Alterations of the Reward System in Parkinson's Disease : Relationship between behavior and molecular signatures

Dans la maladie de Parkinson (MP), la perte progressive des neurones dopaminergiques (DA) touche principalement la substantia nigra pars compacta (SNc). Les symptômes moteurs sont classiquement gérés par une thérapie dopaminergique de remplacement (TDR). Conjointement à la levodopa, l’utilisation d’agonistes dopaminergiques permet de prévenir les complications motrices mais peut être associée à des troubles du système de récompense. Jusqu’à 14% des patients parkinsoniens sous TRD peuvent souffrir de comportement « addiction-like » tels que le pari pathologique, l’hypersexualité ou une prise compulsive de la médication DA. A ce jour la seule solution thérapeutique consiste à diminuer la TRD ce qui détériore les symptômes moteurs. Les neuroadaptations conduisant à ces troubles du système de récompense demeurent mal comprises. Nous proposons un travail dans lequel nous avons évalué les propriétés appétitives de l’agoniste D2/D3 pramipexole (ppx) après une exposition chronique à la L-dopa dans un modèle de rat parkinsonien alpha-synucléine. Dans une première étude, nous avons évalué l’effet d’une stimulation répétée des récepteurs DA sur la sensibilisation du système de récompense en contexte parkinsonien. Nos résultats montrent un effet récompensant du ppx après administrations chronique de L-dopa et perte DA nigrostriatal induite par surexpression de l’alpha-synucléine. Aucune modification transcriptionnelle n’a été observée pour les récepteurs DA. Cependant, nous avons identifié une association entre lésion/traitement pharmacologique et des changements transcriptionnels potentiellement liés à un contexte d’addiction aux psychostimulants. Cette étude fournit des preuves suggérant fortement la lésion parkinsonienne et la thérapie L-dopa comme des facteurs conjointement impliqués dans le remodelage cérébral sous-tendant une préférence de place conditionnée pour le ppx. Les données moléculaires et pharmacologiques générées ont suggéré un rôle clé de la voie glutamatergique dans cette réponse comportementale. Ce résultat est cohérent avec la littérature décrivant un déséquilibre glutamatergique striatal dans les contextes d’addiction aux psychostimulants et de complications motrices associées à la MP. Ainsi, nous avons conçu une deuxième étude visant à investiguer plus avant le potentiel thérapeutique d’une inhibition des récepteurs glutamatergiques. Une lésion bilatérale de la SNc a été réalisée par surexpression de la protéine alpha-synucléine au moyen d’un vecteur AAV. Suite à cette lésion, un traitement chronique à la L-dopa a été réalisé. L’effet de l’antagoniste des récepteurs mGluR5 (metabotropic glutamate receptor 5) MPEP sur les propriétés renforçatrices du ppx a été évalué dans un paradigme de préférence de place conditionnée. Enfin, une analyse des changements d’expression de protéines d’intérêt a été réalisé afin d’associer changements comportementaux drogue/lésion induits et paramètres moléculaires. L’acquisition et l’expression de la préférence de place ppx-induite a été abolie par le MPEP. De plus, nous avons identifié des réseaux neuraux et des modifications d’expression protéiques sous-tendant les plasticités striatales associées à la réponse comportementale. L’ensemble de ces travaux apporte de nouvelles idées sur le contexte physiopathologique associé aux troubles du système de récompense dans la MP. Des données moléculaires et pharmacologiques convergentes suggèrent fortement le mGluR5 comme une cible thérapeutique prometteuse.In Parkinson’s Disease (PD), the progressive dopaminergic (DA) cell loss mainly affects the substantia nigra pars compacta (SNc). The motor symptoms are classically managed by DA replacement therapies (DRT). Although adding DA agonists to levodopa treatment may contribute to prevent motor complications, it may be associated with drug‑induced changes in reward related pathways. Up to 14% of PD patients under DRT may suffer from ‘addiction‑like’ behavior such as pathological gambling, hypersexuality or DA medication‑induced substance abuse. To date, the only therapeutic answer consists in lowering the DA medications which deteriorates the motor symptoms. Neuroadaptations leading to reward bias in PD patients under DRT are still poorly understood. To address this challenge, we propose a work in which we have assessed the rewarding effect of the D2/D3 agonist pramipexole (ppx) after chronic exposure to L‑dopa in an alpha-synuclein PD rat model. In a first study, we assessed the effect of repeated DA receptors stimulations on sensitization of the reward system in a parkinsonian context. Our findings demonstrated that ppx had a rewarding effect after chronic L-dopa administrations and alpha-synuclein-mediated nigral loss. No transcriptional changes within DA receptors were highlighted. However, we identified an association between the main drug or lesion and transcriptional changes which were potentially related to the context of psychostimulant addiction. This study provides evidences strongly suggesting that PD-like lesion and L-dopa therapy were concomitant factors involved in striatal remodeling underlying the ppx-induced place preference. Molecular and pharmacological data suggested a key involvement ofthe glutamatergic pathway in this behavioral outcome. These data were consistent with literature describing major striatal glutamate imbalance as a common feature of drug addiction and Parkinson’s disease physiopathological contexts. Hence, we designed a second study aiming to further investigate the therapeutic potential of glutamatergic receptors inhibition. A bilateral lesion of the SNc was performed in the rat using AAV-mediated overexpression of the alpha-synuclein. This lesion was followed by chronic L-dopa administrations. Then, the effect of the metabotropic glutamate receptor 5 (mGluR5) antagonist MPEP on ppx reinforcing properties was assessed in a place conditioning paradigm. Finally, analysis at the protein level was conducted to associate drug and lesion induced behavioral changes to molecular endpoints. Acquisition and expression of the ppx-induced place preference was abolished by the MPEP. Furthermore, we identified neural networks and protein changes underlying the striatal remodeling associated with the behavioral outcome. All this work provides new insights into the physiopathological context associated to the PD/DRT related reward bias. Convergent molecular and pharmacological data strongly suggest mGluR5 as a promising therapeutic target

Current trends in in silico , in vitro toxicology, and safety biomarkers in early drug development

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Validation of a New Scoring Scale for Behavioral Assessment of L-Dopa-Induced Dyskinesia in the Rat: A New Tool for Early Decision-Making in Drug Development

International audienceThe 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated nonhuman primate (NHP) has been described as the most translatable model for experimental reproduction of L-dopa-induced dyskinesia (LID). However, from a drug discovery perspective, the risk associated with investment in this type of model is high due to the time and cost. The 6-hydroxydopamine (6-OHDA) rat dyskinesia model is recommended for testing compounds but relies on onerous, and nonstandard behavioral rating scales. We sought to develop a simplified and sensitive method aiming at assessing LID in the rat. The purpose was to validate a reliable tool providing earlier insight into the antidyskinetic potential of compounds in a time/cost-effective manner before further investigation in NHP models. Unilaterally 6-OHDA-lesioned rats were administered L-dopa (20 mg/kg) and benserazide (5 mg/kg) daily for 3 weeks starting 4 weeks postlesion, then coadministered with amantadine (20–30–40 mg/kg). An adapted rating scale was used to score LID frequency and a severity coefficient was applied depending on the features of the observed behavior. A gradual increase (about 3-fold) in LID score was observed over the 3 weeks of L-dopa treatment. The rating scale was sensitive enough to highlight a dose-dependent amantadine-mediated decrease (about 2.2-fold) in LID score. We validated a simplified method, able to reflect different levels of severity in the assessment of LID and, thus, provide a reliable tool for drug discovery

Striatal changes underlie MPEP-mediated suppression of the acquisition and expression of pramipexole-induced place preference in an alpha-synuclein rat model of Parkinson’s disease

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Pramipexole induced place preference after L-dopa therapy and nigral dopaminergic loss: linking behavior to transcriptional modifications

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Implication of nigral dopaminergic lesion and repeated L-dopa exposure in neuropsychiatric symptoms of Parkinson’s disease

International audienceThis study aims to investigate the contribution of nigral dopaminergic (DA) cell loss, repeated exposure to DA medication and the combination of both to the development of neuropsychiatric symptoms observed in Parkinson's disease (PD). A bilateral 6-OHDA lesion of the substantia nigra pars compacta (SNc) was performed in rats. A set of animals was repeatedly administered with L-dopa (20 mg/kg/day) and benserazide (5 mg/kg/day) over 10 days starting from day 11 post-lesion. Behavioural testing was performed in week 3 post-lesion: novel object recognition (NOR), elevated plus maze (EPM) social interaction (SI) tests, and amphetamine-induced hyperlocomotion (AIH). Immunohistochemical analysis revealed a significant partial lesion (48%) in 6-OHDA versus sham rats. This lesion was not associated with motor impairment. However, lesioned rats displayed a significant deficit in the NOR, which was reversed by acute treatment with l-dopa/benserazide (12.5 mg/kg and 15 mg/kg respectively). Lesioned rats also displayed a deficit in the EPM which was not reversed by acute treatment with l-dopa. No difference was observed in the SI test or in the AIH assay. In all assays, no effect of chronic l-dopa exposure was observed. This study provides new insights into the neuropathophysiology associated with neuropsychiatric symptoms of PD. Our data strongly emphasises a not previously clearly identified critical role in cognition for the SNc. The results suggest that DA pathways were less directly involved in lesion-induced anxiety-like behaviour. We did not report any effect of chronic l-dopa exposure in the context of partial nigral cell loss

Evaluation of seizure liabilities of epileptogenic but non-convulsive agents in rats

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Mismatch negativity as EEG biomarker supporting CNS drug development: A transnosographic and translational study

The lack of translation from basic research into new medicines is a major challenge in CNS drug development. The need to use novel approaches relying on (i) patient clustering based on neurobiology irrespective to symptomatology and (ii) quantitative biomarkers focusing on evolutionarily preserved neurobiological systems allowing back-translation from clinical to nonclinical research has been highlighted. Here we sought to evaluate the mismatch negativity (MMN) response in schizophrenic (SZ) patients, Alzheimer’s disease (AD) patients, and age-matched healthy controls. To evaluate back-translation of the MMN response, we developed EEG-based procedures allowing the measurement of MMN-like responses in a rat model of schizophrenia and a mouse model of AD. Our results indicate a significant MMN attenuation in SZ but not in AD patients. Consistently with the clinical findings, we observed a significant attenuation of deviance detection (~104.7%) in rats subchronically exposed to phencyclidine, while no change was observed in APP/PS1 transgenic mice when compared to wild type. This study provides new insight into the cross-disease evaluation of the MMN response. Our findings suggest further investigations to support the identification of neurobehavioral subtypes that may help patients clustering for precision medicine intervention. Furthermore, we provide evidence that MMN could be used as a quantitative/objective efficacy biomarker during both preclinical and clinical stages of SZ drug development