The effect of the dopamine agonist, apomorphine, on regional cerebral blood flow in normal volunteers P. M GRASBY.T K r. FRrsroi"iJ,Liilff*.;i".PYr"tfiR FRrrH. P F LTDDLE.Fronr the MR(; Cyclotron Unit, Hatnmersmith Ho.spital; Acadentic Depurtntent of Ps1't'hiatry, Royal Frce Ho.spital and School of ltfedit'ine;National Hospitol ./br Neurolog.t'ond Neurosurger.t': Departntt,nt of' Psychologl,. UttiversitJ,College, Lorulon;and ll'{RC Clirtit'al Pharntucoktgt, Litrit, Littlentore Hospitul. Ox/ortl syNOpsrs Apomorphine, a non-selective dopamine agonist, has been used as a phannacological probe for investigating central dopaminergic neurotransmission in psychiatric illness. In this study repeated measurements of regior.ral cerebral blood Ilow (rCBF) were made in normal volunteers before. and after, the administration of apomorphine (5 or l0 7rg/kg), or placebo. The diff'erence in rCBF. before and after drug (apomorphine lcrsu.r placebo), was used to identify brain areas affected by apomorphine. Compared to placebo, both doses of apornorphine increased blood flow in the anterior cingulate cortex. Apomorphine l0 ag/kg also increased prefrontal rCBF (right > lel1). No decreases in rCBF were noted tollowing either dose of apomorphine. Apomorphine-induced increases of anterior cingulate blood flow might serve as an il lrvo inder of central dopamine function. Such an approach would complement established nenroendocrine challenge paradigms for investigating central dopamine neurotransmission in psychiatric illness.
INTRODUCTIONApornorphine is a non-selective dopaurrne agonist with central and peripheral actiorrs (Anden et al. 1967', Corsini et al. l98l; Creese, 1987). It has been extensively used as a pharmacological probe of dopaminergic systems in both normal volunteers and psychiatric patients (Checkley, 1980; Meltzer et al. 1984). ln neuroendocrine challenge paradigms apomorphineinduced increases in plasma grorvth hormone are used as an index ofcentral dopamine receptor function (Checkley, 1980;Lal, 1987). Recently, an enhanced growth hormone response to apornorphine has been reported to be predictive of women at high risk of affective psychosis af ter childbirth (Wieck er ul. l99l).Despite considerable experimental data on apornorphine's central effects in animals, little rs known about the brain areas targeted, functionally, by apomorphine in humans. The use of positron emission tomography (PET) to measure drug-induced changes in regional cerebrai blood ' Address Ibr corrcspondence: Dr P. M. Grasbv. MRC Cyc)rrtron t,rnit. Hamnrersmith I'lospital, [)u Cane Road. London Wl] 0HS.