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Decreasing Amphetamine-Induced Dopamine Release by Acute Phenylalanine/Tyrosine Depletion: a PET/ [11C]Raclopride Study in Healthy Men

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Decreasing Amphetamine-Induced Dopamine Release by Acute Phenylalanine/Tyrosine Depletion: a PET/ [11C]Raclopride Study in Healthy Men Neuropsychopharmacology (2004) 29, 427–432 & 2004 Nature Publishing Group All rights reserved 0893-133X/04 $25.00 www.neuropsychopharmacology.org Decreasing Amphetamine-Induced Dopamine Release by Acute Phenylalanine/Tyrosine Depletion: A PET/ [11C]Raclopride Study in Healthy Men 1,2, 2 2 1 3 2 Marco Leyton *, Alain Dagher , Isabelle Boileau , Kevin Casey , Glen B Baker , Mirko Diksic , Roger 2 1 1,2 Gunn , Simon N Young and Chawki Benkelfat 1 2 Department of Psychiatry, McGill University, Montre´al, Que´bec, Canada; Department of Neurology & Neurosurgery, McGill University, 3 Montre´al, Que´bec, Canada; Department of Psychiatry, Mackenzie Centre, University of Alberta, Edmonton, Alberta, Canada Acute phenylalanine/tyrosine depletion (APTD) has been proposed as a new method to decrease catecholamine neurotransmission safely, rapidly, and transiently. Validation studies in animals are encouraging, but direct evidence in human brain is lacking. In the present study, we tested the hypothesis that APTD would reduce stimulated dopamine (DA) release, as assessed by positron emission 11 tomography (PET) and changes in [ C]raclopride binding potential (BP), a measure of DA D2/D3 receptor availability. Eight healthy men 11 received two PET scans, both following d-amphetamine, 0.3 mg/kg, p.o., an oral dose known to decrease [ C]raclopride BP in ventral striatum. On the morning before each scan, subjects ingested, in counter-balanced order, an amino-acid mixture deficient in the catecholamine precursors, phenylalanine, and tyrosine, or a nutritionally balanced mixture. Brain parametric images were generated by calculating [11C]raclopride BP at each voxel. BP values were extracted from the t-map (threshold: t ¼ 4.2, equivalent to p 0.05, o Bonferroni corrected) and a priori identified regions of interest from each individual’s coregistered magnetic resonance images. Both 11 receptor parametric mapping and region of interest analyses indicated that [ C]raclopride binding was significantly different on the two 11 test days in the ventral striatum (peak t ¼ 6.31; x ¼À25, y ¼À8, and z ¼ 0.1). In the t-map defined cluster, [ C]raclopride BP values were 11.8 7 11.9% higher during the APTD session (po0.05). The reduction in d-amphetamine-induced DA release exhibited a linear association with the reduction in plasma tyrosine levels (r ¼À0.82, po0.05). Together, the results provide the first direct evidence that APTD decreases stimulated DA release in human brain. APTD may be a suitable new tool for human neuropsychopharmacology research. Neuropsychopharmacology (2004) 29, 427–432, advance online publication, 29 October 2003; doi:10.1038/sj.npp.1300328 Keywords: dopamine; [11C]raclopride; catecholamine; tyrosine depletion INTRODUCTION Rot et al, 2003), amphetamine-induced changes in impulse control (Rot et al, 2003), alcohol self-administration in The acute phenylalanine/tyrosine depletion (APTD) method social drinkers (Leyton et al, 2000a), withdrawal-related was recently developed as a new tool to investigate the craving in nicotine-dependent smokers (Casey et al, 2002), effects of catecholamine neurotransmission in humans and mood both in healthy subjects (Leyton et al, 2000b; (Moja et al, 1996; Sheehan et al, 1996; Leyton et al, Harmer et al, 2001) and manic patients (McTavish et al, 2000b). Initial studies suggest that APTD decreases 2001). subjective effects of amphetamine (McTavish et al, 1999b; An assumption in these studies is that APTD is inducing functionally significant decreases in brain catecholamine A preliminary report based on this study was presented at the Annual synthesis. Animal studies support this possibility. APTD Meeting of the American College of Neuropsychopharmacology, San decreases post-mortem tissue concentrations of the dopa- Juan, Puerto Rico, December 8–12, 2002 mine (DA) metabolites homovanillic acid (HVA) and *Correspondence: M Leyton, Department of Psychiatry, McGill dihydroxyphenylacetic acid (Biggio et al, 1976), ampheta- University, 1033 Pine Avenue West, Montreal, Quebec, Canada mine-induced DA release (McTavish et al, 1999a), and H3A 1A1, Tel: +1-514-398-5804, Fax: +1-514-398-4866, E-mail: [email protected] cerebrospinal fluid (CSF) concentrations of HVA and the Received 05 April 2003; revised 27 August 2003; accepted 02 norepinephrine (NE) metabolite, 3-methoxy-4-hydroxyphe- September 2003 nethyleneglycol (Palmour et al, 1998). In humans, though, Online publication: 3 September 2003 at http://www.acnp.org/ the evidence remains circumstantial: APTD is reported to citations/Npp09030303152/default.pdf decrease blood pressure (Moja et al, 1996) and increase APTD decreases DA release M Leyton et al 428 circulating levels of prolactin (Harmer et al, 2001), but approximately 1.5 h before tracer injection (mean 7 SD, direct evidence of decreased catecholamine transmission in 1.4 7 0.5 h) and 3.5 h after administration of the AA brain is lacking. mixture (3.6 7 0.5 h). In the present study, we sought to assess whether APTD Subjects underwent two scans on separate days between would reduce stimulated DA release in human striatum, as 1400 and 1700 on a Siemens ECAT HR+ PET scanner measured by positron emission tomography (PET) and (maximum resolution 4.1  4.1  4.5 mm3, full-width half- [11C]raclopride. Healthy subjects were administered a maximum in center of field of view in air) with lead septa nutritionally balanced (BAL) amino-acid (AA) mixture removed. At 1 h before tracer injection, a catheter was containing the catecholamine precursors, phenylalanine inserted into the subject’s antecubital vein. Immediately and tyrosine, and, on a separate day, the phenylalanine/ before tracer injection, transmission scans were performed tyrosine-deficient mixture. Ingestion of the latter mixture using 68Ga for attenuation correction. Approximately, induces protein synthesis, leading to a transient reduction 10 mCi of [11C]raclopride was injected as an intravenous in the availability of phenylalanine and tyrosine for entry (i.v.) bolus and data were acquired for 60 min in time into the brain. Since the rate-limiting enzyme in catecho- frames of progressively longer duration. lamine synthesis, tyrosine hydroxylase, is normally incom- High-resolution (1 mm) T1-weighted magnetic resonance pletely saturated (Carlsson and Lindqvist, 1978), reduced (MR) images were obtained for all subjects (3D fast-field availability of the AA precursors decreases DA and NE echo scans with 160 slices, 1 mm isotropic resolution, synthesis. On both test days, subjects received a low oral TR ¼ 18 ms, TE ¼ 10 ms, flip angle ¼ 301). These volumes dose of d-amphetamine (0.3 mg/kg, p.o.). We recently were corrected for image intensity nonuniformity (Sled et al, reported that this dose of d-amphetamine decreases 1998), and linearly and nonlinearly transformed into [11C]raclopride binding potential (BP), and does so standardized stereotaxic space (Talairach and Tournoux, preferentially in the ventral striatum (Leyton et al, 2002). 1988) using automated feature matching to the MNI305 We predicted that APTD would attenuate the ability of d- template (Collins et al, 1994b; Collins and Evans, 1997). amphetamine to elicit DA release, as reflected by higher Each individual’s MRI was then coregistered to their [11C]raclopride BP values on the APTD vs BAL test day. summed radioactivity PET images (Evans et al, 1992). Inspection of the time activity curves suggested that one subject moved during one scan. Movement correction was METHODS made by applying an algorithm that corrects for between- Subjects frame misalignment due to head movement. This coregis- tration method realigns each PET frame to a ligand-specific, Eight healthy men (age, 23.1 7 3.6 years; weight, MRI-derived, four-dimensional template, which represents 72.1 7 10.9 kg) were recruited from advertisements placed radiotracer spatial distribution at each time point (Sechet in local newspapers and on campus. All were healthy et al, 2002; Reilhac et al, 2003). nonsmokers, as determined by a physical exam, standard PET images were reconstructed with a filtered back- laboratory tests, and an interview using the Structured projection using a 6 mm full-width half-maximum Hanning Clinical Interview for DSM-IV (First et al, 1995). None had a filter. Parametric images were generated by calculating 11 first-degree relative history of axis I psychiatric disorders as [ C]raclopride BP (BP ¼ BAvail/KD; BAvail ¼ density of avail- assessed by Research Diagnostic Criteria for Family able receptors) at each voxel, using a simplified reference Histories (Andreasen et al, 1977). On each day of the study, tissue compartmental model with cerebellar activity as the all tested negative on a urine drug screen sensitive to reference (Lammertsma and Hume, 1996; Gunn et al, 1997). cocaine, opiates, phencyclidine, barbiturates, D9-tetrahydro- T-maps were then constructed, representing t-tests of cannabinol, benzodiazepines, and amphetamines (Triaget change in [11C]raclopride BP between the two conditions; r Panel for Drugs of Abuse, Biosite Diagnostics , San Diego, the voxel-by-voxel comparisons assessed the same voxels CA, USA). The study was carried out in accordance with the for every subject (Aston et al, 2000). Clusters of statistically Declaration of Helsinki and was approved by the Montreal significant change were identified by thresholding the t-map Neurological Institute’s Research Ethics Board. at a value of tX4.2, which corresponds to po0.05 corrected for multiple comparisons and a search volume of the entire Procedure striatum (Worsley et al, 1996). BP values for each subject were extracted from the The day before each AA mixture test session, subjects ate a volume delineated by t-values greater than or equal to 4.2, low protein diet provided by the investigators, and fasted as well as from five anatomical regions of interest (ROI). from midnight. On the test day, subjects arrived at 0830 and Identifying the ROI entailed three steps. First, each tissue had blood samples drawn to measure plasma AA concen- type (gray matter, white matter, and CSF) was automatically trations. They then ingested one of the AA mixtures given in classified (Collins et al, 1998).
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