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Biomedical subjects

T L Perry

Publications and source records attributed to T L Perry.

At least 73 records · Page 4Linked to original sources

Multiple system atrophy with neuronal intranuclear hyaline inclusions. Report of a case and review of the literature.

A 31/2-year-old girl presented with frequent falls. She had an unsteady gait, delayed behavioural development absent tendon reflexes and in the legs decreased strength tone and equivocal plantar responses. She then developed ataxia, nystagmus, choreoathetosis, cranial nerve palsies, diminished strength and tone in the arms, sensory deficit in the limbs and autonomic nervous system dysfunction. She became progressively less responsive and succumbed at the age of 63/4 years. Examination of the central, peripheral and autonomic nervous system showed ubiquitous neuronal intranuclear hyaline inclusions and neuronal loss in several sites.

Amino Acids↗

Is a circulating neurotoxin involved in the pathogenesis of Huntington's chorea?

We tested the hypothesis that the premature neuronal death which occurs in Huntington's chorea (HC) might be the result of a genetically-determined enzymatic failure in the degradation of a circulating neurotoxin of either endogenous of exogenous origin. Infant rats were given daily subcutaneous injections of large quantities of whole serum (for 24 days), or of a concentrated serum ultrafiltrate (for 37 days), obtained from HC patients or control subjects. Animals were killed 4 months after the end of injections, and their striata were examined neurochemically. There was a significant but small (16%) reduction in the mean striatal content of gamma-aminobutyric acid (GABA) in rats treated with whole serum from HC patients, but no striatal GABA deficiency was observed in rats treated with ultrafiltrates of serum from HC patients. Nor did these rats have any reduction in their striatal choline acetyltransferase activity. We conclude that if a circulating neurotoxin does contribute to the pathogenesis of HC, it must either be a small molecule which is tightly bound to serum proteins, or less likely a large compound with a molecular weight greater than 10 000.

Animals↗

Interconversion of serine and glycine is normal in psychotic patients.

Fasting plasma serine and glycine concentrations, determined by ion-exchange amino acid chromatography, were similar in a large group of psychotic patients with various forms of schizophrenia and in healthy control subjects. Serine and glycine concentrations were also similar in cerebrospinal fluid of psychotic patients and control subjects. The contents of serine and glycine in autopsied brain of three patients with chronic schizophrenia did not differ from contents of these amino acids in control subjects when analyses were limited to brains frozen rapidly after death. These data do not support a recent suggestion (Waziri et al., 1984) that disturbed serine metabolism may be a biological marker and a vulnerability factor for psychosis.

Adult↗

Chronic treatment with ACTH1-24 does not produce permanent damage to the developing rat brain.

Permanent effects of ACTH1-24 on the developing rat brain were investigated. Rats were injected with 20 IU/kg of ACTH1-24 daily for 4 weeks starting at two days of age. Brain weight, protein, DNA and RNA contents, contents of monoamines and their metabolites, 2',3'-cyclic nucleotide 3'-phosphohydrolase and glutamic acid decarboxylase activities were measured at 24 h and 8 weeks after the last injection. There were no significant changes in these indicators compared to saline-injected controls. These results suggest that chronic treatment with ACTH1-24 does not permanently damage the developing rat brain.

Adrenocorticotropic Hormone↗

Neurochemical abnormalities in brains of renal failure patients treated by repeated hemodialysis.

We examined autopsied brain from 10 patients with end-stage renal failure who had undergone repeated hemodialysis. Eight had classic symptoms, and two had suggestive symptoms of dialysis encephalopathy. Findings were compared with those in autopsied brain from control adults who had never been hemodialyzed. Mean gamma-aminobutyric acid (GABA) contents were significantly reduced in frontal and occipital cortex, cerebellar cortex, dentate nucleus, caudate nucleus, and medial-dorsal thalamus of the hemodialyzed patients, the reduction being greater than 40% in cerebral cortex and thalamus. Choline acetyltransferase activity was reduced by 25-35% in three cortical regions in the hemodialyzed patients. These two abnormalities were observed in the brain of each hemodialyzed patient, regardless of whether or not the patient died with unequivocal dialysis encephalopathy. Pyridoxal phosphate contents were substantially reduced in brains of the hemodialyzed patients, but metabolites of noradrenaline, 3,4-dihydroxyphenylethylamine (dopamine), and 5-hydroxytryptamine (serotonin) were present in normal amounts. Aluminum levels were abnormally high in frontal cortical gray matter in the hemodialyzed patients. Although this study does not clarify the role played by aluminum toxicity in the pathogenesis of dialysis encephalopathy, the abnormalities we found suggest the need for further neurochemical investigations in this disorder.

Adult↗

Brain gamma-aminobutyric acid deficiency in dialysis encephalopathy.

We measured levels of gamma-aminobutyric acid (GABA) in the CSF and in the autopsied brain of patients with dialysis encephalopathy. GABA concentrations were low in the CSF of three of five living patients. Mean GABA content was reduced by 30 to 50% in five brain regions (frontal, occipital, and cerebellar cortex, caudate nucleus, and medial dorsal thalamus) in five fatal cases. GABA content was normal in brain regions where GABA is characteristically reduced in Huntington's disease. Choline acetyltransferase activity was diminished (by 25 to 35%) in cerebral cortex of the dialysis encephalopathy patients.

Adult↗

Brain amino compounds in a Huntington's disease patient on isoniazid therapy.

We describe biochemical abnormalities in autopsied brain of a patient with early Huntington's disease (HD) who died of pentobarbital overdosage while under treatment with isoniazid (INH). The brain contained hydrazine, a terminal metabolite of INH, which inhibits gamma-aminobutyric acid (GABA) aminotransferase. GABA content in the basal ganglia was higher than expected for HD, and GABA content was supranormal in some brain regions. Homocarnosine (GABA-histidine) content was greatly elevated in all brain regions, suggesting chronic GABA elevation in life. Therefore, the increase in brain GABA content observed in experimental animals given INH or hydrazine also occurs in human patients.

Adult↗

Elevation of gamma-aminobutyric acid in human brain may increase dopaminergic neuronal function.

Studies in experimental animals have yielded conflicting findings as to the influence of gamma-aminobutyric acid (GABA) on the activity of nigrostriatal and mesolimbic dopaminergic neurons. We measured cerebrospinal fluid (CSF) concentrations of GABA and homovanillic acid (HVA) in 19 patients before and during treatment with isoniazid. CSF GABA concentrations increased markedly during isoniazid administration, presumably reflecting increases in brain GABA content. At the same time, HVA concentrations in CSF rose significantly. The net effect of elevating brain GABA content in humans appears to be to increase dopamine release from dopaminergic neurons.

Brain↗

Benzodiazepine receptor binding in cerebellar cortex: observations in olivopontocerebellar atrophy.

Benzodiazepine receptor binding was measured in cerebellar cortex of 15 patients with dominantly inherited olivopontocerebellar atrophy (OPCA). The majority of these patients had a moderate to marked Purkinje cell loss, as judged by the lowered levels of dentate nucleus gamma-aminobutyric acid (GABA), a marker of Purkinje cells. Despite the reduction in Purkinje cell number cerebellar cortical benzodiazepine receptor density was either normal or slightly elevated in the OPCA patients. These results are in contrast to the findings in a mutant strain of mice deficient in Purkinje cells in which the concentration of benzodiazepine receptors in cerebellum is greatly reduced. Our data indicate that in the human, cerebellar cortical benzodiazepine receptors are either not significantly associated with Purkinje cells or that in OPCA Purkinje cell loss triggers a de novo synthesis of extra benzodiazepine binding sites. It is concluded that, in contrast with the rodent, in the human benzodiazepine receptor binding may not serve as a marker for cerebellar Purkinje cells.

Atrophy↗

Nigrostriatal dopaminergic neurons remain undamaged in rats given high doses of L-DOPA and carbidopa chronically.

Rats were fed maximally tolerated doses of L-3,4-Dihydroxyphenylalanine (L-DOPA) and carbidopa daily for 120 days in order to achieve a sustained elevation in brain dopamine levels. Some animals were also given buthionine sulfoximine, a gamma-glutamylcysteine synthetase inhibitor, in an unsuccessful effort to reduce brain glutathione contents. L-DOPA- and carbidopa-treated animals displayed no behavioral changes suggestive of nigrostriatal dopaminergic neuronal loss. When sacrificed 60 days after L-DOPA treatment ended, all rats had normal tyrosine hydroxylase activities and dopamine contents in their striata, and cell counts were normal in the substantia nigra. It therefore seems unlikely that a model of Parkinson's disease, suitable for exploring the etiological importance of glutathione deficiency, can be produced in rats merely by administering the largest tolerable doses of L-DOPA.

Animals↗

Tyrosinemia and intractable seizures.

A child with intractable seizures from the age of 10 months and developmental retardation developed jaundice and hepatosplenomegaly at 23 months. She died at the age of 25 months. Methionine and tyrosine were elevated in urine, plasma, CSF, and brain. These elevations were more marked in the CNS than in the blood. 4-Hydroxyphenylpyruvate dioxygenase, an enzyme involved in the metabolism of tyrosine, was undetectable in skin fibroblasts and liver. This finding together with other biochemical data suggest that our case had an inherited disorder of tyrosine metabolism, in the category of tyrosinemia I. Disturbances of tyrosine and methionine metabolism in the CNS in tyrosinemia I may be more important than has been realized. The disorder should be considered in children with unexplained epilepsy and in those who develop hepatic dysfunction while on anticonvulsants.

4-Hydroxyphenylpyruvate Dioxygenase↗

Neurochemical abnormalities in a patient with ataxia-telangiectasia.

We describe biochemical abnormalities found in autopsied brain of a patient with ataxia-telangiectasia. Neuropathologic changes were limited to the cerebellum and spinal cord. The atrophic cerebellum showed marked loss of Purkinje's and granule cells, and moderate loss of stellate and basket cells. Glutamic acid content was markedly reduced, and taurine content somewhat reduced in the cerebellar cortex, while gamma-aminobutyric acid (GABA) content was greatly reduced in the dentate nucleus. GABA receptor binding was reduced by 70% in cerebellar cortex. Phosphoethanolamine content was greatly reduced in the cerebellar cortex and inferior olivary nucleus. This compound was also deficient in 10 other brain regions and was the only extracerebellar neurochemical abnormality observed.

Ataxia Telangiectasia↗

Increased GABA receptor binding in dominantly-inherited cerebellar ataxias.

We measured gamma-aminobutyric acid (GABA) receptor binding in the cerebellar cortex of 14 patients with dominantly-inherited cerebellar ataxias. Most of these patients had moderate to marked Purkinje cell loss as judged from the subnormal dentate nucleus GABA levels. Mean GABA receptor binding (at 25 nM GABA concentration) was elevated significantly by 37% in the total group of 14 patients studied and by 60% in the largest subgroup (n=6) analyzed. Possible explanations for the enhanced binding include glial proliferation, exposure of normally unexposed receptor sites consequent to neuronal degeneration, and/or denervation supersensitivity.

Cerebellar Ataxia↗

Neuronal [3H]benzodiazepine binding and levels of GABA, glutamate, and taurine are normal in Huntington's disease cerebellum.

Alterations in one subunit of the proposed GABA receptor complex, namely, the GABA receptor, have been observed in Huntington's disease cerebellum. We measured binding to a second subunit, the benzodiazepine binding site, in the autopsied cerebellum of 12 patients dying with adult-onset Huntington's disease. Neuronal benzodiazepine ([3H]flunitrazepam) binding density (Bmax) and affinity in cerebellar cortex of the Huntington's disease patients were not significantly different from control values. Similarly, maximal GABA stimulation of benzodiazepine binding was normal in the Huntington's disease cerebellum. In addition, no significant changes were observed in the concentrations of GABA, glutamate, and taurine in cerebellar cortex, nor of GABA in the dentate nucleus.

Amino Acids↗

Striatal GABAergic neuronal activity is not reduced in Parkinson's disease.

The content of gamma-aminobutyric acid (GABA) and the activities of glutamic acid decarboxylase (GAD) and tyrosine hydroxylase (TH) were measured in whole putamen obtained at autopsy from 13 patients dying with idiopathic Parkinson's disease and 13 appropriate control subjects. Mean GABA content was significantly elevated (by 28%) in the putamen of the Parkinson's disease patients. TH activity was markedly reduced, while there was no significant reduction of GAD activity in the putamen of these patients. GABA content was also measured in both sides of the striatum in rats which had received unilateral injections of 6-hydroxydopamine (6-OHDA) in the vicinity of the axons of the nigrostriatal projection. Mean GABA content was found significantly elevated (by 33%) in the ipsilateral striatum. Loss of dopaminergic nigrostriatal neurons, in both human Parkinson's disease and in the rat 6-OHDA model, is accompanied by increased striatal GABA content. The assumption that GABAergic neurotransmission is reduced in the striatum in Parkinson's disease may not be correct.

Amino Acids↗

Hyperasparaginemia in a schizophrenic patient.

A man with a chronic schizophrenia-like psychotic disorder had fasting plasma asparagine concentrations that were consistently 4 to 8 SD above the normal level. Asparagine levels were also high in his cerebrospinal fluid (CSF) and erythrocytes. Ornithine, proline, and glutamate concentrations were irregularly high in fasting plasma, and gamma-aminobutyric acid (GABA) concentrations were elevated in CSF. Whether or not these biochemical abnormalities were related to the psychotic disorder is unclear. However, increased asparagine concentrations, possibly due to an enzymatic deficiency of asparaginase, could lead to deregulation of polyamine biosynthesis and to excessive production of GABA from putrescine. These biochemical changes could in turn cause disordered brain function. A search in mentally ill patients for metabolic abnormalities involving asparagine, or other amino acids, might hasten elucidation of the biochemical basis of the schizophrenias.

Adult↗