Extrastriatal Dopamine D2/3 Receptor Availability in Alcohol Use Disorder and Individuals at High Risk

INTRODUCTION

Reduced striatal dopamine D2/3 receptor availability in alcohol use disorder (AUD) has been demonstrated in recent clinical studies and meta-analyses. However, only a limited number of studies investigated extrastriatal D2/3 availability in AUD or in at-risk populations. In line with a dimensional understanding of addiction, extrastriatal dopaminergic neuroadaptations have been suggested to be relevant from a pathobiological perspective.

METHODS

We investigated D2/3 receptor availability via 18F-fallypride positron emission tomography applying a region of interest (ROI) approach. We selected ROIs for the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC). Our sample included 19 healthy controls (low risk [LR]), 19 individuals at high risk (HR) to develop addiction, and 20 recently detoxified AUD patients.

RESULTS

We found significantly higher D2/3 receptor availability of HR compared to AUD in the left and right rostral ACC (rACC), as well as in the left ventrolateral PFC (vlPFC). We did not observe a significant difference between AUD and LR. After corrections for multiple comparisons none of the ROIs reached significance throughout the group comparison. The D2/3 receptor availability in the left rACC was inversely correlated with symptom severity assessed with the Alcohol Dependency Scale.

DISCUSSION

To our knowledge, the present work is the first study investigating extrastriatal D2/3 receptor availabilities in individuals at HR and patients with AUD. The observation that D2/3 receptor availabilities are highest in HR might suggest that their pathobiology differs from subjects with AUD. Future studies are necessary to clarify the intraindividual course of this biomarker over different disease stages and its possible role as a risk or protective factor.

The relationship between the dopaminergic system and depressive symptoms in cervical dystonia

PURPOSE

Cervical dystonia (CD) is associated with tremor/jerks (50%) and psychiatric complaints (17-70%). The dopaminergic system has been implicated in the pathophysiology of CD in animal and imaging studies. Dopamine may be related to the motor as well as non-motor symptoms of CD. CD is associated with reduced striatal dopamine D_2/3 (D2/3) receptor and increased dopamine transporter (DAT) binding. There are differences in the dopamine system between CD patients with and without jerks/tremor and psychiatric symptoms.

METHODS

Patients with CD and healthy controls underwent neurological and psychiatric examinations. Striatal DAT and D2/3 receptor binding were assessed using [¹²³I]FP-CIT and [¹²³I]IBZM SPECT, respectively. The ratio of specific striatal to non-specific binding (binding potential; BP_ND) was the outcome measure.

RESULTS

Twenty-seven patients with CD and 15 matched controls were included. Nineteen percent of patients fulfilled the criteria for a depression. Striatal DAT BP_ND was significantly lower in depressed versus non-depressed CD patients. Higher DAT BP_ND correlated significantly with higher scores on the Unified Myoclonus Rating Scale (UMRS). The striatal D2/3 receptor BP_ND in CD patients showed a trend towards lower binding compared to controls. The D2/3 BP_ND was significantly lower in depressed versus non-depressed CD patients. A significant correlation between DAT and D2/3R BP_ND was found in both in patients and controls.

CONCLUSIONS

Alterations of striatal DAT and D2/3 receptor binding in CD patients are related mainly to depression. DAT BP_ND correlates significantly with scores on the UMRS, suggesting a role for dopamine in the pathophysiology of tremor/jerks in CD.

Reduction of dopamine D(2/3) receptor binding in the striatum after a single administration of esketamine, but not R-ketamine: a PET study in conscious monkeys

R-ketamine appears to be a potent, long-lasting and safer antidepressant, relative to esketamine (S-ketamine), since it might be free of psychotomimetic side effects. Using [¹¹C]raclopride and positron emission tomography (PET), we investigated whether esketamine and R-ketamine can affect dopamine D_2/3 receptor binding in the conscious monkey brain. A single infusion of esketamine (0.5 mg/kg), but not R-ketamine (0.5 mg/kg), caused a reduction of binding availability of dopamine D_2/3 receptor in the monkey striatum. This study suggests that unlike to R-ketamine, esketamine can cause dopamine release in the striatum, and that its release might be associated with psychotomimetic effects of esketamine.

Agonist signalling properties of radiotracers used for imaging of dopamine D2/3 receptors

Background

Dopamine D_2/3 receptor (D_2/3R) agonist radiopharmaceuticals are considered superior to antagonists to detect dopamine release, e.g. induced by amphetamines. Agonists bind preferentially to the high-affinity state of the dopamine D₂R, which has been proposed as the reason why agonists are more sensitive to detect dopamine release than antagonist radiopharmaceuticals, but this theory has been challenged. Interestingly, not all agonists similarly activate the classic cyclic adenosine mono phosphate (cAMP) and the ?-arrestin-2 pathway, some stimulate preferentially one of these pathways; a phenomenon called biased agonism. Because these pathways can be affected separately by pathologies or drugs (including dopamine releasers), it is important to know how agonist radiotracers act on these pathways. Therefore, we characterized the intracellular signalling of the well-known D_2/3R agonist radiopharmaceuticals NPA and PHNO and of several novel D_2/3R agonists.

Methods

cAMP accumulation and ?-arrestin-2 recruitment were measured on cells expressing human D₂R.

Results

All tested agonists showed (almost) full agonism in both pathways.

Conclusions

The tested D_2/3R agonist radiopharmaceuticals did not exhibit biased agonism in vitro. Consequently, it is likely that drugs (including psychostimulants like amphetamines) and/or pathologies that influence the cAMP and/or the ?-arrestin-2 pathway may influence the binding of these radiopharmaceuticals.

¹²⁴I-Epidepride: a PET radiotracer for extended imaging of dopamine D2/D3 receptors

OBJECTIVES

A new radiotracer, ¹²⁴I-epidepride, has been developed for the imaging of dopamine D2/3 receptors (D2/3Rs). ¹²⁴I-Epidepride (half-life of ¹²⁴I=4.2 days) allows imaging over extended periods compared to (18)F-fallypride (half-life of ¹⁸F=0.076 days) and may maximize visualization of D2/3Rs in the brain and pancreas (allowing clearance from adjacent organs). D2/3 Rs are also present in pancreatic islets where they co-localize with insulin to produce granules and may serve as a surrogate marker for imaging diabetes.

METHODS

¹²⁴I-Epidepride was synthesized using N-[[(2S)-1-ethylpyrrolidin-2-yl]methyl]-5-tributyltin-2,3-dimethoxybenzamide and ¹²⁴I-iodide under no carrier added condition. Rats were used for in vitro and in vivo imaging. Brain slices were incubated with (124)I-epidepride (0.75 μCi/cc) and nonspecific binding measured with 10 μM haloperidol. Autoradiograms were analyzed by OptiQuant. ¹²⁴I-Epidepride (0.2 to 0.3 mCi, iv) was administered to rats and brain uptake at 3 hours, 24 hours, and 48 hours post injection was evaluated.

RESULTS

¹²⁴I-Epidepride was obtained with 50% radiochemical yield and high radiochemical purity (>95%). (124)I-Epidepride localized in the striatum with a striatum to cerebellum ratio of 10. Binding was displaced by dopamine and haloperidol. Brain slices demonstrated localization of ¹²⁴I-epidepride up until 48 hours in the striatum. However, the extent of binding was reduced significantly.

CONCLUSIONS

¹²⁴I-Epidepride is a new radiotracer suitable for extended imaging of dopamine D2/3 receptors and may have applications in imaging of receptors in the brain and monitoring pancreatic islet cell grafting.