Jourdain Vincent A, Morin Nicolas, Grégoire Laurent, Morissette Marc, Di Paolo Thérèse
Neuroscience Research Unit, Centre Hospitalier Universitaire de Québec; and.
Faculty of Pharmacy, Laval University, Quebec, Canada.
J Neurosurg. 2015 Dec;123(6):1383-93. doi: 10.3171/2014.10.JNS141570. Epub 2015 May 1.
Unilateral subthalamotomy is a surgical procedure that may be used to alleviate disabling levodopa-induced dyskinesias (LIDs) in patients with Parkinson disease (PD). However, the mechanisms involved in LID remain largely unknown. The subthalamic nucleus (STN) is the sole glutamatergic nucleus within the basal ganglia, and its lesion may produce changes in glutamate receptors in various areas of the basal ganglia. The authors aimed to investigate the biochemical changes in glutamate receptors in striatal and pallidal regions of the basal ganglia after lesion of the STN in parkinsonian macaque monkeys.
The authors treated 12 female ovariectomized monkeys with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to induce PD-like symptoms, treated 8 of these animals with 3,4-dihydroxy-l-phenylalanine (L-DOPA; levodopa) to induce LID, and performed unilateral subthalamotomy in 4 of these 8 monkeys. Four additional monkeys were treated with saline only and were used as controls. The MPTP monkeys had previously been shown to respond behaviorally to lower doses of levodopa after the STN lesion. Autoradiography of slices from postmortem brain tissues was used to visualize changes in the specific binding of striatal and pallidal ionotropic glutamate receptors (that is, of the α-amino-3-hydroxy 5-methyl-4-isoxazole propionate [AMPA] and N-methyl-d-aspartate [NMDA] NR1/NR2B subunit receptors) and of metabotropic glutamate (mGlu) receptors (that is, mGlu2/3 and mGlu5 receptors). The specific binding and distribution of glutamate receptors in the basal ganglia of the levodopa-treated, STN-lesioned MPTP monkeys were compared with those in the saline-treated control monkeys and in the saline-treated and levodopa-treated MPTP monkeys.
The autoradiographic results indicated that none of the pharmacological and surgical treatments produced changes in the specific binding of AMPA receptors in the basal ganglia. Levodopa treatment increased the specific binding of NMDA receptors in the basal ganglia. Subthalamotomy reversed these increases in the striatum, but in the globus pallidus (GP), the subthalamotomy reversed these increases only contralaterally. Levodopa treatment reversed MPTP-induced increases in mGlu2/3 receptors only in the GP. mGlu2/3 receptor-specific binding in the striatum and GP decreased bilaterally in the levodopa-treated, STN-lesioned MPTP monkeys compared with the other 3 groups. Compared with mGlu5 receptor-specific binding in the control monkeys, that of the levodopa-treated MPTP monkeys increased in the dorsal putamen and remained unchanged in the caudate nucleus and in the GP.
These results implicate glutamate receptors in the previously observed benefits of unilateral subthalamotomy to improve motor control.
单侧丘脑底核毁损术是一种外科手术,可用于缓解帕金森病(PD)患者因左旋多巴诱发的致残性异动症(LIDs)。然而,LIDs的发病机制仍 largely未知。丘脑底核(STN)是基底神经节内唯一的谷氨酸能核团,其损伤可能导致基底神经节各区域谷氨酸受体发生变化。作者旨在研究帕金森病猕猴STN损伤后基底神经节纹状体和苍白球区域谷氨酸受体的生化变化。
作者用1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)处理12只雌性去卵巢猕猴以诱发类似PD的症状,其中8只动物用3,4-二羟基-L-苯丙氨酸(L-DOPA;左旋多巴)处理以诱发LIDs,并对这8只猕猴中的4只进行单侧丘脑底核毁损术。另外4只猕猴仅用生理盐水处理并作为对照。之前已证明MPTP猕猴在STN损伤后对较低剂量的左旋多巴有行为反应。利用死后脑组织切片的放射自显影术来观察纹状体和苍白球离子型谷氨酸受体(即α-氨基-3-羟基-5-甲基-4-异恶唑丙酸[AMPA]和N-甲基-D-天冬氨酸[NMDA] NR1/NR2B亚基受体)以及代谢型谷氨酸(mGlu)受体(即mGlu2/3和mGlu5受体)特异性结合的变化。将经左旋多巴处理、STN损伤的MPTP猕猴基底神经节中谷氨酸受体的特异性结合和分布与生理盐水处理的对照猕猴以及生理盐水处理和左旋多巴处理的MPTP猕猴进行比较。
放射自显影结果表明,药理学和手术治疗均未引起基底神经节AMPA受体特异性结合的变化。左旋多巴治疗增加了基底神经节NMDA受体的特异性结合。丘脑底核毁损术逆转了纹状体中这些增加,但在苍白球(GP)中,丘脑底核毁损术仅对侧逆转了这些增加。左旋多巴治疗仅在GP中逆转了MPTP诱导的mGlu2/3受体增加。与其他3组相比,经左旋多巴处理、STN损伤的MPTP猕猴纹状体和GP中mGlu2/3受体特异性结合双侧降低。与对照猕猴中mGlu5受体特异性结合相比,经左旋多巴处理的MPTP猕猴背侧壳核中的mGlu5受体特异性结合增加,尾状核和GP中的mGlu5受体特异性结合保持不变。
这些结果表明谷氨酸受体与之前观察到的单侧丘脑底核毁损术改善运动控制的益处有关。