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Heldmann M, Mönch E, Kesseböhmer A, Brüggemann N, Münte TF, Ye Z. Pramipexole modulates fronto-subthalamic pathway in sequential working memory. Neuropsychopharmacology 2022; 48:716-723. [PMID: 36352204 PMCID: PMC10066371 DOI: 10.1038/s41386-022-01494-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022]
Abstract
Brain dopamine may regulate the ability to maintain and manipulate sequential information online. However, the precise role of dopamine remains unclear. This pharmacological fMRI study examined whether and how the dopamine D2/3 receptor agonist pramipexole modulates fronto-subthalamic or fronto-striatal pathways during sequential working memory. This study used a double-blind, randomized crossover design. Twenty-two healthy male volunteers completed a digit ordering task during fMRI scanning after receiving a single oral dose of 0.5-mg pramipexole or placebo. The pramipexole effects on task performance, regional activity, activity pattern similarity, and functional connectivity were analyzed. Pramipexole impaired task performance, leading to less accurate and slower responses in the digit ordering task. Also, it downregulated the maintenance-related subthalamic and dorsolateral prefrontal activity, increasing reaction times for maintaining sequences. In contrast, pramipexole upregulated the manipulation-related subthalamic and dorsolateral prefrontal activity, increasing reaction time costs for manipulating sequences. In addition, it altered the dorsolateral prefrontal activity pattern similarity and fronto-subthalamic functional connectivity. Finally, pramipexole reduced maintenance-related striatal activity, which did not affect the behavior. This study confirms the role of the fronto-subthalamic pathway in sequential working memory. Furthermore, it shows that D2 transmission can regulate sequential working memory by modulating the fronto-subthalamic pathway.
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Affiliation(s)
- Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, 23538, Germany.,Institute of Psychology II, University of Lübeck, Lübeck, 23538, Germany
| | - Eliana Mönch
- Department of Neurology, University of Lübeck, Lübeck, 23538, Germany
| | | | - Norbert Brüggemann
- Department of Neurology, University of Lübeck, Lübeck, 23538, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, 23538, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Lübeck, 23538, Germany. .,Institute of Psychology II, University of Lübeck, Lübeck, 23538, Germany.
| | - Zheng Ye
- Institute of Neuroscience, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China.
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García-Ramos R, Santos-García D, Alonso-Cánovas A, Álvarez-Sauco M, Ares B, Ávila A, Caballol N, Carrillo F, Escamilla Sevilla F, E. Freire, Gómez Esteban J, Legarda I, López Manzanares L, López Valdés E, Martínez-Torres I, Mata M, Pareés I, Pascual-Sedano B, Mir P, Martínez Castrillo J. Management of Parkinson’s disease and other movement disorders in women of childbearing age: Part 1. NEUROLOGÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.nrleng.2020.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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García-Ramos R, Santos-García D, Alonso-Cánovas A, Álvarez-Sauco M, Ares B, Ávila A, Caballol N, Carrillo F, Escamilla Sevilla F, Freire E, Gómez Esteban J, Legarda I, López Manzanares L, López Valdés E, Martínez-Torres I, Mata M, Pareés I, Pascual-Sedano B, Mir P, Martínez Castrillo J. Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: Parte 1. Neurologia 2021; 36:149-158. [DOI: 10.1016/j.nrl.2020.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 02/07/2023] Open
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Stocchi F, Fossati B, Torti M. Safety considerations when using non-ergot dopamine agonists to treat Parkinson's disease. Expert Opin Drug Saf 2020; 19:1155-1172. [PMID: 32869676 DOI: 10.1080/14740338.2020.1804550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Nonergot dopamine agonists (NEDA) represent an excellent treatment option for Parkinson's disease (PD) patients, in both early and advanced stages of the disease. The post-marketing phase of NEDA has highlighted, though, the occurrence of important long-term adverse events. AREAS COVERED This review reports recent updates on NEDA adverse events, analyzing neurobiological bases and risk factors of these complications. A literature search has been performed using Medline and reviewing the bibliographies of selected articles. EXPERT OPINION NEDA represents a very important option in the treatment of PD. Criticisms on their use can be overcome through a better knowledge of these molecules and of the risk factors for adverse events which allow specialists to prevent the occurrence of undesired complications and consent a tailor-based approach. Abbreviations: PD: Parkinson's disease, DA: dopamine agonists, NEDA: non-ergot dopamine agonists, ICD: impulse control disorders, DAWS: dopamine agonist withdrawal syndrome, CYP: Cytochrome P, PK: pharmacokinetic, AUC: area under the curve, HRT: hormone replacement therapy, AV: atrioventricular, HF: heart failure, OH: orthostatic hypotension, RBD: REM behavior disorders, PDP: Parkinson's disease psychosis, DRT: dopamine replacement therapy, DDS: dopamine dysregulation syndrome, MMSE: Mini-Mental state examination, EDS: excessive daytime somnolence.
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Affiliation(s)
- Fabrizio Stocchi
- Neurology, Institute for Research and Medical Care IRCCS San Raffaele Pisana , Rome, Italy.,Neurology, San Raffaele University , Rome, Italy
| | - Barbara Fossati
- Department of Neuroscience and Rehabilitation, Casa Di Cura Privata Del Policlinico , Milano, Italy
| | - Margherita Torti
- Neurology, Institute for Research and Medical Care IRCCS San Raffaele Pisana , Rome, Italy
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Young C, Phillips R, Ebenezer L, Zutt R, Peall KJ. Management of Parkinson's Disease During Pregnancy: Literature Review and Multidisciplinary Input. Mov Disord Clin Pract 2020; 7:419-430. [PMID: 32373659 PMCID: PMC7197310 DOI: 10.1002/mdc3.12925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/29/2020] [Accepted: 02/08/2020] [Indexed: 11/09/2022] Open
Abstract
Background There are no standardized clinical guidelines for the management of Parkinson's disease (PD) during pregnancy. Increasing maternal age would suggest that the incidence of pregnancy in women diagnosed with PD is likely to increase. Objective To evaluate the evidence for the treatment of PD during pregnancy and to canvass opinion from patients and clinical teams as to the optimum clinical management in this setting. Methods This involved (1) a literature review of available evidence for the use of oral medical therapy for the management of PD during pregnancy and (2) an anonymized survey of patients and clinical teams relating to previous clinical experiences. Results A literature review identified 31 publications (148 pregnancies, 49 PD, 2 parkinsonism, 21 dopa-responsive dystonia, 32 restless leg syndrome, 1 schizophrenia, and 43 unknown indication) detailing treatment with levodopa, and 12 publications with dopamine agonists. Adverse outcomes included seizures and congenital malformations. Survey participation included patients (n = 7), neurologists (n = 35), PD nurse specialists (n = 50), obstetricians (n = 15), and midwives (n = 20) and identified a further 34 cases of pregnancy in women with PD. Common themes for suggested management included optimization of motor symptoms, preference for levodopa monotherapy, and normal delivery unless indicated by obstetric causes. Conclusions This study demonstrates the paucity of evidence for decision-making in the medical management of PD during pregnancy. Collaboration is needed to develop a prospective registry, with longitudinal maternal and child health outcome measures to facilitate consensus management guidelines.
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Affiliation(s)
- Caitlin Young
- Cardiff University School of Medicine, Cardiff University Cardiff United Kingdom
| | - Rhiannon Phillips
- Division of Population Medicine, School of Medicine Cardiff University Cardiff United Kingdom
| | - Louise Ebenezer
- Princess of Wales Hospital Abertawe Bro Morgannwg University Health Board Bridgend Wales United Kingdom
| | - Rodi Zutt
- Department of Neurology Haga Teaching Hospital The Hague The Netherlands
| | - Kathryn J Peall
- Neuroscience and Mental Health Research Institute, Cardiff University Cardiff United Kingdom
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Abstract
Movement disorders in women during pregnancy are uncommon. Therefore, high quality studies are limited, and guidelines are lacking for the treatment of movement disorders in pregnancy, thus posing a significant therapeutic challenge for the treating physicians. In this chapter, we discuss movement disorders that arise during pregnancy and the preexisting movement disorders during pregnancy. Common conditions encountered in pregnancy include but are not limited to restless legs syndrome, chorea gravidarum, Parkinson disease, essential tremor, and Huntington disease as well as more rare movement disorders (Wilson's disease, dystonia, etc.). This chapter summarizes the published literature on movement disorders and pharmacologic and surgical considerations for neurologists and physicians in other specialties caring for patients who are pregnant or considering pregnancy.
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Affiliation(s)
- Fang Ba
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Janis M Miyasaki
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
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Sazci A, Idrisoglu HA. Pregnancy in Parkinson's disease with PARK2 mutations. Clin Park Relat Disord 2019; 1:52-53. [PMID: 34316600 PMCID: PMC8288558 DOI: 10.1016/j.prdoa.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 11/28/2022] Open
Abstract
We report a pregnancy in a patient with Parkinson's disease with PARK2 mutations. Although pregnancy is uncommon in patients with Parkinson's disease, an early-onset Parkinson's patient with three silent and two missense mutations in the PARK2 gene is presented here.
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Affiliation(s)
- Ali Sazci
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Kocaeli, Umuttepe, 41380 Kocaeli, Turkey
| | - Halil Atilla Idrisoglu
- Department of Neurology, Faculty of Medicine, University of Istanbul, Capa, 34280 Istanbul, Turkey
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Mehanna R, Jankovic J. Young-onset Parkinson's disease: Its unique features and their impact on quality of life. Parkinsonism Relat Disord 2019; 65:39-48. [DOI: 10.1016/j.parkreldis.2019.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/29/2019] [Accepted: 06/01/2019] [Indexed: 12/23/2022]
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