Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Physiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Mov Disord. 2017 Dec;32(12):1694-1700. doi: 10.1002/mds.27169. Epub 2017 Sep 26.
Recent neuroimaging studies implicate nigrostriatal degeneration as a critical factor in producing late-onset parkinsonism in patients with l-dopa-responsive dystonia-causing mutations. However, postmortem anatomical studies do not reveal neurodegeneration in l-dopa-responsive dystonia patients. These contrasting findings make it unclear how parkinsonism develops in l-dopa-responsive dystonia mutation carriers.
We prospectively assessed motor dysfunction, responses to dopaminergic challenge, and dopamine neuron degeneration with aging in a validated knockin mouse model bearing a l-dopa-responsive dystonia-causing mutation found in humans.
As l-dopa-responsive dystonia mice aged, dystonic movements waned while locomotor activity decreased and initiation of movements slowed. Despite the age-related reduction in movement, there was no evidence for degeneration of midbrain dopamine neurons. Presynaptically mediated dopaminergic responses did not change with age in l-dopa-responsive dystonia mice, but responses to D1 dopamine receptor agonists decreased with age.
We have demonstrated for the first time the co-occurrence of dystonia and Parkinson's-like features (mainly consisting of hypokinesia) in a genetic mouse model. In this model we show that these features evolve without dopaminergic neurodegeneration, suggesting that postsynaptic plasticity, rather than presynaptic degeneration, may contribute to the development of parkinsonism in patients with l-dopa-responsive dystonia. © 2017 International Parkinson and Movement Disorder Society.
最近的神经影像学研究表明,黑质纹状体变性是导致伴有 l-多巴反应性肌张力障碍基因突变的患者发生迟发性帕金森病的关键因素。然而,尸检解剖研究并未发现 l-多巴反应性肌张力障碍患者存在神经退行性变。这些相互矛盾的发现使得 l-多巴反应性肌张力障碍突变携带者中帕金森病的发展机制仍不清楚。
我们前瞻性地评估了一种经验证的携带人类 l-多巴反应性肌张力障碍致病突变的基因敲入小鼠模型的运动功能障碍、对多巴胺能挑战的反应以及随年龄增长的多巴胺神经元变性。
随着 l-多巴反应性肌张力障碍小鼠年龄的增长,舞蹈样运动逐渐减轻,而运动活性降低,运动起始减慢。尽管运动相关的减少,但没有证据表明中脑多巴胺神经元发生变性。在 l-多巴反应性肌张力障碍小鼠中,多巴胺能反应的突触前介导并未随年龄而改变,但 D1 多巴胺受体激动剂的反应随年龄而降低。
我们首次在遗传小鼠模型中证明了肌张力障碍和帕金森样特征(主要由运动减少组成)的共同发生。在该模型中,我们发现这些特征的发生没有多巴胺能神经退行性变,这表明突触后可塑性而不是突触前变性可能导致 l-多巴反应性肌张力障碍患者帕金森病的发展。 © 2017 国际帕金森病和运动障碍协会。