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A preliminary report on dopamine system reactivity in PKU: acute effects of haloperidol on neuropsychological, physiological, and neuroendocrine functions

Abstract

Background

Classic phenylketonuria (PKU) is due to an inborn error of metabolism resulting in an inability to metabolize the amino acid phenylalanine. To avoid mental retardation, affected individuals observe a phenylalanine-restricted diet. When dietary control is poor, deficits in prefrontally mediated cognitive functions have been observed. It has been suggested that these deficits are due to disruptions in the mesocortical dopamine system that projects to the prefrontal cortex.

Methods

In this study, dopamine system reactivity was examined in individuals with PKU, relative to age-matched controls, using the non-specific DA antagonist haloperidol, in a repeated measures placebo-controlled design. Outcome variables included neuroendocrine, physiological, and cognitive measures.

Results

Regardless of drug condition, PKU participants differed from control participants in their blood phenylalanine and tyrosine levels, and in their times to complete measures of attention and working memory. Also, relative to placebo, haloperidol influenced several variables irrespective of group status, including serum prolactin secretion, times to complete attention and working memory tasks, and accuracy of working memory performance. An interaction between group and drug condition was observed for the digit span task, where PKU participants exhibited greater relative impairments on haloperidol. When composite indices of impairment were derived, PKU participants demonstrated selective disruption in executive function on haloperidol relative to control subjects.

Conclusions

Findings are consistent with the presence of frontostriatal dysfunction in PKU but are less consistent with the notion that PFC dopamine function is specifically affected.

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Acknowledgements

This work was supported by a Grant-in-Aid of Research, Artistry, and Scholarship awarded to M.L. by the Office of the Vice President for Research at the University of Minnesota. The assistance of the General Clinical Research Center at the University of Minnesota, supported by grant M01-RR00400, from the National Center for Research Resources, the National Institute of Health is gratefully acknowledged. Blood assays for phenylalanine and tyrosine were conducted at Children’s National Medical Center in Washington, D.C. Thanks are extended to Mendel Tuchman for his support of this project. We would also like to thank Dorothy Markowitz for her assistance with the recruitment of PKU participants and the following individuals for their assistance with data collection: Taras Karkoc and Kristin Sullwold.

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Correspondence to Monica Luciana.

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Luciana, M., Hanson, K.L. & Whitley, C.B. A preliminary report on dopamine system reactivity in PKU: acute effects of haloperidol on neuropsychological, physiological, and neuroendocrine functions. Psychopharmacology 175, 18–25 (2004). https://doi.org/10.1007/s00213-004-1775-0

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Keywords

  • Phenylketonuria
  • Dopamine
  • Prefrontal
  • Working memory