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292 33.P2 Readiness Potential in Parkinson’s Disease: Effects of L-Dopa Therapy and Brain Transplants D.N. Vel8zquez Martnez, F. Ostrosky-Solis, Y. Rodr guez, C. Garca de la Cadena, R. Chayo, M.A. Guevara, M. LOpez Cabrera and I. Madrazo Depto. Psicofisiolog fa, Facultad de Psicolog fa; Depto. Farmacolog fa, Facultad de Medicine, Universidad Nacional AutOnoma de Mcico y Centro Medico Siglo XXI, Mexico A fundamental question in the study of trans- plants to the central nervous system is the identification of the brain mechanisms that are related to the clinical improvement observed after intracerebral grafts of catecholamine producing tissue to the nigro-striatal system in some of the patients affected by Parkinson’s disease (PD). The use of reliable event-related potentials may provide complementary clinical and basic information related to the graft therapeutic effects. The Vertex Readiness Potential (RP) or Bereitschaftspotential pre- ceding self-paced voluntary movements and the Motor Potential (MP) have been reported to be modulated by noradrenergic and dopaminergic mechanisms in the brain; they were used to study pre- and postoperative changes after autoadrenal surgery. The RP and MP preceding self-paced volun- tary movements were recorded in 10 normal subjects, 15 PD patients who were candidates for surgery and 5 PD patients who had submitted to autoadrenal transplant. Brain electrical activity was recorded using Ag/AgC1 electrodes placed at F3, F4, Fz, C3, C4, Cz and Pz, all referenced to linked mastoids. Eye movements were moni- tored by electrooculogram placing electrodes above and below the left lid. Brain electrical activity was amplified (bandpass 0.3-70 Hz) and digitalised by a computer. Subjects were in- structed to press a telegraphic key with the index finger approximately every 4 sec. Electro- myographic activity (EMG) was derived from surface electrodes placed over the forearm muscle group that contracted when the key was pressed. A reverse computation program trig- gered from the EMG registered 1500 ms before to 500 msec after the movement onset. Individ- ual trials with excessive muscular activity or eye blinks were excluded. After an average of 80 trials, the RP and MP were identified by the criteria of Shibasaki, Shima and Kuroiwa (J Neurol 1978; 219: 15-25). Evoked potentials were recorded in normals 45 minutes after the administration of placebo or the dopaminergic agonist L-DOPA (250 mg) with 25 mg carbidopa (Sinemet 275). The PD patients were studied with L-DOPA and after 36 hours without L- DOPA both preoperatively and postoperatively (3 months after surgery). For each neuroelectric recording repeated measures ANOVAs were performed in which changes in group (Normal vs. PD), and treatment (Placebo vs. L-DOPA) were analyzed. Without medication, differences between normal subjects and PD patients were observed in the amplitude of the RP and MP; the PD patients had lower amplitude than the normals at Cz, C3 and C4. Before surgery L-DOPA pro- duced a significant (p<0.01) increase in the amplitude of the RP and MP of PD patients, but only marginal changes in normal subjects. In five patients who were registered three months after surgery we observed, without medication, a sig- nificant increase in the amplitude of the RP and MP at Cz and C3 and minor changes in the same direction at C4 and Fz. The changes in these electrophysiological measures seem to be re- lated to dopaminergic activity and could be helpful in evaluating some of the biochemical and electrophysiological changes after brain grafting. (C) FREUND PUBLISHING HOUSE LTD., LONDON. JOURNAL OF NEURAL TRANSPLANTATION & PLASTICITY, Vol. 3, No. 4, 1992

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Page 1: Effects of L-Dopa Therapy and Transplantsdownloads.hindawi.com/journals/np/1992/451309.pdf292 33.P2 ReadinessPotentialinParkinson’sDisease: Effects of L-DopaTherapyandBrainTransplants

292

33.P2

Readiness Potential in Parkinson’s Disease: Effects ofL-Dopa Therapy and Brain Transplants

D.N. Vel8zquez Martnez, F. Ostrosky-Solis, Y. Rodrguez, C. Garcade la Cadena, R. Chayo, M.A. Guevara, M. LOpez Cabrera and I. Madrazo

Depto. Psicofisiolog fa, Facultad de Psicolog fa; Depto. Farmacolog fa, Facultad de Medicine,Universidad NacionalAutOnoma de Mcicoy Centro Medico Siglo XXI, Mexico

A fundamental question in the study of trans-plants to the central nervous system is theidentification of the brain mechanisms that arerelated to the clinical improvement observedafter intracerebral grafts of catecholamineproducing tissue to the nigro-striatal system insome of the patients affected by Parkinson’sdisease (PD). The use of reliable event-relatedpotentials may provide complementary clinicaland basic information related to the grafttherapeutic effects. The Vertex ReadinessPotential (RP) or Bereitschaftspotential pre-ceding self-paced voluntary movements and theMotor Potential (MP) have been reported to bemodulated by noradrenergic and dopaminergicmechanisms in the brain; they were used tostudy pre- and postoperative changes afterautoadrenal surgery.

The RP and MP preceding self-paced volun-tary movements were recorded in 10 normalsubjects, 15 PD patients who were candidates forsurgery and 5 PD patients who had submitted toautoadrenal transplant. Brain electrical activitywas recorded using Ag/AgC1 electrodes placedat F3, F4, Fz, C3, C4, Cz and Pz, all referencedto linked mastoids. Eye movements were moni-tored by electrooculogram placing electrodesabove and below the left lid. Brain electricalactivity was amplified (bandpass 0.3-70 Hz) anddigitalised by a computer. Subjects were in-structed to press a telegraphic key with the indexfinger approximately every 4 sec. Electro-myographic activity (EMG) was derived fromsurface electrodes placed over the forearmmuscle group that contracted when the key waspressed. A reverse computation program trig-gered from the EMG registered 1500 ms beforeto 500 msec after the movement onset. Individ-ual trials with excessive muscular activity or eye

blinks were excluded. After an average of 80trials, the RP and MP were identified by thecriteria of Shibasaki, Shima and Kuroiwa (JNeurol 1978; 219: 15-25). Evoked potentialswere recorded in normals 45 minutes after theadministration of placebo or the dopaminergicagonist L-DOPA (250 mg) with 25 mg carbidopa(Sinemet 275). The PD patients were studiedwith L-DOPA and after 36 hours without L-DOPA both preoperatively and postoperatively(3 months after surgery). For each neuroelectricrecording repeated measures ANOVAs wereperformed in which changes in group (Normalvs. PD), and treatment (Placebo vs. L-DOPA)were analyzed.

Without medication, differences betweennormal subjects and PD patients were observedin the amplitude of the RP and MP; the PDpatients had lower amplitude than the normalsat Cz, C3 and C4. Before surgery L-DOPA pro-duced a significant (p<0.01) increase in theamplitude of the RP and MP of PD patients, butonly marginal changes in normal subjects. In fivepatients who were registered three months aftersurgery we observed, without medication, a sig-nificant increase in the amplitude of the RP andMP at Cz and C3 and minor changes in the samedirection at C4 and Fz. The changes in theseelectrophysiological measures seem to be re-lated to dopaminergic activity and could behelpful in evaluating some of the biochemicaland electrophysiological changes after braingrafting.

(C) FREUND PUBLISHING HOUSE LTD., LONDON. JOURNAL OFNEURALTRANSPLANTATION & PLASTICITY,Vol. 3, No. 4, 1992

Page 2: Effects of L-Dopa Therapy and Transplantsdownloads.hindawi.com/journals/np/1992/451309.pdf292 33.P2 ReadinessPotentialinParkinson’sDisease: Effects of L-DopaTherapyandBrainTransplants

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