Neale R, Gerhardt S, Liebman J M
Psychopharmacology (Berl). 1984;82(1-2):20-6. doi: 10.1007/BF00426374.
It has been suggested that the neuroleptic-induced acute dyskinetic syndrome in monkeys may be a useful model of extrapyramidal dysfunction. Various drugs that have well-characterized effects on clinical extrapyramidal syndromes and on catecholaminergic, cholinergic, or GABAergic neurotransmission were assessed in dyskinesia-susceptible squirrel monkeys. Catecholamine depletors (alpha-methyl-p-tyrosine, tetrabenazine) induced the syndrome, as do dopamine (DA) receptor antagonists, and d-amphetamine reversed the effects of tetrabenazine. The haloperidol-induced syndrome was reversed by the indirectly acting DA agonists amantadine and L-dopa. Neither of the DA autoreceptor agonist TL-99 or 3-PPP elicited this syndrome, suggesting that these agents lack extrapyramidal involvement. Anticholinergics reversed haloperidol-induced dyskinesias and the cholinomimetic arecoline was capable of inducing dyskinesias. When coadministered repeatedly with haloperidol, benztropine suppressed the emergence of susceptibility to neuroleptic-induced dyskinesias. These results confirm that the acute dyskinetic syndrome in the monkey is characterized by DA deficiency and acetylcholine excess. Diazepam and baclofen, which have been reported to have some clinical benefit in tardive dyskinesia, suppressed haloperidol-induced acute dyskinesias without causing gross motor depression. Pharmacological manipulation of GABAergic pathways from striatum may constitute a fruitful approach to the treatment of dyskinetic motor disorders.
有人提出,猴子中抗精神病药物诱发的急性运动障碍综合征可能是锥体外系功能障碍的有用模型。在对运动障碍易感的松鼠猴中评估了各种对临床锥体外系综合征以及对儿茶酚胺能、胆碱能或γ-氨基丁酸能神经传递有明确作用的药物。儿茶酚胺耗竭剂(α-甲基对酪氨酸、丁苯那嗪)诱发了该综合征,多巴胺(DA)受体拮抗剂也能诱发,而右旋苯丙胺可逆转丁苯那嗪的作用。间接作用的DA激动剂金刚烷胺和左旋多巴可逆转氟哌啶醇诱发的综合征。DA自身受体激动剂TL-99或3-PPP均未诱发该综合征,表明这些药物不涉及锥体外系。抗胆碱能药物可逆转氟哌啶醇诱发的运动障碍,拟胆碱药槟榔碱能够诱发运动障碍。当与氟哌啶醇反复联合给药时,苯海索可抑制对抗精神病药物诱发运动障碍易感性的出现。这些结果证实,猴子中的急性运动障碍综合征的特征是DA缺乏和乙酰胆碱过量。据报道,地西泮和巴氯芬在迟发性运动障碍中有一定临床益处,它们可抑制氟哌啶醇诱发的急性运动障碍,而不会引起明显的运动抑制。对纹状体γ-氨基丁酸能通路进行药理学调控可能是治疗运动障碍性运动疾病的有效方法。