Abstract

The dopamine hypothesis proposes that there is a hypodopaminergic state in the prefrontal cortex and a hyperdopaminergic state in the striatum of patients with schizophrenia. Evidence suggests the hyperdopaminergic state in the striatum is due to synaptic dopamine elevation, particularly in the dorsal striatum. However, the molecular mechanisms causing disrupted dopaminergic function in schizophrenia remains unclear. We postulated that the dopamine transporter (DAT), which regulates intra-synaptic dopamine concentrations by transporting dopamine from the synaptic cleft into the pre-synaptic neuron, could be involved in dopaminergic dysfunction in schizophrenia. Therefore, we measured levels of DAT in the cortex and striatum from patients with schizophrenia and controls using postmortem human brain tissue. Levels of desmethylimipramine-insensitive mazindol-sensitive [3H]mazindol binding to DAT were measured using in situ radioligand binding and autoradiography in gray matter from Brodmann’s area (BA) 10, BA 17, the dorsal striatum, and nucleus accumbens from 15 patients with schizophrenia and 15 controls. Levels of desmethylimipramine-insensitive mazindol-sensitive [3H]mazindol binding were significantly higher in BA 10 from patients with schizophrenia (p = 0.004) and significantly lower in the dorsal striatum (dorsal putamen p = 0.005; dorsal caudate p = 0.007) from those with the disorder. There were no differences in levels of desmethylimipramine-insensitive [3H]mazindol binding in BA 17 or nucleus accumbens. These data raise the possibility that high levels of DAT in BA 10 could be contributing to lower synaptic cortical dopamine, whereas lower levels of DAT could be contributing to a hyperdopaminergic state in the dorsal striatum.

Highlights

  • Schizophrenia has a wide range of symptoms that includes hallucinations, delusions, disorganized thinking, anhedonia, and apathy.[1]

  • The molecular basis of schizophrenia has yet to be fully elucidated but one long-standing proposal is the dopamine hypothesis, which posits there is a hyperdopaminergic state in the mesolimbic system that is critical in generating the positive symptoms of schizophrenia.[2]

  • There were no significant differences in desmethylimipramineinsensitive mazindol-sensitive [3H]mazindol binding to the frontal between the binding of desmethylimipramine-insensitive mazin- cortex of rats treated with varying doses of haloperidol for dol-sensitive [3H]mazindol in Brodmann’s area (BA) 10 with that in BA 17, dorsal 3 months (Supplementary Fig. 1a) or in the cortex or striatum from npj Schizophrenia (2019) 20

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Summary

Introduction

Schizophrenia has a wide range of symptoms that includes hallucinations, delusions, disorganized thinking, anhedonia, and apathy.[1]. Studies using single photon emission computerized tomography, which took the reduction [123I](S)-(-)-3-iodo-2-hydroxy-6-methoxy-N-[(1ethyl-2-pyrrolidinyl) methyl]benzamide ([123I]IBZM) binding to the dopamine D2 receptor as an indirect measure of dopamine release following the administration of amphetamine, reported increased levels of dopamine release in patients with schizophrenia.[3,4] This hypothesis has been supported by a metaanalysis[5] and the increase in dopamine release in schizophrenia is of a relatively high effect size.[6] Another study used positron emission tomography (PET) and 3,4-dihydroxy-6-[(18)F]fluoro-Lphenylalanine ((18)F-DOPA) to measure dopamine synthesis capacity to show that there is an elevated dopamine synthesis capacity in the striatum, and in particular the associative but not the limbic striatum, in those at ultra-high risk for psychosis.[7] These data suggested the associate striatum as a key region for dopaminergic dysregulation very early in the onset of the disorder. In a follow-up study it was shown that individuals that developed a psychotic disorder had the greatest dopamine synthesis capacity in the associative striatum and that there was a positive correlation between dopamine synthesis capacity and symptom severity in those that developed a psychotic disorder.[8]

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