Development of a new toolbox for mouse PET-CT brain image analysis fully based on CT images and validation in a PD mouse model.

Automatic analysis toolboxes are popular in brain image analysis, both in clinical and in preclinical practices. In this regard, we proposed a new toolbox for mouse PET-CT brain image analysis including a new Statistical Parametric Mapping-based template and a pipeline for image registration of PET-CT images based on CT images. The new templates is compatible with the common coordinate framework (CCFv3) of the Allen Reference Atlas (ARA) while the CT based registration step allows to facilitate the analysis of mouse PET-CT brain images. From the ARA template, we identified 27 volumes of interest that are relevant for in vivo imaging studies and provided binary atlas to describe them. We acquired 20 C57BL/6 mice with [18F]FDG PET-CT, and 12 of them underwent 3D T2-weighted high-resolution MR scans. All images were elastically registered to the ARA atlas and then averaged. High-resolution MR images were used to validate a CT-based registration pipeline. The resulting method was applied to a mouse model of Parkinson's disease subjected to a test-retest study (n = 6) with the TSPO-specific radioligand [18F]VC701. The identification of regions of microglia/macrophage activation was performed in comparison to the Ma and Mirrione template. The new toolbox identified 11 (6 after false discovery rate adjustment, FDR) brain sub-areas of significant [18F]VC701 uptake increase versus the 4 (3 after FDR) macro-regions identified by the Ma and Mirrione template. Moreover, these 11 areas are functionally connected as found by applying the Mouse Connectivity tool of ARA. In conclusion, we developed a mouse brain atlas tool optimized for PET-CT imaging analysis that does not require MR. This tool conforms to the CCFv3 of ARA and could be applied to the analysis of mouse brain disease models.

Identification of distinct pathological signatures induced by patient-derived α-synuclein structures in nonhuman primates.

Dopaminergic neuronal cell death, associated with intracellular α-synuclein (α-syn)-rich protein aggregates [termed "Lewy bodies" (LBs)], is a well-established characteristic of Parkinson's disease (PD). Much evidence, accumulated from multiple experimental models, has suggested that α-syn plays a role in PD pathogenesis, not only as a trigger of pathology but also as a mediator of disease progression through pathological spreading. Here, we have used a machine learning-based approach to identify unique signatures of neurodegeneration in monkeys induced by distinct α-syn pathogenic structures derived from patients with PD. Unexpectedly, our results show that, in nonhuman primates, a small amount of singular α-syn aggregates is as toxic as larger amyloid fibrils present in the LBs, thus reinforcing the need for preclinical research in this species. Furthermore, our results provide evidence supporting the true multifactorial nature of PD, as multiple causes can induce a similar outcome regarding dopaminergic neurodegeneration.

Safinamide Modulates Striatal Glutamatergic Signaling in a Rat Model of Levodopa-Induced Dyskinesia.

Safinamide (Xadago) is a novel dual-mechanism drug that has been approved in the European Union and United States as add-on treatment to levodopa in Parkinson's disease therapy. In addition to its selective and reversible monoamine oxidase B inhibition, safinamide through use-dependent sodium channel blockade reduces overactive glutamatergic transmission in basal ganglia, which is believed to contribute to motor symptoms and complications including levodopa-induced dyskinesia (LID). The present study investigated the effects of safinamide on the development of LID in 6-hydroxydopamine (6-OHDA)-lesioned rats, evaluating behavioral, molecular, and neurochemical parameters associated with LID appearance. 6-OHDA-lesioned rats were treated with saline, levodopa (6 mg/kg), or levodopa plus safinamide (15 mg/kg) for 21 days. Abnormal involuntary movements, motor performance, molecular composition of the striatal glutamatergic synapse, glutamate, and GABA release were analyzed. In the striatum, safinamide prevented the rearrangement of the subunit composition of N-methyl-d-aspartate receptors and the levodopa-induced increase of glutamate release associated with dyskinesia without affecting the levodopa-stimulated motor performance and dyskinesia. Overall, these findings suggest that the striatal glutamate-modulating component of safinamide's activity may contribute to its clinical effects, where its long-term use as levodopa add-on therapy significantly improves motor function and "on" time without troublesome dyskinesia.

Acute and chronic antiparkinsonian effects of the novel nociceptin/orphanin FQ receptor antagonist NiK-21273 in comparison with SB-612111.

BACKGROUND AND PURPOSE: Nociceptin/orphanin FQ (N/OFQ) peptide (NOP) receptor antagonists have been proposed as a novel therapeutic approach to Parkinson's disease. Main limitations of previous studies were the use of structurally similar compounds and the evaluation of their acute effects only. We report here on the acute and long-term antiparkinsonian effects of the novel compound 2-[3-[4-(2-chloro-6-fluoro-phenyl)-piperidin-1-ylmethyl]-2-(morpholine-4-carbonyl)-indol-1-yl]-acetamide (NiK-21273) in comparison with the potent and selective NOP receptor antagonist SB-612111. EXPERIMENTAL APPROACH: Basic pharmacological properties of NiK-21273 were studied in cell lines and isolated tissues (mouse and rat vas deferens). Antiparkinsonian effects were studied in reserpinized mice and 6-hydroxydopamine hemilesioned rats under both acute and chronic administration protocols. KEY RESULTS: In vitro, NiK-21273 behaved as a potent (pA(2) 7.7) and selective NOP receptor antagonist. In vivo, it reduced hypokinesia in reserpinized mice at 0.1 and 1 but not 10 mg·kg(-1), whereas SB-612111 (0.01-1 mg·kg(-1)) provided a dose-dependent antiparkinsonian effect. NiK-21273 ameliorated motor performance in 6-hydroxydopamine hemilesioned rats at 0.5 and 5 but not 15 mg·kg(-1). SB-612111 replicated these effects in the 0.01-1 mg·kg(-1) range without loss of efficacy. Both antagonists synergized with L-DOPA at subthreshold doses. Chronic administration of NiK-21273 provided delayed improvement in baseline activity at 0.5 and 1.5 mg·kg(-1), although tolerance to the higher dose was observed. Conversely, SB-612111 (1 mg·kg(-1)) maintained its effects over time without modifying baseline activity. CONCLUSIONS AND IMPLICATIONS: NOP receptor antagonists provide motor benefit in parkinsonism models although the 'therapeutic' window and long-term effects may vary between compounds.

A hybrid tool for reaching and grasping rehabilitation: the ArmeoFES.

Many research groups are currently working with robotic devices for hand grasp rehabilitation and restoration. A common problem in this area is the fact that existing and commercially available robotic exoskeletons are able to provide gravity compensation of the shoulder and elbow but do not provide any support for the grasping and releasing movements of the hand. The lack of a flexible support technology for the hand reduces the possible ways in which clinicians can deal with the issue of a personalized, effective rehabilitation. This paper presents new software that allows FES assisted grasping to integrate with the ArmeoSpring (Hocoma AG). The system uses a Man-In-The-Loop control approach, whereby surface EMG signals from proximal muscles are used to trigger and modulate multichannel FES applied to distal muscles, thus allowing patient induced and strength adapted movement control of the hand. Combining volitionally controlled FES with arm-weight-compensation allows early adoption of FES assisted therapy for patients, augmenting their functionalities and extending training capabilities with the ArmeoSpring.

Endogenous nociceptin/orphanin FQ (N/OFQ) contributes to haloperidol-induced changes of nigral amino acid transmission and parkinsonism: a combined microdialysis and behavioral study in naïve and nociceptin/orphanin FQ receptor knockout mice.

The contribution of endogenous nociceptin/orphanin FQ (N/OFQ) to neuroleptic-induced parkinsonism has been evaluated in haloperidol-treated mice. Pharmacological blockade of N/OFQ receptors (NOP) via systemic administration of 1-[(3R,4R)-1-cyclooctylmethyl-3-hydroxymethyl-4-piperidyl]-3-ethyl-1,3-dihydro-2H benzimidazol-2-one (J-113397, 0.01-10 mg/kg i.p.) or central injection of [Nphe(1),Arg(14),Lys(15)]N/OFQ-NH(2) (UFP-101, 10 nmol i.c.v.) attenuated (0.8 mg/kg) haloperidol-induced motor deficits as evaluated by a battery of behavioral tests providing complementary information on motor parameters: the bar, drag and rotarod tests. A combined neurochemical and behavioral approach was then used to investigate whether the substantia nigra reticulata could be involved in antiakinetic actions of J-113397. Microdialysis combined to the bar test revealed that haloperidol (0.3 and 0.8 mg/kg i.p.) caused a dose-dependent and prolonged elevation of immobility time (i.e. akinesia) which was associated with an increase in nigral glutamate and a reduction in GABA release. Conversely, J-113397 (1 mg/kg) alone reduced glutamate and elevated nigral GABA release, and when challenged against haloperidol, counteracted its behavioral and neurochemical effects. Microdialysis coupled to behavioral testing also demonstrated that NOP receptor knockout mice were resistant to haloperidol (0.3 mg/kg) compared to wild-type mice, lack of response being associated with a reversal of glutamate release facilitation into inhibition and no change in nigral GABA release. This study provides pharmacological and genetic evidence that endogenous N/OFQ contributes to haloperidol-induced akinesia and changes of amino acid transmission in mice. Moreover, it confirms the view that NOP receptor antagonists are capable of reversing akinesia across species and genotypes and may prove effective in relieving neuroleptic-induced parkinsonism.

The novel delta opioid receptor agonist UFP-512 dually modulates motor activity in hemiparkinsonian rats via control of the nigro-thalamic pathway.

The present study aimed to characterize the ability of the novel delta opioid peptide (DOP) receptor agonist H-Dmt-Tic-NH-CH(CH2-COOH)-Bid (UFP-512) to attenuate motor deficits in 6-hydroxydopamine (6-OHDA) hemilesioned rats. Lower doses (0.1-10 microg/kg) of UFP-512 administered systemically (i.p.) stimulated stepping activity in the drag test and overall gait abilities in the rotarod test whereas higher doses (100-1000 microg/kg) were ineffective or even worsened Parkinsonism. Microdialysis coupled to an akinesia test (bar test) was then used to determine the circuitry involved in the motor actions of UFP-512. An antiakinetic dose of UFP-512 (10 microg/kg) decreased GABA in globus pallidus (GP) as well as GABA and glutamate (GLU) release in substantia nigra reticulata (SNr). On the other hand, a pro-akinetic dose (1000 microg/kg) of UFP-512 increased pallidal GABA, simultaneously producing a decrease in GABA and an increase in nigral GLU release. Moreover, to test the hypothesis that changes in motor behavior were associated with changes in nigro-thalamic transmission, amino acid release in ventromedial thalamus (VMTh, a target of nigro-thalamic GABAergic projections) was also measured. The anti-akinetic dose of UFP-512 reduced GABA and increased thalamic GLU release while the pro-akinetic dose increased GABA without affecting thalamic GLU release. Finally, regional microinjections were performed to investigate the brain areas involved in motor actions of UFP-512. UFP-512 microinjections into GP increased akinesia whereas UFP-512 microinjections into SNr reduced akinesia. Furthermore, the selective DOP receptor antagonist naltrindole (NTD) increased akinesia when injected into either area, GP being more sensitive. We conclude that UFP-512, depending on dose, improves or worsens motor activity in hemiparkinsonian rats by acting differentially as a DOP receptor agonist in SNr and a DOP receptor antagonist in GP, ultimately decreasing or increasing the activity of nigro-thalamic GABAergc output neurons, respectively.

Nocistatin inhibits 5-hydroxytryptamine release in the mouse neocortex via presynaptic Gi/o protein linked pathways.

BACKGROUND AND PURPOSE: Nocistatin (NST) is a neuropeptide generated from cleavage of the nociceptin/orphanin FQ (N/OFQ) precursor. Evidence has been presented that NST acts as a functional antagonist of N/OFQ, although NST receptor and transduction pathways have not yet been identified. We previously showed that N/OFQ inhibited [(3)H]5-hydroxytryptamine ([(3)H]5-HT) release from mouse cortical synaptosomes via activation of NOP receptors. We now investigate whether NST regulates [(3)H]5-HT release in the same preparation. EXPERIMENTAL APPROACH: Mouse and rat cerebrocortical synaptosomes in superfusion, preloaded with [(3)H]5-HT and stimulated with 1 min pulses of 10 mM KCl, were used. KEY RESULTS: Bovine NST (b-NST) inhibited the K(+)-induced [(3)H]5-HT release, displaying similar efficacy but lower potency than N/OFQ. b-NST action underwent concentration-dependent and time-dependent desensitization, and was not prevented either by the NOP receptor antagonist [Nphe(1) Arg(14),Lys(15)]N/OFQ(1-13)-NH(2) (UFP-101) or by the non-selective opioid receptor antagonist, naloxone. Contrary to N/OFQ, b-NST reduced [(3)H]5-HT release from synaptosomes obtained from NOP receptor knockout mice. However, both N/OFQ and NST were ineffective in synaptosomes pre-treated with the G(i/o) protein inhibitor, Pertussis toxin. NST-N/OFQ interactions were also investigated. Co-application of maximal concentrations of both peptides did not result in additive effects, whereas pre-application of maximal b-NST concentrations partially attenuated N/OFQ inhibition. CONCLUSIONS AND IMPLICATIONS: We conclude that b-NST inhibits [(3)H]5-HT release via activation of G(i/o) protein linked pathways, not involving classical opioid receptors and the NOP receptor. The present data strengthen the view that b-NST is, per se, a biologically active peptide endowed with agonist activity.

Adaptive robotic rehabilitation of locomotion: a clinical study in spinally injured individuals.

STUDY DESIGN: Clinical study on six spinal cord-injured subjects. The performance of two automatic gait-pattern adaptation algorithms for automated treadmill training rehabilitation of locomotion (called DJATA1 and DJATA2) was tested and compared in this study. OBJECTIVES: To test the performance of the two algorithms and to evaluate the corresponding patient satisfaction. We also wanted to evaluate the motivation of the patients to train with a fixed gait pattern versus training where they can influence and change the gait pattern (gait-pattern adaptation). SETTING: Spinal Cord Injury Center Paracare, Balgrist, Zürich, Switzerland. METHODS: The experimental data were collected during six blinded and randomized training trials (comprising three different conditions per algorithm) split into two training sessions per patient. During the experiments, we have recorded the time courses of the six parameters describing the adaptation. Additionally, a special patient questionnaire was developed that allowed us to collect data regarding the quality, perception, speed, and required effort of the adaptation, as well as patients' opinion that addressed their motivation. The achieved adaptation was evaluated based on the time course of adaptation parameters and based on the patient questionnaire. A statistical analysis was made in order to quantify the data and to compare the two algorithms. RESULTS: Significant adaptation of the gait pattern took place. The patients were in most cases able to change the gait pattern to a desired one and have always perceived the adaptation. No statistically significant differences were found between the performances of the two algorithms based on the evaluated data. However, DJATA2 achieved better adaptation scores. All patients preferred treadmill training with gait-pattern adaptation. CONCLUSION: In the future, the patients would like to train with gait-pattern adaptation. Besides the subjective opinion indicating the choice of this training modality, gait-pattern adaptation also might lead to additional improvement of the rehabilitation of locomotion as it increases and promotes active training. SPONSORSHIP: The work was supported by The Swiss Commission for Technology and Innovation (Project No. 4005.1).

Nociceptin/orphanin FQ receptors modulate glutamate extracellular levels in the substantia nigra pars reticulata. A microdialysis study in the awake freely moving rat.

Intracerebral microdialysis was employed in awake freely moving rats to investigate the effects of nociceptin/orphanin FQ receptor ligands on glutamate extracellular levels in the substantia nigra pars reticulata. Nociceptin/orphanin FQ, ineffective at 0.1 microM, induced a prolonged stimulation of nigral glutamate levels at 1 and 10 microM (mean effect of 137+/-9 and 167+/-13%, respectively, of basal values). These effects were prevented by the novel nociceptin/orphanin FQ receptor antagonist [Nphe(1)]nociceptin/orphanin FQ(1-13)NH(2) (100 and 300 microM, respectively) but not by the non-selective opioid receptor antagonist naloxone (10 microM). [Nphe(1)]nociceptin/orphanin FQ(1-13)NH(2) (100 microM) inhibited by itself glutamate outflow (maximal reduction to 71+/-4%) while naloxone was ineffective. The nociceptin/orphanin FQ receptor ligand [Phe(1)psi(CH(2)-NH)Gly(2)]nociceptin/orphanin FQ(1-13)NH(2) also facilitated glutamate outflow at 10 microM (mean effect of 145+/-10%). Intranigral perfusion with tetrodotoxin (1 microM) or with the dopamine D(2) receptor antagonist raclopride (1 microM), failed to affect basal glutamate output and prevented the facilitatory effect of nociceptin/orphanin FQ (10 microM). However, perfusion with the GABA(A) receptor antagonist bicuculline (10 microM) increased local glutamate extracellular levels by itself and attenuated the effect of the peptide. Our data suggest that nociceptin/orphanin FQ increases glutamate extracellular levels in the substantia nigra pars reticulata via activation of nociceptin/orphanin FQ receptors located on non-glutamatergic, possibly dopaminergic and GABAergic, neuronal elements.

Presynaptic group I and II metabotropic glutamate receptors oppositely modulate striatal acetylcholine release.

The effect of metabotropic glutamate receptor agonists and antagonists on KCl (20 mm)-induced endogenous acetylcholine release from rat striatal synaptosomes was investigated. The group I agonist (S)-3,5-dihydroxyphenylglycine (DHPG), 1-1000 nm, potentiated in a concentration-dependent way the KCl-induced acetylcholine release, reaching maximal efficacy at 100 nm (+93 +/- 14%). The effect of DHPG (10 nm) was counteracted by coapplication of (7-hydroximino)cyclopropan-b-chromen-1a-carboxylate (CPCCOEt), 10 microm, a metabotropic glutamate receptor type one selective antagonist, and 2-methyl-6-(phenylethynyl)pyridine (MPEP), 10 microm, a metabotropic glutamate receptor type five selective antagonist, but not by application of either antagonist alone. The group II agonist (2S, 1'R, 2'R, 3'R)-2-(2,3-dicarboxycyclopropyl)glycine (DCG-IV), 1-1000 nm, inhibited in a concentration-dependent way the KCl-induced acetylcholine release displaying maximal efficacy at 300 nm (-32 +/- 2%). The effect of DCG-IV 300 nm was counteracted by the group II selective antagonist (2S)-alpha-ethylglutamic acid (EGLU), 300 microm. The group III agonist L-amino-4-phosphonobutyric acid (L-AP4) failed to alter the KCl-induced acetycholine release up to 300 microm. We conclude that metabotropic glutamate receptors belonging to group I and II are located on the axon terminals of striatal cholinergic interneurons, their activation resulting in facilitation and inhibition, respectively, of acetylcholine release.

Modeling and closed-loop control of hypnosis by means of bispectral index (BIS) with isoflurane.

A model-based closed-loop control system is presented to regulate hypnosis with the volatile anesthetic isoflurane. Hypnosis is assessed by means of the bispectral index (BIS), a processed parameter derived from the electroencephalogram. Isoflurane is administered through a closed-circuit respiratory system. The model for control was identified on a population of 20 healthy volunteers. It consists of three parts: a model for the respiratory system, a pharmacokinetic model and a pharmacodynamic model to predict BIS at the effect compartment. A cascaded internal model controller is employed. The master controller compares the actual BIS and the reference value set by the anesthesiologist and provides expired isoflurane concentration references to the slave controller. The slave controller maneuvers the fresh gas anesthetic concentration entering the respiratory system. The controller is designed to adapt to different respiratory conditions. Anti-windup measures protect against performance degradation in the event of saturation of the input signal. Fault detection schemes in the controller cope with BIS and expired concentration measurement artifacts. The results of clinical studies on humans are presented.

A reliable gait phase detection system.

A new highly reliable gait phase detection system, which can be used in gait analysis applications and to control the gait cycle of a neuroprosthesis for walking, is described. The system was designed to detect in real-time the following gait phases: stance, heel-off, swing, and heel-strike. The gait phase detection system employed a gyroscope to measure the angular velocity of the foot and three force sensitive resistors to assess the forces exerted by the foot on the shoe sole during walking. A rule-based detection algorithm, which was running on a portable microprocessor board, processed the sensor signals. In the presented experimental study ten able body subjects and six subjects with impaired gait tested the device in both indoor and outdoor environments (0-25 degrees C). The subjects were asked to walk on flat and irregular surfaces, to step over small obstacles, to walk on inclined surfaces, and to ascend and descend stairs. Despite the significant variation in the individual walking styles the system achieved an overall detection reliability above 99% for both subject groups for the tasks involving walking on flat, irregular, and inclined surfaces. In the case of stair climbing and descending tasks the success rate of the system was above 99% for the able body subjects and above 96 % for the subjects with impaired gait. The experiments also showed that the gait phase detection system, unlike other similar devices, was insensitive to perturbations caused by nonwalking activities such as weight shifting between legs during standing, feet sliding, sitting down, and standing up.

Improving regulation of mean arterial blood pressure during anesthesia through estimates of surgery effects.

In this paper, a scheme for improvement of the regulation of mean arterial blood pressure (MAP) during anesthesia based on model predictive control (MPC) and estimates of the effects of disturbances (surgical events) is proposed. A linear model for the combined effects of surgical stimulations and volatile anesthetics on MAP is derived from experimental data. Based on it the potential improvement in blood pressure regulation is evaluated via a simulation study. The simulation study shows that when information about the effect of the surgical events on MAP is utilized by the controller maximum MAP deviations can be reduced by as much as 50% even when this information is inaccurate. At worst, (highly inaccurate information) no improvement is obtained.

Nociceptin/orphanin FQ and neurotransmitter release in the central nervous system.

In this article, the effect of nociceptin (orphanin FQ) on transmitter release in the central nervous system in vitro and in vivo is reviewed. Nociceptin inhibits the electrically or K(+)-evoked noradrenaline, dopamine, serotonin, and glutamate release in brain slices from guinea-pig, rat, and mouse. This effect is usually naloxone-resistant but antagonized by OP(4) receptor antagonists like [Phe(1)psi(CH(2)-NH)Gly(2)]-nociceptin(1-13)NH(2). In the rat in vivo, nociceptin diminishes acetylcholine release in the striatum, reduces dopamine release, and prevents the stimulatory effect of morphine on this transmitter in the nucleus accumbens and also elevates extracellular glutamate and gamma-aminobutyric acid levels in mesencephalic dopaminergic areas. The effect of nociceptin on the mesencephalic dopaminergic system might explain its actions on motor behavior.

Identification and targeting policies for computer-controlled infusion pumps.

In this article a series of useful techniques is presented to improve the adaptation capabilities of computer-controlled infusion pumps: an identification algorithm for the time constant of the effect compartment, a smoothing technique for estimation based on noisy data, and an infusion policy to target any effect site concentration with no overshoot.

Stability criterion for controlling standing in able-bodied subjects.

A new stability criterion that can be used to assess the standing condition of a subject from center of pressure (CoP) measurements is presented. This criterion can be applied, for example, to control a standing prosthesis, which should allow a paraplegic subject to stand up, sit down and stand safely without using hands for support. Experiments conducted with able-bodied subjects enabled us to establish a relationship between its stability and the subject's CoP position. Four CoP stability zones were identified: high preference, low preference, undesirable and unstable zones. The high preference zone is defined as the area where the CoP is found 99% of the time during quiet standing. The area where the CoP is found during the remaining 1% of the time is called the low preference zone. The undesirable zone is defined as the CoP area where the subject is forced to change posture in order to maintain balance, and the unstable zone is defined as the CoP area in which the subject is forced to step forward, backward or sideways to maintain stability. A general model of the proposed four stability zones was derived, which can be used to compute stability zones a priori for any subject and thus allows one to assess the subject's stability condition from the CoP measurements.

Increased responsivity of glutamate release from the substantia nigra pars reticulata to striatal NMDA receptor blockade in a model of Parkinson's disease. A dual probe microdialysis study in hemiparkinsonian rats.

Dual probe microdialysis was employed in freely moving 6-hydroxydopamine (6-OHDA) hemilesioned rats to investigate the effects of blockade of N-methyl-D-aspartate (NMDA) receptors in the dorsolateral striatum on glutamate (Glu) release from the ipsilateral substantia nigra pars reticulata (SNr). Perfusion for 60 min with the NMDA antagonist dizocilpine (0.1 and 1 microM) in the dopamine (DA)-denervated striatum stimulated nigral Glu release (peak effect of 139 +/- 7% and 138 +/- 9%, respectively). The lower (0.01 microM) and higher (10 microM) concentrations were ineffective. In sham-operated rats, dizocilpine failed to affect nigral Glu release up to 1 microM but induced a prolonged stimulation at 10 microM (153 +/- 9% at the end of perfusion). The present results show that DA-deficiency in the striatum of hemiparkinsonian rats is associated with increased responsivity of nigral Glu release to striatal NMDA receptor blockade. This suggests that changes of NMDA receptor mediated control of the striatofugal pathways occur during Parkinson's disease (PD).