Enhanced oral activity is induced in neonatal 6-hydroxydopamine- (6-OHDA-) lesioned rats by systemic administration of the dopamine (DA) D1 receptor agonist SKF 38393 and serotonin (5-HT) 5-HT2A,2C agonist m-chlorophenylpiperazine (m-CPP). The DA D1 receptor antagonist SCH 23390 effectively attenuates the effect of SKF 38393 but not m-CPP. The 5-HT2antagonist mianserin attenuates the effects of both m-CPP and SKF 38393, suggesting that DA agonist effects are mediated by 5-HT neurochemical systems. To test whether DA and 5-HT agonist effects and interactions might occur within the neostriatum, rats were implanted with permanent injection cannulae, with tips in the ventral striatum. One group of rats was lesioned at 3 days after birth with 6-OHDA HBr (100 μg salt form, in each lateral ventricle; desipramine HCl pretreatment, 20 mg/kg IP, base form, 1 h), while controls received the vehicle in place of 6-OHDA. Cannulae were implanted when rats weighed 200-250 g. During a 1-h observation session SKF 38393 (5 nmol per side) produced 74.3±19.2 oral movements in intact rats and 310.7±97.0 oral movements in 6-OHDA-lesioned rats. m-CPP (10 nmol per side) produced 72.6±15.1 and 274.5±65.0 oral movements in these respective groups. These responses were several-fold greater than the 25.3±7.3 and 41.8±9.5 oral movements in the same groups after saline (0.5 μl per side) (P<0.05). Mianserin (6 nmol per side) alone had no effect on oral activity but attenuated responses to both SKF 38393 and m-CPP in intact and 6-OHDA-lesioned rats. These findings demonstrate that enhanced oral activity responses are produced by intrastriatal SKF 38393 and m-CPP in neonatal 6-OHDA-lesioned rats. Also, when the 5-HT2 receptor antagonist mianserin was administered intrastriatally, induction of oral activity by the DA D1 agonist SKF 38393 was attenuated. These findings indicate that ventral striatum represents at least one brain focus at which DA and 5-HT systems interact to modulate oral activity in rats.

l-Prolyl-l-leucyl-glycinamide (MIF-1) is known to attenuate apomorphine-induced stereotypies in adult rats that are lesioned as neonates with 6-hydroxydopamine (6-OHDA). To test whether MIF-1 would affect dopamine (DA) agonist-induced and serotonin (5-HT) agonist-induced oral activity, both intact and neonatal 6-OHDA-treated rats were studied. Rats at 3 days from birth were injected with desipramine (20 mg/kg, IP), 1 h before 6-OHDA HBr (100 μg, salt form, in each lateral ventricle) or its vehicle, saline-ascorbic acid (0.1%). At approximately 6 months rats were treated with MIF-1 (0.1, 1.0, or 10.0 mg/kg, IP), 10 min before SKF 39393 HCl (1.0 mg/kg, IP) or m-chlorophenylpiperazine 2HCl (m-CPP 2HCl; 0.5 mg/kg, IP), DA D1 and 5-HT1C,2 receptor agonists, respectively. Although both agonists increased oral activity in control and neonatal 6-OHDA-treated rats, MIF-1 did not modify the response. In rats that received either of the three doses of MIF-1 for 21 consecutive days, there was still no observed effect of MIF-1 on the oral response of control and 6-OHDA-lesioned rats to SKF 38393 and m-CPP. These findings indicate that MIF-1 does not modify the oral activity response of supersensitized D1 and 5-HT1C receptors in adult rats that are lesioned neonatally with 6-OHDA.

Abstract: To study potential biochemical correlates of dopamine (DA) and serotonin receptor supersensitivity, rats were lesioned at 3 days after birth with 6‐hydroxydopamine (6‐OHDA; 67 µg in each lateral ventricle; desipramine pretreatment, 20 mg/kg i.p., 1 h) and then sensitized with the DA D1 agonist, SKF 38393 HCl (3.0 mg/kg i.p. per day) either ontogenetically (daily, for 28 consecutive days from birth) and/or in adulthood (four weekly injections, 6–9 weeks from birth). Controls received vehicle in place of 6‐OHDA or SKF 38393. Enhanced locomotor responses were observed after SKF 38393 at 6 weeks, only in rats that received SKF 38393 + 6‐OHDA in ontogeny. Locomotor responses were further enhanced in this group after the last of four weekly SKF 38393 injections at the 9th week. These weekly SKF 38393 treatments also produced enhanced responses in 6‐OHDA rats that did not receive SKF 38393 in ontogeny. When striata were studied at 11 weeks, the percentages of high and low affinity DA D1 binding sites were not altered. Basal as well as DA‐, NaF‐, and forskolin‐stimulated adenylyl cyclase activities also were not changed. Dot blot analysis showed that there was a reduction of mRNA levels for DA D1, but not serotonin1C, receptors in the 6‐OHDA groups. However, SKF 38393 at 6–9 weeks eliminated this alteration. Based on these findings it can be proposed that supersensitization may be a consequence of altered neuronal cross talk rather than an imbalance of receptor elements per se.

Les antipsychotiques sont administrés chroniquement pour prévenir de nouveaux épisodes psychotiques dans la schizophrénie. Ces médicaments diminuent l’activité des récepteurs dopaminergiques de type 2. Diminuer chroniquement la transmission dopaminergique induit des compensations pouvant mener à une sensibilisation du système dopaminergique. Cette sensibilisation pourrait diminuer l’efficacité des antipsychotiques et exacerber la psychose. Chez le rat, la sensibilisation dopaminergique induite par les antipsychotiques augmente les effets psychomoteurs et motivationnels des agonistes dopaminergiques. Le premier objectif de la présente thèse était de caractériser les substrats neuronaux régulant l’expression de la sensibilisation dopaminergique évoquée par les antipsychotiques. Ceci est important afin d’améliorer le traitement à long terme de la schizophrénie. Pour ce faire, des rats ont reçu un traitement cliniquement pertinent à l’antipsychotique halopéridol. Ce traitement sensibilise aux effets psychomoteurs de l’agoniste dopaminergique d-amphétamine. Cet indice comportemental de sensibilisation dopaminergique a été utilisé pour déterminer les contributions spécifiques du système dopaminergique et l’implication des effets centraux de la d-amphétamine. Puisqu’il y a une relation étroite entre le stress et l’activité dopaminergique, les réponses liées au stress ont également été mesurées. Ceci est important, puisque le stress exacerbe la psychose. La présente thèse démontre que les récepteurs dopaminergiques régulent de manière distincte la sensibilisation dopaminergique. En effet, la transmission via les récepteurs de type 2 exacerbe cette sensibilisation, alors que la transmission via les récepteurs de type 1 la tempère. Également, la présente thèse suggère que des processus périphériques sont nécessaires à l’expression de la sensibilisation dopaminergique. De plus, la sensibilisation pourrait augmenter les réponses au stress. En effet, cette sensibilisation est renversée lorsque la synthèse de l’hormone de stress corticostérone est inhibée, en plus d’être associée à certains comportements suggérant un stress augmenté. Chez le rat, la sensibilisation dopaminergique évoquée par les antipsychotiques potentialise également les effets motivationnels des stimuli conditionnés prédisant des récompenses. Lorsque ces stimuli acquièrent trop de valeur motivationnelle, ils peuvent motiver des comportements pathologiques. Ainsi, une potentialisation de la valeur motivationnelle des stimuli conditionnés provoquée par les antipsychotiques pourrait avoir des implications importantes dans des processus motivationnels anormaux dans la schizophrénie, tels que la psychose et la forte prévalence de toxicomanie. Ainsi, le deuxième objectif de la présente thèse était d’étudier les mécanismes neurobiologiques régulant les effets comportementaux des stimuli conditionnés, particulièrement le rôle du noyau basolatéral de l’amygdale. Ici, le rôle de ce noyau a été étudié chez des animaux non traités aux antipsychotiques, puisque sa contribution reste incomprise. Ce travail pourrait révéler des mécanismes neurobiologiques potentiellement impliqués dans la sensibilisation dopaminergique évoquée par les antipsychotiques. La présente thèse démontre que l’activation optogénétique de l’amygdale basolatérale potentialise les effets comportementaux des stimuli conditionnés, en augmentant leur valeur motivationnelle et leur capacité à guider le comportement vers des récompenses imminentes. Ainsi, une activité excessive de l’amygdale basolatérale pourrait attribuer trop de pouvoir aux stimuli conditionnés, et ceci pourrait jouer un rôle dans l’état motivationnel anormal provoqué par les antipsychotiques. La présente thèse identifie de nouveaux mécanismes par lesquels les antipsychotiques et les stimuli conditionnés favorisent des réponses pathologiques. / Schizophrenia requires long-term antipsychotic treatment to prevent psychosis relapse. Antipsychotic drugs temper psychotic symptoms by reducing dopamine D2 receptor-mediated signalling. Chronically decreasing dopamine transmission produces neuronal compensation leading to supersensitivity to dopamine stimulation. In patients, this dopamine supersensitivity would compromise antipsychotic efficacy and exacerbate psychotic symptoms. In laboratory animals, antipsychotic-evoked dopamine supersensitivity enhances the psychomotor and reward-enhancing effects of dopamine agonists. The first objective of the present thesis was to characterize the biological substrates mediating the expression of antipsychotic-evoked dopamine supersensitivity, a necessary work for developing better long-term treatment strategies. To do so, rats were chronically exposed to a clinically relevant antipsychotic treatment regimen, using the drug haloperidol. Haloperidol produces dopamine supersensitivity, as indicated by an exaggerated psychomotor response to the dopamine agonist d-amphetamine. This behavioural index of supersensitivity was used to examine the specific contributions of the dopamine system and the central effects of d-amphetamine. Given that there is a close relationship between stress and dopamine activity, it was also determined whether antipsychotic-evoked dopamine supersensitivity alters stress-like responses. This is important to consider because stress is a contributing factor to psychosis relapse. The present thesis first reveals that D1- and D2-mediated transmissions contribute distinctively to the expression of antipsychotic-evoked dopamine supersensitivity, with D2 transmission promoting this supersensitivity and D1 transmission tempering it. The present thesis also provides evidence that peripheral processes play a necessary role in dopamine supersensitivity. Additionally, antipsychotic-evoked dopamine supersensitivity could potentiate stress-like responses. Indeed, the expression of supersensitivity is reversed by inhibition of the synthesis of the stress hormone corticosterone and is linked with some signs of heightened stress-related behaviours. In rats, antipsychotic-evoked dopamine supersensitivity potentiates the incentive motivational effects of reward-predictive conditioned stimuli. When these stimuli acquire too much motivational value, they motivate maladaptive responses. Hence, the increased motivational value of conditioned stimuli elicited by antipsychotic exposure could be involved in impaired motivational processes found in schizophrenia, such as psychosis and the greater vulnerability to drug addiction. Thereby, the last goal of the present thesis was to investigate the neurobiological substrates mediating the behavioural effects of reward-predictive stimuli, with a special focus on the role of the basolateral nucleus of the amygdala. This was investigated in antipsychotic-naïve rats because there are important caveats in our current understanding of the functional role of the basolateral amygdala. Such investigation could give novel insights on the neurobiological effects of antipsychotic-evoked dopamine supersensitivity. Here it is shown that optogenetic stimulation of basolateral amygdala neurons potentiates the behavioural effects of conditioned stimuli, by increasing their motivational value and their ability to guide behaviour toward impending rewards. The implication for this is that excessive activity in the basolateral amygdala could attribute too much motivational power to conditioned stimuli, and this could be involved in the abnormal motivational state produced by antipsychotic drugs. Taken together, the present thesis provides novel mechanisms by which antipsychotic drugs and reward-predictive stimuli promote maladaptive responses.

Tardive dyskinesia (TD), first appearing in humans after introduction of the phenothiazine class of antipsychotics in the 1950s, is now recognized as an abnormality resulting predominately by long-term block of dopamine (DA) D2 receptors (R). TD is thus reproduced in primates and rodents by chronic administration of D2-R antagonists. Through a series of studies predominately since the 1980s, it has been shown in rodent modeling of TD that when haloperidol or other D2-R antagonist is added to drinking water, rats develop spontaneous oral dyskinesias, vacuous chewing movements (VCMs), after ~3 months, and this TD is associated with an increase in the number of striatal D2-R. This TD persists for the duration of haloperidol administration and another ~2 months after haloperidol withdrawal. By neonatally lesioning dopaminergic nerves in brain in neonatal rats with 6-hydroxydopamine (6-OHDA), it has been found that TD develops sooner, at ~2 months, and also is accompanied by a much higher number of VCMs in these haloperidol-treated lesioned rats, and the TD persists lifelong after haloperidol withdrawal, but is not associated with an increased D2-R number in the haloperidol-withdrawn phase. TD apparently is related in part to supersensitization of both D1-R and serotoninergic 5-HT2-R, which is also a typical outcome of neonatal 6-OHDA (n6-OHDA) lesioning. Testing during the haloperidol-withdrawn phase in n6-OHDA rats displaying TD reveals that receptor agonists and antagonists of a host of neuronal phenotypic classes have virtually no effect on spontaneous VCM number, except for 5-HT2-R antagonists which acutely abate the incidence of VCMs in part. Extrapolating to human TD, it appears that (1)5-HT2-R supersensitization is the crucial alteration accounting for persistence of TD, (2) dopaminergic-perhaps age-related partial denervation-is a risk factor for the development of TD, and (3) 5-HT2-R antagonists have the therapeutic potential to alleviate TD, particularly if/when an antipsychotic D2-R blocker is withdrawn.

Dopamine receptor supersensitivity (DARSS) often is invoked as a mechanism possibly underlying disordered thought processes and agitation states in psychiatric disorders. This review is focused on identified means for producing DARSS and associating the role of other monoaminergic systems in modulating DARSS. Dopamine (DA) receptors, experimentally, are prone to become supersensitive and to thus elicit abnormal behaviors when coupled with DA or a receptor agonist. In intact (control) rats repeated DA D1 agonist treatments fail to sensitize D1 receptors, while repeated D 2 agonist treatments sensitize D2 receptors. D2 RSS is attenuated by a lesion with DSP-4 (N-(2-chlorethyl)-N-ethyl-2- bromobenzylamine) in early postnatal ontogeny, indicating that noradrenergic nerves have a permissive effect on D2 DARSS. However, if DSP-4 is co-administered with 5,7-dihydroxytryptamine to destroy serotonin (5-HT) nerves, then D2 RSS is restored. In rats treated early in postnatal ontogeny with the neurotoxin 6-hydroxydopamine to largely destroy DA innervation of striatum, both repeated D1 and D2 agonists sensitize D1 receptors. 5-HT nerves appear to have a permissive effect on D1 DARSS, as a 5-HT lesion reduces the otherwise enhanced effect of a D1 agonist. The series of findings demonstrate that DARSS is able to be produced by repeated agonist treatments, albeit under different circumstances. The involvement of other neuronal phenotypes as modulators of DARSS provides the potential for targeting a variety of sites in the aim to prevent or attenuate DARSS. This therapeutic potential broadens the realm of approaches toward treating psychiatric disorders.

Les problèmes de toxicomanie sont très communs chez les schizophrènes. L’administration chronique d’antipsychotiques pourrait être impliquée dans cette cooccurrence en induisant une hypersensibilisation du système dopaminergique. Précédemment, nous avons démontré chez le rat qu’un traitement continu (via une mini-pompe osmotique sous-cutanée), et non pas intermittent (via des injections journalières sous-cutanées), avec l’halopéridol a augmenté la capacité de l’amphétamine à potentialiser un comportement de recherche de récompense. Dans cette étude, nous avons étudié les effets d’un antipsychotique atypique soit l’olanzapine comparé à l’halopéridol. Un traitement continu avec l’halopéridol, et non pas l’olanzapine, a augmenté la capacité de l’amphétamine de potentialiser la poursuite d’une récompense conditionnée (lumière/son préalablement associés à l’eau). De plus, un traitement continu avec l’halopéridol a augmenté l’induction par l’amphétamine de l’activité locomotrice et l’expression d’ARNm pour le c-fos (marqueur fonctionnel d’activité cellulaire) dans le caudé-putamen. Donc, un traitement continu avec un antipsychotique typique, et non pas atypique, a augmenté les caractéristiques motivationnelles attribuées à un stimulus neutre. Ceci est potentiellement lié à au développement d’un état de sensibilisation comportementale aux effets de l’amphétamine et à une augmentation de la capacité de l’amphétamine de susciter la modulation de l’activité du caudé-putamen. Ainsi, un antipsychotique typique tel que l’halopéridol semble modifier les circuits de la récompense de façon à contribuer à des comportements caractérisés par une recherche et une consommation de drogues d’abus alors qu’un antipsychotique atypique tel que l’olanzapine aurait moins tendance à le faire. Nous suggérons que les antipsychotiques atypiques pourraient être une meilleure option chez les patients schizophrènes à risque d’avoir un trouble de consommation de drogues d’abus ou de toxicomanie. / Substance abuse problems are excessively common in schizophrenia. Chronic antipsychotic treatment might be involved in this co-morbidity by inducing supersensitivity in the brain’s dopamine system. We have shown previously in the rat that continuous (via osmotic subcutaneous minipump), but not intermittent (via daily subcutaneous injection), treatment with haloperidol potentiates the ability of amphetamine to enhance the pursuit of a conditioned reward. Here, we assessed the effects of the atypical antipsychotic olanzapine. Continuous treatment with haloperidol, but not with olanzapine, enhanced the capacity of amphetamine to potentiate the pursuit of a conditioned reward (a light-tone stimulus previously paired with water). In addition, continuous haloperidol treatment augmented both amphetamine-induced locomotion and striatal c-fos mRNA expression. These effects were either absent or less pronounced following continuous olanzapine treatment. Thus, continuous treatment with a typical, but not with an atypical, antipsychotic enhanced the incentive motivational properties of a reward cue, and this was potentially linked to the development of behavioural supersensitivity to amphetamine and to a greater ability of amphetamine to engage the caudate-putamen. Thus, a typical antipsychotic like haloperidol appears to modify the brain’s reward system in ways that could contribute to drug-seeking and drug-taking behaviour, but an atypical antipsychotic like olanzapine might be less likely to do so. We suggest that atypical antipsychotics might be a preferential option in schizophrenic patients at risk for drug abuse or addiction.

Les médicaments antipsychotiques améliorent les symptômes de la schizophrénie, mais peuvent perdre leur efficacité à long terme en sensibilisant le système dopaminergique. Les mécanismes sous-tendant cette sensibilisation ne sont pas connus. Le neuropeptide neurotensine module le système dopaminergique et est régulé par les antipsychotiques dans le noyau accumbens. Dans cette région, la neurotensine peut avoir des effets anti- et pro-dopaminergiques via les récepteurs NTS1. Nous avions pour hypothèse que la neurotensine du noyau accumbens module l’expression de la sensibilisation dopaminergique induite par les antipsychotiques. Ainsi, nous avons traité par intermittence ou continuellement des rats à l’antipsychotique halopéridol. Seule l’administration continue sensibilise le système dopaminergique et donc sensibilise aux effets locomoteurs de l’amphétamine. Des microinjections de neurotensine dans le noyau accumbens ont diminué l’hyperlocomotion induite par l’amphétamine chez les rats témoins et ceux traités par intermittence aux antipsychotiques. Au contraire, la sensibilisation dopaminergique induite par un traitement continu serait liée à une augmentation des effets pro-dopaminergiques de la neurotensine. Ceci est indépendant d’un changement de densité des récepteurs NTS1 dans le noyau accumbens. Un traitement intermittent n’a pas d’effet sur cette mesure également. De plus, autant un traitement antipsychotique continu qu’intermittent augmentent la transcription de proneurotensine. Donc, seule l’altération de la fonction de la neurotensine du noyau accumbens corrèle avec la sensibilisation dopaminergique. En parallèle, dans le caudé-putamen, un traitement continu augmente la transcription de proneurotensine et un traitement intermittent augmente la densité des récepteurs NTS1. En somme, la neurotensine du noyau accumbens module la sensibilisation dopaminergique induite par les antipsychotiques. / Antipsychotic medications improve schizophrenia symptoms, but they can also sensitize the dopamine system over time, consequently leading to impaired treatment efficacy. The mechanisms underlying antipsychotic-evoked dopamine supersensitivity are not known. The neuropeptide neurotensin regulates the dopamine system and can be modulated by antipsychotics, particularly in the nucleus accumbens. In this area, neurotensin has both anti- and pro-dopaminergic effects via an interaction with NTS1 receptors. In the present study, we hypothesized that neurotensin in the nucleus accumbens can modulate the expression of dopamine supersensitivity-evoked by an antipsychotic treatment. We treated rats with the antipsychotic haloperidol administered either intermittently or continuously. Continuous, but not intermittent, haloperidol treatment induces dopamine supersensitivity as shown by an increased locomotor activity induced by amphetamine. Microinjections of neurotensin in the nucleus accumbens diminish amphetamine-induced locomotion in control and intermittently antipsychotic-treated rats. Dopamine supersensitivity-evoked by a continuous antipsychotic treatment is linked to a potential enhancement of the pro-dopaminergic effects of neurotensin. This is not caused by any change in NTS1 receptor levels in the nucleus accumbens. An intermittent treatment did not alter NTS1 receptor levels as well in this area. Also, both continuous and intermittent treatment increased neurotensin transcription in the nucleus accumbens. Thus, only neurotensin altered function correlates with dopamine supersensitivity. In the caudate-putamen, continuous antipsychotic treatment increased neurotensin transcription, whereas intermittent treatment increased NTS1 receptor levels. In summary, neurotensin in the nucleus accumbens can modulate the expression of dopamine supersensitivity-evoked by antipsychotics.

Les problèmes de toxicomanie sont très communs chez les schizophrènes. L’administration chronique d’antipsychotiques pourrait être impliquée dans cette cooccurrence en induisant une hypersensibilisation du système dopaminergique. Précédemment, nous avons démontré chez le rat qu’un traitement continu (via une mini-pompe osmotique sous-cutanée), et non pas intermittent (via des injections journalières sous-cutanées), avec l’halopéridol a augmenté la capacité de l’amphétamine à potentialiser un comportement de recherche de récompense. Dans cette étude, nous avons étudié les effets d’un antipsychotique atypique soit l’olanzapine comparé à l’halopéridol. Un traitement continu avec l’halopéridol, et non pas l’olanzapine, a augmenté la capacité de l’amphétamine de potentialiser la poursuite d’une récompense conditionnée (lumière/son préalablement associés à l’eau). De plus, un traitement continu avec l’halopéridol a augmenté l’induction par l’amphétamine de l’activité locomotrice et l’expression d’ARNm pour le c-fos (marqueur fonctionnel d’activité cellulaire) dans le caudé-putamen. Donc, un traitement continu avec un antipsychotique typique, et non pas atypique, a augmenté les caractéristiques motivationnelles attribuées à un stimulus neutre. Ceci est potentiellement lié à au développement d’un état de sensibilisation comportementale aux effets de l’amphétamine et à une augmentation de la capacité de l’amphétamine de susciter la modulation de l’activité du caudé-putamen. Ainsi, un antipsychotique typique tel que l’halopéridol semble modifier les circuits de la récompense de façon à contribuer à des comportements caractérisés par une recherche et une consommation de drogues d’abus alors qu’un antipsychotique atypique tel que l’olanzapine aurait moins tendance à le faire. Nous suggérons que les antipsychotiques atypiques pourraient être une meilleure option chez les patients schizophrènes à risque d’avoir un trouble de consommation de drogues d’abus ou de toxicomanie. / Substance abuse problems are excessively common in schizophrenia. Chronic antipsychotic treatment might be involved in this co-morbidity by inducing supersensitivity in the brain’s dopamine system. We have shown previously in the rat that continuous (via osmotic subcutaneous minipump), but not intermittent (via daily subcutaneous injection), treatment with haloperidol potentiates the ability of amphetamine to enhance the pursuit of a conditioned reward. Here, we assessed the effects of the atypical antipsychotic olanzapine. Continuous treatment with haloperidol, but not with olanzapine, enhanced the capacity of amphetamine to potentiate the pursuit of a conditioned reward (a light-tone stimulus previously paired with water). In addition, continuous haloperidol treatment augmented both amphetamine-induced locomotion and striatal c-fos mRNA expression. These effects were either absent or less pronounced following continuous olanzapine treatment. Thus, continuous treatment with a typical, but not with an atypical, antipsychotic enhanced the incentive motivational properties of a reward cue, and this was potentially linked to the development of behavioural supersensitivity to amphetamine and to a greater ability of amphetamine to engage the caudate-putamen. Thus, a typical antipsychotic like haloperidol appears to modify the brain’s reward system in ways that could contribute to drug-seeking and drug-taking behaviour, but an atypical antipsychotic like olanzapine might be less likely to do so. We suggest that atypical antipsychotics might be a preferential option in schizophrenic patients at risk for drug abuse or addiction.

Tardive dyskinesia (TD), marked by abnormal involuntary movements and frequently expressed as perioral activity, represents an adverse outcome of prolonged antipsychotic therapy, occurring in approximately 5 % of patients per treatment year. Although neuronal mechanisms underlying TD are largely unknown, more recent experimental studies in animal models of TD are providing insight into the neuronal mechanisms associated with TD and implicating newer treatment approaches. It is now evident that a predominance in the ratio of dopamine (DA) D1:D2 receptor (R) activation accounts for induction of perioral movements in rodent models of TD, in nonhuman primate models of TD, and in humans with TD. Experimentally, TD is produced in animal models of TD, in a manner analogous to that by which TD is produced in humans - by continuous and prolonged administration of a DA D2R antagonist (i.e., an antipsychotic drug). More recently, in a rodent model of TD, it has been shown that a lesion of dopaminergic - mainly nigroneostriatal - neurons reduces the time latency for occurrence of TD, also increases the severity of perioral activity, and results in permanence of TD after complete removal of D2R antagonist treatment. The induction of perioral activity is related to DAR supersensitivity but unrelated to numbers of D2R and D2R in the neostriatum, a brain region associated with perioral activity. More apropos, serotoninergic systems are now recognized as having a greater role in effecting perioral activity, and it appears that 5-HT2C receptor antagonists are most effective in abating perioral activity in a rodent model of TD. These processes and mechanisms, topics addressed in this chapter, highlight a newer understanding of mechanisms underlying TD and provide insight into new approaches towards treatment of TD in humans.