Low cerebrospinal fluid glutamate in schizophrenic patients and a new hypothesis on schizophrenia

Decreased expression of mRNAs encoding non-NMDA glutamate receptors GluR1 and GluR2 in medial temporal lobe neurons in schizophrenia

Schizophrenia is associated with a complex pattern of alterations in the glutamatergic system of the brain. Previous studies have shown a reduced density of some hippocampal non-N-methyl-D-aspartate (non-NMDA) receptors which is accompanied by a loss of encoding receptor mRNA. We have extended this work using in situ hybridization histochemistry with oligonucleotide probes specific for two non-NMDA receptor transcripts, GluR1 and GluR2, in right and left medial temporal lobe sections from 9 schizophrenics and 14 matched normal controls. Both mRNAs were found to be decreased bilaterally and to a similar degree in the hippocampal formation in schizophrenia. Analysis of autoradiograms showed a regional loss of GluR1 and GluR2 mRNAs in dentate gyrus, CA4, CA3 and subiculum. GluR2 mRNA was also reduced in parahippocampal gyrus. These reductions ranged from 25% to 70% in terms of 35S nCi/g tissue equivalents. Additionally we measured grain density for the mRNAs over individual pyramidal neurons in each area. GluR1 and GluR2 mRNAs were less abundant per neuron in CA4 and CA3 in schizophrenia than in controls. GluR2 mRNA was also reduced significantly in parahippocampal gyrus neurons, with an increase in the proportion of GluR1 mRNA to GluR2 mRNA in this cell population. No asymmetries in expression of GluR1 and GluR2 were found in normal or schizophrenic brains. These data further the evidence for reduced non-NMDA receptor expression in the medial temporal lobe in schizophrenia. They confirm the decrease in GluR1 mRNA and show that there are similar losses of GluR2 mRNA in the hippocampal formation. The pattern of changes in the two mRNAs suggests a common mechanism which is unknown but which may be a correlate of the neurodevelopmental abnormalities postulated to underlie the disease. The reduction of GluR2 mRNA but not GluR1 mRNA in parahippocampal gyrus neurons in schizophrenia may have functional consequences given the calcium permeability of non-NMDA receptors lacking the GluR2 subunit.

Glutamate receptor subtype expression in human postmortem brain tissue from schizophrenics and alcohol abusers

Antibodies to functional AMPA/kainate (GluR1, GluR2, GluR3), and kainate binding sites (GluR5-7) were used as probes to characterize and quantitate glutamatergic receptor subtypes in human post-mortem brain tissue from schizophrenic subjects and non-psychotic control subjects, which included normal controls and subjects with a previous history of alcohol abuse. Crude membrane fractions from human hippocampi and cingulate cortices were fractionated by SDS-PAGE, electrotransferred to nitrocellulose, and probed for the various glutamate receptor subtypes. Western blots were developed with chemiluminescence and the images analyzed by densitometry. Significant reductions were observed in the hippocampal immunoreactivity of both GluR2 and GluR3 AMPA/kainate receptor subtypes in schizophrenic subjects compared to the entire group of non-psychotic control subjects. No significant changes were observed in schizophrenic hippocampal GluR1 and GluR5 receptor subtypes or in levels of the structural control proteins, NCAM and tau. Significant increases were observed for GluR2 and GluR3 in the hippocampi of subjects with alcohol abuse histories when compared to the non-psychotic normal control group. When subjects with alcohol abuse histories were removed from the non-psychotic control pool, schizophrenics were no longer statistically different from the remaining normal controls. An analysis of GluR2 and GluR3 immunoreactivity in the cingulate cortex revealed no changes in these receptor subtypes among any of the groups. No alterations were observed in the immunoreactivity of these various proteins due to confounding factors such as age, sex, postmortem interval, or smoking history, except in the cingulate cortex were GluR3 receptor subtype levels were significantly reduced in the brains of smokers.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of phencyclidine on the basal and high potassium evoked extracellular GABA levels in the striatum of freely-moving rats: an in vivo microdialysis study

The effect of phencyclidine (PCP) on the gamma-aminobutyric acid-ergic (GABAergic) transmission in the striatum of freely-moving rats was investigated using an in vivo microdialysis. The high potassium (100 mM) increased the extracellular GABA level to 4000% of the basal level. Although the basal GABA level in the striatal dialysate did not show either calcium dependency or tetrodotoxin (TTX) sensitivity, the high potassium evoked GABA level was reduced by 82% under calcium-free conditions (with 12.5 mM magnesium) and by 54% in the presence of 10 microM TTX. The systemic administration of PCP (7.5 mg/kg) or the local perfusion of PCP (100 microM and 1 mM) significantly inhibited the high potassium evoked GABA release in the rat striatum. The local perfusion of MK-801 (10 microM and 100 microM), a more potent and selective N-methyl-D-aspartate (NMDA) receptor antagonist, also inhibited the high potassium evoked striatal GABA release. These drugs did not show any significant effect on the basal extracellular GABA level. NMDA (1 mM) either partly or completely blocked the effect of PCP (1 mM) or MK-801 (100 microM) on the high potassium evoked striatal GABA release. On the other hand, nomifensine (100 microM), a dopamine uptake blocker, did not show any effect on the high potassium evoked GABA release. These results suggest that PCP inhibited the striatal GABAergic neuronal transmission through its antagonism of the NMDA receptor.

Effects of D-cycloserine and (+)-HA-966 on the locomotor stimulation induced by NMDA antagonists and clonidine in monoamine-depleted mice

We have previously observed that an N-methyl-D-aspartate (NMDA) antagonist in combination with the alpha 2-adrenoceptor agonist clonidine produces a marked locomotor stimulation in monoamine-depleted mice. In this paper we report on how the partial glycine agonists D-cycloserine (high intrinsic activity) and (+)-HA-966 [(+)-3-amino-1-hydroxypyrrolid-2-one; low intrinsic activity] affect this response; the interaction with both an uncompetitive and a competitive NMDA antagonist was investigated. (+)-HA-966 was found to counteract the locomotor stimulation produced by clonidine combined with either an uncompetitive (MK-801 = dizocilpine) or a competitive [D-CPPene = 3-(2-carboxypiperazine-4-yl)-1-propenyl-1-phosphonic acid] NMDA antagonist. D-cycloserine potentiated the locomotor stimulation produced by either NMDA antagonist combined with clonidine, although statistical significance was achieved only in the case of MK-801. If the present hyperactivity model has any relevance for psychosis the prediction based on the present results would be that d-cycloserine, contrary to current hopes, might not be so effective in schizophrenia, whereas (+)-HA-966 might be an interesting candidate.

Capillary zone electrophoretic determination of organic acids in cerebrospinal fluid from patients with central nervous system diseases

Organic acids in cerebrospinal fluid (CSF) from patients with various central nervous system (CNS) diseases were determined by capillary zone electrophoresis (CZE). Under one of the two sets of conditions employed, several anionic components of CSF were separated into corresponding peaks on the electropherograms and determined. The other conditions employed were also useful in measurement of the lactate contents in CSF. The CSF levels of lactate and pyruvate and the ratios of lactate to pyruvate were elevated in patients with cerebral infarction and bacterial meningitis, whereas CSF ascorbate was reduced mainly in inflammatory disorders of the CNS. The results showed that CZE can become a powerful tool in the biochemical diagnosis of CNS diseases.

Recent basic findings in support of excitatory amino acid hypotheses of schizophrenia

1. Several clinical and post-mortem tissue findings have suggested a role for excitatory amino acid neuronal systems in the pathophysiology of schizophrenia. 2. These include the ability of NMDA antagonists, phencyclidine and ketamine, to cause both negative and positive symptoms in healthy subjects, and abnormalities in the densities of some types of excitatory amino acid receptors in the postmortem tissue of schizophrenic brains. 3. The present review describes recent basic findings that have examined the involvement of excitatory amino acids in the mechanism of action of antipsychotic drugs. These include studies on the functional links between glutamatergic and dopaminergic systems, effect of acute and chronic antipsychotic drug treatment on excitatory amino acid function, and stress-induced activation of excitatory amino acid release, in particular in the prefrontal cortex.

Lack of effect of antipsychotic and antidepressant drugs on glutamate receptor mRNA levels in rat brains

By employing multiprobe oligonucleotide solution hybridisation (MOSH) we have measured the levels of mRNA encoding the NMDA receptor subtypes (R1, R2A, R2B and R2C) and the non-NMDA glutamate receptor subtypes (GluR1, 2, 3, and 4) within rat brain following, 1-32 days of antipsychotic or antidepressant drug administration. The results suggest that the drugs studied do not significantly alter rat glutamatergic system mRNA levels when compared to controls.

Iron, copper, zinc, magnesium, and calcium in postmortem brain tissue from schizophrenic patients

The regional distribution of iron, copper, zinc, magnesium, and calcium in postmortem brain of schizophrenic patients was compared with that of matched controls. In none of the brain regions investigated (caudate nucleus, hippocampus, amygdala, cortex, corpus mamillare, gyrus cinguli, and hypothalamus) were significant differences observed between these two groups. In the total group, region-specific differences were found for iron, copper, zinc, and calcium, but not for magnesium. Gender differences were observed only for zinc. There was no correlation between a neuroleptic-free period before death and the content of any of the metals investigated, except for a positive correlation between copper in the hippocampus and a neuroleptic-free period. The results of the present study suggest that there are no profound differences in the content of iron, copper, zinc, magnesium, and calcium in postmortem brains between controls and schizophrenic patients.

Systemic phencyclidine administration is associated with increased dopamine, GABA, and 5-HIAA levels in the dorsolateral striatum of conscious rats: an in vivo microdialysis study

In vivo microdialysis was used to study the effects of systemically administered phencyclidine (PCP, 10 mg/kg) on the extracellular levels of dopamine, dihydroxyphenylacetate (DOPAC), homovanillate (HVA), 5-hydroxy-indolacetate (5-HIAA), gamma-aminobutyrate (GABA), glutamate, and aspartate in the rat dorsolateral striatum. In order to demarcate the effects of anesthesia, tissue trauma and gliosis, the effect of PCP was studied in both anesthetized rats with long and short probe implantation periods and in conscious rats with a long probe implantation period. PCP significantly increased the extracellular levels of dopamine in all experimental groups, though the post-implantation interval and anesthesia modulated the degree of increase. PCP increased 5-HIAA levels in both conscious and anesthetized rats after a long post-implantation period and HVA only in anesthetized rats after a long post-implantation period. Glutamate, aspartate, and DOPAC were not affected by PCP challenge but our study indicated for the first time that systemic PCP elevates extracellular GABA in conscious rats.

Systemic administration of amperozide, a new atypical antipsychotic drug, preferentially increases dopamine release in the rat medial prefrontal cortex

The putative atypical antipsychotic drug amperozide (APZ) shows high affinity for serotonin 5-HT2 receptors but only low affinity for dopamine (DA) D2 receptors. By employing microdialysis, we examined the effects of APZ on extracellular concentrations of DA in the nucleus accumbens (NAC), the dorsolateral striatum (STR) and the medial prefrontal cortex (MPC) of awake rats. A 5.0 mg/kg (SC) dose of APZ failed to affect DA concentrations in the NAC, while it increased DA outflow in the STR (by 46%) and the MPC (by 207%). A higher dose of APZ (10 mg/kg, SC) enhanced dialysate DA from the NAC and the STR by 30%, and from the MPC by 326%. Similarly, clozapine (2.5 and 10 mg/kg, SC) produced a greater release of DA in the MPC (+ 127 and + 279%) than in the NAC (+ 52 and + 98%). The selective 5-HT2 receptor antagonist ritanserin (1.5 and 3.0 mg/kg, SC) also produced a slightly higher increase of DA output in the MPC (+ 25 and + 47%) compared with the NAC (+ 19 and + 21%). In contrast, the selective D2 receptor antagonist raclopride (0.5 and 2.0 mg/kg, SC) increased DA release in the NAC (+ 65 and + 119%) to a greater extent than in the MPC (+ 45 and + 67%). These data suggest that the 5-HT2 receptor antagonistic properties of APZ and clozapine may contribute to their preferential effects on DA transmission in the MPC. Infusion of low doses (1, 10 microM, 40 min) of APZ through the probe in the DA terminal areas did not affect significantly DA outflow, while infusion of high doses (100, 1000 microM, 40 min) resulted in a more pronounced elevation of DA levels in the NAC (up to 961%) and the STR (up to 950%) than in the MPC (up to 316%). These findings indicate that the selective action of systemically administered APZ on DA in the MPC is most likely mediated at a level other than the terminal region. Taken together, the present results provide support for the notion that 5-HT2 receptor antagonism may be of considerable significance for the action of atypical antipsychotic drugs on mesolimbocortical dopaminergic neurotransmission.

d-cycloserine adjuvant therapy to conventional neuroleptic treatment in schizophrenia: an open-label study

D-cycloserine, a partial agonist at the strychnine-insensitive glycine site of the NMDA receptor complex, was tested as adjuvant treatment to conventional neuroleptics in chronic schizophrenic volunteers. The drug was administered, o.a.d., at the daily dose of 250 mg for six weeks. Mental status outcome measures were completed at the end of each week of treatment. The major finding was a deterioration of the patients' clinical condition, specifically of their psychotic symptoms. These preliminary results are discussed among others in view of d-cycloserine pharmacologic properties and recent findings on the interaction between NMDA agonists and dopamine system. This study, finally, suggests the need for a controlled dose-finding trial to establish the activity and a therapeutic "window" of this drug in schizophrenia.

D-cycloserine decreases both D1 and D2 dopamine receptors number and their function in rat brain

Twenty-four hours after the implantation of the transstriatal probe D-cycloserine (3 mg/kg IP), a partial agonist of the strychnine-insensitive NMDA-associated glycine recognition site failed to change DA and DOPAC extracellular output in rat striatal dialysates. In extensively washed synaptic plasma membranes prepared both from cortices or striata of rats treated with D-cycloserine [3H]-MK 801 specific binding was increased. In contrast, in striatal membranes the Bmax values of both [3H]-SCH 23390 and [3H]-spiroperidol bindings to D1 and D2 dopamine receptors were decreased. Parallel decreases both of grooming behavior induced by the D1 agonist SKF 38393 (10 mg/kg IP) and of the hyperactivity elicited by the D2 agonist LY 171555 (0.3 mg/kg IP) in rat were observed.

In vivo effects of local and systemic phencyclidine on the extracellular levels of catecholamines and transmitter amino acids in the dorsolateral striatum of anaesthetized rats

The dose-dependent effects of systemically and locally administered phencyclidine (PCP) on the extracellular levels of dopamine, dihydroxyphenylacetate (DOPAC), homovanillate (HVA), 5-hydroxyindolacetate (5-HIAA), gamma-aminobutyrate (GABA), glutamate and aspartate in the dorsolateral striatum of anaesthetized rats were studied by in vivo microdialysis. Both local (1, 5, 50 and 100 microM) and systemic (2 and 10 mg kg-1 i.p.) PCP caused a dose-dependent increase in the extracellular levels of dopamine. The lowest PCP doses caused only a moderate but long-lasting increase in the extracellular levels of dopamine, while the highest PCP doses caused a massive but transient increase followed by a rebound decrease. The low doses of both systemic and local PCP tended to increase the levels of DOPAC, while those of HVA were not changed. The extracellular levels of 5-HIAA were increased only by the lowest (1 microM) locally administered dose of PCP. GABA levels were increased when PCP was administered locally at two doses. None of the treatments affected the extracellular levels of glutamate and aspartate. The results show that the effects of local and systemic PCP administration are dissimilar on the extracellular levels of 5-HIAA and GABA and thus provide new information on the neurochemical effects of PCP.

Increases in strychnine-insensitive glycine binding sites in cerebral cortex of chronic schizophrenics: evidence for glutamate hypothesis

Strychnine-insensitive glycine binding sites, an absolute requirement of the responses mediated by N-methyl-D-aspartate (NMDA) receptors, were measured in the postmortem brains of 13 chronic schizophrenics and 10 controls, using a radiolabeled receptor assay. Specific [3H]glycine binding was significantly increased in six of the 16 areas of the cerebral cortex that were investigated. Scatchard analysis performed in these areas showed a significant increase in the maximum number of binding sites, with no change in the affinity of binding. Multiple regression analysis confirmed that the increase was not due to age at death or interval from death to freezing. The increase was also observed in the off-drug cases of schizophrenics who had not taken antipsychotics for more than 40 days before death. These results suggest that the increases in NMDA-associated glycine binding sites, possibly ascribed to the postsynaptic compensation for impaired glutamatergic neurotransmission, might be implicated in the pathophysiology of schizophrenia.

Effect of phencyclidine on dopamine release in the rat prefrontal cortex; an in vivo microdialysis study

The effect of phencyclidine (PCP) on the extracellular dopamine levels in the rat prefrontal cortex was investigated using an in vivo brain dialysis technique. PCP increased extracellular dopamine levels in the prefrontal cortex of freely-moving rats after the systemic (7.5 mg/kg i.p.) or the local injection (100 microM and 500 microM). The local injection of MK-801, which is a more selective and potent NMDA receptor antagonist than PCP also increased the extracellular dopamine levels (from 10 microM to 100 microM). These results suggest that part of the effect of PCP is attributable to its antagonist effect on the NMDA receptor.

Glutamatergic drugs in Parkinson's disease

Recent findings in monkeys indicate that excitatory amino acids such as glutamate are involved in the pathophysiological cascade of MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine)- induced neuronal cell death. The neuroprotective effects of competitive and non-competitive NMDA (N-methyl-D-aspartate) antagonists against MPTP toxicity support the hypothesis that NMDA receptor-mediated events are involved in the neurotoxicity of MPTP. These results suggest that the clinical trial of NMDA antagonists in patients with Parkinson's disease should be performed. Further evidence obtained in animal models of Parkinson's disease indicates that both competitive NMDA antagonists and AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate) antagonists show symptomatic anti-parkinsonian activity in combination with L-DOPA. Glutamate antagonists may therefore retard the progression and improve the symptomatology of Parkinson's disease. The 1-amino-adamantanes amantadine and memantine have recently been shown to be non-competitive NMDA antagonists and are widely used in Europe as anti-parkinsonian agents. Both compounds are likely to cause pharmacotoxic psychosis as an unwanted side-effect. Clinical trials are needed to test the efficacy of the 1-amino-adamantanes with respect to the progression of Parkinson's disease.

Excitatory amino acids: implications for psychiatric disorders research

The hyperdopaminergic theory of schizophrenia may account for some types of schizophrenia, but schizophrenia with negative symptoms or resulting in a chronic state of deterioration after repeated relapses cannot be explained by this theory. This minireview first discusses the interactions between dopamine and excitatory amino acid (EAA) neurons to produce abnormal behavior. Secondly, it deals with the influence of the psychotropic drugs on EAA, such as the relationship between phencyclidine and the hypoglutamate theory, the involvement of EAA in behavioral sensitization induced by amphetamines, the interactions between antipsychotic, antidepressant and antianxiety drugs and EAA, considering the possibility of developing newer psychotropic drugs related with EAA. Finally, glutamate receptors measured in postmortem schizophrenic brains are tabulated and the bases of the hypoglutamate hypothesis are discussed.

Metabotropic excitatory amino acid receptor agonists selectively potentiate behavioral effects induced by ionotropic excitatory amino acid receptor agonists in mice

The behavioral consequences of co-activation of metabotropic and ionotropic excitatory amino acid receptors were studied in mice using intracerebroventricular (i.c.v.) co-infusion of the metabotropic receptor agonist 1S,3R-1-aminocyclopentane-1,3-dicarboxylate (1S,3R-ACPD) with the subtype-specific ionotropic receptor agonists N-methyl-D-aspartate (NMDA), kainate and alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA). I.c.v. co-infusion of ionotropic receptor agonists (0.3-3 nmol/min) with a fixed dose of 1S,3R-ACPD (144 nmol/min) decreased time to onset of clonic convulsions (P < 0.05). Pretreatment with i.c.v. infusion of 72 nmol of 1S,3R-ACPD reduced time to onset of convulsions induced by an intravenous (i.v.) infusion of NMDA (P < 0.05) but had no effect on convulsions induced by pentylenetetrazol. These results reveal that activation of the metabotropic excitatory amino acid receptor selectively potentiates the behavioral response following activation of the ionotropic excitatory amino acid receptors.

Pressure-induced disorders in neurotransmission and spontaneous behavior in rats: an animal model of psychosis

Disorders in neurotransmission and spontaneous behavior in rats exposed to a high pressure helium-oxygen mixture that shows interesting parallels with the dopaminergic hypothesis of schizophrenia at both the biochemical and the therapeutic responding levels are reviewed. Furthermore, as human subjects exposed to a very high pressure have shown psychotic episodes, we conclude that the pressure-induced disorders in neurotransmission and spontaneous behavior in rats could constitute a valid animal model of schizophreniform psychosis and a useful tool for both the investigation of the biological mechanisms underlying schizophrenia and the development of new antipsychotic drugs.

Distribution of glial fibrillary acidic protein and glutamine synthetase in human cerebral cortical astrocytes--a light and electron microscopic study

Human cerebral cortex was studied immunocytochemically by light and electron microscopy using antibodies against glial fibrillary acidic protein (GFAP) and glutamine synthetase (GS). Glial fibrillary acidic protein-positive cells and processes were present in both cortex and white matter, but in contrast glutamine synthetase-positive cells and processes were present only in cortex. Cell bodies which contained glutamine synthetase had typical ultrastructural features of protoplasmic astrocytes. Glutamine synthetase-positive processes were often present near asymmetrical synapses in the neuropil. These processes often contained mitochondria, but not glial filaments, and were different from unlabelled astrocytic processes, which seldom contained mitochondria, but had large numbers of glial filaments. Glutamine synthetase immunoreactivity therefore affords a means of distinguishing between these two types of astrocytic processes in the human cerebral cortex.

Clozapine improves dizocilpine-induced delayed alteration impairment in rats

The effects of systemic administration of dizocilpine (0.16 mg/kg, i.p.), clozapine (7.5 mg/kg, s.c.) and coadministration of dizocilpine (0.16 mg/kg, i.p.) and clozapine (7.5 mg/kg, s.c.) on acquisition of delayed alternation in a T-maze were tested in rats (N = 7 per group) on six days with 10 choices per day and animal. Clozapine given alone did not impair delayed alternation learning, except of the first day. Dizocilpine induced a significant delayed alternation impairment on all days tested. Pretreatment with clozapine significantly improved the dizocilpine-induced impairment. Treatment-induced changes of delayed alternation learning and of locomotor activities showed no correlation. The results demonstrate that clozapine functionally compensated for deficits induced by a blockade of the N-methyl-D-aspartate (NMDA) subtype of glutamate receptors.

A familial/genetic study of plasma serine and glycine concentrations

Plasma serine and glycine concentrations were assayed in a sample of 28 nuclear families (n = 108). Complex segregation analysis of these familial data reveals significant genetic control of concentrations via a single major gene locus. The serine and glycine metabolizing enzyme serine hydroxymethyltransferase (SHMT) is suggested as the most likely candidate for this single major gene locus.

Ultrastructural features of biopsied temporopolar cortex (area 38) in a case of schizophrenia

An electron microscopic study of tissue from area 38 of the temporopolar cortex obtained at surgery from a schizophrenic patient has established that, although the ultrastructure of this area was in general similar to that found in normal human cerebral cortex, the neuropil contained many unusual asymmetrical synapses. Their synaptic vesicles were clumped, often away from the synaptic thickenings, and the thickenings themselves were short, compared to the total length of apposed pre- and postsynaptic membranes. Some preterminals were unusual in that they were myelinated. The affected terminals were always of the asymmetrical variety, and therefore probably excitatory. Glutamate is likely to be the transmitter at, at least, some of these synapses. The clumped, but numerous, synaptic vesicles, together with short synaptic active zones, is consistent with previous observations of normal glutamate levels in schizophrenic brain, but reduced numbers of glutamate receptors in some cortical areas.

D-aspartate binding to the glutamate uptake site in human brain tissue--effects of leucotomy

Binding of [3H]D-aspartate, as an indicator of glutamate uptake sites, was investigated in post-mortem human brain tissue by use of a centrifugation assay to separate free and bound ligand. Binding was displaceable, apparently saturable and to a single site, with mean KD and Bmax values of 2.3 microM and 40.3 nmol/g tissue in the frontal cortex. The method was applied to the study of tissue from frontal and temporal cortices and the caudate nucleus of five psychiatric patients who had undergone a frontal leucotomy. The effects of this neurosurgical procedure were to diminish by almost 50% the density of D-aspartate binding sites in the frontal cortex and caudate nucleus, while the temporal cortex was less affected. It is concluded that the method provides a potentially useful correlate of glutamatergic innervation in human brain tissue.

Haloperidol and loxapine but not clozapine increase synaptic responses in the hippocampus

Effects of two typical neuroleptics haloperidol and loxapine, and an atypical antipsychotic clozapine on excitatory synaptic transmission were examined in the CA1 area of rat hippocampal slices. Haloperidol (10 mumol) and loxapine (10 mumol) increased extracelllar evoked field potentials by an average of 57 and 125% of the control level respectively. Clozapine (50 mumol) induced a transient depression (21% of control) of the response followed by a small augmentation (10%). Examination of haloperidol actions using the whole cell clamp technique showed an increase in the amplitude of the excitatory postsynaptic current (e.p.s.c.) in response to the drug without any apparent changes in the resting membrane current. These data suggest that haloperidol and loxapine may act by enhancing excitatory synaptic transmission in some areas of the brain, and that novel antipsychotic clozapine differs in its mechanism of action.

The sigma receptor ligand 1,3-di-(2-tolyl)guanidine in animal models of schizophrenia

The behavioral effects of the selective sigma ligand 1,3-di(2-tolyl)guanidine (DTG) were studied in rats. In the radial 8-arm maze, DTG (2, 4 and 8 mg/kg i.p.) reduced the number of arm entries in the spontaneous alternation task. In animals receiving 4 mg/kg DTG, the percentage of 135 degrees angles between consecutive arm entries decreased. In the open field, equipped with a holeboard, DTG (8 mg/kg) reduced the number of line crossings, rearings and head dips. Sniffing, measured in an experimental chamber, was also reduced. DTG prolonged the time that the animals were inactive. In combination with DL-amphetamine (4 mg/kg) or dizocilpine (0.16 mg/kg), DTG (8 mg/kg) decreased--but did not antagonize--the induced enhancement of locomotion and sniffing. These results demonstrate motor depressant effects of DTG on locomotion, rearing and sniffing. Since antagonists of sigma binding sites are known to produce opposite effects, we conclude that DTG--in behavioral terms--acts like an antagonist at sigma binding sites.

Phencyclidine treatment in mice: effects on phencyclidine binding sites and glutamate uptake in cerebral cortex preparations

The effects of a psychotomimetic drug, phencyclidine (PCP), on glutamatergic neurotransmission were studied in mice. The binding of tritiated N-[1-(2-thienyl)cyclohexyl]piperidine (TCP) to cerebral cortical membranes and the uptake of [3H]glutamate by cortical synaptosomal preparations were assessed after PCP treatment (1 mg/d/mouse for 3 days) with implanted minipumps. The binding capacity Bmax of TCP significantly increased but the binding constant KD remained the same after PCP exposure, indicating that more binding sites became available. The basic properties of the binding remained unaltered but the actions of glutamate, glutamate receptor agonists and glycine were potentiated in PCP-treated mice. The uptake of glutamate was saturable, consisting of both high- and low-affinity transport components. After PCP exposure the transport constant Km of the high-affinity component increased and that of the low-affinity component was not changed. The maximal velocity V of the high-affinity component increased while that of the low-affinity transport decreased. Moreover, inhibition by structural analogues was potentiated, suggesting modification of the glutamate transporter. The results show that chronic PCP treatment, used as a model of psychosis, markedly affects the studied glutamatergic parameters.

Amantadine and the glutamate hypothesis of schizophrenia. Experiences in the treatment of neuroleptic malignant syndrome

Amantadine was introduced for the pharmacological management of neuroleptic malignant syndrome (NMS) because of its beneficial effects in Parkinson's disease which were attributed to dopaminomimetic properties. While the dopaminomimetic effects of amantadine are weak under experimental conditions, recent studies have confirmed that amantadine is an antagonist at the N-methyl-D-aspartate (NMDA) type of the glutamate receptor. Amantadine has psychotomimetic properties in patients with Parkinson's disease and normal controls. Two of four patients who received amantadine for NMS suffered an exacerbation of their psychiatric illness. Our observations support the glutamate hypothesis of schizophrenia which suggests that reduced glutamatergic transmission causes a relative dopaminergic excess in the basal ganglia and the limbic system.

The NMDA positive modulator D-cycloserine potentiates the neuroleptic activity of D1 and D2 dopamine receptor blockers in the rat

According to the view that N-methyl-D-aspartate (NMDA) agonists could be seen as putative therapeutic agents in schizophrenia, the present study was aimed at investigating whether the NMDA positive modulator D-cycloserine (DCS) could show neuroleptic activity. When given alone, DCS (1.5, 3, 6, 12 mg/kg) failed to affect the stereotyped behavior induced by 0.5 mg/kg SC apomorphine, a test routinely used to detect neuroleptic activity. Nevertheless, the administration of different doses of DCS (1.5, 3, 6 mg/kg) in combination with the D1 dopamine receptor blocker SCH 23390 or the D2 antagonist YM 09151-2, both given in doses which by themselves were ineffective in blocking apomorphine elicited behavior, induced a dose- dependent neuroleptic effect. Furthermore the positive NMDA modulator allowed (-)-sulpiride, which given alone never antagonized the apomorphine-induced stereotypy, to exhibit a full neuroleptic activity. The lower dose of DCS effective in potentiating antipsychotic effect of dopaminergic blockers also counteracted the behavioral response (hypermotility) induced by the NMDA negative modulator MK-801 (0.25 mg/kg), thus indicating the specificity of DCS effect. The results strengthen the view that drugs which increase NMDA receptor function could be a useful supplement in the therapy of psychotic disorders.

The depolarization block hypothesis of neuroleptic action: implications for the etiology and treatment of schizophrenia

Antipsychotic drugs are known to block dopamine receptors soon after their administration, resulting in an increase in dopamine neuron firing and dopamine turnover. Nonetheless, antipsychotic drugs must be administered repeatedly to schizophrenics before therapeutic benefits are produced. Recordings from dopamine neurons in rats have revealed that chronic antipsychotic drug treatment results in the time-dependent inactivation of dopamine neuron firing via over-excitation, or depolarization block. Furthermore, the clinical profile of the response to antipsychotic drugs appears to correspond to the dopamine system affected: antipsychotic drugs that exert therapeutic actions in schizophrenics inactivate dopamine neuron firing in the limbic-related ventral tegmental area, whereas drugs that precipitate extrapyramidal side effects cause depolarization block of the motor-related substantia nigra dopamine cells. One factor that remains unresolved with regard to the actions of antipsychotic drugs is the relationship between dopamine turnover and depolarization block--i.e., why does a significant level of dopamine release or turnover remain after antipsychotic drug treatment if dopamine cells are no longer firing? We addressed this question using an acute model of neuroleptic-induced depolarization block. In this model, dopamine cells recorded in rats one month after partial dopamine lesions could be driven into depolarization block by the acute administration of moderate doses of haloperidol. However, similar doses of haloperidol, which were effective at increasing dopamine levels in the striatum of intact rats, failed to change dopamine levels in lesioned rats. This is consistent with a model in which neuroleptic drugs exert their therapeutic effects in schizophrenics by causing depolarization block in DA cells, thereby preventing further activation of dopamine neuron firing in response to external stimuli. Thus, attenuating the responsivity of the dopamine system to stimuli may be more relevant to the therapeutic actions of antipsychotic drugs than receptor blockade or decreases in absolute levels of dopamine, which could presumably be circumvented by homeostatic adaptations in this highly plastic system.

A rationale for NMDA receptor antagonist therapy of the neuroleptic malignant syndrome

The triad of rigidity, fever, and elevation of serum creatine phosphokinase (CPK) levels, labeled 'neuroleptic malignant syndrome' (NMS), is a dangerous complication of neuroleptic drug treatment. Amantadine was introduced for the pharmacological management of NMS because of its beneficial effects in Parkinson's disease which were attributed to direct or indirect dopaminomimetic properties of amantadine. While the dopaminomimetic effects of amantadine are weak under experimental conditions, recent studies have confirmed that amantadine is an antagonist at the N-methyl-D-aspartate (NMDA) type of glutamate receptor. Two lines of evidence suggest that amantadine or other NMDA receptor antagonists could be effective drugs for the reversal of NMS symptoms. First, glutamate antagonists restore the balance between glutamatergic and dopaminergic systems when dopaminergic transmission has been antagonized by neuroleptic drugs. Second, by virtue of their effects against rigor and spasticity, NMDA antagonists may reduce increased muscle tone and prevent rhabdomyolysis. In conclusion, NMS may be considered an iatrogenic excitatory aminoacid syndrome which is amenable to NMDA receptor antagonist therapy.

In vitro and in vivo characterization of the NMDA receptor-linked strychnine-insensitive glycine site

Modulation of the NMDA receptor by the strychnine-insensitive glycine site was studied both in vitro and in vivo. In vitro the glycinergic stimulation of [3H]MK801 binding was measured in three different rat forebrain membrane preparations. An increased association rate of [3H]MK801 in the presence of glycine was observed. The binding of the radioligand was also enhanced by D-serine, whereas L-serine was less potent. The concentration-effect curves were shifted to the right by the glycine antagonist 7-chlorokynurenic acid (7CKA). In vivo modulation of the N-methyl-D-aspartate (NMDA) receptor was studied using NMDA induced convulsions in 7 day old rats. The NMDA effect was blocked by (+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten,5,10-imine maleate (MK801) and D-(-)-2-amino-5-phosphono-pentanoic acid (AP5). The effect of a submaximal dose of NMDA was dose-dependently potentiated by 1-10 mg/kg D-serine, whereas higher doses of L-serine were needed to obtain a similar effect. 7CKA did not affect NMDA-induced convulsions but reduced the D-serine potentiation of NMDA responses. This study illustrates the ability of the strychnine-insensitive glycine site to modulate the NMDA receptor function both in vitro and in vivo.

Developments in the drug treatment of schizophrenia

Despite its efficacy in many cases, the drug treatment of schizophrenia remains problematic. A substantial proportion of patients do not improve, and many others suffer from unpleasant side-effects. In this review, Gavin Reynolds describes the new approaches to antipsychotic drug development that attempt to address these problems, and relates some of these approaches to growing evidence for neuronal pathology in the brain in schizophrenia.

Regionally selective deficits in uptake sites for glutamate and gamma-aminobutyric acid in the basal ganglia in schizophrenia

In a post-mortem study of schizophrenic and control subjects, the sodium-dependent binding of D-[3H]aspartate and [3H]nipecotic acid were used to investigate uptake sites of glutamate and gamma-aminobutyric acid (GABA), respectively, in subcortical brain regions. Binding to the glutamate uptake site was substantially reduced in both the putamen and lateral pallidum of the schizophrenic subjects. Binding to the GABA uptake site was substantially reduced in the putamen; smaller reductions were apparent in the caudate nucleus and lateral pallidum. The results suggest that glutamatergic and GABAergic mechanisms in the basal ganglia are abnormal in schizophrenia. These abnormalities could be relevant to the development of psychosis but could also relate to the spectrum of mild motor disturbances often described in the disease.

Typical and atypical neuroleptics antagonize MK-801-induced locomotion and stereotypy in rats

The effects of typical and atypical neuroleptics on MK-801-induced locomotor activity and stereotyped sniffing were tested. Pretreatment with the typical neuroleptic haloperidol (0.01, 0.05, 0.1, 0.5 mg/kg SC) and the dopamine D2 receptor selective antagonist eticlopride (0.005, 0.01, 0.05 mg/kg SC) each resulted in significant and dose-dependent reductions of locomotor activity and sniffing. The atypical neuroleptic clozapine (1.0, 5.0, 10.0 mg/kg SC) was somewhat unique in that all doses reduced locomotor activity, but only the highest dose (10.0 mg/kg) significantly reduced sniffing. The data support a functional interaction between glutamate and dopamine systems, and suggest that the behavioral activation associated with MK-801 may represent a valid model for detecting potential therapeutic agents in the treatment of schizophrenia. The data should be viewed as preliminary, however, until neuroleptics are characterized in other glutamate-based models that minimized or exclude the possible influence of nonspecific motor effects.

The contribution of the different binding sites of the N-methyl-D-aspartate (NMDA) receptor to the expression of behavior

The effects of competitive (CGP 37849 and CGP 39551) and non-competitive (dizocilpine) N-methyl-D-aspartate (NMDA) antagonists were tested in three animal models (catalepsy, sniffing, locomotion) and, in addition, the modulation of these effects by an agonist of the strychnine-insensitive glycine binding site was investigated. Both competitive and non-competitive NMDA antagonists reduced neuroleptic-induced catalepsy. Weak sniffing was induced by the competitive antagonist but strong sniffing by the non-competitive NMDA antagonist. Due to muscle relaxation the competitive antagonist reduced locomotion, in contrast to stimulation of locomotor activity induced by the non-competitive NMDA antagonist. The glycine agonist (D-cycloserine) potentiated the effects of the non-competitive but antagonized those of the competitive NMDA antagonist.

Smithkline Beecham Prize for Young Psychopharmacologists: A review of the relationship between calcium channels and psychiatric disorders

The symptoms and etiology of most major psychiatric disorders probably represent an underlying disturbance of neurotransmitter function. Understanding the mechanisms which control neurotransmitter function, and in particular neurotransmitter release, is therefore of considerable importance in determining the appropriate pharmacological treatment for these disorders. Calcium entry into neurons triggers the release of a wide range of neurotransmitters and recently our understanding of the mechanisms which control neuronal calcium entry has increased considerably. Neuronal calcium entry occurs through either voltage-sensitive or receptor-operated calcium channels. This article reviews the different subtypes of calcium channel, with particular reference to their structure; drugs which act upon them; and the possible function of the subtypes identified to date. In addition, it reviews the potential role of calcium channel antagonists in the treatment of a wide range of psychiatric disorders, and concludes that these drugs may have an increasing therapeutic role particularly in the treatment of drug dependence, mood disorders and Alzheimer's disease.

Competitive and non-competitive N-methyl-D-aspartate antagonists fail to prevent the induction of methamphetamine-induced sensitization

In order to elucidate the possible roles of the glutamate system in the mechanisms underlying behavioral sensitization, which is used as an animal model for human psychosis, we investigated the effects of 3-((+/-)-2-carboxypiperazin-4-yl)propyl-1-phosphonic acid (CPP) and MK-801 ((+)-dizocilpine), a competitive and noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, respectively, on methamphetamine-induced behavioral sensitization in rats. Administration of 0.5 mg/kg MK-801 enhanced 2 mg/kg methamphetamine-induced hyperactivity, whereas it reduced 6 mg/kg methamphetamine-induced stereotyped behavior markedly. CPP (10 mg/kg) reduced 2 mg/kg methamphetamine-induced stereotypy slightly. Repeated treatment with 2 and 6 mg/kg methamphetamine alone induced progressive augmentation of stereotypy, whereas combining either MK-801 or CPP with methamphetamine treatment abolished or attenuated this augmentation. However, when rats were challenged with methamphetamine after a 7-day period of abstinence, the intensity of stereotypy among the rats pretreated with repeated doses of methamphetamine alone or in combination with MK-801 or CPP did not differ significantly. These results indicate that competitive and non-competitive NMDA receptor antagonists modulate acute methamphetamine-induced abnormal behavior and sensitization expression, but they failed to prevent the induction of the neural mechanisms underlying behavioral sensitization.

Equivalent EEG sources determined by FFT approximation in healthy subjects, schizophrenic and depressive patients

In recent years, as a result of increasing calculation power of computers and with the aid of appropriate computer programs it has been made possible to calculate equivalent dipoles as intracranial representations of cerebral electrical activity. The present study investigated the localization of intracerebral equivalent dipoles in healthy controls and psychiatric patients. The equivalent dipole sources were calculated for conventional frequency bands of the background EEG. This was performed using the FFT approximation by Lehmann and Michel. Results showed more anterior equivalent sources for alpha and beta activity in all patients compared to controls. The beta activity was also generated in deeper brain structures in controls compared to patients. These results indicate that frequency bands may be generated in different brain structures in patients suffering from psychiatric diseases as compared to healthy controls and that the calculation of equivalent dipole sources may be a way to perform a sensible and substantial data reduction.

Deficient NMDA-mediated glutamate release from synaptosomes of schizophrenics

Previous studies from our laboratory indicated that the veratridine-induced release of glutamate and GABA from synaptosomes derived from brains of schizophrenics was decreased. In the present study, synaptosomes were prepared from frozen brain samples from schizophrenics and from controls. Stimulation by 10 mumol/L 2-amino-3-hydroxy-5-methoxylisoxazole-4-propionic acid (AMPA) produced equal glutamate release from both groups. Release induced by either 10 mumol/L kainic acid (KA) or n-methyl-d-asparate (NMDA) was reduced significantly in the preparations derived from schizophrenics. Similarly, the amount of GABA released by 50 mumol/L glutamate was also reduced in the schizophrenic-derived synaptosomes. However, in membranes derived from the crude synaptosomal pellet, no differences between the controls and schizophrenics were observed in measures of total glutamate binding or its displacement by NMDA. The data demonstrate a deficiency in NMDA (and possibly KA) receptor functioning schizophrenics and support the "second-generation" theories of schizophrenia as a glutamatergic deficiency disorder.