1
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Xiang Y, Naik S, Zhao L, Shi J, Ke H. Emerging phosphodiesterase inhibitors for treatment of neurodegenerative diseases. Med Res Rev 2024; 44:1404-1445. [PMID: 38279990 DOI: 10.1002/med.22017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 01/29/2024]
Abstract
Neurodegenerative diseases (NDs) cause progressive loss of neuron structure and ultimately lead to neuronal cell death. Since the available drugs show only limited symptomatic relief, NDs are currently considered as incurable. This review will illustrate the principal roles of the signaling systems of cyclic adenosine and guanosine 3',5'-monophosphates (cAMP and cGMP) in the neuronal functions, and summarize expression/activity changes of the associated enzymes in the ND patients, including cyclases, protein kinases, and phosphodiesterases (PDEs). As the sole enzymes hydrolyzing cAMP and cGMP, PDEs are logical targets for modification of neurodegeneration. We will focus on PDE inhibitors and their potentials as disease-modifying therapeutics for the treatment of Alzheimer's disease, Parkinson's disease, and Huntington's disease. For the overlapped but distinct contributions of cAMP and cGMP to NDs, we hypothesize that dual PDE inhibitors, which simultaneously regulate both cAMP and cGMP signaling pathways, may have complementary and synergistic effects on modifying neurodegeneration and thus represent a new direction on the discovery of ND drugs.
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Affiliation(s)
- Yu Xiang
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Swapna Naik
- Department of Pharmacology, Yale Cancer Biology Institute, Yale University, West Haven, Connecticut, USA
| | - Liyun Zhao
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jianyou Shi
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hengming Ke
- Department of Biochemistry and Biophysics, The University of North Carolina, Chapel Hill, North Carolina, USA
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2
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Shafie A, Ashour AA, Anwar S, Anjum F, Hassan MI. Exploring molecular mechanisms, therapeutic strategies, and clinical manifestations of Huntington's disease. Arch Pharm Res 2024; 47:571-595. [PMID: 38764004 DOI: 10.1007/s12272-024-01499-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/02/2024] [Indexed: 05/21/2024]
Abstract
Huntington's disease (HD) is a paradigm of a genetic neurodegenerative disorder characterized by the expansion of CAG repeats in the HTT gene. This extensive review investigates the molecular complexities of HD by highlighting the pathogenic mechanisms initiated by the mutant huntingtin protein. Adverse outcomes of HD include mitochondrial dysfunction, compromised protein clearance, and disruption of intracellular signaling, consequently contributing to the gradual deterioration of neurons. Numerous therapeutic strategies, particularly precision medicine, are currently used for HD management. Antisense oligonucleotides, such as Tominersen, play a leading role in targeting and modulating the expression of mutant huntingtin. Despite the promise of these therapies, challenges persist, particularly in improving delivery systems and the necessity for long-term safety assessments. Considering the future landscape, the review delineates promising directions for HD research and treatment. Innovations such as Clustered regularly interspaced short palindromic repeats associated system therapies (CRISPR)-based genome editing and emerging neuroprotective approaches present unprecedented opportunities for intervention. Collaborative interdisciplinary endeavors and a more insightful understanding of HD pathogenesis are on the verge of reshaping the therapeutic landscape. As we navigate the intricate landscape of HD, this review serves as a guide for unraveling the intricacies of this disease and progressing toward transformative treatments.
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Affiliation(s)
- Alaa Shafie
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, PO Box 11099, 21944, Taif, Saudi Arabia
| | - Amal Adnan Ashour
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, PO Box 11099, 21944, Taif, Saudi Arabia
| | - Saleha Anwar
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Farah Anjum
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, PO Box 11099, 21944, Taif, Saudi Arabia
| | - Md Imtaiyaz Hassan
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India.
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3
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Abstract
The vesicular monoamine transporter 2 (VMAT2) is a proton-dependent antiporter responsible for loading monoamine neurotransmitters into synaptic vesicles. Dysregulation of VMAT2 can lead to several neuropsychiatric disorders including Parkinson's disease and schizophrenia. Furthermore, drugs such as amphetamine and MDMA are known to act on VMAT2, exemplifying its role in the mechanisms of actions for drugs of abuse. Despite VMAT2's importance, there remains a critical lack of mechanistic understanding, largely driven by a lack of structural information. Here, we report a 3.1 Å resolution cryo-electron microscopy (cryo-EM) structure of VMAT2 complexed with tetrabenazine (TBZ), a non-competitive inhibitor used in the treatment of Huntington's chorea. We find TBZ interacts with residues in a central binding site, locking VMAT2 in an occluded conformation and providing a mechanistic basis for non-competitive inhibition. We further identify residues critical for cytosolic and lumenal gating, including a cluster of hydrophobic residues which are involved in a lumenal gating strategy. Our structure also highlights three distinct polar networks that may determine VMAT2 conformational dynamics and play a role in proton transduction. The structure elucidates mechanisms of VMAT2 inhibition and transport, providing insights into VMAT2 architecture, function, and the design of small-molecule therapeutics.
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Affiliation(s)
- Michael P Dalton
- Department of Structural Biology, University of PittsburghPittsburghUnited States
| | - Mary Hongying Cheng
- Laufer Center for Physical and Quantitative Biology, and Department of Biochemistry and Cell Biology, School of Medicine, Stony Brook UniversityStony BrookUnited States
| | - Ivet Bahar
- Laufer Center for Physical and Quantitative Biology, and Department of Biochemistry and Cell Biology, School of Medicine, Stony Brook UniversityStony BrookUnited States
| | - Jonathan A Coleman
- Department of Structural Biology, University of PittsburghPittsburghUnited States
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4
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Lerose V, Ponticelli M, Benedetto N, Carlucci V, Lela L, Tzvetkov NT, Milella L. Withania somnifera (L.) Dunal, a Potential Source of Phytochemicals for Treating Neurodegenerative Diseases: A Systematic Review. PLANTS (BASEL, SWITZERLAND) 2024; 13:771. [PMID: 38592845 PMCID: PMC10976061 DOI: 10.3390/plants13060771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/28/2024] [Accepted: 03/06/2024] [Indexed: 04/11/2024]
Abstract
Withania somnifera (L.) Dunal is a medicinal plant belonging to the traditional Indian medical system, showing various therapeutic effects such as anti-cancer, anti-inflammatory, anti-microbial, anti-diabetic, and hepatoprotective activity. Of great interest is W. somnifera's potential beneficial effect against neurodegenerative diseases, since the authorized medicinal treatments can only delay disease progression and provide symptomatic relief and are not without side effects. A systematic search of PubMed and Scopus databases was performed to identify preclinical and clinical studies focusing on the applications of W. somnifera in preventing neurodegenerative diseases. Only English articles and those containing the keywords (Withania somnifera AND "neurodegenerative diseases", "neuroprotective effects", "Huntington", "Parkinson", "Alzheimer", "Amyotrophic Lateral Sclerosis", "neurological disorders") in the title or abstract were considered. Reviews, editorials, letters, meta-analyses, conference papers, short surveys, and book chapters were not considered. Selected articles were grouped by pathologies and summarized, considering the mechanism of action. The quality assessment and the risk of bias were performed using the Cochrane Handbook for Systematic Reviews of Interventions checklist. This review uses a systematic approach to summarize the results from 60 investigations to highlight the potential role of W. somnifera and its specialized metabolites in treating or preventing neurodegenerative diseases.
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Affiliation(s)
- Valentina Lerose
- Department of Science, University of Basilicata, V.le Ateneo Lucano 10, 85100 Potenza, Italy; (V.L.); (N.B.); (V.C.); (L.L.)
| | - Maria Ponticelli
- Department of Science, University of Basilicata, V.le Ateneo Lucano 10, 85100 Potenza, Italy; (V.L.); (N.B.); (V.C.); (L.L.)
| | - Nadia Benedetto
- Department of Science, University of Basilicata, V.le Ateneo Lucano 10, 85100 Potenza, Italy; (V.L.); (N.B.); (V.C.); (L.L.)
| | - Vittorio Carlucci
- Department of Science, University of Basilicata, V.le Ateneo Lucano 10, 85100 Potenza, Italy; (V.L.); (N.B.); (V.C.); (L.L.)
| | - Ludovica Lela
- Department of Science, University of Basilicata, V.le Ateneo Lucano 10, 85100 Potenza, Italy; (V.L.); (N.B.); (V.C.); (L.L.)
| | - Nikolay T. Tzvetkov
- Institute of Molecular Biology “Roumen Tsanev”, Department of Biochemical Pharmacology & Drug Design, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 21, 1113 Sofia, Bulgaria;
| | - Luigi Milella
- Department of Science, University of Basilicata, V.le Ateneo Lucano 10, 85100 Potenza, Italy; (V.L.); (N.B.); (V.C.); (L.L.)
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5
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Curtis K, Sung V. Real-World Experience With Deutetrabenazine for Huntington Disease Chorea. J Clin Pharmacol 2024; 64:178-181. [PMID: 37565322 DOI: 10.1002/jcph.2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/09/2023] [Indexed: 08/12/2023]
Abstract
Huntington disease (HD) is a hereditary neurodegenerative disorder with a hallmark feature of chorea. While no disease-modifying therapies currently exist for HD, symptomatic treatment of HD-associated chorea includes US Food and Drug Administration-approved vesicular monoamine transporter type 2 inhibitors-tetrabenazine and deutetrabenazine. Deutetrabenazine was more recently approved (2017), and while structurally similar to tetrabenazine, deutetrabenazine has a unique pharmacokinetic profile that allows for a longer half-life, reduced plasma fluctuations, and less frequent dosing. In pivotal trials, deutetrabenazine seemed to have an improved safety and tolerability profile over tetrabenazine but real-world data to confirm this are lacking. Here, we evaluate our real-world clinical experience with deutetrabenazine for HD-associated chorea. We performed a retrospective chart review of all patients with HD who initiated treatment with deutetrabenazine from January 2017 to May 2019 at the University of Alabama at Birmingham. Total maximal chorea scores, patient-reported subjective efficacy, dosing information, and subjective reports of adverse events (AEs) were abstracted for each patient. Our review included 58 patients with a mean length of treatment of 476.4 days. In the reviewed time period, the mean treatment difference in total maximal chorea scores was 4.4. The combined total rate of occurrence of any AEs was relatively low, at 32.8%, and the most commonly reported AEs were sedation (15.5%), insomnia (6.9%), and diarrhea (3.4%). Our real-world data support current literature indicating that deutetrabenazine is an effective and well-tolerated treatment for HD-associated chorea. Further studies repeating this on a larger scale, across a greater geography and practice pattern, are needed.
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Affiliation(s)
- Kendall Curtis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Neurology, Division of Movement Disorders, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Victor Sung
- Department of Neurology, Division of Movement Disorders, University of Alabama at Birmingham, Birmingham, Alabama, USA
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6
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Dalton MP, Cheng MH, Bahar I, Coleman JA. Structural mechanisms for VMAT2 inhibition by tetrabenazine. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.09.05.556211. [PMID: 37732203 PMCID: PMC10508774 DOI: 10.1101/2023.09.05.556211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
The vesicular monoamine transporter 2 (VMAT2) is a proton-dependent antiporter responsible for loading monoamine neurotransmitters into synaptic vesicles. Dysregulation of VMAT2 can lead to several neuropsychiatric disorders including Parkinson's disease and schizophrenia. Furthermore, drugs such as amphetamine and MDMA are known to act on VMAT2, exemplifying its role in the mechanisms of actions for drugs of abuse. Despite VMAT2's importance, there remains a critical lack of mechanistic understanding, largely driven by a lack of structural information. Here we report a 3.1 Å resolution cryo-EM structure of VMAT2 complexed with tetrabenazine (TBZ), a non-competitive inhibitor used in the treatment of Huntington's chorea. We find TBZ interacts with residues in a central binding site, locking VMAT2 in an occluded conformation and providing a mechanistic basis for non-competitive inhibition. We further identify residues critical for cytosolic and lumenal gating, including a cluster of hydrophobic residues which are involved in a lumenal gating strategy. Our structure also highlights three distinct polar networks that may determine VMAT2 conformational dynamics and play a role in proton transduction. The structure elucidates mechanisms of VMAT2 inhibition and transport, providing insights into VMAT2 architecture, function, and the design of small-molecule therapeutics.
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Affiliation(s)
- Michael P Dalton
- Department of Structural Biology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
| | - Mary Hongying Cheng
- Laufer Center for Physical and Quantitative Biology, and Department of Biochemistry and Cell Biology, School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Ivet Bahar
- Laufer Center for Physical and Quantitative Biology, and Department of Biochemistry and Cell Biology, School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jonathan A Coleman
- Department of Structural Biology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
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7
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Bandala C, Cárdenas-Rodríguez N, Mendoza-Torreblanca JG, Contreras-García IJ, Martínez-López V, Cruz-Hernández TR, Carro-Rodríguez J, Vargas-Hernández MA, Ignacio-Mejía I, Alfaro-Rodriguez A, Lara-Padilla E. Therapeutic Potential of Dopamine and Related Drugs as Anti-Inflammatories and Antioxidants in Neuronal and Non-Neuronal Pathologies. Pharmaceutics 2023; 15:pharmaceutics15020693. [PMID: 36840015 PMCID: PMC9966027 DOI: 10.3390/pharmaceutics15020693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Dopamine (DA), its derivatives, and dopaminergic drugs are compounds widely used in the management of diseases related to the nervous system. However, DA receptors have been identified in nonneuronal tissues, which has been related to their therapeutic potential in pathologies such as sepsis or septic shock, blood pressure, renal failure, diabetes, and obesity, among others. In addition, DA and dopaminergic drugs have shown anti-inflammatory and antioxidant properties in different kinds of cells. AIM To compile the mechanism of action of DA and the main dopaminergic drugs and show the findings that support the therapeutic potential of these molecules for the treatment of neurological and non-neurological diseases considering their antioxidant and anti-inflammatory actions. METHOD We performed a review article. An exhaustive search for information was carried out in specialized databases such as PubMed, PubChem, ProQuest, EBSCO, Scopus, Science Direct, Web of Science, Bookshelf, DrugBank, Livertox, and Clinical Trials. RESULTS We showed that DA and dopaminergic drugs have emerged for the management of neuronal and nonneuronal diseases with important therapeutic potential as anti-inflammatories and antioxidants. CONCLUSIONS DA and DA derivatives can be an attractive treatment strategy and a promising approach to slowing the progression of disorders through repositioning.
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Affiliation(s)
- Cindy Bandala
- Neurociencia Básica, Instituto Nacional de Rehabilitación LGII, Secretaría de Salud, Mexico City 14389, Mexico
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico
- Correspondence: (C.B.); (E.L.-P.); Tel.: +52-(55)-5999-1000 (ext. 19307) (C.B.); +52-(55)-57296000 (ext. 62712) (E.L.-P.)
| | - Noemi Cárdenas-Rodríguez
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico
- Laboratorio de Neurociencias, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Mexico City 04530, Mexico
| | | | | | - Valentín Martínez-López
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico
| | | | - Jazmín Carro-Rodríguez
- Escuela de Biología Experimental, Unidad Iztapalapa, Universidad Autónoma Metropolitana, Mexico City 09340, Mexico
| | | | - Iván Ignacio-Mejía
- Laboratorio de Medicina Traslacional, Escuela Militar de Graduados de Sanidad, Mexico City 11200, Mexico
| | - Alfonso Alfaro-Rodriguez
- Neurociencia Básica, Instituto Nacional de Rehabilitación LGII, Secretaría de Salud, Mexico City 14389, Mexico
| | - Eleazar Lara-Padilla
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico
- Correspondence: (C.B.); (E.L.-P.); Tel.: +52-(55)-5999-1000 (ext. 19307) (C.B.); +52-(55)-57296000 (ext. 62712) (E.L.-P.)
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8
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Chou CY, Agin-Liebes J, Kuo SH. Emerging therapies and recent advances for Tourette syndrome. Heliyon 2023; 9:e12874. [PMID: 36691528 PMCID: PMC9860289 DOI: 10.1016/j.heliyon.2023.e12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/27/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Tourette syndrome is the most prevalent hyperkinetic movement disorder in children and can be highly disabling. While the pathomechanism of Tourette syndrome remains largely obscure, recent studies have greatly improved our knowledge about this disease, providing a new perspective in our understanding of this condition. Advances in electrophysiology and neuroimaging have elucidated that there is a reduction in frontal cortical volume and reduction of long rage connectivity to the frontal lobe from other parts of the brain. Several genes have also been identified to be associated with Tourette syndrome. Treatment of Tourette syndrome requires a multidisciplinary approach which includes behavioral and pharmacological therapy. In severe cases surgical therapy with deep brain stimulation may be warranted, though the optimal location for stimulation is still being investigated. Studies on alternative therapies including traditional Chinese medicine and neuromodulation, such as transcranial magnetic stimulation have shown promising results, but still are being used in an experimental basis. Several new therapies have also recently been tested in clinical trials. This review provides an overview of the latest findings with regards to genetics and neuroimaging for Tourette syndrome as well as an update on advanced therapeutics.
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Affiliation(s)
- Chih-Yi Chou
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, USA
| | - Julian Agin-Liebes
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, USA
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, USA
- Corresponding author. 650 West 168th Street, Room 305, New York, NY, 10032, USA. Fax: +(212) 305 1304.
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Feleus S, van Schaijk M, Roos RAC, de Bot ST. The Many Faces of Huntington’s Chorea Treatment: The Impact of Sudden Withdrawal of Tiapride after 40 Years of Use and a Systematic Review. J Pers Med 2022; 12:jpm12040589. [PMID: 35455705 PMCID: PMC9025785 DOI: 10.3390/jpm12040589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 02/01/2023] Open
Abstract
Huntington’s Disease (HD) is a rare, neurodegenerative disorder characterized by chorea, cognitive decline, and behavioral changes. Despite wide clinical use since the mid-1980s, tiapride was recently withdrawn from the Dutch market without rationale. Although alternatives are available, many patients experienced dysregulation after this unwanted change. We provide insight into the impact of sudden tiapride withdrawal by reviewing medical records of HD patients who were using tiapride at the time of withdrawal. In addition, we performed a systematic search in five databases on tiapride efficacy and its safety profile in HD. Original research and expert opinions were included. In our patient group on tiapride, 50% required tiapride import from abroad. Regarding the review, 12 articles on original datasets and three expert opinions were included. The majority of studies showed an improvement in chorea while patients were on tiapride. Due to limited sample sizes, not all studies performed statistical tests on their results. Fifty percent of clinical experts prefer tiapride as initial chorea monotherapy, especially when comorbid behavioral symptoms are present. Side effects are often rare and mild. No safety concerns were reported. In conclusion, tiapride is almost irreplaceable for some patients and is an effective and safe chorea treatment in HD.
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Affiliation(s)
- Stephanie Feleus
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
- Department of Epidemiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
- Correspondence:
| | - Malu van Schaijk
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Advisium, ‘s Heeren Loo, P.O. Box 647, 3800 AP Amersfoort, The Netherlands
| | - Raymund A. C. Roos
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Susanne T. de Bot
- Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
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10
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Kopf S, Bourriquen F, Li W, Neumann H, Junge K, Beller M. Recent Developments for the Deuterium and Tritium Labeling of Organic Molecules. Chem Rev 2022; 122:6634-6718. [PMID: 35179363 DOI: 10.1021/acs.chemrev.1c00795] [Citation(s) in RCA: 141] [Impact Index Per Article: 70.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Organic compounds labeled with hydrogen isotopes play a crucial role in numerous areas, from materials science to medicinal chemistry. Indeed, while the replacement of hydrogen by deuterium gives rise to improved absorption, distribution, metabolism, and excretion (ADME) properties in drugs and enables the preparation of internal standards for analytical mass spectrometry, the use of tritium-labeled compounds is a key technique all along drug discovery and development in the pharmaceutical industry. For these reasons, the interest in new methodologies for the isotopic enrichment of organic molecules and the extent of their applications are equally rising. In this regard, this Review intends to comprehensively discuss the new developments in this area over the last years (2017-2021). Notably, besides the fundamental hydrogen isotope exchange (HIE) reactions and the use of isotopically labeled analogues of common organic reagents, a plethora of reductive and dehalogenative deuteration techniques and other transformations with isotope incorporation are emerging and are now part of the labeling toolkit.
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Affiliation(s)
- Sara Kopf
- Leibniz-Institut für Katalyse e. V., 18059 Rostock, Germany
| | | | - Wu Li
- Leibniz-Institut für Katalyse e. V., 18059 Rostock, Germany
| | | | - Kathrin Junge
- Leibniz-Institut für Katalyse e. V., 18059 Rostock, Germany
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11
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Zakharov D, Buriak I, Mihailov V. Tardive neuroleptic-induced dyskinesias. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:31-35. [DOI: 10.17116/jnevro202212201131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Enantiodivergent Synthesis of Benzoquinolizidinones from L-Glutamic Acid. Molecules 2021; 26:molecules26195866. [PMID: 34641410 PMCID: PMC8512815 DOI: 10.3390/molecules26195866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
Benzoquinolizidinone systems were synthesized in both enantiomeric forms from L-glutamic acid. The key chiral arylethylglutarimide intermediate was synthesized from dibenzylamino-glutamate and homoveratrylamine. Aldol reaction of the glutarimide afforded a mixture of syn and anti-aldol adducts. Subsequent regioselective hydride reduction of the glutarimide carbonyl followed by N-acyliminium ion cyclization afforded a product with opposite absolute configurations at C3 and C11b. Cope elimination of the dibenzylamino group then converted the two diastereomers into enantiomers.
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13
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Kumar V, Singh A. Targeting N17 domain as a potential therapeutic target for the treatment of Huntington disease: An opinion. EXCLI JOURNAL 2021; 20:1086-1090. [PMID: 34267617 PMCID: PMC8278213 DOI: 10.17179/excli2021-3670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/04/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Vishal Kumar
- Department of Pharmacology, ISF College of Pharmacy, Moga-142001, Punjab, India.,Affiliated to IK Gujral Punjab Technical University, Jalandhar, Punjab-144603, India
| | - Arti Singh
- Department of Pharmacology, ISF College of Pharmacy, Moga-142001, Punjab, India.,Affiliated to IK Gujral Punjab Technical University, Jalandhar, Punjab-144603, India
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14
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Behl T, Kumar S, Sehgal A, Singh S, Kumari S, Brisc MC, Munteanu MA, Brisc C, Buhas CL, Judea-Pusta C, Buhas CL, Judea-Pusta C, Nistor-Cseppento DC, Bungau S. Rice bran, an off-shoot to newer therapeutics in neurological disorders. Biomed Pharmacother 2021; 140:111796. [PMID: 34098194 DOI: 10.1016/j.biopha.2021.111796] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Normal brain functioning involves the interaction of interconnected molecular and cellular activities, which appear to alter normal to abnormal brain functioning when worsened, contributing to the emergence of neurological disorders. There are currently millions of people who are living with brain disorders globally and this will rise if suitable prevention strategies are not explored. Nutraceutical intended to treat numerous health goals with little adverse effect possible together can be more beneficial than pharmaceutical monotherapy for fostering balanced brain functioning. Nutraceutical provides a specific composition of effective macronutrients and micronutrients that are difficult to synthesize in the laboratory. Numerous elements of rice fibers in rice bran are characterized as natural anti-oxidant and having potential anti-inflammatory activity. The rice bran captures interest among the researchers as it is widespread, affordable, and rich in nutrients including protein, fat, carbohydrates, bioactive components, and dietary fiber. This review covers the neuroprotective multiplicity of rice bran and its constituents to deter pathological conditions of the brain and to facilitate balanced brain functioning at the same time.
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Affiliation(s)
- Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India.
| | - Sachin Kumar
- Department of Pharmaceutical Sciences & Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Aayush Sehgal
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Sukhbir Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Shilpa Kumari
- Department of Pharmaceutical Sciences & Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Mihaela Cristina Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Mihai Alexandru Munteanu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Ciprian Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Camelia Liana Buhas
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Claudia Judea-Pusta
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Camelia Liana Buhas
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Claudia Judea-Pusta
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | | | - Simona Bungau
- Department of Pharmacy, Faculty of Pharmacy, University of Oradea, Romania
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15
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Ueda K, Black KJ. A Comprehensive Review of Tic Disorders in Children. J Clin Med 2021; 10:2479. [PMID: 34204991 PMCID: PMC8199885 DOI: 10.3390/jcm10112479] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 01/13/2023] Open
Abstract
Tics are characterized by sudden, rapid, recurrent, nonrhythmic movement or vocalization, and are the most common movement disorders in children. Their onset is usually in childhood and tics often will diminish within one year. However, some of the tics can persist and cause various problems such as social embarrassment, physical discomfort, or emotional impairments, which could interfere with daily activities and school performance. Furthermore, tic disorders are frequently associated with comorbid neuropsychiatric symptoms, which can become more problematic than tic symptoms. Unfortunately, misunderstanding and misconceptions of tic disorders still exist among the general population. Understanding tic disorders and their comorbidities is important to deliver appropriate care to patients with tics. Several studies have been conducted to elucidate the clinical course, epidemiology, and pathophysiology of tics, but they are still not well understood. This article aims to provide an overview about tics and tic disorders, and recent findings on tic disorders including history, definition, diagnosis, epidemiology, etiology, diagnostic approach, comorbidities, treatment and management, and differential diagnosis.
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Affiliation(s)
- Keisuke Ueda
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Kevin J. Black
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA
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16
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Lapostolle A, Delion T, Arnaud S, Manceau P, Degos B. Thrombocytopenia and agranulocytosis in a FXTAS choreic patient treated with tetrabenazine. Neurol Sci 2021; 42:3475-3477. [PMID: 33970378 DOI: 10.1007/s10072-021-05310-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Arnaud Lapostolle
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris, Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Timo Delion
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris, Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Souraya Arnaud
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris, Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Philippe Manceau
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris, Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Bertrand Degos
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris, Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France. .,Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, 75005, Paris, France.
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17
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Scalise R, Sgandurra G, Menici V, Capodagli N, Di Pietro R, Romeo DM, Sini F, Pagliano E, Foscan M, Cioni G, Battini R. A Retrospective Longitudinal Study in a Cohort of Children With Dyskinetic Cerebral Palsy Treated With Tetrabenazine. Front Neurol 2021; 12:612429. [PMID: 33716922 PMCID: PMC7953156 DOI: 10.3389/fneur.2021.612429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/22/2021] [Indexed: 11/20/2022] Open
Abstract
Tetrabenazine has been studied with a variety of hyperkinetic movement disorders, but there is limited and empirical literature on the potential efficacy of tetrabenazine in children with dyskinetic cerebral palsy (DCP). The purpose of this study was to evaluate the efficacy of tetrabenazine in a sample of children with DCP using the Movement Disorders—Childhood Rating Scale 4–18 Revised (MD-CRS 4–18 R). The study is a multicenter retrospective longitudinal study in which the participants were selected from the databases of each Center involved, according to detailed inclusion criteria. The study was performed on 23 children and adolescents (19 male and 4 females; mean age 8.28 years, SD 3.59) with DCP having been evaluated before starting the treatment (baseline), after 6 and 12 months of treatment and in a sub-cohort after >2 years follow-up. A linear mixed model was used to evaluate the effects of the different timings on each MD-CRS 4–18 R Index (Index I, Index II, and Global Index) adding age and type of movement disorder as random effect. A significant clinical improvement related to a reduction of MD-CRS 4-18 R Indexes was detected between the baseline and after 6 and 12 months of treatment. Findings support the efficacy of tetrabenazine in children with DCP through a standardized outcome measure (MD-CRS 4–18 R) and confirm the use of this scale as a suitable tool to detect changes in further randomized clinical trials.
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Affiliation(s)
- Roberta Scalise
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Tuscan PhD Programme of Neuroscience, University of Florence, Pisa and Siena, Florence, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valentina Menici
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Nicola Capodagli
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberta Di Pietro
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Domenico M Romeo
- Pediatric Neurology Unit, Catholic University, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - Francesca Sini
- Pediatric Neurology Unit, Catholic University, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - Emanuela Pagliano
- Neurodevelopmental Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Maria Foscan
- Neurodevelopmental Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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18
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Abstract
Introduction: Tourette syndrome (TS) is a neurodevelopmental disorder characterized by multiple tics which often persisting in forms of different severity throughout adult life. The prevalence of neuropsychiatric co-morbidity in patients with TS is high. Treatment of TS can involve pharmacological, behavioral, or, in rare cases, surgical therapies. Over the last two decades there has been growing interest in the use of aripiprazole, a novel partial dopamine receptor agonist, as a promising anti-tic agent.Areas covered: The authors reviewed the available literature evaluating the role of aripiprazole in the treatment of TS and other tic disorders in both children and adults. This includes data from five randomized controlled trials (RCTs) and eleven open-label studies.Expert opinion: There is moderate quality evidence supporting the use of aripiprazole in reducing tic severity in children and adolescents, however there is a lack of robust evidence evaluating its use in adults, despite expert consensus. Overall, it appears that aripiprazole is a safe and effective treatment for tics. Further large scale RCTs assessing the long-term efficacy and safety of aripiprazole in the treatment of tics are warranted, especially in adult populations with TS.
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Affiliation(s)
- Joanna H Cox
- Sandwell and West Birmingham NHS Foundation Trust, Birmingham, UK
| | - Andrea E Cavanna
- Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK.,School of Life and Health Sciences, Aston University, Birmingham, UK.,University College London and Institute of Neurology, London, UK
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19
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Baell JB. Personal Accounts of Australian Drug Discovery at the Public–Private Interface. Aust J Chem 2021. [DOI: 10.1071/ch20244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The public–private interface is a vibrant and invigorating stage for drug discovery and can allow for relatively higher risk but more rewarding research. Although adequate resourcing is a perennial challenge, persistence, optimism, and flexibility will pay dividends and can allow for a thoroughly rewarding career. In this account of chronological research experiences, selected examples are used to support this contention.
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20
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Chang CH, Ching PY, Pan CC. Tetrabenazine for treating neuroleptic-induced tardive dyskinesia: A case report of a patient with chronic schizophrenia. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_40_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Noel JM, Jackson CW. ASHP Therapeutic Position Statement on the Use of Antipsychotic Medications in the Treatment of Adults with Schizophrenia and Schizoaffective Disorder. Am J Health Syst Pharm 2020; 77:2114-2132. [PMID: 32871013 PMCID: PMC7499485 DOI: 10.1093/ajhp/zxaa303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
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Affiliation(s)
- Jason M Noel
- University of Maryland School of Pharmacy, Baltimore, MD
| | - Cherry W Jackson
- Auburn University Harrison School of Pharmacy, Auburn, AL.,Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, School of Medicine, Birmingham, AL
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22
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Cruces-Solis H, Nissen W, Ferger B, Arban R. Whole-brain signatures of functional connectivity after bidirectional modulation of the dopaminergic system in mice. Neuropharmacology 2020; 178:108246. [PMID: 32771528 DOI: 10.1016/j.neuropharm.2020.108246] [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] [Received: 03/24/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
While neuropsychiatric drugs influence neural activity across multiple brain regions, the current understanding of their mechanism of action derives from studies that investigate an influence of a given drug onto a pre-selected and small number of brain regions. To understand how neuropsychiatric drugs affect coordinated activity across brain regions and to detect the brain regions most relevant to pharmacological action in an unbiased way, studies that assess brain-wide neuronal activity are paramount. Here, we used whole-brain immunostaining of the neuronal activity marker cFOS, and graph theory to generate brain-wide maps of neuronal activity upon pharmacological challenges. We generated brain-wide maps 2.5 h after treatment of the atypical dopamine transporter inhibitor modafinil (10, 30, and 100 mg/kg) or the vesicular monoamine transporter 2 inhibitor tetrabenazine (0.25, 0.5 and 1 mg/kg). Modafinil increased the number of cFOS positive neurons in a dose-dependent manner. Moreover, modafinil significantly reduced functional connectivity across the entire brain. Graph theory analysis revealed that modafinil decreased the node degree of cortical and subcortical regions at the three doses tested, followed by a reduction in global efficiency. Simultaneously, we identified highly interconnected hub regions that emerge exclusively upon modafinil treatment. These regions were the mediodorsal thalamus, periaqueductal gray, subiculum, and rhomboid nucleus. On the other hand, while tetrabenazine had mild effects on cFOS counts, it reduced functional connectivity across the entire brain, cortical node degree, and global efficiency. As hub regions, we identified the substantia innominata and ventral pallidum. Our results uncovered novel mechanisms of action at a brain-wide scale for modafinil and tetrabenazine. Our analytical approach offers a tool to characterize signatures of whole-brain functional connectivity for drug candidates and to identify potential undesired effects at a mesoscopic scale. Additionally, it offers a guide towards targeted experiments on newly identified hub regions.
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Affiliation(s)
- Hugo Cruces-Solis
- Central Nervous System Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach Riß, Germany.
| | - Wiebke Nissen
- Central Nervous System Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach Riß, Germany
| | - Boris Ferger
- Central Nervous System Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach Riß, Germany
| | - Roberto Arban
- Central Nervous System Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach Riß, Germany.
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23
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Kajero JA, Seedat S, Ohaeri J, Akindele A, Aina O. Investigation of the effects of cannabidiol on vacuous chewing movements, locomotion, oxidative stress and blood glucose in rats treated with oral haloperidol. World J Biol Psychiatry 2020; 21:612-626. [PMID: 32264772 DOI: 10.1080/15622975.2020.1752934] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objectives: Tardive dyskinesia (TD) unlike acute dystonia may be irreversible. This study investigated the effects of oral cannabidiol (CBD) on haloperidol-induced vacuous chewing movement (VCM) model of TD. Methods: There were six experimental groups with different combinations of oral cannabidiol with 5 mg/kg of haloperidol given orally. Behavioural assays and FBS were measured. VCMs were assessed after the last dose of medication. Blood for oxidative stress assays was collected on the 8th day after the administration of the last dose of medication. Results: This study found that CBD co-administration with haloperidol attenuated the VCMs and increased motor tone produced by haloperidol. CBD alone at 5 mg/kg appears to have anxiolytic properties but may not be as effective as haloperidol which exhibited a greater anxiolytic effect at 5 mg/kg. Treatment with CBD alone at 5 mg/kg also appeared to enhance brain DPPH scavenging activity. Conclusions: We confirmed that CBD can ameliorate motor impairments produced by haloperidol. Our data suggest that CBD can be combined with haloperidol to prevent the emergent of extrapyramidal side effects and long-term movement disorders, such as acute dystonic disorder and TD.
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Affiliation(s)
| | - Soraya Seedat
- Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Jude Ohaeri
- Department of Psychological Medicine, University of Nigeria, Enugu State, Nigeria
| | - Abidemi Akindele
- Faculty of Basic Medical Sciences, Department of Pharmacology, Therapeutics & Toxicology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Oluwagbemiga Aina
- Department of Biochemistry, Nigerian Institute of Medical Research Yaba Lagos, Lagos, Nigeria
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24
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Stone NL, Murphy AJ, England TJ, O'Sullivan SE. A systematic review of minor phytocannabinoids with promising neuroprotective potential. Br J Pharmacol 2020; 177:4330-4352. [PMID: 32608035 PMCID: PMC7484504 DOI: 10.1111/bph.15185] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022] Open
Abstract
Embase and PubMed were systematically searched for articles addressing the neuroprotective properties of phytocannabinoids, apart from cannabidiol and Δ9 -tetrahydrocannabinol, including Δ9 -tetrahydrocannabinolic acid, Δ9 -tetrahydrocannabivarin, cannabidiolic acid, cannabidivarin, cannabichromene, cannabichromenic acid, cannabichromevarin, cannabigerol, cannabigerolic acid, cannabigerivarin, cannabigerovarinic acid, cannabichromevarinic acid, cannabidivarinic acid, and cannabinol. Out of 2,341 studies, 31 articles met inclusion criteria. Cannabigerol (range 5 to 20 mg·kg-1 ) and cannabidivarin (range 0.2 to 400 mg·kg-1 ) displayed efficacy in models of Huntington's disease and epilepsy. Cannabichromene (10-75 mg·kg-1 ), Δ9 -tetrahydrocannabinolic acid (20 mg·kg-1 ), and tetrahydrocannabivarin (range 0.025-2.5 mg·kg-1 ) showed promise in models of seizure and hypomobility, Huntington's and Parkinson's disease. Limited mechanistic data showed cannabigerol, its derivatives VCE.003 and VCE.003.2, and Δ9 -tetrahydrocannabinolic acid mediated some of their effects through PPAR-γ, but no other receptors were probed. Further studies with these phytocannabinoids, and their combinations, are warranted across a range of neurodegenerative disorders.
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Affiliation(s)
- Nicole L. Stone
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
| | - Alexandra J. Murphy
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
| | - Timothy J. England
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
| | - Saoirse E. O'Sullivan
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
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25
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Deolankar SC, Modi PK, Subbannayya Y, Pervaje R, Prasad TSK. Molecular Targets from Traditional Medicines for Neuroprotection in Human Neurodegenerative Diseases. ACTA ACUST UNITED AC 2020; 24:394-403. [DOI: 10.1089/omi.2020.0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Sayali Chandrashekhar Deolankar
- Center for Systems Biology and Molecular Medicine, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, India
| | - Prashant Kumar Modi
- Center for Systems Biology and Molecular Medicine, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, India
| | - Yashwanth Subbannayya
- Center for Systems Biology and Molecular Medicine, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, India
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26
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Koch J, Shi WX, Dashtipour K. VMAT2 inhibitors for the treatment of hyperkinetic movement disorders. Pharmacol Ther 2020; 212:107580. [PMID: 32454050 DOI: 10.1016/j.pharmthera.2020.107580] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/14/2020] [Indexed: 11/24/2022]
Abstract
Hyperkinetic movement disorders comprise a variety of conditions characterized by involuntary movements, which include but are not limited to tardive dyskinesia, chorea associated with Huntington's Disease, and tic disorders. The class of medications that have been used to treat these conditions includes Vesicular Monoamine Transporter-2 (VMAT2) inhibitors. In 2008, the FDA approved tetrabenazine as a treatment for chorea associated with Huntington's Disease. Optimization of the pharmacology of tetrabenazine has since led to the approval of two new VMAT2 inhibitors, deutetrabenazine and valbenazine. The objective of this review is to provide background on the role of VMAT in monoamine neurotransmission, the mechanism of VMAT2 inhibition on the treatment of hyperkinetic disorders (specifically tardive dyskinesia and chorea associated with Huntington's Disease), the pharmacology and pharmacokinetics of the commercially available VMAT2 inhibitors, and a summary of the clinical data to support application of these medications.
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Affiliation(s)
- Jessa Koch
- Pharmacy Practice, Loma Linda University School of Pharmacy, Shryock Hall, 24745 Stewart St, Loma Linda, CA 92350, United States of America; Department of Neurology, Loma Linda University School of Medicine, Faculty Medical Offices, 11370 Anderson, Suite B-100, Loma Linda, CA 92350, United States of America.
| | - Wei-Xing Shi
- Pharmaceutical, Administrative and Basic Sciences, Loma Linda University Schools of Pharmacy and Medicine, 11175 Campus St, CSP21020, Loma Linda, CA 92350, United States of America.
| | - Khashayar Dashtipour
- Pharmacy Practice, Loma Linda University School of Pharmacy, Shryock Hall, 24745 Stewart St, Loma Linda, CA 92350, United States of America; Department of Neurology, Loma Linda University School of Medicine, Faculty Medical Offices, 11370 Anderson, Suite B-100, Loma Linda, CA 92350, United States of America.
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27
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Schneider F, Bradbury M, Baillie TA, Stamler D, Hellriegel E, Cox DS, Loupe PS, Savola JM, Rabinovich-Guilatt L. Pharmacokinetic and Metabolic Profile of Deutetrabenazine (TEV-50717) Compared With Tetrabenazine in Healthy Volunteers. Clin Transl Sci 2020; 13:707-717. [PMID: 32155315 PMCID: PMC7359938 DOI: 10.1111/cts.12754] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/26/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022] Open
Abstract
Deutetrabenazine (Austedo, Teva Pharmaceuticals) is a deuterated form of tetrabenazine. It is the first deuterated drug to receive US regulatory approval and is approved for treatment of chorea in Huntington's disease and tardive dyskinesia. Two oral single dose studies comparing deutetrabenazine (25 mg) with tetrabenazine (25 mg) in healthy volunteers evaluated the impact of deuteration on pharmacokinetics of the active metabolites, alpha-dihydrotetrabenazine (α-HTBZ) and beta-dihydrotetrabenazine (β-HTBZ), metabolite profile, safety, and tolerability. In the two-way, cross-over study, the mean elimination half-life of deuterated total (α + β)-HTBZ was doubled compared with nondeuterated total (α + β)-HTBZ, with a twofold increase in overall mean exposure (area under the concentration-time curve from zero to infinity (AUC0-inf )) and a marginal increase in mean peak plasma concentration (Cmax ). In the mass balance and metabolite profiling study, there were no novel plasma or urinary metabolites of [14 C]-deutetrabenazine relative to [14 C]-tetrabenazine. Specific deuteration in deutetrabenazine resulted in a superior pharmacokinetic profile and an increased ratio of active-to-inactive metabolites, attributes considered to provide significant benefits to patients.
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Affiliation(s)
- Frank Schneider
- Teva Pharmaceutical Industries, Ratiopharm GmbH, Ulm, Germany
| | - Margaret Bradbury
- Formerly of Teva Pharmaceuticals, Alterity Therapeutics Limited, Newark, California, USA
| | - Thomas A Baillie
- Department of Medicinal Chemistry, School of Pharmacy, University of Washington, Seattle, Washington, USA
| | - David Stamler
- Formerly of Teva Pharmaceuticals, Alterity Therapeutics Limited, Newark, California, USA
| | - Edward Hellriegel
- Teva Pharmaceutical Products R&D, Inc., West Chester, Pennsylvania, USA
| | - Donna S Cox
- Formerly of Teva Pharmaceuticals, Pfizer Corporation, Norristown, Pennsylvania, USA
| | - Pippa S Loupe
- Teva Pharmaceuticals Industries, New Orleans, Louisiana, USA
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28
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Paek SM. Synthesis of Tetrabenazine and Its Derivatives, Pursuing Efficiency and Selectivity. Molecules 2020; 25:molecules25051175. [PMID: 32151010 PMCID: PMC7179236 DOI: 10.3390/molecules25051175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/27/2020] [Accepted: 03/03/2020] [Indexed: 12/30/2022] Open
Abstract
Tetrabenazine is a US Food and Drug Administration (FDA)-approved drug that exhibits a dopamine depleting effect and is used for the treatment of chorea in Huntington’s disease. Mechanistically, tetrabenazine binds and inhibits vesicular monoamine transporter type 2, which is responsible for importing neurotransmitters from the cytosol to the vesicles in neuronal cells. This transportation contributes to the release of neurotransmitters inside the cell to the synaptic cleft, resulting in dopaminergic signal transmission. The highly potent inhibitory activity of tetrabenazine has led to its advanced applications and in-depth investigation of prodrug design and metabolite drug discovery. In addition, the synthesis of enantiomerically pure tetrabenazine has been pursued. After a series of research studies, tetrabenazine derivatives such as valbenazine and deutetrabenazine have been approved by the US FDA. In addition, radioisotopically labeled tetrabenazine permits the early diagnosis of Parkinson’s disease, which is difficult to treat during the later stages of this disease. These applications were made possible by the synthetic efforts aimed toward the efficient and asymmetric synthesis of tetrabenazine. In this review, various syntheses of tetrabenazine and its derivatives have been summarized.
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Affiliation(s)
- Seung-Mann Paek
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju Daero 501, Jinju, Gyeongnam 52828, Korea
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29
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Szpisjak L, Salamon A, Zadori D, Klivenyi P, Vecsei L. Selecting dopamine depleters for hyperkinetic movement disorders: how do we choose? Expert Opin Pharmacother 2019; 21:1-4. [DOI: 10.1080/14656566.2019.1685980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Laszlo Szpisjak
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Andras Salamon
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Denes Zadori
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Peter Klivenyi
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Laszlo Vecsei
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
- MTA-SZTE Neuroscience Research Group, Szeged, Hungary
- Department of Neurology, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
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Behaviour of Tetrabenazine in Acid Medium: Reassessment and Impact on Formulation. Pharmaceutics 2019; 11:pharmaceutics11010044. [PMID: 30669539 PMCID: PMC6359103 DOI: 10.3390/pharmaceutics11010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/21/2022] Open
Abstract
Thorough studies of previous analytical stress data of tetrabenazine, a dopamine depleting agent, showed a potential susceptibility to acidic conditions. Hence, the behavior of tetrabenazine acidic solutions was studied by LC-MS and NMR spectroscopy. Reverse-phase LC-MS analysis of tetrabenazine acidic aqueous solutions consistently showed a main lipophilic impurity in a proportion of 15 to 20%. NMR spectroscopy studies did not allow to completely ascertain its structure. However, we hypothesize an interconversion of trans-tetrabenazine with its unstable cis isomer via an open isoquinolinium intermediate. Evaluation of tetrabenazine integrity in orodispersible films was reassessed in light of these observations after formulation and during stability study. Even if interconversion of trans-tetrabenazine with its cis isomer was observed in orodispersible films containing tetrabenazine, this phenomenon seems not to have any consequences for the overall tetrabenazine bioavailability.
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Paulsen JS, Lourens S, Kieburtz K, Zhang Y. Sample enrichment for clinical trials to show delay of onset in huntington disease. Mov Disord 2019; 34:274-280. [PMID: 30644132 DOI: 10.1002/mds.27595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/19/2018] [Accepted: 11/26/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Disease-modifying clinical trials in persons without symptoms are often limited in methods to assess the impact associated with experimental therapeutics. This study suggests sample enrichment approaches to facilitate preventive trials to delay disease onset in individuals with the dominant gene for Huntington disease. METHODS Using published onset prediction indexes, we conducted the receiver operating curve analysis for diagnosis within a 3-year clinical trial time frame. We determined optimal cut points on the indexes for participant recruitment and then conducted sample size and power calculations to detect varying effect sizes for treatment efficacy in reducing 3-year rates of disease onset (or diagnosis). RESULTS Area under the curve for 3 onset prediction indexes all demonstrated excellent value in sample enrichment methodology, with the best-performing index being the multivariate risk score (MRS). CONCLUSIONS This study showed that conducting an intervention trial in premanifest and prodromal individuals with the gene expansion for Huntington disease is highly feasible using sample enrichment recruitment methods. Ongoing natural history studies are highly likely to indicate additional markers of disease prior to diagnosis. Statistical modeling of identified markers can facilitate participant enrichment to increase the likelihood of detecting a difference between treatment arms in a cost-effective and efficient manner. Such variations may expedite translation of emerging therapies to persons in an earlier phase of the disease. TRIAL REGISTRATION PREDICT-HD is registered with www.clinicaltrials.gov, number NCT00051324. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jane S Paulsen
- Departments of Neurology, Psychiatry, and Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Spencer Lourens
- Department of Biostatistics, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, Indiana, USA
| | - Karl Kieburtz
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
| | - Ying Zhang
- Department of Biostatistics, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, Indiana, USA
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32
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Abstract
The basal ganglia and dopaminergic pathways play a central role in hyperkinetic movement disorders. Vesicular monoamine transporter 2 (VMAT2) inhibitors, which deplete dopamine at presynaptic striatal nerve terminals, are a class of drugs that have long been used to treat hyperkinetic movement disorders, but have recently gained more attention following their development for specific indications in the United States. At present, there are three commercially available VMAT2 inhibitors: tetrabenazine, deutetrabenazine, and valbenazine. Pharmacokinetics, metabolism, and dosing vary significantly between the three drugs, and likely underlie the more favorable side effect profile of the newer agents (deutetrabenazine and valbenazine). Tetrabenazine and deutetrabenazine have demonstrated safety and efficacy in the treatment of chorea associated with Huntington's disease, including in randomized controlled trials, although direct comparison studies are limited. Both deutetrabenazine and valbenazine have demonstrated safety and efficacy in the treatment of tardive dyskinesia, with multiple double-blind, placebo-controlled trials, whereas tetrabenazine has been studied less rigorously. There have been no blinded, prospective trials with tetrabenazine in Tourette's syndrome (TS); however, double-blind, placebo-controlled trials in TS are ongoing for both deutetrabenazine and valbenazine. Given the favored side effect profile of newer VMAT2 inhibitors, clinicians should be aware of the distinctions between agents and become familiar with differences in their use, especially as there is potential for their utilization to increase across the range of hyperkinetic movement disorders.
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Affiliation(s)
- Arjun Tarakad
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, 7200 Cambridge St., 9th floor, Houston, TX, 77030, USA
| | - Joohi Jimenez-Shahed
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, 7200 Cambridge St., 9th floor, Houston, TX, 77030, USA.
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33
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Abstract
The recent approval of treatments for tardive dyskinesia (TD) has rekindled interest in this chronic and previously recalcitrant condition. A large proportion of patients with chronic mental illness suffer from various degrees of TD. Even the newer antipsychotics constitute a liability for TD, and their liberal prescription might lead to emergence of new TD in patient populations previously less exposed to antipsychotics, such as those with depression, bipolar disorder, autism, or even attention deficit hyperactivity disorder. The association of TD with activity limitations remains poorly understood. We review potential new avenues of assessing the functional sequelae of TD, such as the performance of instrumental activities of daily living, residential status, and employment outcomes. We identify several mediating aspects, including physical performance measures and cognition, that may represent links between TD and everyday performance, as well as potential treatment targets.
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34
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Rutin as a Potent Antioxidant: Implications for Neurodegenerative Disorders. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:6241017. [PMID: 30050657 PMCID: PMC6040293 DOI: 10.1155/2018/6241017] [Citation(s) in RCA: 194] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/29/2018] [Indexed: 12/16/2022]
Abstract
A wide range of neurodegenerative diseases (NDs), including Alzheimer's disease, Parkinson's disease, Huntington's disease, and prion diseases, share common mechanisms such as neuronal loss, apoptosis, mitochondrial dysfunction, oxidative stress, and inflammation. Intervention strategies using plant-derived bioactive compounds have been offered as a form of treatment for these debilitating conditions, as there are currently no remedies to prevent, reverse, or halt the progression of neuronal loss. Rutin, a glycoside of the flavonoid quercetin, is found in many plants and fruits, especially buckwheat, apricots, cherries, grapes, grapefruit, plums, and oranges. Pharmacological studies have reported the beneficial effects of rutin in many disease conditions, and its therapeutic potential in several models of NDs has created considerable excitement. Here, we have summarized the current knowledge on the neuroprotective mechanisms of rutin in various experimental models of NDs. The mechanisms of action reviewed in this article include reduction of proinflammatory cytokines, improved antioxidant enzyme activities, activation of the mitogen-activated protein kinase cascade, downregulation of mRNA expression of PD-linked and proapoptotic genes, upregulation of the ion transport and antiapoptotic genes, and restoration of the activities of mitochondrial complex enzymes. Taken together, these findings suggest that rutin may be a promising neuroprotective compound for the treatment of NDs.
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35
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Zoons E, Booij J, Delnooz CCS, Dijk JM, Dreissen YEM, Koelman JHTM, van der Salm SMA, Skorvanek M, Smit M, Aramideh M, Bienfait H, Boon AJW, Brans JWM, Hoogerwaard E, Hovestadt A, Kamphuis DJ, Munts AG, Speelman JD, Tijssen MAJ. Randomised controlled trial of escitalopram for cervical dystonia with dystonic jerks/tremor. J Neurol Neurosurg Psychiatry 2018; 89:579-585. [PMID: 29326295 DOI: 10.1136/jnnp-2017-317352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/24/2017] [Accepted: 12/18/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Trials for additional or alternative treatments for cervical dystonia (CD) are scarce since the introduction of botulinum neurotoxin (BoNT). We performed the first trial to investigate whether dystonic jerks/tremor in patients with CD respond to the selective serotonin reuptake inhibitor (SSRI) escitalopram. METHODS In a randomised, double-blind, crossover trial, patients with CD received escitalopram and placebo for 6 weeks. Treatment with BoNT was continued, and scores on rating scales regarding dystonia, psychiatric symptoms and quality of life (QoL) were compared. Primary endpoint was the proportion of patients that improved at least one point on the Clinical Global Impression Scale for jerks/tremor scored by independent physicians with experience in movement disorders. RESULTS Fifty-threepatients were included. In the escitalopram period, 14/49 patients (29%) improved on severity of jerks/tremor versus 11/48 patients (23%) in the placebo period (P=0.77). There were no significant differences between baseline and after treatment with escitalopram or placebo on severity of dystonia or jerks/tremor. Psychiatric symptoms and QoL improved significantly in both periods compared with baseline. There were no significant differences between treatment with escitalopram and placebo for dystonia, psychiatric or QoL rating scales. During treatment with escitalopram, patients experienced slightly more adverse events, but no serious adverse events occurred. CONCLUSION In this innovative trial, no add-on effect of escitalopram for treatment of CD with jerks was found on motor or psychiatric symptoms. However, we also did not find a reason to withhold patients treatment with SSRIs for depression and anxiety, which are common in dystonia. TRIAL REGISTRATION NUMBER NTR2178.
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Affiliation(s)
- Evelien Zoons
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Joke M Dijk
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
| | | | | | - Sandra M A van der Salm
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.,Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands
| | - Matej Skorvanek
- Department of Neurology, Safarik University, Kosice, Slovakia.,Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
| | - Marenka Smit
- Department of Neurology, University Medical Center, Groningen, The Netherlands
| | - Majid Aramideh
- Department of Neurology, Noordwest Ziekenhuis Groep, Alkmaar, The Netherlands
| | | | - Agnita J W Boon
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeroen W M Brans
- Department of Neurology, Noordwest Ziekenhuis Groep, Alkmaar, The Netherlands
| | - Edo Hoogerwaard
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Ad Hovestadt
- Department of Neurology, Meander Medisch Centrum, Amersfoort, The Netherlands
| | - Daan J Kamphuis
- Department of Neurology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | | | - Johannes D Speelman
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
| | - Marina A J Tijssen
- Department of Neurology, University Medical Center, Groningen, The Netherlands
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Mogwitz S, Buse J, Wolff N, Roessner V. Update on the Pharmacological Treatment of Tics with Dopamine-Modulating Agents. ACS Chem Neurosci 2018; 9:651-672. [PMID: 29498507 DOI: 10.1021/acschemneuro.7b00460] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
More than 40 years of research and clinical practice have proven the effectiveness of dopamine receptor antagonists in the pharmacological treatment of tics. A blockade of the striatal dopamine-D2 receptors is mainly responsible for their tic-reducing effect. A broad spectrum of dopamine-modulating agents, such as typical and atypical antipsychotics, but also dopamine receptor agonists are used with an immanent discord between experts about which of them should be considered as first choice. The present Review outlines the state of the art on pharmacological treatment of tics with dopamine-modulating agents by giving an systematic overview of studies on their effectiveness and a critical discussion of their specific adverse effects. It is considered as an update of a previous review of our research group published in 2013. The Review closes with a description of the current resulting treatment recommendations including the results of a first published revised survey on European expert's prescription preferences. Based on the enormously growing evidence on its effectiveness and safety, aripiprazole currently seems to be the most promising agent in the pharmacological treatment of tics. Furthermore, benzamides (especially tiapride), which are commonly used in Europe, have proven their excellent effectiveness-tolerability profile over decades in clinical practice and are therefore also highly recommended for the treatment of tics. Nevertheless, pharmacological treatment of tics remains an indiviual choice depending on each patient's own specific needs.
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Affiliation(s)
- Sabine Mogwitz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, 01307 Dresden, Germany
| | - Judith Buse
- Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, 01307 Dresden, Germany
| | - Nicole Wolff
- Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, 01307 Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, 01307 Dresden, Germany
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37
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Russ JB, Nallappan AM, Robichaux-Viehoever A. Management of Pediatric Movement Disorders: Present and Future. Semin Pediatr Neurol 2018; 25:136-151. [PMID: 29735111 DOI: 10.1016/j.spen.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Management of movement disorders in children is an evolving field. This article outlines the major categories of treatment options for pediatric movement disorders and general guidelines for their use. We review the evidence for existing therapies, which continue to lack large-scale controlled trials to guide treatment decisions. The field continues to rely on extrapolations from adult studies and lower quality evidence such as case reports and case series to guide treatment guidelines and consensus statements. Developments in new pharmaceuticals for rare diseases have begun to provide hope for those cases in which a genetic diagnosis can be made. Advances in surgical therapies such as deep brain stimulation as well as new modes of treatment such as gene therapy, epigenetic modulation, and stem cell therapy hold promise for improving outcomes in both primary and secondary causes of movement disorders. There is a critical need for larger, multicenter, controlled clinical trials to fully evaluate treatments for pediatric movement disorders.
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Affiliation(s)
- Jeffrey B Russ
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Akila M Nallappan
- Undergraduate Program, Case Western Reserve University, Cleveland, OH
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38
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Masson R, Pagliano E, Baranello G. Efficacy of oral pharmacological treatments in dyskinetic cerebral palsy: a systematic review. Dev Med Child Neurol 2017; 59:1237-1248. [PMID: 28872668 DOI: 10.1111/dmcn.13532] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2017] [Indexed: 12/19/2022]
Abstract
AIM To evaluate the actual evidence of efficacy of oral pharmacological treatments in the management of dyskinetic cerebral palsy (CP). METHOD A systematic review was performed according to the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Articles were searched for in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, Database of Reviews of Effectiveness, OTSeeker, Physiotherapy Evidence Database, REHABDATA, and ClinicalTrials.gov. RESULTS Sixteen articles met the eligibility criteria. Eight studies on trihexyphenidyl and two on levodopa showed contradictory results. Low efficacy was reported for diazepam, dantrolene sodium, perphenazine, and etybenzatropine. Tetrabenazine, gabapentin and levetiracetam should be studied in more detail. The updated available evidence does not support any therapeutic algorithm for the management of dyskinetic CP. INTERPRETATION This lack of evidence is partially owing to the inconsistency of classifications of patients and of outcome measures used in the reviewed studies. Further randomized, double-blind, placebo-controlled pharmacological trials, optimized for different age groups, based on valid, reliable, and disease-specific rating scales are strongly needed. Outcome measures should be selected within the framework of the International Classification of Functioning, Disability and Health. WHAT THIS PAPER ADDS Evidence to prove (or disprove) the efficacy of oral drugs in dyskinetic cerebral palsy is low. The most investigated drugs, trihexyphenidyl and levodopa, show contradictory results. Tetrabenazine, levetiracetam, and gabapentin efficacy should be studied in more detail. Lack of evidence is partially due to the inconsistency of classifications and outcome measures used. Outcome measures should be selected within the framework of the International Classification of Functioning, Disability and Health in next clinical trials.
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Affiliation(s)
- Riccardo Masson
- Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Milan, Italy
| | - Emanuela Pagliano
- Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Milan, Italy
| | - Giovanni Baranello
- Developmental Neurology Unit, "Carlo Besta" Neurological Institute Foundation, Milan, Italy
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Caroff SN, Aggarwal S, Yonan C. Treatment of tardive dyskinesia with tetrabenazine or valbenazine: a systematic review. J Comp Eff Res 2017; 7:135-148. [PMID: 28965423 DOI: 10.2217/cer-2017-0065] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Up to 30% of patients taking antipsychotics may develop tardive dyskinesia (TD). Recent evidence-based recommendations demonstrate an unmet need for effective TD management. This systematic review was designed to update the evidence for TD treatment, comparing two vesicular monoamine transporter 2 (VMAT2) inhibitors, tetrabenazine and valbenazine. Of 487 PubMed/Embase search results, 11 studies met the review criteria. Valbenazine efficacy was demonstrated in rigorously designed clinical trials that meet the guidelines for AAN Class I evidence. Due to differences in study designs and a lack of standardized and controlled trials with tetrabenazine, a formal meta-analysis comparing the agents was not possible. However, valbenazine appears to have fewer side effects and a more favorable once-daily dosing regimen for the treatment of TD.
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Affiliation(s)
- Stanley N Caroff
- Corporal Michael J Crescenz Veterans Affairs Medical Center & the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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40
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Dean SL, Singer HS. Treatment of Sydenham's Chorea: A Review of the Current Evidence. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2017; 7:456. [PMID: 28589057 PMCID: PMC5459984 DOI: 10.7916/d8w95gj2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/09/2017] [Indexed: 12/26/2022]
Abstract
Background Sydenham’s chorea (SC), the neurologic manifestation of rheumatic fever, remains the most prevalent form of chorea in children. Suggested treatments of chorea in SC include prophylactic penicillin, symptomatic (antipsychotic and anticonvulsant) medications, and immunomodulatory therapy (steroids, intravenous immunoglobulin (IVIG), and plasma exchange). In this manuscript, we undertook a systematic review of the published literature to examine the data supporting these therapeutic recommendations. Methods A search of PubMed, Embase, Psychinfo, and clinicaltrials.gov was conducted for publications pertaining to the treatment of SC/rheumatic chorea from 1956 to 2016. Results Penicillin prophylaxis appears to reduce the likelihood of further cardiac complications and the recurrence rate of chorea. Data on symptomatic therapy for chorea are limited to individual case reports or series and rare comparison studies. The efficacy of steroid use is supported by a single placebo-controlled study and several case series. Information on other immunomodulatory therapies such as IVIG and plasmapheresis are limited to a small number of reports and a single comparison study. Discussion Treatment decisions in SC are currently based on the treating physician’s clinical experience, the desire to avoid side effects, and the existence of only limited scientific evidence. Based on a review of the available literature, chorea often improves with symptomatic therapy and immunotherapy tends to be reserved for those who fail to respond. Steroids are beneficial; however, data using IVIG and plasmapheresis are very limited. Larger, well-controlled studies, using standardized assessment scales, are required if therapeutic decisions for SC are to be based on meaningful information.
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Affiliation(s)
- Shannon L Dean
- Department of Child Neurology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Harvey S Singer
- Department of Child Neurology, Johns Hopkins Hospital, Baltimore, MD, USA
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41
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Witter DP, Holbert RC, Suryadevara U. Pharmacotherapy for the treatment of tardive dyskinesia in schizophrenia patients. Expert Opin Pharmacother 2017; 18:965-972. [PMID: 28443349 DOI: 10.1080/14656566.2017.1323874] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Tardive dyskinesia (TD) is an iatrogenic movement disorder most commonly observed in patients with psychotic disorders who are treated with dopamine blocking antipsychotic medications. Treatment options are limited, and recommendations for treatment are based on a relative scarcity of evidence. Areas covered: After briefly highlighting current mechanistic theories of TD, this review will discuss the evidence for a number of medications of several different classes that have been studied for the treatment of TD since the 1970s with an emphasis on placebo controlled trials when possible. We used a Pubmed search of primary studies, reviews, and metaanalyses on the topic of TD treatment in order to cover this topic. Expert opinion: Treatment of TD is difficult given limited data and incomplete understanding of the mechanism. Treatment of TD must be evaluated on an individual basis with careful weight given to severity of symptoms. We suggest the use of atypical versus conventional antipsychotics whenever possible and would recommend trials with one or more of a number of additional agents starting with valbenazine.
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Affiliation(s)
- Daniel P Witter
- a Department of Psychiatry , University of Florida College of Medicine , Gainesville , FL , USA
| | - Richard C Holbert
- a Department of Psychiatry , University of Florida College of Medicine , Gainesville , FL , USA.,b University of Florida Psychiatric Hospital , Gainesville , FL , USA
| | - Uma Suryadevara
- a Department of Psychiatry , University of Florida College of Medicine , Gainesville , FL , USA.,c Malcom Randall VA Medical Center , Gainesville , FL , USA
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42
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Rodrigues FB, Duarte GS, Costa J, Ferreira JJ, Wild EJ. Tetrabenazine Versus Deutetrabenazine for Huntington's Disease: Twins or Distant Cousins? Mov Disord Clin Pract 2017; 4:582-585. [PMID: 28920068 PMCID: PMC5573977 DOI: 10.1002/mdc3.12483] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/25/2017] [Accepted: 02/12/2017] [Indexed: 01/13/2023] Open
Abstract
Background Tetrabenazine is the only US Food and Drug Administration‐approved drug for Huntington's disease, and deutetrabenazine was recently tested against placebo. A switching‐trial from tetrabenazine to deutetrabenazine is underway, but no head‐to‐head, blinded, randomized controlled trial is planned. Using meta‐analytical methodology, the authors compared these molecules. Methods RCTs comparing tetrabenazine or deutetrabenazine with placebo in Huntington's disease were searched. The authors assessed the Cochrane risk‐of‐bias tool, calculated indirect treatment comparisons, and applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results The evidence network for this report comprised 1 tetrabenazine trial and 1 deutetrabenazine trial, both against placebo. Risk of bias was moderate in both. Participants in the tetrabenazine and deutetrabenazine trials did not differ significantly on motor scores or adverse events. Depression and somnolence scales significantly favored deutetrabenazine. Conclusion There is low‐quality evidence that tetrabenazine and deutetrabenazine do not differ in efficacy or safety. It is important to note that these results are likely to remain the only head‐to‐head comparison between these 2 compounds in Huntington's disease.
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Affiliation(s)
- Filipe B Rodrigues
- Huntington's Disease Center Institute of Neurology University College London London United Kingdom.,Laboratory of Clinical Pharmacology and Therapeutics Faculty of Medicine University of Lisbon Lisbon Portugal.,Clinical Pharmacology UnitInstituto de Medicina Molecular Lisbon Portugal
| | - Gonçalo S Duarte
- Laboratory of Clinical Pharmacology and Therapeutics Faculty of Medicine University of Lisbon Lisbon Portugal.,Clinical Pharmacology UnitInstituto de Medicina Molecular Lisbon Portugal
| | - João Costa
- Laboratory of Clinical Pharmacology and Therapeutics Faculty of Medicine University of Lisbon Lisbon Portugal.,Clinical Pharmacology UnitInstituto de Medicina Molecular Lisbon Portugal.,Cochrane Movement Disorders Group Faculty of Medicine University of Lisbon Lisbon Portugal.,Center for Evidence-Based Medicine Faculty of Medicine University of Lisbon Lisbon Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics Faculty of Medicine University of Lisbon Lisbon Portugal.,Clinical Pharmacology UnitInstituto de Medicina Molecular Lisbon Portugal
| | - Edward J Wild
- Huntington's Disease Center Institute of Neurology University College London London United Kingdom
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Abstract
INTRODUCTION Abnormal involuntary movements often improve in response to anti-dopaminergic drugs. In contrast to classic neuroleptics that block dopamine receptors, drugs that deplete presynaptic dopamine by blocking vesicular monoamine transporter type 2 (VMAT2) seem to be safer and have little or no risk of tardive dyskinesia. This is one reason why there has been a recent emergence of novel VMAT2 inhibitors. Areas covered: Since the approval of tetrabenazine, the classic VMAT2 inhibitor, in the treatment of chorea associated with Huntington disease (HD), other VMAT2 inhibitors (e.g. deutetrabenazine and valbenazine) have been studied in the treatment of HD-related chorea, tardive dyskinesia and tics associated with Tourette syndrome. This review, based largely on a detailed search of PubMed, will summarize the pharmacology and clinical experience with the various VMAT2 inhibitors. Expert commentary: Because of differences in pharmacology and pharmacokinetics these new VMAT2 inhibitors promise to be at least as effective as tetrabenazine but with a lower risk of adverse effects, such as sedation, insomnia, depression, parkinsonism, and akathisia.
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Affiliation(s)
- Joseph Jankovic
- a Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology , Baylor College of Medicine , Houston , TX , USA
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44
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Quinlan S, Kenny A, Medina M, Engel T, Jimenez-Mateos EM. MicroRNAs in Neurodegenerative Diseases. MIRNAS IN AGING AND CANCER 2017; 334:309-343. [DOI: 10.1016/bs.ircmb.2017.04.002] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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45
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Termsarasab P, Thammongkolchai T, Frucht SJ. Medical treatment of dystonia. JOURNAL OF CLINICAL MOVEMENT DISORDERS 2016; 3:19. [PMID: 28031858 PMCID: PMC5168853 DOI: 10.1186/s40734-016-0047-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/08/2016] [Indexed: 11/25/2022]
Abstract
Therapeutic strategies in dystonia have evolved considerably in the past few decades. Three major treatment modalities include oral medications, botulinum toxin injections and surgical therapies, particularly deep brain stimulation. Although there has been a tremendous interest in the later two modalities, there are relatively few recent reviews of oral treatment. We review the medical treatment of dystonia, focusing on three major neurotransmitter systems: cholinergic, GABAergic and dopaminergic. We also provide a practical guide to medication selection, therapeutic strategy and unmet needs.
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Affiliation(s)
- Pichet Termsarasab
- Movement Disorder Division, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Steven J. Frucht
- Movement Disorder Division, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
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