Evaluation of hypothalamic dopaminergic function by neuropharmacologic means in aged women

The function of the hypothalamic tuberoinfundibular dopaminergic (TIDA) neurons involved in the control of prolactin secretion was investigated in aged subjects with the use of nomifensine, an indirect-acting dopamine (DA) agonist, domperidone, a DA receptor antagonist, and DA, which acts directly on the pituitary lactotropes. In all 33 women, aged 69-92 yr, were studied. Baseline prolactin values were slightly but significantly higher in aged women (13 +/- 1.2 ng/ml, M +/- S.E.M.) than in a group of control fertile women (8 +/- 0.7 ng/ml). Oral administration of nomifensine (200 mg), in 14 aged women suppressed plasma prolactin (greater than or equal to 30% of baseline) in 8 subjects, a proportion not different from that present in fertile women (7/15) also receiving a single oral dose of nomifensine. Intravenous infusion of DA (0.04 microgram/kg min, 120 min) induced a similar inhibition in plasma prolactin in the aged and the fertile women, while administration of domperidone (4 mg i.v.) evoked a higher plasma prolactin rise, 15 min post-administration, in fertile than aged women. In all, presence of baseline prolactin levels only slightly elevated and prolactin responsiveness to nomifensine and DA not different from that of fertile women denote preservation of TIDA neuronal function in old women. The blunted response to domperidone of the old women is likely attibutable to a reduced pituitary pool of prolactin.