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Doyenne de la thérapeutique antiparkinsonienne, puissant outil pharmacologique au profil singulier, l’apomorphine est aujourd’hui indiquée comme thérapeutique de deuxième intention, au stade où les fluctuations liées au traitement oral handicapent le quotidien des patients. Si ses effets sur la triade parkinsonienne et les fluctuations motrices sont connus et objectivés depuis le milieu du XXème siècle, son spectre d’action sur les troubles non moteurs a, quant à lui, été encore peu exploré. Ce travail de thèse avait deux objectifs : (1) établir un état de l’art quant aux connaissances actuelles sur l’apomorphine et (2) étudier les effets d’un traitement par pompe à apomorphine sur la symptomatologie non motrice parkinsonienne, en particulier aux plans cognitifs et émotionnels, sur une période de six mois. Pour ce faire, deux études ont été menées. La première, intitulée APO-TEP, s’intéressait à l’évolution de l’état cognitif et de la qualité de vie de patients présentant la maladie à un stade avancé, mais ne pouvant bénéficier de la chirurgie de stimulation cérébrale profonde du noyau subthalamique. Une exploration du métabolisme cérébral était associée à l’évaluation clinique. Ce travail a permis de mettre en évidence une amélioration significative des fonctions motrices, cognitivo-psychiatriques (fonctions exécutives et apathie) et de la qualité de vie après six mois de traitement. Des modifications d’activité cérébrale dans les réseaux fonctionnels cognitifs, moteurs et limbiques ont par ailleurs été observées, soutenant l’idée d’un substratum anatomo-fonctionnel diffus. La seconde étude, intitulée APO-EMO, évalue les effets du traitement par pompe à apomorphine sur la sphère émotionnelle, souvent altérée dans la maladie de Parkinson. Cette dernière étude est toujours en cours ; les résultats préliminaires ne mettent pour l’heure pas en évidence d’effets sur la perception individuelle des émotions (intelligence émotionnelle et expressivité). Les analyses visant à explorer les effets du traitement sur le mimétisme facial et la reconnaissance des expressions faciales émotionnelles seront menées dans un second temps. L’ensemble de ces résultats expérimentaux est discuté à la lumière des données de la littérature et plusieurs perspectives cliniques et de recherche sont développées. De nouveaux travaux, visant à mieux comprendre les réseaux neuronaux et les voies neurochimiques activées par l’apomorphine en perfusion continue, sont à mener. Longtemps cantonnée au rang de curiosité pharmacologique, l’apomorphine semble enfin trouver sa place dans l’arsenal thérapeutique. / Apomorphine is a peculiar drug, currently used as a second-line therapy in Parkinson’s disease (PD). If its motor efficacy has been amply established, questions remain about its effect on non motor symptoms, a common burden in PD. This thesis address these questions by (1) reviewing the state of the art of the current knowledge about apomorphine (history, pharmacology and current interest in neurological disorders) and (2) exploring the effect of continuous subcutaneous apomorphine infusion (CSAI) on cognitive and emotional symptoms in PD, while studying brain metabolism. Two studies were conducted: APO-TEP and APO-EMO. Well-tolerated, CSAI appears to be an interesting option in advanced PD. Changes in brain metabolism (motor, cognitive and limbic networks) were observed at 6 months and correlated to clinical improvement (executive functions, apathy and motricity) in patients with advanced PD and contra-indications for subthalamic nucleus deep brain stimulation. Preliminary results of the ongoing APO-EMO study suggest that CSAI does not seem to improve emotional self-perception in patients; however we will further explore its effect on facial mimicry and facial emotion recognition. If further research is still needed, apomorphine seems to be destined to become a key feature of future therapeutic strategies, in PD (nonmotor symptoms, advanced PD, withdrawal of oral medications) but also in other dopaminergic disorders, and rightly so.

Various methods were tried in an attempt to obtain a technique for quantifying the gnawing effects of apomorphine on rats. A technique using a restraining tube was developed. Under a 2 milligram per kilogram intraperitoneal injection of apomorphine, four female Long Evans hooded rats were placed on continuous and fixed reinforcement schedules using a gnawable pine block. Subjects would learn to turn their heads away from the gnawable object in order to obtain 15 seconds of gnawing time. The rate of response increased from less than one response in 5 minutes to over 3 responses per minute in 10 one-half hour conditioning sessions. Rates of response stabilized during the last 5 experimental sessions and fixed ratio schedules of up to 5:1 were obtained in five additional 1 '1/ 2 hour sessions.

Há décadas os campos magnéticos (CMs) são alvo de investigação científica. Entretanto, o grande corpo de evidências, está relacionado a campos eletromagnéticos e não a campos magnéticos contínuos. Nosso interesse é direcionado para a modulação das respostas comportamentais e motoras, na preservação de neurônios pós-lesão isquêmica e na possibilidade de uma interferência funcional com drogas que modifiquem a neurotransmissão encefálica. Utilizamos 130 Gerbilos, alocados em 13 grupos experimentais. Grupos específicos foram submetidos a isquemia encefálica global bilateral e a implantação de um capacete magnético com potencia de 3200G. Quatro dias após os procedimentos cirúrgicos os animais foram avaliados no monitor de atividades e no Rotarod, após receberem uma injeção de Apomorfina (APO) (2,5mg /kg) ou Racloprida (RAC) (0,9ml/kg). Valor de p significativo <0,05. No monitor de atividades, os animais do grupo isquemia atravessaram o maior número de sensores horizontais (F12,117: 9,39) e verticais (F12,117: 10,60) do que todos os outros grupos. Animais isquêmicos injetados com APO e tratados com campo magnético atravessam um número menor de sensores do que os grupos isquêmicos. Os isquêmicos injetados com APO e estimulados com o polo norte dispararam menos sensores do que os isquêmicos injetados com APO. Animais injetados com RAC com ou sem estimulação magnética disparam menos sensores do que os animais isquêmicos e isquêmicos tratados com polo norte e sul. No teste do Rotarod, o grupo isquêmico apresentou o menor tempo de permanência no teste do que os demais grupos. Ainda, animais isquêmicos tratados com APO e RAC e estimulação magnética pelo polo norte apresentam maior tempo de permanência em relação aos grupos isquemia e isquemia injetado com Apo e RAC (F12,117: 11,29). Nossos dados confirmam a possibilidade de interação dos polos magnéticos e os mecanismos de ação das drogas utilizadas no experimento. / For decades, magnetic fields (CMs) have been the subject of scientific research. However, the great body of evidence is related to electromagnetic fields and not to continuous magnetic fields. Our interest is directed to the modulation of behavioral and motor responses, the preservation of neurons after brain ischemic injury and the possibility of functional interference with drugs that modify brain neurotransmission. We used 130 gerbils, allocated in 13 experimental groups. Specific groups were submitted to bilateral global brain ischemia and the implantation of a magnetic helmet with power of 3200G. Four days after the surgical procedures, the animals were evaluated on the activity monitor and Rotarod after receiving an injection of Apomorphine (APO) (2.5 mg / kg) or Raclopride (RAC) (0.9 ml / kg). Significant p value was set as <0.05. In the activity monitor, the animals in the ischemia group crossed fired the largest number of horizontal sensors (F12,117: 9,39) and vertical sensors (F12,117: 10,60) than all the other groups. Ischemic animals injected with APO and magnetic field fired a smaller number of sensors than the ischemic groups and injected with APO. Animals stimulated with the north pole fired fewer sensors than ischemic animals injected with APO. RAC injected animals, with or without magnetic stimulation fired fewer sensors than ischemic animals or ischemic with north and south magnetic stimulation. In the Rotarod test, the ischemic group had the shortest permanence time in the test than the other groups. Still, ischemic animals treated with APO and RAC and North Pole magnetic stimulation present a longer permanence time in comparison to the ischemia group and ischemia with APO and RAC. Ischemic animals injected with APO and magnetic field pass through a smaller number of sensors than the ischemic groups and injected with APO. In the Rotarod test, the ischemic group had the shortest residence time in the test than the other groups. Still, ischemic animals treated with APO and north pole present a longer residence time in relation to the ischemia groups with APO and RAC (F12,117: 11,29). Our data confirm the possibility of interaction of the magnetic poles and the action mechanisms of action of the drugs used in the experiment.

Há décadas os campos magnéticos (CMs) são alvo de investigação científica. Entretanto, o grande corpo de evidências, está relacionado a campos eletromagnéticos e não a campos magnéticos contínuos. Nosso interesse é direcionado para a modulação das respostas comportamentais e motoras, na preservação de neurônios pós-lesão isquêmica e na possibilidade de uma interferência funcional com drogas que modifiquem a neurotransmissão encefálica. Utilizamos 130 Gerbilos, alocados em 13 grupos experimentais. Grupos específicos foram submetidos a isquemia encefálica global bilateral e a implantação de um capacete magnético com potencia de 3200G. Quatro dias após os procedimentos cirúrgicos os animais foram avaliados no monitor de atividades e no Rotarod, após receberem uma injeção de Apomorfina (APO) (2,5mg /kg) ou Racloprida (RAC) (0,9ml/kg). Valor de p significativo <0,05. No monitor de atividades, os animais do grupo isquemia atravessaram o maior número de sensores horizontais (F12,117: 9,39) e verticais (F12,117: 10,60) do que todos os outros grupos. Animais isquêmicos injetados com APO e tratados com campo magnético atravessam um número menor de sensores do que os grupos isquêmicos. Os isquêmicos injetados com APO e estimulados com o polo norte dispararam menos sensores do que os isquêmicos injetados com APO. Animais injetados com RAC com ou sem estimulação magnética disparam menos sensores do que os animais isquêmicos e isquêmicos tratados com polo norte e sul. No teste do Rotarod, o grupo isquêmico apresentou o menor tempo de permanência no teste do que os demais grupos. Ainda, animais isquêmicos tratados com APO e RAC e estimulação magnética pelo polo norte apresentam maior tempo de permanência em relação aos grupos isquemia e isquemia injetado com Apo e RAC (F12,117: 11,29). Nossos dados confirmam a possibilidade de interação dos polos magnéticos e os mecanismos de ação das drogas utilizadas no experimento. / For decades, magnetic fields (CMs) have been the subject of scientific research. However, the great body of evidence is related to electromagnetic fields and not to continuous magnetic fields. Our interest is directed to the modulation of behavioral and motor responses, the preservation of neurons after brain ischemic injury and the possibility of functional interference with drugs that modify brain neurotransmission. We used 130 gerbils, allocated in 13 experimental groups. Specific groups were submitted to bilateral global brain ischemia and the implantation of a magnetic helmet with power of 3200G. Four days after the surgical procedures, the animals were evaluated on the activity monitor and Rotarod after receiving an injection of Apomorphine (APO) (2.5 mg / kg) or Raclopride (RAC) (0.9 ml / kg). Significant p value was set as <0.05. In the activity monitor, the animals in the ischemia group crossed fired the largest number of horizontal sensors (F12,117: 9,39) and vertical sensors (F12,117: 10,60) than all the other groups. Ischemic animals injected with APO and magnetic field fired a smaller number of sensors than the ischemic groups and injected with APO. Animals stimulated with the north pole fired fewer sensors than ischemic animals injected with APO. RAC injected animals, with or without magnetic stimulation fired fewer sensors than ischemic animals or ischemic with north and south magnetic stimulation. In the Rotarod test, the ischemic group had the shortest permanence time in the test than the other groups. Still, ischemic animals treated with APO and RAC and North Pole magnetic stimulation present a longer permanence time in comparison to the ischemia group and ischemia with APO and RAC. Ischemic animals injected with APO and magnetic field pass through a smaller number of sensors than the ischemic groups and injected with APO. In the Rotarod test, the ischemic group had the shortest residence time in the test than the other groups. Still, ischemic animals treated with APO and north pole present a longer residence time in relation to the ischemia groups with APO and RAC (F12,117: 11,29). Our data confirm the possibility of interaction of the magnetic poles and the action mechanisms of action of the drugs used in the experiment.

The naturally occuring ergot alkaloids of the fungus, Claviceps purpurea, and their many derivatives have been of neuropharmacological interest for many years because of their ability to affect peripheral and central adrenergic and serotonergic systems. More recently, selected compounds such as lergotile (2-chloro-6-methyl ergoline-8-beta acetonitrile) and and bromocriptine (2-bromo-alpha-ergocryptine), have been given additional attention due to their possible therapeutic potential in the treatment of parkinson’s disease, acromegaly and other disorders. There have been considerable data published attempting to establish the mechanism(s) whereby the ergot compounds exert their effects. A large portion of these experiments involves the interaction of ergot compounds with dopaminergic systems. This is a logical course of study, since many of the actions of the ergot compounds mimic the actions of compounds known to affect dopaminergic neurons, e.g. antagonists such as the phenothiazines and butyrophenones and agonists such as levodopa and apomorphine. In the last decade, much attention also has been focused on the role of serotonin (5-hydroxytryptamine) in the mediation of dopaminergic systems. There have been many conflicting reports published as to the role of serotonin but it is still uncertain whether or not serotonin does indeed play a role. The present study investigates two dopaminergic effects of the standard dopamine agonist apomorphine and the ergoline lergotrile and the similarities or differences that exist when serotonergic function is altered.

Nitric oxide (NO) is a neurotransmitter which is synthesized on demand from L-arginine by the enzyme nitric-oxide-oxidase, and is implicated in a variety of physiological functions, including release and uptake of dopamine. Amphetamine induces stereotyped behavior via release of dopamine from dopaminergic neurons in the striatum and related structures, while apomorphine induces such behavior via activation of central dopaminergic receptors. Recently we have demonstrated that a NO donors and a NO-synthase inhibitor modify the response of some central dopaminergic receptors to their agonists and antagonists. In the present study we examined the effect of two NO donors and one NO-synthase inhibitor on stereotyped behavior induced in rats by amphetamine and apomorphine, and the sex-selectivity of this effect. A highly significant dose-dependent sexual differentiation was recorded in the stereotyped behavior of amphetamine, as the duration and intensity of this effect was shortened by L-NAME but not by L-arginine and Molsidomine. Differences in the stereotyped behavior between female and male rats administered apomorphine were dose-dependent, but were not affected by any of the three drugs tested. It is concluded that while nitric oxide is involved in the reactivity of central dopamine receptors, the intensity and duration of this effect is drug- and sex-dependent.

Since prolyl-leucyl-glycinamide (MIF-1) modifies the behavior of adult rats after treatment with neuroleptics, we examined whether MIF-1 would also modify adult behavior after treatment of neonatal rats with 6-hydroxydopamine (6-OHDA). Rats received 6-OHDA (100 μg i.c.v.) or diluent at 3 days after birth and either MIF-1 (2.0 mg/kg per day s.c. × 10 days) or diluent beginning at 28 or 29 days after birth. At 5 weeks, a low dose (0.1 mg/kg s.c.) of apomorphine increased the distance traveled, time in ambulation, number of stereotypic movements, and number of movements per time in stereotypy, but decreased the time in stereotypy in the 6-OHDA group. MIF-1 (× 7 or 8 days) showed a tendency to attenuate the increased number of movements and significantly (P < 0.05) reduced all of the other effects of neonatal 6-OHDA. Behavior induced by higher doses of apomorphine in the 6-OHDA group (reduced licking and head nodding; increased paw treading, taffy pulling and self-biting) were not attenuated by MIF-1. At 38 or 39 days, total in vitro binding of [3H]SCH-23390 and [3H]spiroperidol to striatal homogenates was not altered in any of the groups. The findings demonstrate that specific early developmental alterations in apomorphine-induced behaviors can be modified by treatment of adult rats with MIF-1, even in the absence of overt changes in the binding of striatal dopamine D-1 and D-2 receptors.

On the morning of the first day of pregnancy, Wistar rats were administered a single IP injection of either zinc sulfate (10.0 mg/kg) or saline. For the remainder of pregnancy, half the rats in each group then consumed filtered tap water while the other half consumed filtered tap water with 50 ppm of cadmium (CdCl2). At eight weeks after birth, the behavioral profile of male offspring was assessed in the following way: Apomorphine (non-selective dopamine receptor agonist), (+)-7-hydroxy-2-(di-n-propylamino) tetralin (7-OH-DPAT) (D3 agonist) and (+/-)-1-phenyl-2,3,4,5-tetrahydro-(1H)-3-benzazepine-7,8-diol (SKF 38393) (D1 agonist) were used to evaluate stereotyped behavior, yawning activity and oral movements - indices for these respective agonists. In addition, two dopamine receptor antagonists, haloperidol (D2 antagonist) and 7-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-(1H)-3-benzapine (SCH 23390) (D1 antagonist) were used to evaluate cataleptogenic activity. Additional behavioral parameters studied were locomotor activity, irritability and reaction to a painful stimulus. Dopamine and its metabolites 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and 3-methoxytyramine (3-MT) were quantified in the striatum, hippocampus and in the frontal cortex of the brain by means of HPLC/ED technique. In addition, cadmium levels were analyzed in the brain, liver, kidney and bone of newborn rats. Our results indicate that prenatal exposure of pregnant rats to cadmium produced alterations in the reactivity of central dopamine receptors and modulated the level of dopamine and its metabolites in the offsprings' brains. A single injection of zinc, preceding cadmium consumption, attenuated some of the effects of cadmium on the offsprings' dopaminergic system. Zinc also reduced cadmium deposition in the brain, kidney and bone, but enhanced its accumulation in liver. In summary, zinc may exert some neuroprotective effects against cadmium neurotoxicity.