The incidence and clinical characteristics of impulse control disorders in patients with prolactinoma receiving dopamine agonist / 中华内分泌代谢杂志

Objective:To understand the incidence and clinical characteristics of dopamine agonist(DA) therapy-related impulse control disorders(ICDs) in prolactinoma patients.Methods:Outpatients diagnosed with prolactinoma from the Department of Endocrinology in Huashan Hospital from December 2019 to June 2020 were consecutively included and clinical data were collected. Impulse control disorders were screened with Questionnaire for Impulsive-Compulsive Disorders in Parkinson′s Disease(QUIP). Barratt Impulsiveness Scale 11(BIS-11) was used to evaluate personality construct of impulsiveness from three sub-factors . Health related quality of life was evaluated by the MOS 36-Item Short Form Health Survey(SF-36).Results:Among the 111 cases included, 40 were male and 53 were female, with an average age of(34.74±9.05) years and an average disease duration of(66.69±50.70) months. The initial prolactin level was 147.25(89.97, 470) ng/mL and the percentage of macroadenoma was 46.8%. Ninety cases received DA while 21 cases didn′t. According to the QUIP, any ICD was screened positive in 22 cases(24.7%) in the DA group and 3 cases(14.3%) in the untreated group. The attention impulsiveness scores of BIS-11 in the DA group were higher than the untreated group(23.32±3.67 vs 21.71±2.55, P=0.022). Among the ICDs positive cases in the DA group, the most common disorders were pathological gambling(40.6%) and hypersexuality(40.6%). Compared with the negative group, the non-planning impulsiveness scores of BIS-11 in the positive group were higher, while the scores of social function(69.32±24.62 vs 83.08±17.11, P=0.021), role emotional(50.00±45.72 vs 71.10±40.68, P=0.043) and mental health(55.27±22.75 vs 64.59±17.53, P=0.048) in SF-36 scale were lower in the positive group. Besides, the percentage of male(68.2% vs 38.2%, P=0.014) and initial prolactin level[470.00(130.00, 3 770.00) vs 140.29(79.50, 465.59) ng/mL, P=0.028] in the positive group were higher. Male was an independent risk factor of the presence of ICDs( OR=3.46, 95% CI 1.24-9.61, P=0.017). No significant difference was found in the type of drugs, duration, maximal or cumulative dose of treatment with DA between the two groups. Conclusion:Impulse control disorders may occur in prolactinoma patients receiving DA treatment and affect the quality of life. Endocrinologists should screen impulse control disorders in this patient set.

Updates on the Diagnosis and Treatment of Restless Legs Syndrome / 신경정신의학

Restless legs syndrome (RLS) is a neurological sleep disorder characterized by an urge to move the legs or arms and is associated with discomfort and paresthesia in the legs. RLS is diagnosed based on the clinical symptoms, and polysomnography is performed to quantify the periodic limb movements during sleep or in patients who undergo the suggested immobilization test. Determining the cause of RLS is important for accurately diagnosing and evaluating this condition. The treatment of RLS varies according to the etiology, severity, and frequency of the patients' symptoms. Accurate identification and treatment of the cause of RLS are important in patients with secondary RLS. Iron supplementation could be useful in patients with uremia, iron deficiency, and for RLS during pregnancy. Dopamine agonists have been used as the first-line treatment for primary RLS. On the other hand, augmentation is a known adverse effect associated with the long-term use of dopamine agonists. Therefore, recent treatment guidelines recommend the administration of anticonvulsants, such as pregabalin and gabapentin, to treat RLS. Iron, opioids, or benzodiazepines may be useful in patients refractory to anticonvulsants or dopamine agonists. RLS is a chronic condition. Therefore, it is essential to establish a long-term treatment plan, considering both the efficacy and adverse effects of therapeutic agents used in patients.

Trastorno de control de impulsos (TCI) en enfermedad de Parkinson / Impulse control disorders (ICD) in Parkinson's disease

RESUMEN Los trastornos del control de impulsos (TCI) son complicaciones psiquiátricas de la enfermedad de Parkinson (EP), cada vez más reconocidos, pero que persisten subdiagnosticados y pueden llegar a ser muy disruptivos para la vida familiar del paciente, en especial si no son detectados a tiempo. Si bien uno de sus principales riesgos es el uso de agonistas dopaminérgicos, estos no son su única causa, se pueden ver sin relación con medicamentos o con cualquier tratamiento para la EP. Por lo tanto, se debe interrogar sistemáticamente por su presencia y educar al paciente y su familia para que sean reportados en cualquier momento. El objetivo de este capítulo es describir los diferentes tipos de TCI, sus factores de riesgo y tratamiento.

SUMMARY Impulse Control Disorders (ICD) are psychiatric complications of Parkinson's Disease (PD), increasingly recognized, but which persist underdiagnosed and can be vert disruptive to the patient's family life, especially if they are not detected in time. Although one of its main risks is the use of dopamine agonists, these are not the only cause, they can be seen without realtion to medications ot any treatment for PD, therefore it should be questioned systematically by their presence and educate the patient and his family to be reported at any time. The objective of this chapter is to describe the different types of ICD, their risk factors and treatment.

Updates on the Treatment of Restless Legs Syndrome / 수면정신생리

Restless legs syndrome (RLS) is a sleep disorder characterized by an urge to move the legs or arms and uncomfortable paresthesia in the legs. Treatment of RLS can be various depending on the causes, severity, and frequency of the symptoms. In the case of secondary RLS, it is important to identify and manage the cause of RLS. Dopamine agonists have been used as firstline treatments for primary RLS treatment. However, due to augmentation, which is a common side effect of dopamine agonists, recent treatment guidelines are changing to prefer to anticonvulsants such as pregabalin and gabapentin. Iron, opioid, or benzodiazepine may be used when anticonvulsants or dopamine agonists are not adequately treated. Because RLS is a chronic disease, it is essential to establish a long-term treatment plan considering both efficacy and side effects.

Cervical dystonia in Parkinson’s disease: Retrospective study of later-stage clinical features

@#Objective: Cervical dystonia (CD) is a clinically under-recognized symptom occurring at the later- to end-stages of Parkinson’s disease (PD). The frequency of CD and its influence on prognosis have not been well studied. Here, we conducted an in-depth examination of CD incidence and impact on disease progression in later-stage PD. Methods: We retrospectively reviewed the clinical features of 22 deceased patients with sporadic PD treated at a hospital in Japan from 1983 to 2008. Results: The most common cause of death in PD was pneumonia. CD, in particular retrocollis, was frequent in the later stages of the disease in elderly patients (9/22, 40.9%). Pneumonia incidence increased sharply in the later period with CD. There was a positive trend between CD duration and duration of pergolide use. Conclusion: Analysis revealed that CD increases markedly in late- to end-stage PD, which may be associated with aspiration pneumonia due to dysphagia. Pathological mechanisms underlying CD might be influenced by treatments including dopamine agonists. Prevention of CD may increase quality of life and prolong survival of PD patients.

Abnormal Sleep Delta Rhythm and Interregional Phase Synchrony in Patients with Restless Legs Syndrome and Their Reversal by Dopamine Agonist Treatment

BACKGROUND AND PURPOSE: The purpose of this study was to characterize abnormal cortical activity during sleep in restless legs syndrome (RLS) patients and to determine the effects of treatment with a dopamine agonist. Based on whole-brain electroencephalograms, we attempted to verify alterations in the functional network as well as the spectral power of neural activities during sleep in RLS patients and to determine whether the changes are reversed by treatment with pramipexole. METHODS: Twelve drug-naïve RLS patients participated in the study. Overnight polysomnography was performed before and after treatment: the first recording was made immediately prior to administering the first dose of pramipexole, and the second recording was made 12–16 weeks after commencing pramipexole administration. Sixteen age-matched healthy participants served as a control group. The spectral power and interregional phase synchrony were analyzed in 30-s epochs. The functional characteristics of the cortical network were quantified using graph-theory measures. RESULTS: The delta-band power was significantly increased and the small-world network characteristics in the delta band were disrupted in RLS patients compared to the healthy controls. These abnormalities were successfully treated by dopaminergic medication. The delta-band power was significantly correlated with the RLS severity score in the RLS patients prior to treatment. CONCLUSIONS: Our findings suggest that the spectral and functional network characteristics of neural activities during sleep become abnormal in RLS patients, and these abnormalities can be successfully treated by a dopamine agonist.

Nocturnal Restless Arms and Face Improved by Dopamine Agonist: Is It a Variant of Restless Legs Syndrome?

The symptoms of restless legs syndrome (RLS) usually involve legs and can extend to other body parts. However, isolated body parts other than leg have rarely been involved. A 32-year-old woman had abnormal sensations of both forearms and face during night, which caused a difficulty falling in sleep. The symptoms were relieved by shaking and rubbing. She experienced a clear benefit from pramipexole, but a recurrence of restlessness was followed in both arms subsequent to pramipexole withdrawal. Finally, she had been prescribed a dose of 0.375 mg, which was well tolerated for 6 years. We report a case of nocturnal restless arms and face without leg involvement, which was like RLS in terms of clinical criteria except lesion site.

Prolactinomas: evolution after menopause

ABSTRACT Objetive The aim was to assess the evolution of tumor size and prolactin (PRL) levels in patients with micro and macroprolactinomas diagnosed and treated with dopamine agonists during fertile age, and the effects of suspension of drugs after menopause. Retrospective study, 29 patients with prolactinomas, 22 microadenomas and 7 macroadenomas, diagnosed during their fertile age were studied in their menopause; treatment was stopped in this period. Age at menopause was 49 ± 3.6 years. The average time of treatment was 135 ± 79 months. The time of follow-up after treatment suspension was 4 to 192 months. Results Pre-treatment PRL levels in micro and macroadenomas were 119 ± 57 ng/mL and 258 ± 225 ng/mL, respectively. During menopause after treatment suspension, and at the latest follow-up: in microadenomas PRL levels were 23 ± 13 ng/mL and 16 ± 5.7 ng/mL, respectively; in macroadenomas, PRL levels were 20 ± 6.6 ng/mL 5t5and 25 ± 18 ng/mL, respectively. In menopause after treatment suspension, the microadenomas had disappeared in 9/22 and had decreased in 13/22. In the group of patients whose tumor had decreased, in the latest follow-up, tumors disappeared in 7/13 and remained unchanged in 6/13. In macroadenomas, after treatment suspension 3/7 had disappeared, 3/7 decreased and 1/7 remained unchanged. In the latest control in the 3 patients whose tumor decreased, disappeared in 1/3, decreased in 1/3 and there was no change in the remaining. Conclusions Normal PRL levels and sustained reduction or disappearance of adenomas were achieved in most of patients, probably due to the decrease of estrogen levels. Dopamine agonists might be stopped after menopause in patients with prolactinomas.

Diagnosis and Treatment of Restless Legs Syndrome

Restless legs syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations. It most commonly affects the legs. Moving the affected body part, such as walking or stretching provide relief the urge to move the legs and any accompanying unpleasant sensation partially or totally. RLS is relatively common, affecting 5 to 15 % of the general population, with prevalence rates increasing alongside age. Restless legs syndrome can lead to sleep-onset or sleep-maintenance insomnia, and occasionally excessive daytime sleepiness, all leading to significant morbidity. Dopaminergic systems are known to be strongly related with RLS that are closely linked to CNS iron homeostasis. Besides defective dopaminergic system that is closely related with iron metabolism, genetic factors play a role in early-onset individual with a positive family history. The diagnosis can be made based on the symptom characteristics, differential diagnosis is important because many conditions could mimic RLS symptoms. Dopamine agonists (DAs) have been considered the first-line therapy, but with the growing appreciation of problems associated with long-term treatment, particularly augmentation and impulse control disorder, alpha-2-delta drugs, such as gabapentin, are now considered the first line of treatment in patients with troublesome RLS. In more severe cases, a combination therapy may be required.

Prolactinoma / Prolactinoma

Os prolactinomas são os adenomas de hipófise mais comuns e frequentemente afetam mulheres jovens, em faixa etária de fertilidade. A hiperprolactinemia causa hipogonadismo, irregularidade menstrual ou amenorreia em mulheres, níveis baixos de testosterona sérica em homens e infertilidade e disfunção sexual em ambos os gêneros. Macroprolactinomas podem causar cefaleia, aliteração visual e hipopituitarismo. O tratamento clínico com agonista dopaminérgico é o padrão-ouro, sendo a cabergolina a droga de escolha por sua maior eficácia e tolerabilidade. Em cerca de 20% dos casos, o tratamento é parcial ou totalmente ineficaz, situação na qual a cirurgia, em geral por via transesfenoidal, está indicada. A radioterapia é indicada somente para controle de crescimento tumoral em casos invasivos/agressivos. Nos macroprolactinomas invasivos, a abordagem em geral necessária é a de diversas modalidades terapêuticas combinadas, incluindo debulking e drogas recém-aprovadas como a temozolamida. Com relação à gestação, a droga de escolha para induzir a ovulação ainda é a bromocriptina. Nos casos de microprolactinomas e de macroprolactinomas intrasselares, o agonista dopaminérgico pode ser suspenso após a confirmação da gestação. Nos macroprolactinomas, o manejo deve ser individualizado.

Prolactinomas are the most common pituitary adenomas that affect young women at fertile age. Hyperprolactinemia causes hypogonadism, menstrual irregularities or amenorrhea in women, low serum testosterone levels in men, and infertility and sexual dysfunction in both men and women. Macroprolactinomas may cause cephalea, visual disturbance, and hypopituitarism. Clinical treatment with dopamine agonists is the gold standard, with cabergoline as the first choice due to its greater efficiency and tolerability. In about 20% of the cases, treatment is partially or completely ineffective, a situation in which surgery, in general by transsphenoidal route, is indicated. Radiotherapy is indicated only in the control of tumor growth in invasive/aggressive cases. In invasive macroprolactinoma, the necessary approach, in general, is the combination of several therapeutic modalities, including debulking and recently-approved drugs, such as temozolamide. As for pregnancy, the drug of choice to induce ovulation still is bromocriptine. In the cases of microprolactinomas and intrasselar macroprolactinomas, the treatment with dopaminergic agonists may be suspended after pregnancy is confirmed. In macroprolactinomas, management should be individualized.

Resultados visuales en pacientes con macroprolactinoma tratados con agonistas de dopamina / Visual outcome in patients with macroprolactinoma treated with dopamine agonists

Background: Dopamine agonists (DA) effectively reduce tumor size of macroprolactinomas, with the consequent improvement of eventual visual impairment. Aim: To study the visual outcomes in patients with macroprolactinoma treated with DA. Material and Methods: Retrospective cohort study which included patients with macroprolactinoma controlled at a Neuro-endocrinology and Neuro-ophthalmology Department between 1997'and2011, and treated exclusively with DA (bromocriptine or cabergoline). Patients who were operated or had previous radiotherapy and those with an incomplete follow up, were excluded. We analyzed and compared the visual status before and after the beginning of DA treatment. Results: Thirty one patients aged 8 to 59years, were included. Eighteen patients (58%) had visual impairment at the moment of diagnosis (group 1) and 13 had no alterations (group 2). Mean follow up was 36.5 months. Fifteen patients from group 1 (83%) had visual improvement, two remained stable (11 %) and one had a visual deterioration (6%). In group 2, only one non-compliant patient had a visual deterioration. Conclusions: DAs are effective in the management of neuro-ophthalmic complications associated to macroprolactinomas and should be considered asfirst choice therapy in these tumors.

Bromocriptine Therapy for the Treatment of Invasive Prolactinoma: The Single Institute Experience

OBJECTIVE: The objective of this study was to describe and characterize the clinical course of treatment for invasive prolactinoma patients using bromocriptine. METHODS: The study group included 23 patients who were treated with bromocriptine for their invasive prolactinomas. Clinical histories, serum prolactin level and pituitary hormone assessments, tumor diameter and signal intensity on sella magnetic resonance imaging (MRI), visual field exams and the dosage of medications were reviewed for each patient. RESULTS: During 30 months (median, range 6-99) of follow-up period, 19 patients treated with bromocriptine alone achieved biochemical remission. Four patients changed the medication to cabergoline due to the adverse effects or observed resistance of bromocriptine treatment. All of five patients who had visual symptoms improved after the course of medication. Four surgically treated patients were not able to discontinue medication because they could not maintain biochemical remission state without medication. Multivariate analysis showed that decreased enhancement on the initial followed MRI after medication and longer follow-up periods were associated with higher radiologic response. CONCLUSION: We reassure that the dopamine agonist is safe and effective for the treatment of invasive pituitary adenomas. Meanwhile, surgery has a limited role on biochemical remission. Decreased enhancement on the initial follow-up MRI after medication may reflect the treatment response. Further study is required to validate the role of MRI or other factors on the actual prognosis.

Polysomnographic Characteristics and Prescription Status of Restless Legs Syndrome Patients in Naturalistic Setting / 수면정신생리

OBJECTIVES: The aim of this study is to evaluate the polysomnographic characteristics and prescription status of restless legs syndrome (RLS) patients in naturalistic setting. METHODS: We reviewed medical record of the patients over 18 years olds who (i) satisfied the clinical RLS diagnostic criteria and (ii) had the polysomnography and got treatment related thereto. As a baseline, we evaluated the four diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG) and the International Restless Legs Scale (IRLS) of the subjects. Then the polysomnography and the suggested immobilization test (SIT) were conducted and, after one month of pharmacotherapy using dopamine agonist, the IRLS was evaluated again. RESULTS: A total of 211 subjects participated in this analysis and 94 (44.5%) of them were male and the other 117 (55.5%) were female and the average age of the 211 subjects was 46.9+/-14.2. Out of such 211 subjects, 136 subjects (64.5%) also had the obstructive sleep apnea (OSA), and 53 subjects (25.1%) also had the periodic limb movement disorder (PLMD). 185 subjects (87.7%) out of the 211 subjects had some other sleep disorders except RLS. The results of the polysomnography were as follows : 78.0% of sleep efficiency, 86.8 min of wake after sleep onset, and 3.4% of N3. More specifically, 12.4/h of the average apnea hypopnea index, 14.8/h of the periodic limb movement during sleep (PLMS), 41.2/h of the periodic limb movement during wake during SIT and 21.6/h of total arousal index during sleep. Out of the total subjects, 149 (70.6%) of them took the ropinirole and 47 (22.3%) of them took the pramipexole, and the average dosage of ropinirole was 0.9mg(dosage range 0.125-5 mg) while the average dosage of pramipexole was 0.5 mg (dosage range 0.125-4 mg). The dosage of the ropinirole showed a significant positive correlation with the age (r=0.25, p=0.002) and also with the IRLS (r=0.23, p=0.038). The IRLS at the baseline was 24.9 while the same was decreased down to 13.4 after one month. CONCLUSIONS: Analyzing the result of this study, a majority of clinical RLS subjects demonstrated comorbidity with some other sleep disorder such as the OSA or PLMD. 25.1% of the subjects showed a PLMD, which was less than in previous researches and the average PLMS was not very high as 14.8/h. The dosage of dopamine agonist taken was often a bit more than the amount recommended in Korea. A prospective research using a large scale controlled subjects will be necessary with respect to this topic.

Prediction and Prevention of Ovarian Hyperstimulation Syndrome / 대한불임학회지

Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of ovulation induction. Before ovarian stimulation, identification of patients vulnerable to developing OHSS is necessary. And ovarian stimulation should be started with low doses of gonadotropin or GnRH antagonist protocol. During monitoring of ovarian stimulation with risk of OHSS, coasting, low doses hCG and GnRH agonist for triggering ovulation are considered. If severe OHSS is predicted, cycle cancellation and cryopreservation of all embryos should be considered to reduce late-onset OHSS and morbidity. And metformin and dopamine agonist for reducing OHSS are being proposed as a prophylactic treatment for OHSS.

Investigations on prevalence and risk factors of visual hallucination in patients with Parkinson' s disease / 上海第二医科大学学报

Objective To investigate the prevalence and characteristics of visual hallucination among patients with Parkinson's disease (PD), and analyse the potential risk factors. Methods One hundred and twenty-eight patients with PD were administered self-prepared visual hallucination questionnaires, and prevalence of visual hallucination was surveyed. The differences in sex, age, disease duration, Mini Mental State Exam (MMSE) scores, Hoehn & Yahr stage, types of medicine used and levodopa equivalent doses (LDE) were compared between the patients with visual hallucination and those without visual hallucination. The prevalence of rapid eye movement sleep behavior disorder (RBD) was investigated in patients with visual hallucination. Results Eighteen patients (14.06%) experienced visual hallucination, among whom 10 (55.56%) experienced visual hallucination no less than one time per day, 11 (61.11%) "saw" the shadow of human figure and 15(83.33%)were complicated with RBD. There were significant differences in MMSE scores, Hoehn & Yahr stage, female proportion and usage of dopamine agonists between patients with visual hallucination and those without visual hallucination(P<0.05). Conclusion Visual hallucination is a common non-motor symptom among patients with PD, and cognitive function, disease severity and usage of dopamine agonista may be related to visual hallucination.

Agonistas dopaminérgicos para prolactinomas: quando, quanto e por quanto tempo? / Dopamine agonists for prolactinomas: when, how much and how long?

Os prolactinomas são os tumores hipofisários mais comuns e têm como tratamento de escolha os agonistas dopaminérgicos, que propiciam normalização dos níveis de prolactina, redução tumoral e reversão da galactorreia e das manifestações do hipogonadismo na maioria dos casos. A cabergolina é preferível a bromocriptina por ser mais eficaz e mais bem tolerada. Todo macroprolactinoma, a princípio, deve ser tratado, e a terapia dos microprolactinomas pode ser reservada para casos de amenorreia, galactorreia incômoda, distúrbios sexuais ou infertilidade. Ainda existem controvérsias sobre a dose máxima desses medicamentos e sobre a duração ideal do tratamento. Sugerem os autores sua suspensão depois de 24 meses, caso tenha havido normalização dos níveis de prolactina, particularmente quando a ressonância magnética hipofisária não revele anormalidade.

Prolactinomas are the most common hipophisary tumors. Their treatment of choice are dopamine agonists that provide in most cases normalization of prolactin levels, tumor reduction and reversal of both galactorrhea and hypogonadism symptoms. Cabergoline is preferable to bromocriptine because it is more effective and better tolerated. While all macroprolactinomas, a priori, should be treated, the therapy of microprolactinomas can be reserved for cases of amenorrhea, bothersome galactorrhea, sexual disturbances or infertility. There is still controversy about the maximum dose of dopamine agonists and the ideal duration of treatment. The authors suggest treatment withdrawal after 24 months if there has been normalization of prolactin levels, particularly in patients with normal pituitary magnetic resonance findings.

Comparative Cognitive Effects of Levo-Dopa Plus Carbidopa and Dopamine Agonist as an Initial Therapy of Parkinson's Disease

BACKGROUND: Cognitive impairments are common in patients with Parkinson's disease (PD). However little is known about the cognitive effects of dopaminergic therapy. METHODS: The study was a single-blind prospective study of 21 patients with PD. Each patient had received either levodopa (Sinemet(R), n=8) or dopamine agonist (Requip(R), n=13) during 24 consecutive weeks. Neuropsychological battery, including Korean version of Alzheimer's Disease Assessment Scale(R) cognitive subscale (ADAS-Cog) and frontal-executive function part of SNSB (Seoul Neuropsychological Screening Battery), were performed two times, before and after the 24 weeks of management. Patients also received quantitative ratings of motor symptom severity and functional status using Unified Parkinson's Disease Rating Scale (UPDRS) before and after the dopaminergic therapy. RESULTS: After six months of treatment, motor scale improved in both groups (p0.05). In ADAS-Cog testing, Requip(R) group improved at more categories than Sinemet(R) group but without statistical difference (p>0.05). The results of frontal-executive function test did not differ between the groups, either. CONCLUSIONS: Our study does not provide an evidence that dopaminergic treatment improves cognitive functions in Parkinson's disease. Furthermore, we found no significant difference in the effect on cognition between the two tested drugs and no difference in the results of the above-listed neuropsychological tests between the first and the last visits.

Pisa Syndrome in Parkinson's Disease With a Good Response to Dopamine Therapy

No abstract available.

Lesion of Subthalamic Nucleus in Parkinsonian Rats: Effects of Dopamine D1 and D2 Receptor Agonists on the Neuronal Activities of the Substantia Nigra Pars Reticulata

OBJECTIVE: It was hypothesized that dopamine agonist administration and subthalamic nucleus (STN) lesion in the rat might have a synergistic effect on the neuronal activities of substantia nigra pars reticulata (SNpr) as observed in patients with Parkinson's disease. The effects of SKF38393 (a D1 receptor agonist) and Quinpirole (a D2 receptor agonist) were compared in parkinsonian rat models with 6- hydroxydopamine (6-OHDA) after STN lesion. METHODS: SKF38393 and Quinpirole were consecutively injected intrastriatally. SNpr was microrecorded to ascertain the activity of the basal ganglia output structure. The effect of SKF38393 or Quinpirole injection on the firing rate and firing patterns of SNpr was investigated in medial forebrain bundle (MFB) lesioned rats and in MFB+STN lesioned rats. RESULTS: The administration of SKF38393 decreased SNpr neuronal firing rates and the percentage of burst neurons in the MFB lesioned rats, but did not alter them in MFB+STN lesioned rats. The administration of Quinpirole significantly decreased the spontaneous firing rate in the MFB lesioned rats. However, after an additional STN lesion, it increased the percentage of burst neurons. CONCLUSION: This study demonstrated that dopamine agonists and STN lesion decreased the hyperactive firing rate and the percentage of burst neurons of SNpr neurons in 6-OHDA lesioned rats, respectively. Quinpirole with STN lesion increased a percentage of burst neurons. To clear the exact interactive mechanism of D1 and D2 agonist and the corresponding location, it should be followed a study using a nonselective dopamine agonist and D1, D2 selective antagonist.

Inhibitory Action of Jiangru Power on Rat Prolactinoma Induced by Diethylstilbestrol / 中华中医药杂志

Objective: To study the inhibitory action of Jiangru Power on rat prolactinoma induced by diethylstilbestrol.Methods: Prolactinoma Rat models were prepared by embedding estrogen subcutaneously.Then they were randomly divided into three groups,respectively given intragastric administration of placebo,Jiangru Power and Norprolac.After four weeks of treatment,all the animals were executed.Each pituitary gland was weighed.Serum prolactin(PRL) levels were measured by RIA method.Pituitary tumor transformed gene(PTTG) mRNA levels in pituitary tissue were measured by RT-PCR method.Results: The weight of pituitary gland and serum PRL level in Jiangru Power or Norprolac group all were obviously lower than those in placebo group(P