Effects of topiramate on oral dyskinesia induced by reserpine

Association of the HSPG2 gene with neuroleptic-induced tardive dyskinesia

Tardive dyskinesia (TD) is characterized by repetitive, involuntary, and purposeless movements that develop in patients treated with long-term dopaminergic antagonists, usually antipsychotics. By a genome-wide association screening of TD in 50 Japanese schizophrenia patients with treatment-resistant TD and 50 Japanese schizophrenia patients without TD (non-TD group) and subsequent confirmation in independent samples of 36 treatment-resistant TD and 136 non-TD subjects, we identified association of a single nucleotide polymorphism, rs2445142, (allelic p=2 x 10(-5)) in the HSPG2 (heparan sulfate proteoglycan 2, perlecan) gene with TD. The risk allele was significantly associated with higher expression of HSPG2 in postmortem human prefrontal brain (p<0.01). Administration of daily injection of haloperidol (HDL) for 50 weeks significantly reduced Hspg2 expression in mouse brains (p<0.001). Vacuous chewing movements (VCMs) induced by 7-week injection of haloperidol-reserpine were significantly infrequent in adult Hspg2 hetero-knockout mice compared with wild-type littermates (p<0.001). Treatment by the acetylcholinesterase inhibitor, physostigmine, was significantly effective for reduction of VCMs in wild-type mice but not in Hspg2 hetero-knockout mice. These findings suggest that the HSPG2 gene is involved in neuroleptic-induced TD and higher expression of HSPG2, probably even after antipsychotic treatment, and may be associated with TD susceptibility.

Progesterone attenuates neuroleptic-induced orofacial dyskinesia via the activity of its metabolite, allopregnanolone, a positive GABA(A) modulating neurosteroid

GABAergic hypofunction in the basal ganglia is stated as an important mechanism underlying the pathophysiology of tardive dyskinesia. In the present study we sought to establish the protective effect of progesterone in haloperidol-induced orofacial dyskinesia. Besides this we also tried to find out whether the GABA(A) facilitatory action of progesterone metabolites is responsible for the action of progesterone in attenuating the haloperidol-induced orofacial dyskinesia, an animal model of tardive dyskinesia. Chronic administration of haloperidol (1 mg/kg, i.p. 21 days) induced significant increase in hyperkinetic orofacial dyskinetic movements and oxidative damage in the brain as compared to control group. Coadministration of progesterone (5-20 mg/kg, i.p. 21 days) dose dependently prevented the hyperkinetic orofacial movements as well as oxidative damage parameters. The protective activity of progesterone was reversed by pre treatment with finasteride (50 mg/kg i.p.), a 5alpha-reductase inhibitor that blocks the metabolism of progesterone to allopregnanolone and other metabolites. Further, chronic administration of haloperidol resulted in significant decrease in dopamine levels in rat striatum homogenates and increase in catecholamine metabolite levels. Coadministration of progesterone also reversed the decrease in dopamine levels induced by chronic haloperidol treatment, an effect which was again reversed by pre treatment with finasteride. Our study provides strong evidence that the protective effect of progesterone resides in the GABAergic as well as neuroprotective activity of its metabolite allopregnanolone. These findings lend support to recognized GABA hypofunction theory of tardive dyskinesia and strongly suggest progesterone as a protective therapy in this debilitating movement disorder.

Valeriana officinalis does not alter the orofacial dyskinesia induced by haloperidol in rats: role of dopamine transporter

Chronic treatment with classical neuroleptics in humans can produce a serious side effect, known as tardive dyskinesia (TD). Here, we examined the effects of V. officinalis, a medicinal herb widely used as calming and sleep-promoting, in an animal model of orofacial dyskinesia (OD) induced by long-term treatment with haloperidol. Adult male rats were treated during 12 weeks with haloperidol decanoate (38 mg/kg, i.m., each 28 days) and with V. officinalis (in the drinking water). Vacuous chewing movements (VCMs), locomotor activity and plus maze performance were evaluated. Haloperidol treatment produced VCM in 40% of the treated rats and the concomitant treatment with V. officinalis did not alter either prevalence or intensity of VCMs. The treatment with V. officinalis increased the percentage of the time spent on open arm and the number of entries into open arm in the plus maze test. Furthermore, the treatment with haloperidol and/or V. officinalis decreased the locomotor activity in the open field test. We did not find any difference among the groups when oxidative stress parameters were evaluated. Haloperidol treatment significantly decreased [(3)H]-dopamine uptake in striatal slices and V. officinalis was not able to prevent this effect. Taken together, our data suggest a mechanism involving the reduction of dopamine transport in the maintenance of chronic VCMs in rats. Furthermore, chronic treatment with V. officinalis seems not produce any oxidative damage to central nervous system (CNS), but it also seems to be devoid of action to prevent VCM, at least in the dose used in this study.

Possible anti-oxidant and neuroprotective mechanisms of zolpidem in attenuating typical anti-psychotic-induced orofacial dyskinesia: a biochemical and neurochemical study

Tardive dyskinesia is a serious motor side effect of chronic anti-psychotic therapy. The pathophysiology of this disabling and commonly irreversible movement disorder continues obscure and may be caused due to GABAergic hypofunction or increased oxidative damage and free radical generation. Chronic treatment with typical antipsychotics leads to the development of abnormal hyperkinetic orofacial movements (vacuous chewing movements, tongue protrusions and facial jerking) in rats and is widely accepted as the animal model for tardive dyskinesia. Zolpidem, a GABA-mimetic drug is structurally related to melatonin and has been reported to possess anti-oxidant and neuroprotective effects both in vivo and in vitro. The study was carried out to investigate whether zolpidem can be used in the treatment of typical anti-psychotic-induced orofacial dyskinesia. Chronic haloperidol (1 mg/kg, i.p. for 21 days) and chlorpromazine (5 mg/kg, i.p. for 21 days) treatment significantly induced orofacial hyperkinetic movements and zolpidem [N, N, 6-trimethyl-2-p-tolyl-imidazo (1, 2-a) pyridine 3-acetamideL-(+)] dose dependently (1, 2, 5 mg/kg i.p. for 21 days) reduced these haloperidol and chlorpromazine-induced hyperkinetic orofacial movements. Biochemical analysis revealed that haloperidol and chlorpromazine treatment significantly induced increase in lipid peroxidation and decrease in the levels of total nitric oxide levels, non-protein thiols (NPSH) and of anti-oxidant defense enzymes, superoxide dismutase (SOD) and catalase in the striatum of rat brain. Co-administration of zolpidem (1, 2, 5 mg/kg i.p. for 21 days) significantly reduced the lipid peroxidation and restored the non-protein thiols and total nitric oxide levels induced by chronic haloperidol and chlorpromazine treatment. It also significantly reversed the haloperidol and chlorpromazine-induced decrease in brain SOD and catalase activity. Neurochemical analysis (Neurotransmitter and their metabolite level estimation) revealed that haloperidol and chlorpromazine significantly decreased the dopamine, norepinephrine and serotonin levels in brain homogenates where as it caused a significant increase in the metabolite (VMA and HVA) levels in urine, which were significantly reversed by zolpidem at higher doses. Result of the present study support the therapeutic use of zolpidem in the treatment of typical anti-psychotic-induced orofacial dyskinesia.

Effects of diphenyl–diselenide on orofacial dyskinesia model in rats

Recently, we have described the beneficial effects of Diphenyl diselenide, an organochalcogen with glutathione peroxidase-like activity, on reserpine-induced orofacial dyskinesia in old rats. In this study, our aim was to examine the effects of diselenide on haloperidol-induced orofacial dyskinesia in rats. Male wistar rats received one single dose of Haloperidol decanoate (57 mg/kg/im) or control. After this dose, the animals received daily administration of diphenyl diselenide (1, 5 or 10 mg/kg/sc) or control, during 28 days. Twenty-four hours after the last diselenide or control solution injection, all the rats were observed for quantification of oral dyskinesia through the frequency of vacuous chewing movements (VCM) and tongue protrusion (TP) and the duration of facial twitching (FT). Haloperidol caused a significant increase in VCM, TP and FT observed in the 4 weekly evaluations (p<0.05). The co-administration of diselenide (5 mg/kg) reversed this effect for all the parameters in four behavioral sessions. The results of the present study demonstrate the possible protective activity of diphenyl diselenide on haloperidol-induced orofacial diskinesia. This effect is in accordance to the involvement of neurotoxicity in orofacial dyskinesia and suggest that studies be continued with new antioxidant compounds.

Sleep deprivation abolishes the locomotor stimulant effect of ethanol in mice

The present study aimed to investigate the effects of sleep deprivation (SD) on the dose-dependent stimulant effect of ethanol (ETOH) on the open-field behavior of female and male mice. Sleep-deprived (48 h, multiple platforms method) or home-cage control female mice were treated with saline (SAL) or 1.4, 1.8 or 2.2g/kg ETOH 5 min before behavioral testing. ETOH produced a dose-dependent increase in open-field locomotor behavior. This locomotor stimulant effect did not reflect a general stimulation in motor activity, since it was accompanied by a simultaneous decrease in rearing frequency as well as by no modification in immobility duration. The effects of ETOH on these three behavioral parameters were specifically modified by SD: the locomotor stimulant effect was abolished, the rearing inhibitory effect was potentiated and the lack of effect on immobility was changed to increase in immobility. Similar results were obtained for male mice although the effects of SD had a lower magnitude. The present findings demonstrate that the acute effect of ETOH on mice's motor activity are behaviorally complex and can be specifically modulated by SD.

Effects of baclofen on reserpine-induced vacuous chewing movements in mice

We have described that GABA mimetic drugs present the ability to inhibit the expression of reserpine-induced oral movements. In this respect, oral movements is associated with important neuropathologies. This study investigates the effects of an acute or a repeated treatment of different doses of the GABA(B) agonist baclofen, as well as withdrawal from these treatments, on the development and/or expression of reserpine-induced vacuous chewing movements (VCM). Male mice received two injections of vehicle or of 1mg/kg reserpine separated by 48 h. In the first experiment, 24h later, animals were acutely treated with vehicle or baclofen (1, 2 or 4 mg/kg). In the second experiment, animals were treated with vehicle or baclofen (1 or 4 mg/kg) for four consecutive days receiving a concomitant injection of 1mg/kg reserpine (or vehicle) on Days 2 and 4. Twenty-four hours later, animals received vehicle or baclofen. Thirty minutes after the last injection, they were observed for quantification of VCM and open-field general activity. The acute administration of all the doses of baclofen abolished the manifestation of reserpine-induced VCM. Repeated treatment with 1mg/kg baclofen induced tolerance to the ability of an acute injection of this dose to reduce VCM. Treatment with baclofen (4 mg/kg) did not modify spontaneous VCM. Acute administration of the highest dose induced a decrease in general motor activity and a potentiation of the reserpine-induced decrease in general activity. These results reinforce the involvement of GABAergic hypofunction in the expression of oral movements and suggest that a repeated treatment with baclofen induces compensatory changes in GABAergic transmission that can attenuate its acute property to decrease VCM.

Hemichorea-hemiballismus may respond to topiramate

Topiramate is a broad-spectrum anticonvulsant that is now widely used for adult and pediatric epilepsy. In a singular case, topiramate was recently reported to benefit vascular hemichorea-hemiballismus. The authors describe three cases of hemichorea-hemiballismus, one of vascular etiology and two of metabolic etiology, effectively treated with topiramate.

Effects of social isolation on aging-induced orofacial movements in rats

World population is becoming older, and aging is a common risk factor for a number of pathologies. In this respect, it is important to study possible factors that could modify alterations implicated in the process of aging. The aim of the present study is to verify the effects of social isolation on the expression of orofacial movements in adult and old rats. Adult and old rats were housed isolated for 5 days or kept in their home cages in groups of six. Before and after this period, orofacial movements and open-field general activity were evaluated. Aging-induced orofacial movements were abolished by isolation. On the other hand, isolated adult rats presented an increase in orofacial movements. General activity was decreased by aging but was not modified by isolation. Our results indicate that social isolation produces different effects in adult and old rats, and these effects are specific for orofacial movements and not related to a decrease in general motor activity.

The importance of housing conditions on behavioral sensitization and tolerance to ethanol

The differential outcomes of social isolation and crowding environment on the effects of single or repeated administration of ethanol on open-field behavior were examined in female mice. Whereas housing conditions did not alter the increase in locomotor activity induced by ethanol single administration, behavioral sensitization (a progressive increase of a drug effect following repeated drug administration) to the locomotor activating effect of ethanol was significantly greater in crowded mice as compared to isolated and control groups. Single administration of ethanol significantly decreased rearing frequency and increased immobility duration, there being tolerance to these ethanol behavior effects after repeated treatment. Social isolation attenuated the increase in immobility behavior induced by single administration of ethanol and potentiated the tolerance of ethanol-induced rearing decrease, verified after repeated treatment. These results point out that both sensitization and tolerance to the behavioral effects of ethanol can be critically influenced by housing conditions.

Behavioral characterization of morphine effects on motor activity in mice

A biphasic effect of morphine on locomotion has been extensively described. Nevertheless, the effects of this opioid on other behavioral parameters have been overlooked. The aim of the present study was to verify the effects of different doses of morphine on motor behaviors observed in an open-field. Adult female mice were injected with saline or morphine (10, 15 and 20 mg/kg, i.p.) and observed in an open-field for quantification of locomotor and rearing frequencies as well as duration of immobility and grooming. The lowest dose of morphine decreased locomotion (and increased immobility duration) while the highest dose increased it. All doses tested decreased rearing and grooming. Thus, the effects of morphine on locomotion do not parallel to its effects on rearing and grooming. Our results indicate that locomotion not always reflects the effect of drugs on motor activity, which can be better investigated when other behavioral parameters are concomitantly taken into account.

Beneficial effects of vitamin C and vitamin E on reserpine-induced oral dyskinesia in rats: Critical role of striatal catalase activity

Oral dyskinesias are implicated in a series of neuropathologies and have been associated to an increase in oxidative stress. Several antioxidants, including vitamin E, decrease reserpine-induced oral dyskinesia (OD) in rodents and we have described a protective role of striatal catalase against the development of OD. The aim of this study was to verify the effects of vitamin C alone or in combination with vitamin E on reserpine-induced OD as well as to determine a possible role of catalase in the antidyskinetic property of these vitamins. Different doses of vitamin C attenuated reserpine-induced increase in OD. A similar treatment with an effective dose of vitamin C concomitant to an effective dose of vitamin E potentiated the antidyskinetic effect of both vitamins when administered alone. The administration of these vitamins alone produced an increase in striatal catalase activity that likewise was potentiated by their combined administration. In addition, the antidyskinetic property of vitamin E and vitamin C was abolished by a concomitant treatment with the catalase inhibitor aminotriazole. These results indicate a beneficial effect of these vitamins and reinforce the critical role of striatal catalase against the development of oral dyskinesias.

Effects of gabaergic drugs on reserpine-induced oral dyskinesia

Recently we have described the antidyskinetic property of the GABA mimetic drugs valproic acid and topiramate on reserpine-induced oral dyskinesia. In this respect, oral dyskinesia has been associated with important neuropathologies. The present study investigates the effects of different doses of the GABA(A) agonist tetrahydroisoxazolopyridine (THIP), of the GABA(B) agonist baclofen as well as of the GABA(A) modulator diazepam on the manifestation of reserpine-induced orofacial dyskinesia. Male Wistar rats received two injections of vehicle or of 1mg/kg reserpine separated by 48 h. Twenty-four hours later, animals were acutely treated with vehicle or THIP (2, 4 or 8 mg/kg), baclofen (1, 2 or 4 mg/kg) or diazepam (1, 2 or 4 mg/kg) and were observed for quantification of oral dyskinesia and open-field general activity. In order to verify the effects of these drugs per se on spontaneous oral movements, male Wistar rats were acutely treated with vehicle, 8 mg/kg THIP, 4 mg/kg baclofen or 4 mg/kg diazepam and observed for quantification of oral dyskinesia. The two highest doses of THIP or of baclofen abolished the manifestation of reserpine-induced oral dyskinesia while the lowest dose of baclofen attenuated it. Diazepam did not modify reserpine-induced oral dyskinesia at any dose tested. The highest doses of these drugs did not modify spontaneous oral movements. Reserpine-induced decrease in open-field general activity was not modified by any of the doses of THIP and diazepam or by the two lowest doses of baclofen. The highest dose of baclofen potentiated the increase in the duration of immobility induced by reserpine. These results reinforce the involvement of GABAergic hypofunction in the expression of oral dyskinesias, and support the potential therapeutic use of THIP and baclofen in the treatment of oral dyskinesias.