Models and biomarkers of motor and neuropsychiatric complications in Parkinson’s disease

Abstract: Parkinson's disease (PD) is a neurodegenerative disorder characterised by typicalmotor symptoms that are caused by severe dopamine depletion in the cortico-basalganglia network. Parkinsonian motor symptoms are improved by dopaminergicmedications, the most effective being the dopamine precursor L-DOPA. Thiscompound exerts its motor effects by stimulating dopamine D1 and D2 receptors,whose expression are segregated between the movement-promoting and movement-suppressing pathways of the basal ganglia circuitry. As the disease progresses,treatment with L-DOPA give rise to involuntary movements (dyskinesia), whichlimits its utility. Drugs that directly stimulate dopamine receptors, referred to asdopamine agonists, are commonly used to delay the use of L-DOPA or reduce itsdosage. Although less prone to induce dyskinesia, dopamine agonists have a highliability to induce neuropsychiatric side effects, in particular, impulsive-compulsivebehaviours. However, it remains to be established whether pharmacotherapiescombining L-DOPA and dopamine agonists give rise to specific profiles of motorand non-motor complications.The overarching aim of this thesis is to develop improved experimental modelsto advance translational research on the motor and neuropsychiatric complicationsof PD therapy. Both well-established and new experimental models are used todefine correlations and causal links between regimens of dopaminergic treatment,behavioural changes, and biomarkers of network and cellular dysfunction in thecortico-basal ganglia system.Using in vivo local field potential recordings to study biomarkers of networkdysfunctions, we show that changes in broad-band oscillatory activities of cortico-striatal circuits are correlated to ongoing motions and do not reflect parkinsonian-specific states. Moreover, we demonstrate that dyskinesias induced by D1 receptorstimulation are associated with prominent narrowband cortico-striatal oscillationsin the high gamma range (70-110 Hz). Following treatment with a D2 agonist, thesenarrowband gamma oscillations are less pronounced, whereas this treatment inducesprominent theta oscillations (5-10 Hz) in the deep basal ganglia nuclei. Thus, thecomposition of the dopaminergic therapies might affect these neurophysiologicalbiomarkers and should be considered in future investigations.Next, using a set of pharmacological tools and markers of cellular dysfunctions,we show that adjuvant treatment with D2/3 agonists alters the pattern of dopamine-related neuroplasticity in the basal ganglia compared to L-DOPA monotherapy,despite similar dyskinetic behaviours. The antidyskinetic effects of compounds modulating D1 receptor signalling were stronger in L-DOPA-treated animals, whileNMDA receptor antagonists produced markedly larger effects in the combinedtreatment group. Thus, adjuvant dopamine agonist treatment has a significantimpact on the neuroplasticity and pharmacological response profiles of L-DOPA-induced dyskinesia. In a last study, we show that treatment with a D2/3 agonistinduces compulsive behaviours and impulsive decision-making in both intact andpartially dopamine-depleted rats regardless of L-DOPA coadministration.Taken together, the findings of this thesis shed new light on the maladaptivecellular changes and network dynamics through which dopaminergic pharmacotherapies for PD affects motor behaviours. Moreover, this thesis work reveals the importance of including realistic models of combined therapies in future translational research on L-DOPA-induced dyskinesia.