Accumulation of 5-HT in non-terminal axons after p-chloro-N-methylamphetamine without degeneration of identified 5-HT nerve terminals

Orphan neurones and amine excess: the functional neuropathology of Parkinsonism and neuropsychiatric disease

The aetiology and treatment of Parkinsonism is currently conceptualised within a dopamine (DA) deficiency-repletion framework. Loss of striatal DA is thought to cause motor impairment of which tremor, bradykinaesia and rigidity are prominent features. Repletion of deficient DA should at least minimise parkinsonian signs and symptoms. In Section 2, based on extensive pre-clinical and clinical findings, the instability of this approach to Parkinsonism is scrutinised as the existing negative findings challenging the DA deficiency hypothesis are reviewed and reinterpreted. In Section 3 it is suggested that Parkinsonism is due to a DA excess far from the striatum in the area of the posterior lateral hypothalamus (PLH) and the substantia nigra (SN). This unique area, around the diencephalon/mesencephalon border (DCMCB), is packed with many ascending and descending fibres which undergo functional transformation during degeneration, collectively labelled 'orphan neurones'. These malformed cells remain functional resulting in pathological release of transmitter and perpetual neurotoxicity. Orphan neurone formation is commonly observed in the PLH of animals and in man exhibiting Parkinsonism. The mechanism by which orphan neurones impair motor function is analogous to that seen in the diseased human heart. From this perspective, to conceptualise orphan neurones at the DCMCB as 'Time bombs in the brain' is neither fanciful nor unrealistic [E.M. Stricker, M.J. Zigmond, Comments on effects of nigro-striatal dopamine lesions, Appetite 5 (1984) 266-267] as the DA excess phenomenon demands a different therapeutic approach for the management of Parkinsonism. In Section 4 the focus is on this novel concept of treatment strategies by concentrating on non-invasive, pharmacological and surgical modification of functional orphan neurones as they affect adjacent systems. The Orphan neurone/DA excess hypothesis permits a more comprehensive and defendable interpretation of the interrelationship between Parkinsonism and schizophrenia and other related disorders.

Dual serotoninergic projections to forebrain in the rat: morphologically distinct 5-HT axon terminals exhibit differential vulnerability to neurotoxic amphetamine derivatives

The cerebral cortex of the rat and other mammals is innervated by two morphologically distinct classes of serotoninergic (5-HT) axon terminals: fine axons with minute varicosities and beaded axons characterized by large, spherical varicosities. Fine and beaded 5-HT axons exhibit different regional and laminar distributions in forebrain and arise from separate brainstem nuclei, the dorsal and median raphe nuclei, respectively. The present neuroanatomic study, based on immunocytochemical methods to visualize 5-HT axons, demonstrates that the two axon types differ markedly in their vulnerability to the neurotoxic amphetamine derivatives, methylenedioxyamphetamine (MDA), and p-chloroamphetamine (PCA). While both drugs cause extensive degeneration of fine 5-HT axons throughout forebrain, beaded 5-HT axons are consistently spared. Fine 5-HT axons, which richly innervate most regions of dorsal forebrain in control rats, are rarely seen 2 weeks after treatment with MDA or PCA; this loss of fine axons reflects a marked denervation that persists for months after drug administration. The serotoninergic axon terminals remaining after MDA or PCA administration are almost entirely of the beaded type and appear to be unaffected by both drugs. Over a wide range of doses (2.5-40 mg/kg PCA) and survival times (2 weeks to 2 months), these spared 5-HT axons with large, spherical varicosities cannot be distinguished from the normal, beaded 5-HT axons in control rats by morphologic criteria. Moreover, beaded 5-HT axons exhibit a highly characteristic regional distribution which is the same in control as in MDA- and PCA-treated rats: these axons innervate specific zones or layers within parietal and occipital cortex, hippocampus, cingulate cortex, entorhinal cortex, and the olfactory bulb, among other forebrain areas, and they form a dense plexus lining the ventricular system. Taken together, the results of this study demonstrate that fine 5-HT axons are highly vulnerable to the neurotoxic effects of the amphetamine derivatives MDA and PCA, while beaded 5-HT axons are markedly resistant. These findings are consistent with the hypothesis that there are two anatomically and functionally distinct sets of serotoninergic neurons projecting to forebrain. While both of these neuronal systems utilize 5-HT as a neurotransmitter, they differ in several features: 1) origin from separate nuclei in the brainstem (the dorsal and median raphe), 2) two types of morphologically distinct axon terminals, 3) markedly different distribution and innervation patterns in forebrain, and 4) dissimilar pharmacological properties. The results further suggest that psychotropic amphetamine derivatives have a selective action upon fine serotoninergic axons that arise from the dorsal raphe nucleus.

Immediate and long-term effects of 3,4-methylenedioxymethamphetamine on serotonin pathways in brain of rat

In the rat, administration of the psychoactive analog of amphetamine 3,4-methylenedioxymethamphetamine (MDMA), causes selective, pronounced decreases in markers of central serotonergic function. The time course of these neurochemical changes was examined in several serotonergic nerve terminal regions of the brain. Fifteen min after subcutaneous injection of MDMA (10 mg/kg), the enzymatic activity of tryptophan hydroxylase (the rate-limiting enzyme for the biosynthesis of serotonin) was significantly decreased in the frontal cortex; by 1 hr after the injection, the activity of tryptophan hydroxylase had significantly declined in the neostriatum, hippocampus and hypothalamus as well. Although extensive recovery had occurred by 2 weeks, the activity of the enzyme remained significantly depressed in most regions. Decline of the regional content of 5-hydroxytryptamine (5-HT) closely paralleled, but was usually preceded by, that of the enzyme. Concentrations of the primary metabolite of 5-HT, 5-hydroxyindoleacetic acid (5-HIAA), were less responsive: in most regions levels of 5-HIAA had significantly decreased by 3 hr, but not by 1 hr, following treatment. Markers of dopamine function were altered transiently but had returned to control values by 24 hr. Administration of multiple doses of MDMA (5 doses over a 24-hr period) resulted in significant decreases in serotonergic parameters for up to 110 days after treatment. The rate and extent of recovery varied according to both the dose administered and the region examined. The persistence of these serotonergic deficits suggests that MDMA induced the destruction of serotonin-containing axon terminals.

Amine accumulation in Parkinson's disease and other disorders

Amine accumulation in the axons of degenerating, amine-containing neurones is a natural component of neurone death in many species, including man. While it is becoming increasingly clear that this phenomenon may have functional significance in animal models of Parkinson's Disease, its potential importance in the clinical syndrome has been pretermitted. There are several reasons for this. Failure to sample tissue which contains accumulated amines, the masking of accumulation by adjacent depleted tissues and the degradation of accumulated amines in post-mortem tissues from Parkinsonian brains could account for the low incidence of detection of accumulation in this disorder. Increased levels of amines have been detected in the brains of patients with other conditions including cerebral infarction, Alzheimer's Disease and Huntington's Chorea. These increases have been attributed previously to enhanced aminergic activity, rather than a stage in the degenerative process, as our hypothesis suggests. In addition to the potential importance of amine accumulation in the pathophysiology of various clinical syndromes, a more thorough investigation of this phenomenon in animal models would seem essential since they are used routinely to both describe the basic principles of dopamine function and to evaluate therapeutic possibilities in Parkinson's Disease.

Amine accumulation in behavioural pathology

When nigro-striatal and meso-cortical neurons degenerate there is a loss of dopamine in the terminal fields and an accumulation of amines in the axons of these systems as they traverse the hypothalamus through the medial forebrain bundle. Traditional lines of thought have attributed the occurrence of motor and consummatory deficits which occur after dopamine neuron degeneration to the loss of functional dopamine neurotransmitter in the terminal fields. However, we have hypothesized that hypothalamic amine accumulation represents an area of brain tissue where processes such as neurotransmitter release, ephaptic transmission or local axon swelling may be affecting adjacent neurons and may thereby participate in the production of behavioural deficits. There is a considerable amount of evidence from studies on both peripheral and central catecholamine-containing neurons indicating that when their axons degenerate a release of functional neurotransmitter can occur. Information from neuropharmacological studies indicates that several drugs which facilitate behavioural recovery from dopamine-depleting lesions may do so by affecting amine release or receptor sensitivity near areas of accumulation rather than depleted terminal fields. We conclude that amine accumulation is a component of dopamine neuron degeneration which should be considered when assessing the role of the central catecholamine systems in the control of various behavioural and physiological processes.

A role for amine accumulation in the syndrome of ingestive deficits following lateral hypothalamic lesions

Lesions of the lateral hypothalamus produce ascending catecholamine neuron degeneration which results in terminal depletion and proximal accumulation above the lesions. The occurrence of deficits in ingestive behaviour has been attributed traditionally to the loss of functional dopamine neurotransmitter in the terminal fields. However, release of functional amines may occur in the lateral hypothalamus at areas of accumulation, to produce at least some of the behavioural symptoms characterizing the lateral hypothalamic syndrome. Recovery from behavioural deficits as a result of various pharmacological treatments, after dopamine-depleting lesions, may be mediated by changes in amine release or modified sensitivity of receptors affected by released amines. We conclude that amine accumulation should be considered when interpreting experiments implicating central catecholamine systems in the control of consumatory behaviour and the regulation of body weight.

Supra-ependymal serotoninergic nerves in mammalian brain: morphological, pharmacological and functional studies

Supra-ependymal nerves in mammals (mainly rats) have been shown to contain serotonin (5-hydroxytryptamine, 5-HT) by combined Falck-Hillarp fluorescence histochemistry, ultrastructural monoamine cytochemistry and pharmacology as well as by immunohistochemistry and autoradiography. Supra-ependymal 5-HT cells do not occur. At least in rats, virtually all supra-ependymal nerves contain 5-HT and in our opinion the occasionally described non-5-HT supra-ependymal nerve cells and their processes contribute little to the supra-ependymal nerve plexus (with the possible exception of those cells above the median eminence). The cells of origin of the supra-ependymal 5-HT nerves are situated in raphe nuclei. The axons and terminals (varicosities) contain small and large dense core vesicles in both of which 5-HT is stored. A co-transmitter has not been found among the candidates investigated so far (leu- and met-enkephalin, substance P and gamma-aminobutyric acid (GABA)). The nerves possess uptake mechanisms specific for 5-HT and possibly GABA. Occasionally desmosome-like junctions are observed between 5-HT nerve terminals and ependymal cells but no true synapses. The function of these nerves is not known. They do not appear to regulate ciliary movement, but might influence the shape of ependymal cells.

Inhibition of 5-hydroxytryptamine uptake by tetrahydronorharmane in vivo

Injection of tetrahydronorharmane (THN) elicited a dose-dependent increase of the level of 5-hydroxytryptamine (5-HT) and a fall of 5-hydroxyindoleacetic acid in the rat brain whereas noradrenaline and dopamine levels remained unchanged. The effect on indoles was shortlasting which may be explained by the short half life of THN or its metabolization to 6-OH-THN. The 5-HT depleting action of parachloro-N-methylamphetamine (CMA) was used to study uptake inhibition in vivo. The results support the notion that THN acts as an inhibitor of the reuptake of 5-HT in vivo. Further evidence for this hypothesis was obtained by intraventricular injection of radiolabelled 5-HT. The disappearance of (3H)-5-HT from brain tissue was reduced by THN. Thus, THN may exert its central 5-HT-like effects in pharmacological experiments by preventing 5-HT from being removed from the synaptic cleft.