeys with long-term MPTP exposure, slow symptom progression and/or long symptom duration prior to initiation of levodopa therapy were more resistant to developing LIDs (e.g., dyskinesia developed no sooner than 146 days of chronic levodopa administration). All animals were similarly symptomatic at the start of levodopa treatment and had similar therapeutic responses to the drug. These data suggest distinct differences in the propensity to develop LIDs in monkeys with different rates of symptom progression or symptom durations prior to levodopa and demonstrate the value of these models for further studying the pathophysiology of LIDs.
左旋多巴诱导的运动障碍(LIDs)是帕金森病(PD)患者长期管理中的一个主要问题。由于临床人群中风险因素相互依存,很难独立研究可能影响LIDs发生的因素。本研究利用不同类型MPTP诱导帕金森病的猕猴,评估症状进展速度、症状严重程度以及左旋多巴治疗反应和持续时间在LIDs发生过程中可能涉及的程度。在开始左旋多巴治疗前,急性(短期)MPTP暴露、症状快速发作且持续时间短的猕猴,在每日给予左旋多巴11至24天之间出现运动障碍。相比之下,在开始左旋多巴治疗前长期MPTP暴露、症状进展缓慢和/或持续时间长的猕猴对发生LIDs更具抵抗力(例如,慢性左旋多巴给药146天后才出现运动障碍)。所有动物在左旋多巴治疗开始时症状相似,对药物的治疗反应也相似。这些数据表明,在左旋多巴治疗前症状进展速度或持续时间不同的猕猴中,发生LIDs的倾向存在明显差异,并证明了这些模型在进一步研究LIDs病理生理学方面的价值。