Willis Gregory L
The Bronowski Institute of Behavioural Neuroscience, Coliban Medical Centre, Kyneton, Victoria, Australia.
Brain Res. 2008 Jun 27;1217:119-31. doi: 10.1016/j.brainres.2008.03.083. Epub 2008 Apr 11.
Circadian involvement in Parkinson's disease (PD) and more specifically in nigro-striatal dopamine (NSD) function is of increasing interest to the neurosciences. Given that bright light therapy is of therapeutic value in PD, possible mechanisms underlying retinal involvement in this phenomenon was explored further by administering anti-Parkinsonian chemotherapies into the vitreus humour directly adjacent to the retina. 2 microl of a 100 mM solution of L-Dopa significantly improved motor function in the later stages of degeneration and during the day while the injection of 2 microl of a 10 mM solution of the melatonin receptor antagonist ML-23 improved motor function in the early stages of PD and during the dark phase of the light/dark cycle. The results suggest that the function of nigral cells is regulated by a more global system embracing circadian physiology that extends from the retina to the pineal. Furthermore, the induction of PD is characterised by an imbalance between melatonin and dopamine (DA) whereby this ratio is elevated at least 6 to 1 in favour of melatonin. The commonly observed treatment failures and side effects of DA replacement therapy probably result from increasing endogenous DA without taking parallel melatonin dysfunction into account. The proposed integrated function of the NSD and circadian systems may permit therapeutic targeting at a level which is safer, more effective and without the side effects of systemically administered regimens of DA replacement.
昼夜节律与帕金森病(PD)的关联,尤其是与黑质纹状体多巴胺(NSD)功能的关联,越来越受到神经科学领域的关注。鉴于强光疗法对帕金森病具有治疗价值,通过将抗帕金森病化疗药物直接注射到紧邻视网膜的玻璃体液中,进一步探索了视网膜参与这一现象的潜在机制。2微升100 mM的左旋多巴溶液在退变后期和白天显著改善了运动功能,而注射2微升10 mM的褪黑素受体拮抗剂ML-23在帕金森病早期和光/暗周期的黑暗阶段改善了运动功能。结果表明,黑质细胞的功能受一个更广泛的系统调节,该系统包含从视网膜延伸到松果体的昼夜节律生理学。此外,帕金森病的诱发特征是褪黑素与多巴胺(DA)之间的失衡,即该比例至少升高至6比1,有利于褪黑素。多巴胺替代疗法常见的治疗失败和副作用可能是由于增加内源性多巴胺而未考虑到同时存在的褪黑素功能障碍。所提出的NSD和昼夜节律系统的整合功能可能允许在一个更安全、更有效且无全身给药多巴胺替代方案副作用的水平上进行治疗靶向。