 |
Previous Article | Next Article 
The Journal of Neuroscience, July 15, 2001, 21(14):5147-5157
The Role of Dopamine Receptors in Regulating the Size of
Axonal Arbors
C. L.
Parish1,
D. I.
Finkelstein1,
J.
Drago1, 2,
E.
Borrelli3, and
M. K.
Horne1, 2
1 Neurosciences Group, Department of Medicine and
2 Department of Neurology, Monash Medical Center, Clayton
3168, Australia, and 3 Institut de Génétique et
de Biologie Moléculaire et Cellulaire, 67404 Illkirch Cedex,
France
 |
ABSTRACT |
Factors that regulate terminal arbor size of substantia nigra pars
compacta (SNpc) neurons during development and after injury are not
well understood. This study examined the role of dopamine receptors in
regulating arbor size. Terminal arbors were examined in mice with
targeted deletion of the D1 or D2 dopamine receptor [D1( / ) and
D2( / ) mice, respectively]. Terminal trees were also examined after
treatment with receptor blockers and after partial SNpc lesions.
Immunohistochemistry was performed, and the number of SNpc neurons and
dopaminergic terminals in the striatum was estimated. The number of
dopaminergic SNpc neurons were reduced in D1( / ) and D2( / ) mice.
Density of dopaminergic terminals was unchanged in D1( / ) mice and
increased in D2 ( / ) mice. Steady-state striatal DA and DOPAC levels
revealed that dopamine activity was enhanced in D2( / ) mice but
reduced in D1( / ) mice.
Two months after partial SNpc lesions, striatal terminal density was
normal in both wild-type and D1( / ) mice but reduced in D2( / )
mice. Administration of DA receptor antagonists resulted in larger
terminal arbors in D1( / ) and wild-type mice, whereas D2( / ) mice
showed no change in terminal density.
Functional blockade of the D2R during development or in the adult brain
results in increased axonal sprouting. Partial SNpc lesions resulted in
compensatory sprouting, only in mice with functional D2R. These results
suggest that individual dopaminergic axons in D2( / ) mice have
reached maximal arbor size. We conclude that the D2 receptor may play a
role in modulating the extent of the terminal arbor of SNpc neurons.
Key words:
regeneration; dopamine receptors; sprouting; axonal
arbor; dopamine antagonists; D1 receptor knock-out; D2 receptor
knock-out; 6-OHDA lesions
 |
INTRODUCTION |
There is now substantial evidence
that neurons in the adult CNS can form new synapses,
neurites, and branches (Raisman and Field, 1973 ; Fagan and Gage, 1994 ;
Frotscher et al., 1997 ). After injury in the striatum or substantia
nigra pars compacta (SNpc), a number of compensatory changes occur that
suggest regenerative processes are present. These changes include the
formation of new synaptic terminals, growth-cone structures (indicating
axonal sprouting), neurite formation, increased number of tyrosine
hydroxylase-immunoreactive (TH-IR) hypertrophic fibers penetrating the
striatum, the upregulated expression of factors that support neurite
outgrowth and cell survival, and increased dopamine levels (Zigmond et
al., 1984 ; Onn et al., 1986 ; Hornykiewicz, 1993 ; Thomas et al., 1994 ;
Blanchard et al., 1995 , 1996 ; Cheng et al., 1998 ; Ho and Blum, 1998 ;
Batchelor et al., 1999 ; Liberatore et al., 1999 ; Finkelstein et al.,
2000 ).
Recently, we reconstructed single axons derived from SNpc neurons that
survived small injections of the neurotoxin 6-hydroxydopamine (6-OHDA)
(Finkelstein et al., 2000 ). The surviving neurons appeared to
compensate for the partial denervation of the striatum by the acquisition of collateral branches and increased terminal numbers. When
observed with electron microscopy, the surviving terminals were ~30%
greater in size with a morphology that suggested enhanced efficiency
(Finkelstein et al., 2000 ). Although the remaining axons formed very
large terminal arbors, up to 10 times normal size in some neurons, it
appeared that the sprouting was regulated, because sprouting was
proportional to the size of the lesion. For example, the density of
dopamine (DA) terminals in the striatum remained at near normal levels
until neuronal loss in the SNpc reached ~80% (Finkelstein et al.,
2000 ). This suggested to us that the extent of sprouting might be
regulated to maintain normal steady-state DA levels in the striatum. If
this was so, it seems likely that DA receptors, either presynaptic on
nigrostriatal terminals or postsynaptic on striatal neurons, might
participate in mediating the extent of the sprouting response. The
predominant receptor types expressed in the dorsal tier of the striatum
(the target region for the SNpc) are the D1 dopamine receptor (D1R) and
D2 dopamine receptor (D2R) (Bjorklund and Lindvall, 1984 ; Gerfen et
al., 1987 ; Weiner et al., 1991 ; Missale et al., 1998 ), whereas only D2
receptor transcripts are identified in nigrostriatal neurons (Drago et
al., 1998 ). The availability of knock-out mice, with target deletion of
D1R (D1 ( / ) (Drago et al., 1994 ) and D2R (D2 ( / ) (Baik et al.,
1995 ), provides an opportunity for investigating the role of these two
receptors in modulating the extent of sprouting in development and
after partial loss of neurons in the SNpc of the adult brain. The
extent of sprouting in surviving neurons after a partial lesion of the
SNpc in these animals was compared with that observed in wild-type (Wt)
mice. In addition the DA receptor antagonists, haloperidol and
N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ) were
administered to normal and knock-out animals to further assess the role
of D1R and D2R in regulating terminal arbor size of dopaminergic
projection neurons. Furthermore, knowledge of the contribution of D1R
and D2R in the modulation of compensatory responses may aid in the
understanding and treatment of neurodegenerative disorders.
 |
MATERIALS AND METHODS |
D1 dopamine receptor-deficient mice were generated and genotyped
as previously described (Drago et al., 1994 ). D1(+/+),
heterozygous D1(+/ ), and homozygous mutant D1( / )
littermates were derived by interbreeding heterozygous mice. The
heterozygous mice, originally in a hybrid C57/BL6 and 129/Sv
genetic background had been backcrossed for four generations into a
C57/BL6 background. D2 heterozygous mice were obtained from the
original colony at Institut de Génétique et de Biologie
Moléculaire et Cellulaire (Strasbourg, France). D2(+/+), D2
(+/ ), and D2( / ) littermates were derived by interbreeding D2
heterozygous mice. Again, D2 heterozygous breeders had been backcrossed
for four generations on a C57/BL6 background. All mice were kept in a
temperature-controlled room (22°C) under a 12 hr light/dark cycle.
All mice had ad libitum access to food and water and from
the time of weaning, D1( / ) mice were also provided with vitamized
rat chow supplemented with peanut butter. Southern analysis was used to
identify the genotypes of all mice (Drago et al., 1994 ; Baik et al.,
1995 ).
All methods conformed to the Australian National Health and Medical
Research Council published code of practice for the use of animal
research and were approved by the Monash University Animal Ethics Committee.
Immunohistochemistry for tyrosine hydroxylase and
dopamine transporter
Animals were killed by an overdose of sodium pentobarbitone
(Lethobarb; 0.35 mg/gm) and perfused with 30 ml of warmed
(37°C) 0.1M PBS, pH 7.4, with heparin (1 U/ml), followed
by 30 ml of chilled 4% paraformaldehyde (Sigma, St. Louis, MO) and
0.2% picric acid in 0.1 M phosphate buffer (4°C), pH
7.4. The brains were then removed and left at 4°C overnight in 30%
sucrose in PBS.
A 1:15 series was cut on the coronal plane through the striatum with a
section thickness of 16 µm. Sections were mounted directly onto
slides coated with 0.1% chrome alum and 1% gelatin in water and then
stored at 70°C until required. Coronal sections (50 µm thick)
were cut through the SNpc with one series being mounted onto chrome
alum gelatinized slides for counterstaining, and alternate sections
were placed free-floating in cryoprotectant for TH immunohistochemistry.
Dopamine transporter immunohistochemistry. Dopamine
transporter (DAT) immunohistochemistry was used to label dopaminergic terminals in the caudate putamen (CPu) so that stereological counts could be made of terminal density. The sections were fixed to the
gelatinized slides with 10% neutral buffered formalin (30 sec), rinsed
in PBS (3 × 10 min), then incubated in blocking solution (PBS,
0.3% Triton X-100, and 5.0% normal rabbit serum) for 15 min followed
by a wash in PBS (1 × 10 min). The primary antibody rat anti-DAT
(Chemicon, Temecula, CA; 1:3000 in PBS, 0.3% Triton X-100, and 1.0%
normal rabbit serum) was then added to the slides and left overnight at
4°C. The next day the slides were washed in PBS (3 × 10 min),
and a biotinylated secondary antibody (rabbit, anti-rat IgG, 1:300;
Vector Laboratories, Burlingame, CA) was applied for 2 hr at 4°C
followed by washes in PBS and incubation in avidin peroxidase for 2 hr.
These sections were then washed three times in PBS (to remove unbound
avidin peroxidase), incubated for 15 min in intensified cobalt-nickel
diaminobenzidine (DAB) (Sigma), and finally hydrogen peroxide (0.01%)
was added to this solution for a further 5 min (Adams, 1981 ;
Finkelstein et al., 2000 ). The sections were then dehydrated through
graded alcohol and cleared before being coverslipped using a
polystyrene mounting medium.
Tyrosine hydroxylase immunohistochemistry. Tyrosine
hydroxylase immunohistochemistry on free-floating sections was used to identify dopaminergic neurons within the SNpc. The 50-µm-thick sections were washed with PBS (3 × 10 min). Blocking solution was
then added (PBS, 0.3% Triton X-100, and 10.0% normal goat serum) for
15 min, and the sections were then washed in PBS (10 min). The primary
antibody (mouse anti-tyrosine hydroxylase; Boehringer Mannheim, Castle
Hill, Australia; 1:1000 in PBS, 0.3% Triton X-100 and 1% normal goat
serum) was added to the wells and left overnight at 4°C. The next day
the sections were rinsed in PBS (3 × 5 min) then incubated in
biotinylated secondary antibody (biotinylated goat anti-mouse, 1:300;
Sigma) for 2 hr. Sections were washed in PBS and incubated in avidin
peroxidase (1:5000) for 2 hr. Sections were then reacted with cobalt
and nickel-intensified DAB. Sections were mounted onto slides using 1%
gelatin, counterstained with 1% neutral red, dehydrated, and coverslipped.
Fractionator design for estimating total numbers of SNpc neurons
and DAT-immunoreactive varicosities in CPu
The number of neurons in the SNpc and density of DAT-IR
varicosities in the CPu were estimated using a fractionator
sampling design (Gundersen et al., 1988 ; West et al., 1991 ; Finkelstein et al., 2000 ). Staining with Neutral Red delineated the area of the
SNpc in each section. In each of the sections sampled, SNpc neurons
were counted, using the nuclei of stained SNpc cells as the counting
unit according to optical dissector rules (Gundersen et al., 1988 ). For
TH immunohistochemistry, labeled profiles were only counted if the
first recognizable profile of the cell came into focus within the
counting frame (West et al., 1991 ). Neutral Red or tyrosine hydroxylase
counts of SNpc neurons were made on alternate coronal sections. Counts
were made at regular predetermined intervals (x = 140 µm, y = 140 µm). These counts were derived by means
of a grid program, Stereoinvestigator (MicroBrightField, Colchester, VT), through which a systematic sample of the area occupied
by the SNpc was made from a random starting point. An unbiased counting
frame of known area (45 × 35 µm = 1575 µm2) was superimposed on the image of
the tissue sections viewed under a 100×, numerical aperture
(NA) 1.30 oil immersion objective. The entire
z-dimension of each section was sampled, hence the section
thickness sampling fraction was 1. Counts were taken from 10 sections
at a 1:2 interval, extending from the most rostral to the most caudal
parts of the SNpc. After all sections from a SNpc were analyzed, the
fraction of the area of the sections sampled was calculated (West et
al., 1991 , 1996 ). The area sampling fraction is obtained by dividing
the area of the counting frame by the area of the distance between
sampling regions i.e., x and y intervals. As
detailed above, the x and y intervals in sections were both 140 µm, and the area of the counting frame was 1575 µm2. Therefore, the area sampling
fraction is 1575/(140 × 140) = 0.0804. The total number of
neurons in the SNpc was estimated by multiplying the number of neurons
counted within the sampled regions with the reciprocals of the fraction
of the sectional area sampled and the fraction of the section thickness
sampled (West et al., 1991 ; Coggeshall and Lekan, 1996 ; Finkelstein et al., 2000 ).
DAT-IR varicosities in the dorsal 400 µm of the CPu were counted from
16-µm-thick serial sections, at a 1 in 15 series, providing approximately eight sections from each striatum for counting. The
dorsal region of CPu was chosen for sampling because it predominantly receives the SNpc projection (Fallon and Moore, 1978 ; Bjorklund and
Lindvall, 1984 ; Gerfen et al., 1987 ), and our previous study demonstrated that sprouting was confined to this region of the striatum
(Finkelstein et al., 2000 ). The striatum was sectioned and examined
from its most rostral pole through to the level of the hippocampus
heading toward the end of the triangular septal nuclei. Counts of
DAT-IR varicosities were made at regular predetermined intervals
(x = 170 µm, y = 170 µm). An
unbiased counting frame of known area (5 × 4 µm = 20 µm2) was superimposed on the image of
the tissue sections viewed under a 100×, NA 1.30 oil immersion
objective. DAT-positive terminals were identified as predominantly
round swellings in association with axonal processes. Total terminal
numbers (DAT number) were estimated as described for counts of SNpc
neurons (above). The coefficients of error (CE) and coefficients of
variance (CV) were calculated as estimates of precision, and values of
<0.1 were accepted (Braendgaard et al., 1990 ; West and Gundersen,
1990 ; West et al., 1991 ). Density of DAT-IR varicosities and the number of varicosities per neuron were calculated.
Determination of striatal dopamine levels
Dopamine levels in the dorsal striatum of D1 and D2 adult mutant
mice were determined using HPLC. Mice were killed by cervical dislocation, and their brains were rapidly removed and frozen. The CPu
was dissected out and weighed. The dissected striatal tissue was placed
in 200 µl of 4 M perchloric acid
(HClO4) containing 0.15% sodium metabisulphate
(Na2S2O5)
and 0.05% disodium EDTA as well as the internal standard,
0.01% dihydroxybenzylamine (DHBA).
The sample tissue was then homogenized, and cellular and vesicular
membranes were disrupted using a sonicator. The samples were stored at
70°C and centrifuged on the day of analysis. The samples were
analyzed by ion exchange HPLC. The HPLC was coupled to an LC-4A
amphometric detector and the height of the peaks was recorded using a
chart recorder with peak heights determined manually (Herges and
Taylor, 1999 ).
The mobile phase consisted of 8% v/v methanol in purified deionized
water containing 14.2 gm of trichloroacetic acid, 0.25 gm of EDTA, and
3.2 gm of sodium hydroxide. After adjusting the pH of the mobile phase
to pH 2.8 (using 5 M sodium hydroxide), the final solution
was filtered through a 0.45 µm Durapore membrane filter (Waters, a
division of Millipore, Bedford, MA) and degassed using a vacuum pump
(Herges and Taylor, 1999 ). For every chromatograph run, a standard
curve of dopamine (0.1-2.0 µg) with DHBA as the internal standard
was established, and precision, accuracy, and recovery were determined.
The dopamine standards were prepared fresh before each chromatograph
analysis. The internal standard (DHBA, 0.1 mg/ml) was added to each
dopamine standard solution. The dopamine content of the samples was
calculated from the ratios of the peak heights of dopamine to the
internal standard, DHBA. The dihydroxphenylacetic acid (DOPAC) content
of the sample was also calculated as the ratio of the peak height of
DOPAC and the internal standard. DA activity was expressed as the
concentration of DOPAC to DA, [DOPAC]/[DA].
Drug treatment groups
The reversible dopamine receptor antagonist haloperidol (2.5 mg/kg; Serenace, Searle Laboratories, Australia) was administered to
animals in drinking water continuously for 2 months. The irreversible receptor antagonist EEDQ (Sigma) was dissolved in 50% ethanol then
diluted with 0.9% saline to an ethanol concentration of 5%, and 6 mg/kg was injected intraperitoneally every third day for a period of 2 months.
Lesioning
A partial lesion of the SNpc was produced in the mice by
injecting the neurotoxin 6-OHDA into the right SNpc. Mice were
anesthetized with 4% chloral hydrate in PBS (10 ml/kg, i.p.), and
heads were secured in a stereotaxic head frame with the bite bar 3 mm
above horizontal. A 1.5 µg/µl solution of 6-OHDA was prepared with
ascorbic acid (0.2 mg/ml) and kept on ice until the time of injection. A 10 µl Hamilton syringe (with a 26 gauge needle) mounted in a syringe pump (Cole-Parmer, Vernon Hills, IL) was inserted into the
right SNpc through a small hole drilled through the top of the skull. A
single injection (2.5 µg) of 6-OHDA (Sigma) was made into the right
SNpc (anteroposterior, 3.0 mm; lateral, 1.05 mm; dorsoventral, 4.7 mm,
with respect to lambda) (Franklin and Paxinos, 1997 ). On completion of
the injection, the needle was left in place for 5 min then slowly
withdrawn at a rate of 1 mm/min. After surgery, the skin was sutured,
antiseptic (1% w/w iodine, Betadine; Faulding and Company, Salisbury,
South Australia) was applied to the wound, and the mice were
left in a warmed cage to recover. Paracetamol (100 mg/kg) was
administered in drinking water as an analgesic after surgery.
 |
RESULTS |
SNpc neurons and DAT-positive terminals in the striatum were
counted in Wt, D1( / ), D1(+/ ), D2(+/ ), and D2( / ) mice to calculate the size of the terminal arbors of SNpc neurons. Counts were
also obtained on the pharmacologically manipulated as well as lesioned
animals to assess their ability to regulate terminal arbor size. ANOVAs
with Tukey post hoc tests were used with statistical differences set at the level of p < 0.05.
Morphology of the nigrostriatal pathway in D1 and D2 receptor
knock-out mice
Stereology of the substantia nigra pars compacta
SNpc neurons were counted in Wt, D1( / ), D1(+/ ),
D2(+/ ) , and D2( / ) animals (Table
1). Staining with Neutral Red delineated the area of the SNpc in each section. The SNpc was recognized as the
sheet of densely packed neurons of ~16 µm in soma size. The ventral
margin of the SNpc was distinguished from the substantia nigra pars
reticulata neurons, the somata being larger (~20 µm) and
less densely packed than those in the SNpc. Lying rostromedially to
SNpc was the ventral tegmental area, which was distinguished from the SNpc by its smaller (13 µm) and less densely packed cells. Caudally, the medial border of the SNpc abutted the medial lemniscus, which contained loosely scattered neurons (Nelson et al., 1996 ).
No significant difference was seen in the number of SNpc neurons in the
two groups of Wt mice (D1+/+ and D2+/+) hence, the results from these
mice were pooled in subsequent analyses. In both D1 and D2 receptor
knock-out mice, the number of neurons in the SNpc was significantly
less (19 and 22%, respectively) than in the Wt controls (Table 1,
Figs. 1A,
2B.) The CE for SNpc counts for these animals ranged from 0.018 to 0.097 and a CV was between 0.02 and 0.89, indicating an accurate sampling protocol. In
these same animals, tyrosine hydroxylase-positive SNpc neurons were
counted in alternate sections to those in which Neutral Red SNpc cells
were counted. As expected, the majority (90%) of neurons in the SNpc
of Wt mice were TH-IR (Table 1). In both D1 and D2 receptor knock-out
mice however, the proportion of TH-IR neurons was significantly reduced
(64 and 77% of total SNpc neurons respectively) (Table 1, Figs. 1, 2).
Counts of Neutral Red and tyrosine hydroxylase-stained SNpc neurons in
heterozygous mice were intermediate between those of the Wt and
receptor knock-out mice (Fig. 1, Table 1).

View larger version (10K):
[in this window]
[in a new window]
|
Figure 1.
Histograms showing the number of neurons counted
in the SNpc (mean ± SD) of D1 dopamine receptor mutants
(A) and D2 dopamine receptor mutants
(B). Counts of SNpc neurons stained with Neutral
Red are shown in black, and TH-IR counts are shown in
gray. A, D1( / ) have significantly
fewer (19%) Neutral Red-stained cells and 43% fewer TH-IR cells than
Wt mice. Counts in heterozygous mice were intermediate between Wt and
D1( / ) and significantly different to both. B,
Similarly, counts of Neutral Red-stained cells and TH-IR cells
are reduced (23 and 36%, respectively) in D2( / ) compared with Wt
and with heterozygous counts intermediate between those seen in the
D2( / ) and Wt.
|
|

View larger version (110K):
[in this window]
[in a new window]
|
Figure 2.
A-C are photomicrographs showing
Neutral Red staining through the middle to rostral portion of SNpc in
Wt, D1( / ), and D2( / ) mice, respectively. D-F
are photomicrographs of TH-IR SNpc neurons. Note the significant
reduction in the counts of SNpc neurons in the receptor knock-out mice
compared with Wt. Scale bars, 250 µm.
|
|
Stereology of DAT-labeled varicosities
Striatal tissue was processed for DAT immunohistochemistry, and
counts of varicosities were estimated stereologically as described in
Materials and Methods (see Fig. 5). Density was determined as the
number of varicosities estimated within the chosen counting area.
DAT-IR varicosities and terminals were uniformly distributed within the
dorsal striatum. The density of varicosities in the CPu of D1( / )
mice was normal, whereas in D2( / ) mice it was significantly greater
than in Wt and D1( / ) animals (74% increase) (Fig.
3, Table 1).

View larger version (9K):
[in this window]
[in a new window]
|
Figure 3.
Histograms of estimates of DAT-IR terminal density
in the dorsal CPu of D1( / ) mice (A) and
D2( / ) mice (B). A, There is no
significant difference between terminal densities of Wt, D(+/ ), and
D1( / )mice. B, The density of terminals in the dorsal
CPu of D2( / ) is significantly greater than in Wt mice, with
heterozygous animals having intermediate densities.
|
|
We wished to derive a representation of the average size of the
terminal arbor of SNpc neurons for each genotype. The only way to
measure the actual size of the arbor is to anterogradely fill and
reconstruct individual axons, which is time-consuming and
labor-intensive. Because of these constraints only a small sample of
the neuronal population can be analyzed. Ideally, arbor size could be
obtained by dividing the total number of DAT-IR terminals in the dorsal
CPu (obtained by multiplying DAT-IR density by volume of dorsal CPu) by
the actual number of TH-IR neurons counted in the SNpc. However, the
precise volume of the dorsal tier innervated by SNpc neurons cannot be
delineated and furthermore, the volume of the CPu varies according to
the genotype. Previously we have devised a method for comparing arbor
size after different treatments by dividing terminal density by the
number of SNpc neurons (Finkelstein et al., 2000 ). However, this method
assumes that the volume of the CPu volume and hence the volume of the dorsal tier innervated by SNpc neurons is the same in all groups. Because the volume of the CPu in the D1( / ) mice is significantly less than D2( / ) and Wt mice (Table 1), this method is not suitable for this study. We therefore devised a new method for determining arbor
size, which takes into consideration varying striatal volumes. We can
estimate the total volume of the CPu (VCPu), and we have assumed that
the proportion of the CPu volume innervated by SNpc neurons is the
same in all genotypes. Dividing VCPu by the number of SNpc provides a
figure that is proportional to the average size of the terminal tree of
an individual SNpc neuron in a particular genotype and provides a means
for comparing the extent of branching across genotypes. Because this
number was obtained from the whole volume of the CPu (rather than the
dorsal tier), it is proportional to rather than a precise indication of
the size of the terminal arbor and may result in an overestimation of
the terminal tree size. First, we obtained a normalized representation
of the number of terminals (NTN) in the dorsal CPu (Fig.
4) using the formula:
where DT = density of terminals in the dorsal CPu, and
subscript refers to the relevant genotype. In Figure 4 this value was
plotted against the number of TH-IR SNpc neurons in each animal. However, the size of the average terminal tree can be determined by
dividing the terminal number by the number of SNpc. Hence, terminal
tree size (TT) is the number of DAT terminals (DT) multiplied by CPu
volume (VCPu) divided by the number of SNpc neurons (NSNpc), for any
given genotype neurons (Tables 1, 2).
For the purpose of comparison a normalized terminal tree (NTT) was
calculated using the terminal tree size of Wt as the standard:
Although the density of varicosities in the CPu of D1( / ) mice
was normal, the number of TH-IR SNpc neurons and volume of CPu was reduced (Fig. 1) so that the NTT of SNpc neurons in the D1( / ) animals was in fact, larger than in the Wt mice (Table 1).

View larger version (14K):
[in this window]
[in a new window]
|
Figure 4.
A plot of normalized number of DAT-IR terminals in
the dorsal striatum plotted against number of neurons in the SNpc. The
number of DAT terminals in the dorsal striatum of D1( / ) mice
(open circles) was approximately half of that observed
in Wts (filled circles and open
triangles). However, D1( / ) mice had reduced numbers of SNpc
neurons and consequently, larger terminal trees (Table 1). In the case
of D2( / ) mice (closed triangle), the normalized
terminal number in the dorsal striatum was three times normal despite a
significant reduction in the number of SNpc neurons.
|
|
The density of varicosities in the CPu of D2( / ) mice was
significantly greater than in Wt and D1( / ) animals (74% increase) (Figs. 3, 5, Table 1). Because of this
(and the reduced number of TH-IR SNpc neurons in D2( / ) mice), the
NTT of TH-IR SNpc neurons in the D2( / ) mice were ~300% larger
than in the Wt controls. The counts from D2(+/ ) mice were
intermediate between those of the Wt and D2( / ) mice.

View larger version (119K):
[in this window]
[in a new window]
|
Figure 5.
Photomicrographs of DAT-IR
varicosities in the dorsal CPu of Wt, D1( / ), and D2( / )
mice (A-C, respectively). Note the similarity in
density of DAT-IR in Wt and D1( / ) mice, whereas the increased
density of DAT-IR varicosities in the D2( / ) mice. D
shows a diagram of the counting frame seen in B. Here,
five varicosities were counted in total and include the
gray varicosities within the frame as well as the
black varicosities that lie on the inclusion lines. The
white varicosity was not counted because it lay on an
exclusion line. Scale bar, 25 µm.
|
|
Determination of striatal dopamine activity
Basal levels of dopamine and DOPAC in the dorsal striatum of
Wt, D1(+/ ), D1( / ), D2(+/ ), and D2( / ) mice were determined and expressed as amount of dopamine or DOPAC per gram of CPu tissue and
dopamine activity, expressed as the ratio of DOPAC per dopamine. Although dopamine levels in the striatum of D2( / ), D2(+/ ), and
D1(+/ ) (n = 6, 7, and 11, respectively) were not
significantly different from controls (n = 19) (Fig.
6A,B), dopamine levels in D1( / ) mice (n = 6) were significantly greater
(33%) than in Wt mice. However, both DOPAC levels and dopamine
activity were significantly reduced in the D1( / ) mice
(n = 6) compared with wild-types (n = 12), suggesting increased dopamine storage and decreased turnover in
the dopaminergic terminals of these animals (Fig.
6A-C).

View larger version (15K):
[in this window]
[in a new window]
|
Figure 6.
Dopamine and DOPAC concentrations (mean ± SD) in the CPu of D1( / ) mice and D2( / ) mice (A,
B, respectively). Dopamine concentration is
significantly greater in D1( / ) mice than in wild types, whereas
there was no difference between dopamine concentration in D2( / )
mice and Wts. DOPAC levels were decreased in D1( / ) mice, whereas
DOPAC levels were elevated in D2( / ) (B).
Dopamine activity was reduced in the D1( / ) and increased in the
D2( / ) mice (C). D shows a plot
of the level of dopamine activity per SNpc terminal in the striatum of
Wt, D1( / ), and D2( / ) mice (calculated by dividing DA activity
by terminal density). In the D1( / ) mice, dopamine activity per
terminal were reduced, whereas they were significantly increased in
D2( / ) mice.
|
|
Conversely, dopamine levels were normal in the D2 ( / ) mice, whereas
there was a statistically significant increase in DOPAC levels and
dopamine activity (n = 3). Together, this implies
normal dopamine storage but a high dopamine turnover (Fig. 6).
Dopamine activity per terminal was calculated by dividing each
measure by the density of DAT-IR terminals. Although D2( / ) mice had
normal striatal dopamine levels, dopamine activity per terminal was
markedly increased (Fig. 6D). In contrast, striatal dopamine levels in D1( / ) mice were elevated, yet dopamine
activity was sixfold less than Wt mice (Fig.
6D).
Effects of dopamine receptor antagonists on D1 and D2 receptor
knock-out mice
In haloperidol-treated Wt mice, DAT terminal density was 34%
greater than in untreated Wt mice and 37% greater in EEDQ-treated mice
than untreated Wt mice (Table 2). Terminal density also increased in
D1( / ) mice after treatment with haloperidol (46%) and EEDQ (55%)
(Table 2). In contrast, there was no significant change in terminal
density of D2( / ) mice after treatment with either antagonist (Fig.
7).
Effects of 6-OHDA lesioning of the SNpc in D1 and D2 receptor
knock-out mice
A small dose of the neurotoxin 6-OHDA was injected into the right
SNpc of Wt, D1( / ), and D2( / ) mice to produce a partial lesion.
Animals were allowed to recover over 2 months, and the number of SNpc
neurons as well as DAT-IR varicosities in the dorsal CPu were counted
and density was calculated. An index of the terminal tree (TT) size was
made (as above), and an NTT was calculated. In total, 17 Wt (+/+), 14 D1( / ), and 13 D2( / ) mice received partial lesions of their
right SNpc. Stereological estimates of SNpc neuron numbers confirmed
that a variety of lesion sizes were created, ranging from 2 to 83%. In
some animals, the number of neurons in the contralateral SNpc was
reduced, presumably because of diffusion of the toxin. In these cases,
the contralateral hemisphere was included as an example of a small
lesion size.
As shown previously in rats (Finkelstein et al., 2000 ), our estimates
of DAT-IR terminal density showed that Wt mice were able to maintain
terminal density within a normal range until >75% of SNpc neurons
were lost. D1 ( / ) mice also maintained normal terminal density in
the CPu until ~75% of SNpc neurons was destroyed
(Figs.
8A,
9B). In contrast, in D2( / )
mice, terminal density was reduced linearly in proportion to the lesion
size. After a 40% lesion, terminal density fell by ~50% of
nonlesioned values in D2( / ) mice and by ~100% after lesions of
75% (Figs. 8B, 9C). After lesions of
wild-type and D1( / ) mice, there was no change in distribution of
terminals or density of terminals. However, there was clear reduction
in density of terminals in the dorsal striatum after lesions of the
D2( / ), compared with ventral striatum. In all genotypes, terminals
were again predominantly found in the matrix region innervated by the
dorsal SNpc. In the lesioned animals, the SNpc cell loss was more
pronounced around the site of the injection. There was, however, no
visible unevenness of terminals within the dorsal striatum of Wt or D1
mice. After larger lesions in D2( / ), terminal density was unevenly
distributed with areas showing no terminals, whereas other regions
contained small clusters of varicosities.

View larger version (17K):
[in this window]
[in a new window]
|
Figure 7.
Histograms of density of DAT-IR terminals
(mean ± SD) in the dorsal CPu of Wt, D1( / ) and D2( / )
mice, treated with haloperidol and EEDQ. There was no significant
difference in density of terminals in untreated Wts and D1( / ) mice
however, treatment with either antagonist resulted in significantly
increased density of terminals in both types of mice. Density of
terminals in untreated D2( / ) mice was higher than in treated Wts
and D1( / ) mice yet, treatment with either haloperidol or EEDQ had
no significant effect on the terminal densities seen in the D2 ( / )
mice.
|
|

View larger version (10K):
[in this window]
[in a new window]
|
Figure 8.
Plots of density of DAT-IR terminals in the CPu
against the size of SNpc lesion.
A, Density of DAT-IR terminals in
Wt is maintained until ~75% SNpc neurons are lost, at which point
terminal density rapidly falls, presumably because remaining neurons
can no longer compensate through sprouting. Similarly in D1( / ) mice
(B), density of DAT-IR terminals remains normal
until the lesion size approaches 75%, at which point density falls. In
contrast, density of DAT-IR terminals in D2( / ) mice
(C) is abnormally high in the absence of a lesion
and falls linearly, in proportion to the neurons lost. In all three
figures, triangles represent values from unlesioned
animals, and circles are representative of the lesioned
animals.
|
|

View larger version (61K):
[in this window]
[in a new window]
|
Figure 9.
Photomicrograph showing examples of the density of
DAT-IR terminals in animals with ~70% lesions of the SNpc from Wt
(A), D1( / ) (B), and
D2( / ) (C) mice. Note the reduced
density of DAT-IR terminals in a 70% lesioned D2 animal.
|
|
 |
DISCUSSION |
This study demonstrates the role of the D1R and D2R in modulating
the size of the striatal terminal arbor of SNpc neurons and in
regulating steady-state striatal DA levels.
In both D1( / ) and D2( / ) mice the number of SNpc neurons was
reduced. Nevertheless, in both genotypes the size of the terminal tree
of SNpc neurons is greater than in Wt mice, the increase being more
pronounced in D2( / ). The increase in terminal arbor size in
D2( / ) mice and increased DA activity is consistent with the
hypothesis that the D2 autoreceptor acts to regulate the delivery of
DA. Our findings suggest that this regulation is not confined to DA
storage, synthesis, and turnover in the terminals but is also manifest
in the density of DA terminals.
Released dopamine is converted to DOPAC after reuptake into the nerve
terminal and into homovanillic acid at extraneuronal sites. DOPAC
however, is the major dopamine metabolite in rodent brains and, levels
in the striatum reflect the activity of dopaminergic neurones within
the nigrostriatal pathway (Cooper et al., 1996 ). Dopamine activity,
expressed as a ratio of DOPAC and dopamine is independent of tissue
weight, thereby yielding a reliable index. Using these measures,
dopamine activity in the D2( / ) mice was high, despite normal
dopamine levels. This suggests impaired regulation of dopamine storage
and release, as might be expected when D2 autoreceptor function is not
present (Cooper et al., 1996 ). In contrast, D1( / ) mice have high
levels of dopamine but low dopamine activity, suggesting that in these
animals dopamine levels reflect storage within terminals with reduced
transmitter release. This suggests augmented D2 function in D1 mutants.
A direct mechanism seems unlikely, because the D1 receptor is not
expressed presynaptically. However, a compensatory increase in D2
levels seen in the D1( / ) mice (data not shown) may underlie the
augmented D2 function. Either transynaptic signaling or some "long
loop" signaling through striatal projections onto SNpc cell bodies
may also contribute.
In a previous study in rats we reconstructed individual axons and
demonstrated that after lesions, axonal arbors were larger (Finkelstein
et al., 2000 ). This increase was related to the extent of the lesion.
In that study we developed the method for estimating neuronal arbor
size by estimating terminal density and dividing this by the number of
SNpc neurons. This was found to correlate well with reconstructed arbor
size, and a similar method has been used in this current study. In that
study, striatal volumes were the same in each animal, reducing the
assumptions and arithmetic corrections necessary in the present study.
Nevertheless, the concordance between the two studies is reassuring. In
rats we found that terminal density was maintained within the normal
range until the number of SNpc neurons were reduced by ~80%. We
confirmed this observation in Wt and D1( / ) mice. In both groups,
terminal density was normal until ~75% of SNpc neurons were
destroyed. The size of the terminal arbors must have progressively
increased in both Wt and D1( / ) mice, until lesions reached ~75%,
beyond this point remaining neurons could compensate no further, hence the decreased density. The findings were quite different in the D2( / ) mice. Terminal density was abnormally high in these animals and did not increase, even after EEDQ and haloperidol, which increased terminal density in Wt and D1( / ) mice. After lesions in D2( / ) mice, terminal density progressively fell in proportion to the size of
the lesion, suggesting that the size of the terminal arbor did not
increase to compensate for the effect of the lesion.
To explain these findings, we conclude that the D2R must play a role in
regulating terminal density. In Wt and D1( / ) mice, terminal density
is at normal levels, and blockade of D2R results in an increase in
terminal density and size of terminal arbor. The lack of effect of
haloperidol and EEDQ on D2( / ) mice suggests that when affecting
terminal tree size, these agents are acting through the D2R rather than
other DA receptors. The results also suggest that during development,
lack of D2R results in unchecked branching of DA terminals. Further
stimulus to sprout through lesioning cannot elicit a compensatory
response, presumably because maximal sprouting has already occurred in
these animals. The extensive sprouting of SNpc neurons in the striatum
of D2( / ) mice is not readily explained by the neurotrophic
hypothesis, because glial cell-derived neurotrophic factor levels are
reduced, and levels of brain derived neurotrophic factor and
neurotrophin-3 are unchanged in their striatum (Bozzi and Borrelli,
1999 ).
The dopamine D2 receptor exists in two forms; as an autoreceptor
present on the presynaptic cell and as a postsynaptic receptor (Creese,
1982 ; Kandel et al., 1991 ; Usiello et al., 2000 ). Because D2( / )
mice used in this study have both isoforms ablated, the identity of the
specific D2R involved in the regulation of terminal arbor size and
regenerative sprouting remains unknown. However, because the
presynaptic receptor is expressed at a higher level and has a role in
regulating the firing rate and propagation of action potentials as well
as DA synthesis and release (Cooper et al., 1996 ), we hypothesize that
this receptor is most likely to be the major player regulating
proliferation and sprouting in SNpc neurons. Recently it was reported
that D2 agonists may delay and reduce dyskinesia in Parkinson's
disease (Rascol et al., 2000 ). It is of interest to speculate whether
use of D2 agonists in Parkinson's disease may result in reduced
compensatory sprouting and hence reduced dyskinesia but at the cost of
increased severity of the disease because of reduction in regenerative
sprouting mechanism.
Although striatal dopamine levels in D1( / ) mice were elevated, as
previously described (El-Ghundi et al., 1998 ), dopamine activity was
markedly reduced. This suggests that the behavior of D1( / ) mice is
not explained by enhanced dopaminergic activity but by some other
mechanism. On the other hand, despite our finding of increased dopamine
activity in D2( / ) mice, their behavior is normal in most respects,
suggesting that postsynaptic compensation has occurred (Clifford et
al., 2000 ). It must be stressed however that DA measures in this study
are not synaptic DA but the levels of total DA (including extracellular
DA and vesicular DA) and DOPAC. Although these are useful markers of DA
storage and turnover, a more detailed examination of synaptic function
is required before drawing firm conclusions about the synaptic effects
of DA in these mutants. Nevertheless, it is widely held that the
presynaptic D2R regulates DA synthesis and release (Cooper et al.,
1996 ), and it seems likely that absence of its influence has resulted in increased DA activity and sprouting in the D2( / ) mutants. These
studies were conducted on genetically manipulated mice and, because
D2Rs are normally expressed early in development (Drago et al., 1998 ),
it is difficult to ignore potential developmental compensatory effects.
These effects may have been reflected in both the absolute number and
the proportion of TH-IR-positive nigral neurons as well as the density
of DAT-IR terminals in the striatum of the D1( / ) and D2( / ) mice.
The reason for the reduction in the number of SNpc neurons and TH-IR
SNpc neurons is not clear. Widespread changes are recognized in the
dopamine receptor knock-out mice (Drago et al., 1998 ). Transynaptic
effects, in addition to dysregulated supply of factors known to be
important for survival of neurons (Bozzi and Borrelli, 1999 ), may be
important. Furthermore, chronic DA receptor stimulation and blockade
may also have effects on both TH and L-aromatic amino acid
decarboxylase enzyme activity and mRNA levels (Cho et al., 1997 ). The
presynaptic location of the D2R and the direct input of the
D1R-positive terminals on the TH-positive elements (Caille et al.,
1996 ) provide further potential mechanisms for the modulation of the
growth of nigrostriatal cells and the effect of transcriptional regulation. On the basis of the studies on receptor knock-out mice
alone, it would be hard to assess whether the increased terminal tree
was in response to reduced cell numbers or disturbances in regulation
of axonal proliferation. However, the responses to receptor antagonists
(haloperidol and EEDQ) and 6-OHDA lesions are clearly a response of the
adult system that can be explained in the way that we have offered.
Furthermore, the wild-type mice demonstrated these responses,
indicating that they are generic responses to injury shared by both
genetically manipulated and normal animals.
One of the reasons for using genetically manipulated animals is the
absence of a pure DA receptor antagonist. Although haloperidol has a
greater effect on D2R, it also acts at all DA receptors as well as
other receptor systems, including the acetylcholine receptor, and some
of its effects could have been mediated by actions other than through
DA receptors. However, the actions of EEDQ are relatively DA
receptor-specific and were similar to those of haloperidol, suggesting
that this was unlikely.
There appears to be a maximum size of terminal tree, as seen in the D2
( / ) mice and in the Wt and D1( / ) after lesions of ~75%. This
suggests that an individual neuron can support a maximum number of
terminals, and it is interesting to speculate regarding what factors
might limit further expansion. These may include limitations caused by
metabolic demand, oxidative stress, and axonal transport.
In summary, these findings suggest that the D2 receptor may play a role
in modulating the extent of the terminal arbor of SNpc neurons. These
results require further elaboration with the use of selective D2
receptor agonists and antagonists and the use of D2 isotype-specific
mutants as well as investigations into the paths through which these
influences are exerted.
 |
FOOTNOTES |
Received Dec. 27, 2000; revised April 17, 2001; accepted April 26, 2001.
This work was supported by grants from the Bethlehem Griffith
Foundation and the Australian National Health and Medical Research Council. J.D. is a Logan Fellow at Monash University. We thank J. Marriott (Pharmacy College, Monash University) for establishing HPLC in
the laboratory and J. S. Massalas (Department of Medicine, Monash
University) for technical assistance.
C.L.P. and D.I.F. contributed equally to this work.
Correspondence should be addressed to Prof. Malcolm Horne, Department
of Neurology, Monash Medical Centre, Clayton Road, Clayton, 3168, Australia. E-mail: malcolm.horne{at}med.monash.edu.au.
 |
REFERENCES |
-
Adams JC
(1981)
Heavy metal intensification of DAB-based HRP reaction product.
J Histochem Cytochem
29:775[ISI][Medline].
-
Baik JH,
Picetti R,
Saiardi A,
Thiriet G,
Dierich A,
Depaulis A,
Le Meur M,
Borrelli E
(1995)
Parkinsonian-like locomotor impairment in mice lacking dopamine D2 receptors.
Nature
377:424-428[Medline].
-
Batchelor PE,
Liberatore GT,
Wong JY,
Porritt MJ,
Frerichs F,
Donnan GA,
Howells DW
(1999)
Activated macrophages and microglia induce dopaminergic sprouting in the injured striatum and express brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor.
J Neurosci
19:1708-1716[Abstract/Free Full Text].
-
Bjorklund A,
Lindvall O
(1984)
In: Dopamine-containing systems in the CNS. Amsterdam: Elsevier.
-
Blanchard V,
Chritin M,
Vyas S,
Savasta M,
Feuerstein C,
Agid Y,
Javoy-Agid F,
Raisman-Vozari R
(1995)
Long-term induction of tyrosine hydroxylase expression: compensatory response to partial degeneration of the dopaminergic nigrostriatal system in the rat brain.
J Neurochem
64:1669-1679[ISI][Medline].
-
Blanchard V,
Anglade P,
Dziewczapolski G,
Savasta M,
Agid Y,
Raisman-Vozari R
(1996)
Dopaminergic sprouting in the rat striatum after partial lesion of the substantia nigra.
Brain Res
709:319-325[ISI][Medline].
-
Bozzi Y,
Borrelli E
(1999)
Absence of the dopamine D2 receptor leads to a decreased expression of GDNF and NT-4 mRNAs in restricted brain areas.
Eur J Neurosci
11:1275-1284[ISI][Medline].
-
Braendgaard H,
Evans SM,
Howard CV,
Gundersen HJ
(1990)
The total number of neurons in the human neocortex unbiasedly estimated using optical disectors.
J Microsc
157:285-304[ISI][Medline].
-
Caille I,
Dumartin B,
Bloch B
(1996)
Ultrastructural localization of D1 dopamine receptor immunoreactivity in rat striatonigral neurons and its relation with dopaminergic innervation.
Brain Res
730:17-31[ISI][Medline].
-
Cheng HW,
Tong J,
McNeill TH
(1998)
Lesion-induced axon sprouting in the deafferented striatum of adult rat.
Neurosci Lett
242:69-72[Medline].
-
Cho S,
Neff NH,
Hadjiconstantinou M
(1997)
Regulation of tyrosine hydroxylase and aromatic L-amino acid decarboxylase by dopaminergic drugs.
Eur J Pharmacol
323:149-157[ISI][Medline].
-
Clifford JJ,
Usiello A,
Vallone D,
Kinsella A,
Borrelli E,
Waddington JL
(2000)
Topographical evaluation of behavioural phenotype in a line of mice with targeted gene deletion of the D2 dopamine receptor.
Neuropharmacology
39:382-390[ISI][Medline].
-
Coggeshall RE,
Lekan HA
(1996)
Methods for determining numbers of cells and synapses: a case for more uniform standards of review.
J Comp Neurol
364:6-15[ISI][Medline]. [Erratum (1996) 369:162]
-
Cooper JR,
Bloom FE,
Roth RH
(1996)
In: The biochemical basis of neuropharmacology, Ed 7. New York: Oxford UP.
-
Creese
(1982)
Dopamine receptors explained.
Trends Neurosci
5:40-43.
-
Drago J,
Gerfen CR,
Lachowicz JE,
Steiner H,
Hollon TR,
Love PE,
Ooi GT,
Grinberg A,
Lee EJ,
Huang SP,
Bartlett PF,
Jose PA,
Sibley DR,
Westphal H
(1994)
Altered striatal function in a mutant mouse lacking D1A dopamine receptors.
Proc Natl Acad Sci USA
91:12564-12568[Abstract/Free Full Text].
-
Drago J,
Padungchaichot P,
Accili D,
Fuchs S
(1998)
Dopamine receptors and dopamine transporter in brain function and addictive behaviors: insights from targeted mouse mutants.
Dev Neurosci
20:188-203[ISI][Medline].
-
El-Ghundi M,
George SR,
Drago J,
Fletcher PJ,
Fan T,
Nguyen T,
Liu C,
Sibley DR,
Westphal H,
O'Dowd BF
(1998)
Disruption of dopamine D1 receptor gene expression attenuates alcohol-seeking behavior.
Eur J Pharmacol
353:149-158[ISI][Medline].
-
Fagan AM,
Gage FH
(1994)
Mechanisms of sprouting in the adult central nervous system: cellular responses in areas of terminal degeneration and reinnervation in the rat hippocampus.
Neuroscience
58:705-725[ISI][Medline].
-
Fallon JH,
Moore RY
(1978)
Catecholamine innervation of the basal forebrain. IV. Topography of the dopamine projection to the basal forebrain and neostriatum.
J Comp Neurol
180:545-580[ISI][Medline].
-
Finkelstein DI,
Stanic D,
Parish CL,
Tomas D,
Dickson K,
Horne MK
(2000)
Axonal sprouting following lesions of the rat substantia nigra
Neuroscience
97:99-112[ISI][Medline].
-
Franklin KBJ,
Paxinos G
(1997)
In: The mouse brain in stereotaxic coordinates. San Diego: Academic.
-
Frotscher M,
Heimrich B,
Deller T
(1997)
Sprouting in the hippocampus is layer-specific.
Trends Neurosci
20:218-223[ISI][Medline].
-
Gerfen CR,
Herkenham M,
Thibault J
(1987)
The neostriatal mosaic: II. Patch- and matrix-directed mesostriatal dopaminergic and non-dopaminergic systems.
J Neurosci
7:3915-3934[Abstract].
-
Gundersen HJ,
Bagger P,
Bendtsen TF,
Evans SM,
Korbo L,
Marcussen N,
Moller A,
Nielsen K,
Nyengaard JR,
Pakkenberg B,
Sørensen FB,
Vesterby A,
West MJ
(1988)
The new stereological tools: disector, fractionator, nucleator and point sampled intercepts and their use in pathological research and diagnosis.
APMIS
96:857-881[ISI][Medline].
-
Herges S,
Taylor DA
(1999)
Modulatory effect of p-chlorophenylalanine microinjected into the dorsal and median raphe nuclei on cocaine-induced behaviour in the rat.
Eur J Pharmacol
374:329-340[Medline].
-
Ho A,
Blum M
(1998)
Induction of interleukin-1 associated with compensatory dopaminergic sprouting in the denervated striatum of young mice: model of aging and neurodegenerative disease.
J Neurosci
18:5614-5629[Abstract/Free Full Text].
-
Hornykiewicz O
(1993)
Parkinson's disease and the adaptive capacity of the nigrostriatal dopamine system: possible neurochemical mechanisms.
Adv Neurol
60:140-147[Medline].
-
Kandel ER,
Schwartz JH,
Jessell TM
(1991)
In: Principles of neural science, Ed 3. New York: Elsevier.
-
Liberatore GT,
Finkelstein DI,
Wong JY,
Horne MK,
Porritt MJ,
Donnan GA,
Howells DW
(1999)
Sprouting of dopaminergic axons after striatal injury: confirmation by markers not dependent on dopamine metabolism.
Exp Neurol
159:565-573[Medline]<
|