Variations of monoamines and their metabolites in the human brain putamen

Variations of monoamines and their metabolites in the human brain putamen

Brain Research, 579 (1992) 285-290 © 1992 Elsevier Science Publishers B.V. All fights reserved. 0006-8993/92/$05.00 285 BRES 17691 Variations of mo...

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Brain Research, 579 (1992) 285-290 © 1992 Elsevier Science Publishers B.V. All fights reserved. 0006-8993/92/$05.00

285

BRES 17691

Variations of monoamines and their metabolites in the human brain putamen Christine Konradi a'b, Johannes Kornhuber a, Emin Sot]c a'b, Stephan Heckers c, Peter Riederer a'b and Helmut Beckmann a University of Wiirzburg, "Department of Psychiatry and bClinical Neurochemistry Group, Warzburg (FRG) and CBeth Israel Hospital, Harvard Medical School, Department of Neurology, Boston, MA 02215 (USA) (Accepted 17 December 1991)

Key words: Catechol-O-methyltransferase; Monoamine; Dopamine; Human brain; Monoamine oxidase; Norepinephrine; Serotonin

The levels of the monoamines dopamine (DA), serotonin (5-HT) and norepinephrine (NE) and the monoaminergic metabolites 3,4-dihydroxyphenylacetic acid (DOPAC), homovanilhc acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were measured with HPLC-ECD in 42 samples from human brain putamen. The influence of gender and of age was investigated and correlations between the monoamines were established. The DAergic system shows a significant difference between males and females, with females having lower DA and higher DOPAC levels and a higher DOPAC/DA ratio than males. No gender-related differences of 5-HT and its metabolites were observed, nor of NE. Three different age groups (group 1:0-9.9 years; group 2:10-59.9 years; group 3:60 years and older) were defined according to previous studies on ontogenesis and senescence in human brain. An increase in 5-HT levels, decrease in 5-HIAA levels and a decrease in the 5-HIAAJ5-HT ratio were observed after the first decade of life. Changes in the DAergic system were seen in senescence, with decreasing DA levels and an increase in the HVA/DA ratio. DOPAC, HVA and the DOPAC/DA ratio are unaffected. NE is similar in all age groups. The analysis of the relation of the levels of the three monoamines proved a strong correlation between the DAergic and 5-HTergic systems. The nature of this relationship might have an impact on neuro-psychiatric disorders and brain function. INTRODUCTION M o n o a m i n e s like d o p a m i n e ( D A ) , serotonin (5-HT) or n o r e p i n e p h r i n e (NE) serve as neurotransmitters in the brain and in p e r i p h e r a l organs. While N E and D A are synthesized in similar pathways, with tyrosine hydroxylase as the rate-limiting enzyme 4°, 5 - H T is the product of a different pathway with t r y p t o p h a n hydroxylase activity as the rate-limiting step 14. Metabolic inactivation of m o n o a m i n e s in the brain is p e r f o r m e d by m o n o a m i n e oxidase ( M A O ) and of D A and N E also by catechol-O-methyltransferase ( C O M T ) . M A O is an enzyme of the o u t e r mitochondrial m e m b r a n e , located in neurons and glial cells, with two i n d e p e n d e n t subtypes, M A O - A and -B. B o t h subtypes are characterized by substrate and inhibitor specificities 17 and transcribed from two separate genes 4. C O M T is a soluble enzyme and localized p r e d o m i nantly extraneuronally 3. A second, m e m b r a n e - b o u n d COMT, which is localized in neurons was described, with a hundred-fold lower K m than the soluble form 16'26'27. It is i m p o r t a n t to note that the D A - d e r i v e d product of M A O and an a l d e h y d e d e h y d r o g e n a s e , 3,4-dihydroxy-

phenylacetic acid ( D O P A C ) is therefore mostly of intraneuronal origin, while homovanillic acid ( H V A ) , a product of COMT, M A O and a l d e h y d e d e h y d r o g e n a s e , is extraneuronally synthesized. Variations of the m o n o a m i n e r g i c n e u r o t r a n s m i t t e r and respective metabolite levels in h u m a n C S F and brain are r e p o r t e d with respect to age 8'23'28'34, sex 1, b o d y size 5 and CNS disorders 1'31'32. U n f o r t u n a t e l y , the majority of these studies were done with h u m a n CSF, leaving questions about the true representation of brain metabolism. Therefore, the present study of non-pathological variations of m o n o a m i n e s and their metabolites was carried out in p o s t - m o r t e m h u m a n brain p u t a m e n . We m e a s u r e d D A , 5-HT and N E and the metabolites H V A , D O P A C and 5-hydroxyindoleacetic acid ( 5 - H I A A ) , with H P L C - E C D . A g e and genderrelated changes as well as the relationship of these substances to each o t h e r were analyzed. MATERIALS AND METHODS Samples from human brain putamen (24 males, 18 females), aged from 0.125 to 82 years, were used for the HPLC-ECD analysis. Tissue was taken at autopsy by a neuropathologist, and had a

Correspondence: C. Konradi. Present address: Massachusetts General Hospital, Harvard Medical School, Department of Molecular Neurobiology, Building 149 13th Street, Charlestown, MA 02129, USA. Fax: (1) (617) 726-5677.

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Fig. 1. a: levels of DA, 5-HT and NE in the three age groups, b: levels of the metabolites of DA (DOPAC and HVA) and 5-HT (5-HIAA). Open bars are mean values. Group 1: under 10 years; group 2:10 until 60 years; group 3:60 years or older. *Indicates P < 0.05. **Indicates P < 0.005.

post-mortem delay between 6 and 82 h (mean 43.2 + 21.4 S.D.). The causes of death included accidents, sudden infant death and suicide. Brain tissue was frozen at -80°C, and stored for 84-898 days (mean 397 + 204 S.D.) until analysis. Attention to the even age distribution with regard to gender, post-mortem delay and storage time was paid. Statistical analysis included the Mann-Whitney U-test and Spearman's rank correlation. All values are given as mean + S.D. Concentrations are measured in/xg substance/g brain wet weight.

DOPAC/DA

ratio t h a n females. A g e and p o s t - m o r t e m

RESULTS

h i g h e r storage time.

Gender and monoamines

Monoamines in age

t i m e w e r e similar in e i t h e r g r o u p (Table I). T h e r e was a h i g h e r s t o r a g e t i m e of m a l e brains (Table I), which, since the m e t a b o l i z i n g e n z y m e M A O is n o t affected by freezing o r storage t i m e ~9'21, w o u l d r a t h e r a c c o u n t for d e c r e a s e d D A levels and an i n c r e a s e d D O P A C / D A

ra-

tio. T h e r e f o r e , t h e h i g h e r D A levels and l o w e r D O P A C / D A ratio in m a l e s c a n n o t be an artifact of the

L e v e l s o f m o n o a m i n e s and m o n o a m i n e r g i c m e t a b o -

W e arbitrarily established t h r e e age groups; g r o u p 1:

lites in m a l e s and f e m a l e s are s h o w n in Table I. M a l e s

p o s t n a t a l to u n d e r 10 years, g r o u p 2 : 1 0 years until 60 years and g r o u p 3 : 6 0 years and a b o v e . Since studies

had

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287 TABLE I

TABLE II

Gender and monoamines

Matching o f the three age groups

Values are mean + S.D.

n (M/F)

Group I 7/4

Age range (years) Mean age (years) Post-mortem delay (h)

0.13-6 14-55 50-82 0.99 + 1.71 35.7 + 12.0 74.5 + 6.93 52.8 + 21.3 42.0 + 22.1 36.1 + 18.1

Storage time (days)

432 + 169

Male n = 24

Female n = 18

5-HT ~mol/g) 5-HIAA (9mol/g) 5-HIAA/5-HT DA (,umol/g) HVA ~mol/g) DOPAC (~mol/g) HVA/DA DOPAC/DA NA ~mol/g)

1.06 1.19 1.34 3.33 7.53 0.61 2.58 0.23 0.03

0.97 1.00 1.17 2.51 6.33 1.05 3.04 0.50 0.03

age (years) post-mortem delay (h) storage time (days)

34.6 + 27.9 44.7 + 22.4 463 + 193

+ 0.45 + 0.44 + 0.92 + 1.85 + 3.39 + 0.35 + 1.05 + 0.19 ___0.03

+ + + + + + + + +

0.38 0.31 0.65 1.45" 2.24 0.63 1.59 0.43** 0.02

Group 2 12/9

393 + 238

Group 3 5/5

365 + 170

higher in group 1 when compared to group 2 (Fig. lb). The D A metabolites H V A and D O P A C are unchanged

37.4 + 28.3 41.3 + 20.5 308 + 188"

during life (Fig. lb). Investigation of the monoamine/respective metabolite ratios revealed a significantly higher 5 - H I A A / 5 - H T ratio in early childhood when compared to either one of the other groups, while the H V A / D A

* Indicates P < 0.05. ** Indicates P < 0.005 (Mann-Whitney U-Test).

ratio was higher in group 3 when compared to group 1 (Fig. 2).

about receptor binding22'33, synaptogenesis t5 and mono-

C o r r e l a t i o n s b e t w e e n the m o n o a m i n e s

amine oxidase 21 have shown significant differences at the beginning of the first decade of life, age 10 years was picked as upper limit of group 1. The group consists of ten patients u n d e r age 2 years and one of age 6 years. Age 60 as lower limit of group 3 was chosen from observations of accelerated decline of brain functions and D A levels after this age 7. Table II lists the data of the

A positive correlation between the DAergic and 5-HTergic system was observed (Fig. 3). Both m o n o a m ines as well as their metabolites showed an interdependency (Fig. 3, Table III). N E did not correlate with either m o n o a m i n e . DISCUSSION

case histories of the three age groups. Looking at the m o n o a m i n e s , 5-HT is lowest in group 1 and D A lowest in group 3 (Fig. la). Of the metabolites, the 5-HT metabolite 5 - H I A A was significantly DOPAC/DA

Role of monoamine

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Fig. 2. The metabolite/substrate levels of DA and 5-HT in the three age groups/Open bars are mean values. Group I: under 10 years; group 2:10 until 50 years; group 3:50 years or older. *Indicates P < 0.05. **Indicates P < 0.001.

288

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tyramine, respectively 35, and since D A is described as a M A O - B substrate in humans 11, the D O P A C / D A ratio is a measure of intraneuronal M A O - B activity. Thus, the higher D O P A C / D A ratio in females is most likely a reflection of their higher M A O - B activity 24'29. In concordance, despite their higher D A levels, males, who in general have a lower M A O - B activity than females 24'29, show a lower D O P A C / D A ratio. This indicates, that in vivo the intraneuronal M A O - B level in the nigrostriatal pathway is so low that it is actually saturated, since higher enzyme levels at lower D A concentrations, as shown in females, show a higher yield of D O P A C . In concordance, M A O - B levels in immunocytochemical 2°'41 and histochemical studies TM of the DAergic perikarya of the substantia nigra, were under the detection level. In contrast, the age-related increase of M A O - B , as published earlier 1°'13'21'25'3°, was not reflected in the





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D O P A C / D A ratio, which is the same in all age groups (Fig. 2). This finding supports the hypothesis that the M A O - B activity increases in aging extraneuronally and represents gliosis 25'36. Moreover, the extraneuronal turnover H V A / D A is higher in group 3 (Fig. 2), which fits into this model. However, unlike in the DAergic neurons, the M A O - B level is very high in glial cells T M . A n increased M A O - B activity in glial cells therefore might not solely explain an increased H V A / D A turnover rate. A higher leakage of DAergic neurons in senescence or a decreased D A reuptake z'9'as, is more likely the reason for the increased H V A / D A rate and might also be responsible for the decrease in the D A level in senescence (group 3, Fig. la). Thus, while the observed gender differences in the D O P A C / D A ratio can be attributed to different levels of intraneuronal M A O - B activity, the observed age differences of the H V A / D A ratio can best be explained by an increased extraneuronal availability of D A (e.g., leakage of neurons or reduced reuptake).

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Fig. 3. Correlations of the monoamines DA and 5-HT and their metabolites HVA and 5-HIAA. Correlation coefficients and P-values: see Table III.

(n.s.) and, as a result, the D O P A C / D A ratio was higher (Table I). Since D O P A C and D A outside the neuron are rapidly metabolized by C O M T to H V A and 3-methoxy-

TABLE III Spearman's rank correlation coefficients between monoamines and monoaminergic metabolites

5-HT NE DOPAC HVA 5-HIAA DOPAC/DA HVA/DA 5-HIAA/5-HT * Indicates P < 0.05. ** Indicates P < 0.005. *** Indicates P < 0.001.

DA

5-HT

NE

DO PA C

HVA

5-HIAA

0.382* 0.187 0.098 0.493*** 0.335* -0.491"** -0.539"** -0.062

-0.042 -0.186 0.539*** 0.389* -0.337* 0.163 -0.576"**

0.127 -0.170 0.110 -0.077 -0.385* 0.239

0.157 -0.037 0.755"** 0.010 0.153

0.508*** -0.167 0.407* -0.082

-0.254 0.073 0.479**

289

Role of monoamine oxidase A While decreased DA levels (Fig. la) and an increased HVA/DA ratio (Fig. 2) were found in group 3, the 5-HTergic system had the highest turnover rate early in life. 5-HT levels were lowest in group 1 (Fig. la), and 5-HIAA levels were higher than in group 2 (Fig. lb), resulting in a higher 5-HIAA/5-HT ratio. Since 5-HT is metabolized by MAO-A to 5-HIAA 37, the 5-HIAA/ 5-HT ratio reflects MAO-A activity. Thus, a previous report which showed a higher MAO-A activity in children under 10 years 21 is supported by the present finding. Interdependent variations of monoamines In all age groups, a strong correlation of DA with 5-HT and most of their metabolites was seen (Table III, Fig. 3). DOPAC was the exception which correlated with the DOPAC/DA ratio only (Table III). As discussed above, DOPAC levels in the nigrostriatal system seem to reflect predominantly the intraneuronal MAO-B activity and are independent of DA concentrations

REFERENCES 1 Agren, H., Mefford, I.N., Rudorfer, M.V., Linnoila, M. and Potter, W.Z., Interacting neurotransmitter systems. A non-experimental approach to the 5HIAA-HVA correlation in human CSF, J. Psychiatr. Res., 20 (1986) 175-193. 2 Allard, P. and Marcusson, J.O., Age-correlated loss of dopamine uptake sites labeled with [3H]GBR-12935 in human putamen, Neurobiol. Aging, 10 (1989) 661-664. 3 Axelrod, J., Methylation reactions in the formation and metabolism of catecholamines and other biogenic amines, Pharmacol. Rev., 18 (1966) 95-113. 4 Bach, A.W., Lan, N.C., Johnson, D.L., Abell, C.W., Bembenek, M.E., Kwan, S.W., Seeburg, P.H. and Shih, J.C., cDNA cloning of human liver monoamine oxidase A and B: molecular basis of differences in enzymatic properties, Proc. Natl. Acad. Sci. USA, 85 (1988) 4934-4938. 5 Banki, C.M. and Molnar, G., The influence of age, height, and body weight on cerebrospinal fluid amine metabolites and tryptophan in women, Biol. Psychiatry, 16 (1981) 753-762. 6 Birkmayer, W., Danielczyk, W., Neumayer, E. and Riederer, P., The balance of biogenic amines as condition for normal behaviour, J. Neural. Transm., 33 (1972) 163-178. 7 Carlsson, A., Aging and brain neurotransmitters. In D. Platt (Ed.), Funktionsst6rungen des Gehirns im Alter, Schattauer Verlag, Stuttgart, 1981, pp. 67-81. 8 Carlsson, A., Adolfsson, R., Aquilonius, S.M., Gottfries, C.G., Oreland, L., Svennerholm, L. and Winblad, B., Biogenic amines in human brain in normal aging, senile dementia, and chronic alcoholism, Adv. Biochem. Psychopharmacol., 23 (1980) 295-304. 9 De Keyser, J., Ebinger, G. and Vauquelin, G., Age-related changes in the human nigrostriatal dopaminergic system, Ann. Neurol., 27 (1990) 157-161. 10 Fowler, C.J., Wiberg, A., Oreland, L., Marcusson, J. and Winblad, B., The effect of age on the activity and molecular properties of human brain monoamine oxidase, J. Neural. Transm., 49 (1980) 1-20. 11 Glover, V., Sandier, M., Owen, E and Riley, G.J., Dopamine is a monoamine oxidase B substrate in man, Nature, 265 (1977)

(Table III). Disturbances in the DAergic as well as the 5-HTergic system are described for a variety of neuropsychiatric diseases 12'23'39. However, it is the correlation of both which might be necessary for proper brain function 6. It is reasonable to assume that subtle changes in one system, if accompanied by subtle changes in the other system, would lead to a synergistic effect, even though both are within the control range. Such a condition would explain why neuropsychiatric diseases are not attributable to changes in only one of either system. Therefore, a closer evaluation of both systems and, more importantly, how they correlate in the brains of patients with neuropsychiatric disorders, might help us in the understanding of these disorders and provide new therapeutic aspects.

Acknowledgements. This study was supported by the Deutsche Hirnliga (C.K. and P.R.) and by the Deutsche Forschungsgemeinschaft (J.K.).

80-81. 12 Goodman, W.K., McDougle, C.J., Price, L.H., Riddle, M.A., Pauls, D.L. and Leckman, J.F., Beyond the serotonin hypothesis: a role for dopamine in some forms of obsessive compulsive disorder, J. Clin. Psychiatry, 51 (1990) 36-43 (discussion). 13 Gottfries, C.G., Oreland, L., Wiberg, A. and Winblad, B., Lowered monoamine oxidase activity in brains from alcoholic suicides, J. Neurochem., 25 (1975) 667-673. 14 Green, J.P., Histamine and serotonin. In G. Siegel, B. Agranoff, R.W. Albers and P. Molinoff (Eds.), Basic Neurochemistry, Raven Press, New York, 1989, pp. 253-270. 15 Huttenlocher, P.R., Synaptic density in human frontal cortex developmental changes and effects of aging, Brain. Res., 163 (1979) 195-205. 16 Jeffery, D.R. and Roth, J.A., Purification and kinetic mechanism of human brain soluble catechol-O-methyltransferase, J. Neurochem., 44 (1985) 881-885. 17 Johnston, J.P., Some observations upon a new inhibitor of monoamine oxidase in brain tissue, Biochem. Pharmacol., 17 (1968) 1285-1297. 18 Konradi, C., Kornhuber, J., Froelich, L., Fritze, J., Heinsen, H., Beckmann, H., Schulz, E. and Riederer, P., Demonstration of monoamine oxidase-A and -B in the human brainstem by a histochemical technique, Neuroscience, 33 (1989) 383-400. 19 Konradi, C., Riederer, P. and Youdim, M.B., Hydrogen peroxide enhances the activity of monoamine oxidase type-B but not of type-A: a pilot study, J. Neural. Transm. Suppl., 22 (1986) 61-73. 20 Konradi, C., Svoma, E., Jellinger, K., Riederer, P., Denney, R. and Thibault, J., Topographic immunocytochemical mapping of monoamine oxidase-A, monoamine oxidase-B and tyrosine hydroxylase in human post mortem brain stem, Neuroscience, 26 (1988) 791-802. 21 Kornhuber, J., Konradi, C., Mack-Burkhardt, E, Riederer, P., Heinsen, H. and Beckmann, H., Ontogenesis of monoamine oxidase-A and -B in the human brain frontal cortex, Brain Research, 499 (1989) 81-86. 22 Kornhuber, J., Mack-Burkhardt, E, Konradi, C., Fritze, J. and Riederer, P., Effect of antemortem and postmortem factors on [3H]MK-801 binding in the human brain: transient elevation

290 during early childhood, Life Sci., 45 (1989) 745-749. 23 Morgan, D.G., May, P.C. and Finch, C.E., Dopamine and serotonin systems in human and rodent brain: effects of age and neurodegenerative disease, J. Am. Geriatr. Soc., 35 (1987) 334345. 24 Murphy, D.L., Wright, C., Buchsbaum, M., Nichols, A., Costa, J.L. and Wyatt, R.J., Platelet and plasma amine oxidase activity in 680 normals: sex and age differences and stability over time, Bioehem. Med., 16 (1976) 254-265. 25 Oreland, L., Arai, Y. and Stenstr6m, A., Age, neuro-psychiatric diseases and brain monoamine oxidase. In K.E Tipton, P. Dostert and M. Strolin Benedetti (Eds.), Monoamine Oxidase and Disease, Academic Press, London, 1984, pp. 291-300. 26 Rivett, A.J., Francis, A. and Roth, J.A., Distinct cellular localization of membrane-bound and soluble forms of catecholO-methyltransferase in brain, J. Neurochem., 40 (1983) 215219. 27 Rivett, A.J., Francis, A. and Roth, J.A., Localization of membrane-bound catechol-O-methyltransferase, J. Neurochem., 40 (1983) 1494-1496. 28 Robinson, D.S., Changes in monoamine oxidase and monoamines with human development and aging, Fed. Proc., 34 (1975) 103-107. 29 Robinson, D.S., Davis, J.M., Nies, A., Ravaris, C.L. and Sylwester, D., Relation of sex and aging to monoamine oxidase activity of human brain, plasma, and platelets, Arch. Gen. Psychiatry, 24 (1971) 536-539. 30 Robinson, D.S., Nies, A., Davis, J.N., Bunney, W.E., Davis, J.M., Colburn, R.W., Bourne, H.R., Shaw, D.M. and Coppen, A.J., Ageing, monoamines, and monoamine-oxidase levels, Lancet, 1 (1972) 290-291. 31 Roy, A., De Jong, J. and Linnoila, M., Cerebrospinal fluid monoamine metabolites and suicidal behavior in depressed patients. A 5-year follow-up study, Arch. Gen. Psychiatry, 46 (1989) 609-612. 32 Roy, A., Pickar, D., Linnoila, M., Doran, A.R., Ninan, P. and Paul, S.M., Cerebrospinal fluid monoamine and monoamine

33

34

35

36

37

38

39

40

41

metabolite concentrations in melancholia, Psychiatry Res., 15 (1985) 281-292. Seeman, P., Bzowej, N.H., Guan, H.C., Bergeron, C., Becker, L.E., Reynolds, G.P., Bird, E.D., Riederer, P., Jellinger, K., Watanabe, S. et al., Human brain dopamine receptors in children and aging adults, Synapse, l (1987) 399-404. Seifert Jr., W.E., Foxx, J.L. and Butler, I.J., Age effect on dopamine and serotonin metabolite levels in cerebrospinal fluid, Ann. Neurol., 8 (1980) 38-42. Sourkes, T.L., Disorders of the basal ganglia. In G. Siegel, B. Agranoff, R.W. Albers and P. Molinoff (Eds.), Basic Neurochemistry, Raven Press, New York, 1989, pp. 811-826. Strolin Benedetti, M. and Dostert, P., Monoamine oxidase, brain ageing and degenerative diseases, Biochem. Pharmacol., 38 (1989) 555-561. Suzuki, O., Katsumata, Y. and Oya, M., Substrate specificity of type A and type B monoamine oxidase. In K. Kamijo, E. Usdin and T. Nagatsu (Eds.), Monoamine Oxidase: Basic and Clinical Frontiers, Elsevier/Excerpta Medica, Amsterdam, 1982, pp. 74-86. Tedroff, J., Aquilonius, S.M., Hartvig, P., Lundqvist, H., Gee, A.G., Uhlin, J. and Langstrom, B., Monoamine re-uptake sites in the human brain evaluated in vivo by means of 11C-nomifensine and positron emission tomography: the effects of age and Parkinson's disease, Acta Neurol. Scand., 77 (1988) 192-201. Van Praag, H.M., Asnis, G.M., Kahn, R.S., Brown, S.L., Korn, M., Friedman, J.M. and Wetzler, S., Monoamines and abnormal behaviour. A multi-aminergic perspective, Br. J. Psychiatry, 157 (1990) 723-734. Weiner, N. and Molinoff, P.B., Catecholamines. In G. Siegel, B. Agranoff, R.W. Albers and P. Molinoff (Eds.), Basic Neurochemistry, Raven Press, New York, 1989, pp. 233-252. Westlund, K.N., Denney, R.M., Rose, R.M. and Abell, C.W., Localization of distinct monoamine oxidase A and monoamine oxidase B cell populations in human brainstem, Neuroscience, 25 (1988) 439-456.