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. 2012 Sep;36(6):2839-48.
doi: 10.1111/j.1460-9568.2012.08202.x. Epub 2012 Jul 5.

Serotonin transporter inhibition attenuates l-DOPA-induced dyskinesia without compromising l-DOPA efficacy in hemi-parkinsonian rats

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Serotonin transporter inhibition attenuates l-DOPA-induced dyskinesia without compromising l-DOPA efficacy in hemi-parkinsonian rats

Christopher Bishop et al. Eur J Neurosci. 2012 Sep.

Abstract

Long-term dopamine replacement therapy with l-DOPA in Parkinson's disease often leads to the development of abnormal involuntary movements known as l-DOPA-induced dyskinesia. Growing evidence suggests that, following dopamine cell loss, serotonin neurons acting as surrogates for dopaminergic processes take up l-DOPA, convert it to dopamine and release it in an unregulated fashion that precipitates dyskinesia. Although most studies have focused on serotonin 5-HT(1) receptor stimulation as an antidyskinetic strategy, targeting the serotonin transporter modulation of dopamine activity has been overlooked. Therefore, in the current study, selective serotonin reuptake inhibitors were tested for their ability to reduce l-DOPA- and apomorphine-induced dyskinesia. In Experiments 1 and 2, hemi-parkinsonian rats were primed with l-DOPA until stable dyskinesia developed. Rats in Experiment 1 were administered the selective serotonin reuptake inhibitors paroxetine, citalopram or fluoxetine, followed by l-DOPA. Abnormal involuntary movements and forepaw adjusting steps were recorded to determine the effects of these compounds on dyskinesia and motor performance, respectively. Brains were collected on the final test day, after which striatal and raphe monoamines were examined via high-performance liquid chromatography. In Experiment 2, dyskinesias were measured after selective serotonin reuptake inhibitors and apomorphine. Serotonin reuptake inhibitors dose-dependently attenuated l-DOPA- but not apomorphine-induced dyskinesia, and preserved l-DOPA efficacy. Neurochemically, serotonin transporter inhibition enhanced striatal and raphe serotonin levels and reduced its turnover, indicating a potential mechanism of action. The present results support targeting serotonin transporters to improve Parkinson's disease treatment and provide further evidence for the role of the serotonin system in l-DOPA's effects.

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Figures

Figure 1
Figure 1
Effects of the serotonin reuptake inhibitors (SSRIs) paroxetine (A,D), citalopram (B,E) and fluoxetine (C,F) on L-DOPA-induced abnormal involuntary movements (AIMs; A–C) and rotations (D–F). Rats were treated with vehicle, paroxetine (0.5 or 1.25 mg/kg, i.p.), citalopram (3 or 5 mg/kg, i.p.) or fluoxetine (10 or 20 mg/kg, i.p.) 30 minutes prior to vehicle or L-DOPA (6 mg/kg, s.c.) + benserazide (15 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 3 hours after L-DOPA. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle + L-DOPA vs. paroxetine (1.25), citalopram (5) and fluoxetine (20) + L-DOPA, +p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.5), citalopram (3) and fluoxetine (10) + L-DOPA, ^p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.3), citalopram (1) and fluoxetine (5) + L-DOPA.
Figure 1
Figure 1
Effects of the serotonin reuptake inhibitors (SSRIs) paroxetine (A,D), citalopram (B,E) and fluoxetine (C,F) on L-DOPA-induced abnormal involuntary movements (AIMs; A–C) and rotations (D–F). Rats were treated with vehicle, paroxetine (0.5 or 1.25 mg/kg, i.p.), citalopram (3 or 5 mg/kg, i.p.) or fluoxetine (10 or 20 mg/kg, i.p.) 30 minutes prior to vehicle or L-DOPA (6 mg/kg, s.c.) + benserazide (15 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 3 hours after L-DOPA. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle + L-DOPA vs. paroxetine (1.25), citalopram (5) and fluoxetine (20) + L-DOPA, +p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.5), citalopram (3) and fluoxetine (10) + L-DOPA, ^p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.3), citalopram (1) and fluoxetine (5) + L-DOPA.
Figure 1
Figure 1
Effects of the serotonin reuptake inhibitors (SSRIs) paroxetine (A,D), citalopram (B,E) and fluoxetine (C,F) on L-DOPA-induced abnormal involuntary movements (AIMs; A–C) and rotations (D–F). Rats were treated with vehicle, paroxetine (0.5 or 1.25 mg/kg, i.p.), citalopram (3 or 5 mg/kg, i.p.) or fluoxetine (10 or 20 mg/kg, i.p.) 30 minutes prior to vehicle or L-DOPA (6 mg/kg, s.c.) + benserazide (15 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 3 hours after L-DOPA. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle + L-DOPA vs. paroxetine (1.25), citalopram (5) and fluoxetine (20) + L-DOPA, +p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.5), citalopram (3) and fluoxetine (10) + L-DOPA, ^p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.3), citalopram (1) and fluoxetine (5) + L-DOPA.
Figure 1
Figure 1
Effects of the serotonin reuptake inhibitors (SSRIs) paroxetine (A,D), citalopram (B,E) and fluoxetine (C,F) on L-DOPA-induced abnormal involuntary movements (AIMs; A–C) and rotations (D–F). Rats were treated with vehicle, paroxetine (0.5 or 1.25 mg/kg, i.p.), citalopram (3 or 5 mg/kg, i.p.) or fluoxetine (10 or 20 mg/kg, i.p.) 30 minutes prior to vehicle or L-DOPA (6 mg/kg, s.c.) + benserazide (15 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 3 hours after L-DOPA. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle + L-DOPA vs. paroxetine (1.25), citalopram (5) and fluoxetine (20) + L-DOPA, +p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.5), citalopram (3) and fluoxetine (10) + L-DOPA, ^p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.3), citalopram (1) and fluoxetine (5) + L-DOPA.
Figure 1
Figure 1
Effects of the serotonin reuptake inhibitors (SSRIs) paroxetine (A,D), citalopram (B,E) and fluoxetine (C,F) on L-DOPA-induced abnormal involuntary movements (AIMs; A–C) and rotations (D–F). Rats were treated with vehicle, paroxetine (0.5 or 1.25 mg/kg, i.p.), citalopram (3 or 5 mg/kg, i.p.) or fluoxetine (10 or 20 mg/kg, i.p.) 30 minutes prior to vehicle or L-DOPA (6 mg/kg, s.c.) + benserazide (15 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 3 hours after L-DOPA. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle + L-DOPA vs. paroxetine (1.25), citalopram (5) and fluoxetine (20) + L-DOPA, +p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.5), citalopram (3) and fluoxetine (10) + L-DOPA, ^p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.3), citalopram (1) and fluoxetine (5) + L-DOPA.
Figure 1
Figure 1
Effects of the serotonin reuptake inhibitors (SSRIs) paroxetine (A,D), citalopram (B,E) and fluoxetine (C,F) on L-DOPA-induced abnormal involuntary movements (AIMs; A–C) and rotations (D–F). Rats were treated with vehicle, paroxetine (0.5 or 1.25 mg/kg, i.p.), citalopram (3 or 5 mg/kg, i.p.) or fluoxetine (10 or 20 mg/kg, i.p.) 30 minutes prior to vehicle or L-DOPA (6 mg/kg, s.c.) + benserazide (15 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 3 hours after L-DOPA. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle + L-DOPA vs. paroxetine (1.25), citalopram (5) and fluoxetine (20) + L-DOPA, +p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.5), citalopram (3) and fluoxetine (10) + L-DOPA, ^p<0.05 vs. vehicle + L-DOPA vs. paroxetine (0.3), citalopram (1) and fluoxetine (5) + L-DOPA.
Figure 2
Figure 2
Effects of the serotonin reuptake inhibitors (SSRIs) paroxetine, citalopram and fluoxetine on L-DOPA reversal of motor deficit on the forepaw adjusting steps test. Rats were treated with vehicle, paroxetine (0.5 or 1.25 mg/kg, i.p.), citalopram (3 or 5 mg/kg, i.p.) or fluoxetine (10 or 20 mg/kg, i.p.) 30 minutes prior to vehicle or L-DOPA (6 mg/kg, s.c.) + benserazide (15 mg/kg, s.c.). Forepaw adjusting steps were evaluated 60 minutes after final treatments. Values (as means ± S.E.M.) are expressed as percent stepping with the lesioned forepaw vs. intact forepaw. Significant differences were determined by 1-way ANOVAs for each SSRI. When appropriate, treatment differences were analyzed with Fischer LSD post-hocs. *p<0.05 vs. vehicle + vehicle, +p<0.05 vs. vehicle + L-DOPA ^p<0.05 vs. fluoxetine (10) + L-DOPA.
Figure 3
Figure 3
The effects the direct dopamine receptor agonist apomorphine (A,B) and their modulation by serotonin reuptake inhibitors (SSRIs) paroxetine, citalopram and fluoxetine (C,D) on abnormal involuntary movements (AIMs; A,C) and rotations (B,D). In experiment 1, rats (n=6) were treated with vehicle or apomorphine (0.025, 0.05 or 0.1 mg/kg, s.c.). In experiment 2 rats were pretreated with vehicle, paroxetine (0.5 mg/kg, i.p.), citalopram (3 mg/kg, i.p.) or fluoxetine (10 mg/kg, i.p.) 30 minutes prior to apomorphine (0.05 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 90 minutes after apomorphine. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle vs. apomorphine (0.1) +p<0.05 vehicle vs. apomorphine (0.05), ^p<0.05 vehicle vs. apomorphine (0.025) #p<0.05 vs. all other treatments.
Figure 3
Figure 3
The effects the direct dopamine receptor agonist apomorphine (A,B) and their modulation by serotonin reuptake inhibitors (SSRIs) paroxetine, citalopram and fluoxetine (C,D) on abnormal involuntary movements (AIMs; A,C) and rotations (B,D). In experiment 1, rats (n=6) were treated with vehicle or apomorphine (0.025, 0.05 or 0.1 mg/kg, s.c.). In experiment 2 rats were pretreated with vehicle, paroxetine (0.5 mg/kg, i.p.), citalopram (3 mg/kg, i.p.) or fluoxetine (10 mg/kg, i.p.) 30 minutes prior to apomorphine (0.05 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 90 minutes after apomorphine. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle vs. apomorphine (0.1) +p<0.05 vehicle vs. apomorphine (0.05), ^p<0.05 vehicle vs. apomorphine (0.025) #p<0.05 vs. all other treatments.
Figure 3
Figure 3
The effects the direct dopamine receptor agonist apomorphine (A,B) and their modulation by serotonin reuptake inhibitors (SSRIs) paroxetine, citalopram and fluoxetine (C,D) on abnormal involuntary movements (AIMs; A,C) and rotations (B,D). In experiment 1, rats (n=6) were treated with vehicle or apomorphine (0.025, 0.05 or 0.1 mg/kg, s.c.). In experiment 2 rats were pretreated with vehicle, paroxetine (0.5 mg/kg, i.p.), citalopram (3 mg/kg, i.p.) or fluoxetine (10 mg/kg, i.p.) 30 minutes prior to apomorphine (0.05 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 90 minutes after apomorphine. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle vs. apomorphine (0.1) +p<0.05 vehicle vs. apomorphine (0.05), ^p<0.05 vehicle vs. apomorphine (0.025) #p<0.05 vs. all other treatments.
Figure 3
Figure 3
The effects the direct dopamine receptor agonist apomorphine (A,B) and their modulation by serotonin reuptake inhibitors (SSRIs) paroxetine, citalopram and fluoxetine (C,D) on abnormal involuntary movements (AIMs; A,C) and rotations (B,D). In experiment 1, rats (n=6) were treated with vehicle or apomorphine (0.025, 0.05 or 0.1 mg/kg, s.c.). In experiment 2 rats were pretreated with vehicle, paroxetine (0.5 mg/kg, i.p.), citalopram (3 mg/kg, i.p.) or fluoxetine (10 mg/kg, i.p.) 30 minutes prior to apomorphine (0.05 mg/kg, s.c.). Summed axial, limb and orolingual (ALO) AIMs and rotations were evaluated every 10 minutes for 90 minutes after apomorphine. Values are expressed as medians (AIMs+median absolute difference) or means (+standard error of the mean). Significant differences were determined by non-parametric Friedman ANOVAs with Wilcoxon post-hocs (AIMs) or 2-way repeated measures ANOVAs (rotations) and Fischer LSD post-hocs. *p<0.05 vehicle vs. apomorphine (0.1) +p<0.05 vehicle vs. apomorphine (0.05), ^p<0.05 vehicle vs. apomorphine (0.025) #p<0.05 vs. all other treatments.

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