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Mastrodonato A, Jin M, Kee N, Lanio M, Tapia J, Quintana L, Zamora AM, Deng SX, Xu X, Landry DW, Denny CA. Prophylactic (R,S)-ketamine and (2S,6S)-HNK decrease fear expression by differentially modulating fear neural ensembles. Biol Psychiatry 2024:S0006-3223(24)01649-4. [PMID: 39389408 DOI: 10.1016/j.biopsych.2024.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 09/20/2024] [Accepted: 09/30/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND We previously reported that a single injection of (R,S)-ketamine or its metabolite (2S,6S)-hydroxynorketamine (HNK) prior to stress attenuates learned fear. However, whether these drugs attenuate learned fear through divergent or convergent effects on neural activity remains to be determined. METHODS 129S6/SvEv male mice were injected with saline, (R,S)-ketamine, or (2S,6S)-HNK one week before a 3-shock contextual fear conditioning (CFC) paradigm. Five days later, mice were re-exposed to the aversive context, and euthanized one hour later to quantify active cells. Brains were processed for c-fos immunoreactivity, and neural networks were built with a novel, wide-scale imaging pipeline. RESULTS We found that (R,S)-ketamine and (2S,6S)-HNK attenuate learned fear. Fear-related neural activity was altered in: dorsal CA3 following (2S,6S)-HNK; ventral CA3 and CA1, infralimbic (IL) and prelimbic (PL) regions, insular cortex (IC), retrosplenial cortex (RSP), piriform cortex (PIR), nucleus reuniens (RE), and periaqueductal grey (PAG) following both (R,S)-ketamine and (2S,6S)-HNK; and in the paraventricular nucleus of thalamus (PVT) following (R,S)-ketamine. Dorsal CA3 and ventral hippocampus activation correlated with freezing in the (R,S)-ketamine group, and RSP activation correlated with freezing in both (R,S)-ketamine and (2S,6S)-HNK groups. (R,S)-ketamine increased connectivity between cortical and subcortical regions while (2S,6S)-HNK increased connectivity within these regions. CONCLUSIONS This work identifies novel nodes in fear networks, involving the RE, PIR, IC, PAG and RSP, that can be targeted with neuromodulatory strategies or pharmaceutical compounds to treat fear-induced disorders. This approach could be used to optimize target engagement and dosing strategies of existing medications.
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Affiliation(s)
- Alessia Mastrodonato
- Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA; Division of Systems Neuroscience, Area Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, 10032, USA; MIND Area, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, 10032, USA.
| | - Michelle Jin
- Neurobiology and Behavior (NB&B) Graduate Program, Columbia University, New York, NY, 10027, USA; Medical Scientist Training Program (MSTP), Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
| | - Noelle Kee
- Barnard College, New York, NY, 07649, USA
| | - Marcos Lanio
- Neurobiology and Behavior (NB&B) Graduate Program, Columbia University, New York, NY, 10027, USA; Medical Scientist Training Program (MSTP), Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
| | - Juliana Tapia
- Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA; Division of Systems Neuroscience, Area Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, 10032, USA
| | | | - Andrea Muñoz Zamora
- Division of Systems Neuroscience, Area Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, 10032, USA
| | - Shi-Xian Deng
- Department of Medicine, Columbia University, New York, NY 10032, USA; Organic Chemistry Collaborative Center (OCCC), Department of Medicine, Columbia University, New York, NY 10032, USA
| | - Xiaoming Xu
- Department of Medicine, Columbia University, New York, NY 10032, USA; Organic Chemistry Collaborative Center (OCCC), Department of Medicine, Columbia University, New York, NY 10032, USA
| | - Donald W Landry
- Department of Medicine, Columbia University, New York, NY 10032, USA; Organic Chemistry Collaborative Center (OCCC), Department of Medicine, Columbia University, New York, NY 10032, USA
| | - Christine A Denny
- Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA; Division of Systems Neuroscience, Area Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, 10032, USA.
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Kaldewaij R, Salamone PC, Enmalm A, Östman L, Pietrzak M, Karlsson H, Löfberg A, Gauffin E, Samuelsson M, Gustavson S, Capusan AJ, Olausson H, Heilig M, Boehme R. Ketamine reduces the neural distinction between self- and other-produced affective touch: a randomized double-blind placebo-controlled study. Neuropsychopharmacology 2024; 49:1767-1774. [PMID: 38918578 PMCID: PMC11399133 DOI: 10.1038/s41386-024-01906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/07/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Abstract
A coherent sense of self is crucial for social functioning and mental health. The N-methyl-D-aspartate antagonist ketamine induces short-term dissociative experiences and has therefore been used to model an altered state of self-perception. This randomized double-blind placebo-controlled cross-over study investigated the mechanisms for ketamine's effects on the bodily sense of self in the context of affective touch. Thirty healthy participants (15 females/15 males, age 19-39) received intravenous ketamine or placebo while performing self-touch and receiving touch by someone else during functional MRI - a previously established neural measure of tactile self-other-differentiation. Afterwards, tactile detection thresholds during self- and other-touch were assessed, as well as dissociative states, interoceptive awareness, and social touch attitudes. Compared to placebo, ketamine administration elicited dissociation and reduced neural activity associated with self-other-differentiation in the right temporoparietal cortex, which was most pronounced during other-touch. This reduction correlated with ketamine-induced reductions in interoceptive awareness. The temporoparietal cortex showed higher connectivity to somatosensory cortex and insula during other- compared to self-touch. This difference was augmented by ketamine, and correlated with dissociation strength for somatosensory cortex. These results demonstrate that disrupting the self-experience through ketamine administration affects neural activity associated with self-other-differentiation in a region involved in touch perception and social cognition, especially with regard to social touch by someone else. This process may be driven by ketamine-induced effects on top-down signaling, rendering the processing of predictable self-generated and unpredictable other-generated touch more similar. These findings provide further evidence for the intricate relationship of the bodily self with the tactile sense.
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Affiliation(s)
- Reinoud Kaldewaij
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
| | - Paula C Salamone
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Adam Enmalm
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Lars Östman
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Michal Pietrzak
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Hanna Karlsson
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Andreas Löfberg
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Emelie Gauffin
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Martin Samuelsson
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Sarah Gustavson
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Andrea J Capusan
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Håkan Olausson
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | - Rebecca Boehme
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
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Chrobak AA, Bielak S, Nowaczek D, Żyrkowska A, Sobczak AM, Fafrowicz M, Bryll A, Marek T, Dudek D, Siwek M. Divergent pattern of functional connectivity within the dorsal attention network differentiates schizophrenia and bipolar disorder patients. Front Psychiatry 2024; 15:1474313. [PMID: 39364382 PMCID: PMC11446793 DOI: 10.3389/fpsyt.2024.1474313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 08/26/2024] [Indexed: 10/05/2024] Open
Abstract
Introduction Schizophrenia (SZ) and bipolar disorder (BD) share common clinical features, symptoms, and neurocognitive deficits, which results in common misdiagnosis. Recently, it has been suggested that alterations within brain networks associated with perceptual organization yield potential to distinguish SZ and BD individuals. The aim of our study was to evaluate whether functional connectivity (FC) of the dorsal attention network (DAN) may differentiate both conditions. Methods The study involved 90 participants: 30 remitted SZ patients, 30 euthymic BD patients, and 30 healthy controls (HC). Resting state functional magnetic resonance imaging was used to compare the groups in terms of the FC within the core nodes of the DAN involving frontal eye fields (FEF) and intraparietal sulcus (IPS). Results BD patients presented weaker inter-hemispheric FC between right and left FEF than HC. While SZ did not differ from HC in terms of inter-FEF connectivity, they presented increased inter- and intra-hemispheric FC between FEF and IPS. When compared with BD, SZ patients showed increased FC between right FEF and other nodes of the network (bilateral IPS and left FEF). Conclusion We have shown that altered resting state FC within DAN differentiates BD, SZ, and HC groups. Divergent pattern of FC within DAN, consisting of hypoconnectivity in BD and hyperconnectivity in SZ, might yield a candidate biomarker for differential diagnosis between both conditions. More highly powered studies are needed to confirm these possibilities.
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Affiliation(s)
| | - Sylwia Bielak
- Department of Adult, Child and Adolescent Psychiatry, University Hospital in Cracow, Kraków, Poland
| | | | - Aleksandra Żyrkowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
- Doctoral School in the Social Sciences, Jagiellonian University, Kraków, Poland
| | - Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Amira Bryll
- Chair of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz Marek
- Faculty of Psychology, SWPS University, Katowice, Poland
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Kraków, Poland
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Maximo JO, Briend F, Armstrong WP, Kraguljac NV, Lahti AC. Higher-order functional brain networks and anterior cingulate glutamate + glutamine (Glx) in antipsychotic-naïve first episode psychosis patients. Transl Psychiatry 2024; 14:183. [PMID: 38600117 PMCID: PMC11006887 DOI: 10.1038/s41398-024-02854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 02/07/2024] [Accepted: 02/26/2024] [Indexed: 04/12/2024] Open
Abstract
Human connectome studies have provided abundant data consistent with the hypothesis that functional dysconnectivity is predominant in psychosis spectrum disorders. Converging lines of evidence also suggest an interaction between dorsal anterior cingulate cortex (dACC) cortical glutamate with higher-order functional brain networks (FC) such as the default mode (DMN), dorsal attention (DAN), and executive control networks (ECN) in healthy controls (HC) and this mechanism may be impaired in psychosis. Data from 70 antipsychotic-medication naïve first-episode psychosis (FEP) and 52 HC were analyzed. 3T Proton magnetic resonance spectroscopy (1H-MRS) data were acquired from a voxel in the dACC and assessed correlations (positive FC) and anticorrelations (negative FC) of the DMN, DAN, and ECN. We then performed regressions to assess associations between glutamate + glutamine (Glx) with positive and negative FC of these same networks and compared them between groups. We found alterations in positive and negative FC in all networks (HC > FEP). A relationship between dACC Glx and positive and negative FC was found in both groups, but when comparing these relationships between groups, we found contrasting associations between these variables in FEP patients compared to HC. We demonstrated that both positive and negative FC in three higher-order resting state networks are already altered in antipsychotic-naïve FEP, underscoring the importance of also considering anticorrelations for optimal characterization of large-scale functional brain networks as these represent biological processes as well. Our data also adds to the growing body of evidence supporting the role of dACC cortical Glx as a mechanism underlying alterations in functional brain network connectivity. Overall, the implications for these findings are imperative as this particular mechanism may differ in untreated or chronic psychotic patients; therefore, understanding this mechanism prior to treatment could better inform clinicians.Clinical trial registration: Trajectories of Treatment Response as Window into the Heterogeneity of Psychosis: A Longitudinal Multimodal Imaging Study, NCT03442101 . Glutamate, Brain Connectivity and Duration of Untreated Psychosis (DUP), NCT02034253 .
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Affiliation(s)
- Jose O Maximo
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Frederic Briend
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
- UMR1253, iBrain, Université de Tours, Inserm, Tours, France
| | - William P Armstrong
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nina V Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Uzungil V, Luza S, Opazo CM, Mees I, Li S, Ang CS, Williamson NA, Bush AI, Hannan AJ, Renoir T. Phosphoproteomics implicates glutamatergic and dopaminergic signalling in the antidepressant-like properties of the iron chelator deferiprone. Neuropharmacology 2024; 246:109837. [PMID: 38184274 DOI: 10.1016/j.neuropharm.2024.109837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/08/2024]
Abstract
BACKGROUND Current antidepressants have limitations due to insufficient efficacy and delay before improvement in symptoms. Polymorphisms of the serotonin transporter (5-HTT) gene have been linked to depression (when combined with stressful life events) and altered response to selective serotonergic reuptake inhibitors. We have previously revealed the antidepressant-like properties of the iron chelator deferiprone in the 5-HTT knock-out (KO) mouse model of depression. Furthermore, deferiprone was found to alter neural activity in the prefrontal cortex of both wild-type (WT) and 5-HTT KO mice. METHODS In the current study, we examined the molecular effects of acute deferiprone treatment in the prefrontal cortex of both genotypes via phosphoproteomics analysis. RESULTS In WT mice treated with deferiprone, there were 22 differentially expressed phosphosites, with gene ontology analysis implicating cytoskeletal proteins. In 5-HTT KO mice treated with deferiprone, we found 33 differentially expressed phosphosites. Gene ontology analyses revealed phosphoproteins that were predominantly involved in synaptic and glutamatergic signalling. In a drug-naïve cohort (without deferiprone administration), the analysis revealed 21 differentially expressed phosphosites in 5-HTT KO compared to WT mice. We confirmed the deferiprone-induced increase in tyrosine hydroxylase serine 40 residue phosphorylation (pTH-Ser40) (initially revealed in our phosphoproteomics study) by Western blot analysis, with deferiprone increasing pTH-Ser40 expression in WT and 5-HTT KO mice. CONCLUSION As glutamatergic and synaptic signalling are dysfunctional in 5-HTT KO mice (and are the target of fast-acting antidepressant drugs such as ketamine), these molecular effects may underpin deferiprone's antidepressant-like properties. Furthermore, dopaminergic signalling may also be involved in deferiprone's antidepressant-like properties.
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Affiliation(s)
- Volkan Uzungil
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Sandra Luza
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia
| | - Carlos M Opazo
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Isaline Mees
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Shanshan Li
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Ching-Seng Ang
- Bio21 Mass Spectrometry and Proteomics Facility, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Nicholas A Williamson
- Bio21 Mass Spectrometry and Proteomics Facility, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Ashley I Bush
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Anthony J Hannan
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Thibault Renoir
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia.
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Martino M, Magioncalda P. A three-dimensional model of neural activity and phenomenal-behavioral patterns. Mol Psychiatry 2024; 29:639-652. [PMID: 38114633 DOI: 10.1038/s41380-023-02356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
How phenomenal experience and behavior are related to neural activity in physiology and psychopathology represents a fundamental question in neuroscience and psychiatry. The phenomenal-behavior patterns may be deconstructed into basic dimensions, i.e., psychomotricity, affectivity, and thought, which might have distinct neural correlates. This work provides a data overview on the relationship of these phenomenal-behavioral dimensions with brain activity across physiological and pathological conditions (including major depressive disorder, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder, anxiety disorders, addictive disorders, Parkinson's disease, Tourette syndrome, Alzheimer's disease, and frontotemporal dementia). Accordingly, we propose a three-dimensional model of neural activity and phenomenal-behavioral patterns. In this model, neural activity is organized into distinct units in accordance with connectivity patterns and related input/output processing, manifesting in the different phenomenal-behavioral dimensions. (1) An external neural unit, which involves the sensorimotor circuit/brain's sensorimotor network and is connected with the external environment, processes external inputs/outputs, manifesting in the psychomotor dimension (processing of exteroception/somatomotor activity). External unit hyperactivity manifests in psychomotor excitation (hyperactivity/hyperkinesia/catatonia), while external unit hypoactivity manifests in psychomotor inhibition (retardation/hypokinesia/catatonia). (2) An internal neural unit, which involves the interoceptive-autonomic circuit/brain's salience network and is connected with the internal/body environment, processes internal inputs/outputs, manifesting in the affective dimension (processing of interoception/autonomic activity). Internal unit hyperactivity manifests in affective excitation (anxiety/dysphoria-euphoria/panic), while internal unit hypoactivity manifests in affective inhibition (anhedonia/apathy/depersonalization). (3) An associative neural unit, which involves the brain's associative areas/default-mode network and is connected with the external/internal units (but not with the environment), processes associative inputs/outputs, manifesting in the thought dimension (processing of ideas). Associative unit hyperactivity manifests in thought excitation (mind-wandering/repetitive thinking/psychosis), while associative unit hypoactivity manifests in thought inhibition (inattention/cognitive deficit/consciousness loss). Finally, these neural units interplay and dynamically combine into various neural states, resulting in the complex phenomenal experience and behavior across physiology and neuropsychiatric disorders.
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Affiliation(s)
- Matteo Martino
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
| | - Paola Magioncalda
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Radiology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
- Department of Medical Research, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
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Gautam D, Raza MU, Miyakoshi M, Molina JL, Joshi YB, Clayson PE, Light GA, Swerdlow NR, Sivarao DV. Click-train evoked steady state harmonic response as a novel pharmacodynamic biomarker of cortical oscillatory synchrony. Neuropharmacology 2023; 240:109707. [PMID: 37673332 DOI: 10.1016/j.neuropharm.2023.109707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/25/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023]
Abstract
Sensory networks naturally entrain to rhythmic stimuli like a click train delivered at a particular frequency. Such synchronization is integral to information processing, can be measured by electroencephalography (EEG) and is an accessible index of neural network function. Click trains evoke neural entrainment not only at the driving frequency (F), referred to as the auditory steady state response (ASSR), but also at its higher multiples called the steady state harmonic response (SSHR). Since harmonics play an important and non-redundant role in acoustic information processing, we hypothesized that SSHR may differ from ASSR in presentation and pharmacological sensitivity. In female SD rats, a 2 s-long train stimulus was used to evoke ASSR at 20 Hz and its SSHR at 40, 60 and 80 Hz, recorded from a prefrontal epidural electrode. Narrow band evoked responses were evident at all frequencies; signal power was strongest at 20 Hz while phase synchrony was strongest at 80 Hz. SSHR at 40 Hz took the longest time (∼180 ms from stimulus onset) to establish synchrony. The NMDA antagonist MK801 (0.025-0.1 mg/kg) did not consistently affect 20 Hz ASSR phase synchrony but robustly and dose-dependently attenuated synchrony of all SSHR. Evoked power was attenuated by MK801 at 20 Hz ASSR and 40 Hz SSHR only. Thus, presentation as well as pharmacological sensitivity distinguished SSHR from ASSR, making them non-redundant markers of cortical network function. SSHR is a novel and promising translational biomarker of cortical oscillatory dynamics that may have important applications in CNS drug development and personalized medicine.
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Affiliation(s)
- Deepshila Gautam
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, 37604, USA
| | - Muhammad Ummear Raza
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, 37604, USA
| | - M Miyakoshi
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J L Molina
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA; VISN 22 MIRECC, SD Veterans Administration Health System, La Jolla, CA, USA
| | - Y B Joshi
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA; VISN 22 MIRECC, SD Veterans Administration Health System, La Jolla, CA, USA
| | - P E Clayson
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - G A Light
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA; VISN 22 MIRECC, SD Veterans Administration Health System, La Jolla, CA, USA
| | - N R Swerdlow
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA; VISN 22 MIRECC, SD Veterans Administration Health System, La Jolla, CA, USA
| | - Digavalli V Sivarao
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, 37604, USA.
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Lee S, Cheong Y, Ryu Y, Kosaka H, Jung M. Vasotocin receptor gene genotypes moderate the relationship between cortical thickness and sensory processing. Transl Psychiatry 2023; 13:356. [PMID: 37990008 PMCID: PMC10663457 DOI: 10.1038/s41398-023-02657-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/24/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
Sensory processing is the process by which the central nervous system gathers, interprets, and regulates sensory stimuli in response to environmental cues. However, our understanding of the genetic factors and neuroanatomical correlations that influence sensory processing is limited. The vasotocin system modulates sensory input responsiveness, making it a potential candidate for further investigation. Additionally, human neuroimaging studies have demonstrated that the ability to modulate sensory stimuli is related to neuroanatomical features such as cortical thickness. Therefore, this study aimed to examine the relationship between functional polymorphisms in vasotocin receptor (VTR) genes, sensory profiles, and neuroanatomical correlations. We used structural magnetic resonance imaging (MRI) and the Adolescent/Adult Sensory Profile (AASP) questionnaire in 98 healthy adult participants to assess sensory processing and identified seven single nucleotide polymorphisms. We found that A-allele carriers of rs1042615 in VTR had higher scores for "sensory sensitivity" and "sensation avoiding". Moreover, higher scores for three AASP subscales were associated with decreased cortical thickness in various regions, including the right precentral, paracentral, and fusiform gyri, as well as bilateral inferior temporal gyri. This study sheds light on the potential role of genetic variations in the VTR in modulating sensory processing and correlation with cortical thickness which has future implications for better understanding sensory abnormalities in neurodevelopmental disorders.
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Affiliation(s)
- Seonkyoung Lee
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Yongjeon Cheong
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Yeseul Ryu
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Hirotaka Kosaka
- Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui, Japan.
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Eiheiji, Japan.
| | - Minyoung Jung
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, Republic of Korea.
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Dickie EW, Shahab S, Hawco C, Miranda D, Herman G, Argyelan M, Ji JL, Jeyachandra J, Anticevic A, Malhotra AK, Voineskos AN. Robust hierarchically organized whole-brain patterns of dysconnectivity in schizophrenia spectrum disorders observed after personalized intrinsic network topography. Hum Brain Mapp 2023; 44:5153-5166. [PMID: 37605827 PMCID: PMC10502662 DOI: 10.1002/hbm.26453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 07/05/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Spatial patterns of brain functional connectivity can vary substantially at the individual level. Applying cortical surface-based approaches with individualized rather than group templates may accelerate the discovery of biological markers related to psychiatric disorders. We investigated cortico-subcortical networks from multi-cohort data in people with schizophrenia spectrum disorders (SSDs) and healthy controls (HC) using individualized connectivity profiles. METHODS We utilized resting-state and anatomical MRI data from n = 406 participants (n = 203 SSD, n = 203 HC) from four cohorts. Functional timeseries were extracted from previously defined intrinsic network subregions of the striatum, thalamus, and cerebellum as well as 80 cortical regions of interest, representing six intrinsic networks using (1) volume-based approaches, (2) a surface-based group atlas approaches, and (3) Personalized Intrinsic Network Topography (PINT). RESULTS The correlations between all cortical networks and the expected subregions of the striatum, cerebellum, and thalamus were increased using a surface-based approach (Cohen's D volume vs. surface 0.27-1.00, all p < 10-6 ) and further increased after PINT (Cohen's D surface vs. PINT 0.18-0.96, all p < 10-4 ). In SSD versus HC comparisons, we observed robust patterns of dysconnectivity that were strengthened using a surface-based approach and PINT (Number of differing pairwise-correlations: volume: 404, surface: 570, PINT: 628, FDR corrected). CONCLUSION Surface-based and individualized approaches can more sensitively delineate cortical network dysconnectivity differences in people with SSDs. These robust patterns of dysconnectivity were visibly organized in accordance with the cortical hierarchy, as predicted by computational models.
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Affiliation(s)
- Erin W. Dickie
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioUSA
| | - Saba Shahab
- Department of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Colin Hawco
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioUSA
| | - Dayton Miranda
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
| | - Gabrielle Herman
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
| | - Miklos Argyelan
- Psychiatry Research, The Zucker Hillside HospitalGlen CoveNew YorkUSA
- Institute of Behavioral Science, Feinstein Institutes for Medical ResearchManhassetNew YorkUSA
- Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Jie Lisa Ji
- Department of PsychiatryYale UniversityNew HavenConnecticutUSA
| | - Jerrold Jeyachandra
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
| | - Alan Anticevic
- Department of PsychiatryYale UniversityNew HavenConnecticutUSA
| | - Anil K. Malhotra
- Psychiatry Research, The Zucker Hillside HospitalGlen CoveNew YorkUSA
- Institute of Behavioral Science, Feinstein Institutes for Medical ResearchManhassetNew YorkUSA
- Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Aristotle N. Voineskos
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioUSA
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10
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Avery SN, Rogers BP, McHugo M, Armstrong K, Blackford JU, Vandekar SN, Woodward ND, Heckers S. Hippocampal Network Dysfunction in Early Psychosis: A 2-Year Longitudinal Study. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:979-989. [PMID: 37881573 PMCID: PMC10593896 DOI: 10.1016/j.bpsgos.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/17/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
Background Hippocampal abnormalities are among the most consistent findings in schizophrenia. Numerous studies have reported deficits in hippocampal volume, function, and connectivity in the chronic stage of illness. While hippocampal volume and function deficits are also present in the early stage of illness, there is mixed evidence of both higher and lower functional connectivity. Here, we use graph theory to test the hypothesis that hippocampal network connectivity is broadly lowered in early psychosis and progressively worsens over 2 years. Methods We examined longitudinal resting-state functional connectivity in 140 participants (68 individuals in the early stage of psychosis, 72 demographically similar healthy control individuals). We used an anatomically driven approach to quantify hippocampal network connectivity at 2 levels: 1) a core hippocampal-medial temporal lobe cortex (MTLC) network; and 2) an extended hippocampal-cortical network. Group and time effects were tested in a linear mixed effects model. Results Early psychosis patients showed elevated functional connectivity in the core hippocampal-MTLC network, but contrary to our hypothesis, did not show alterations within the broader hippocampal-cortical network. Hippocampal-MTLC network hyperconnectivity normalized longitudinally and predicted improvement in positive symptoms but was not associated with increasing illness duration. Conclusions These results show abnormally elevated functional connectivity in a core hippocampal-MTLC network in early psychosis, suggesting that selectively increased hippocampal signaling within a localized cortical circuit may be a marker of the early stage of psychosis. Hippocampal-MTLC hyperconnectivity could have prognostic and therapeutic implications.
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Affiliation(s)
- Suzanne N. Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Baxter P. Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, Tennessee
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Simon N. Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
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11
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Odkhuu S, Kim WS, Tsogt U, Shen J, Cheraghi S, Li L, Rami FZ, Le TH, Lee KH, Kang NI, Kim SW, Chung YC. Network biomarkers in recovered psychosis patients who discontinued antipsychotics. Mol Psychiatry 2023; 28:3717-3726. [PMID: 37773447 PMCID: PMC10730417 DOI: 10.1038/s41380-023-02279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/08/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023]
Abstract
There are no studies investigating topological properties of resting-state fMRI (rs-fMRI) in patients who have recovered from psychosis and discontinued medication (hereafter, recovered patients [RP]). This study aimed to explore topological organization of the functional brain connectome in the RP using graph theory approach. We recruited 30 RP and 50 age and sex-matched healthy controls (HC). The RP were further divided into the subjects who were relapsed after discontinuation of antipsychotics (RP-R) and who maintained recovered state without relapse (RP-M). Using graph-based network analysis of rs-fMRI signals, global and local metrics and hub information were obtained. The robustness of the network was tested with random failure and targeted attack. As an ancillary analysis, Network-Based Statistic (NBS) was performed. Association of significant findings with psychopathology and cognitive functioning was also explored. The RP showed intact network properties in terms of global and local metrics. However, higher global functional connectivity strength and hyperconnectivity in the interconnected component were observed in the RP compared to HC. In the subgroup analysis, the RP-R were found to have lower global efficiency, longer characteristic path length and lower robustness whereas no such abnormalities were identified in the RP-M. Associations of the degree centrality of some hubs with cognitive functioning were identified in the RP-M. Even though network properties of the RP were intact, subgroup analysis revealed more altered topological organizations in the RP-R. The findings in the RP-R and RP-M may serve as network biomarkers for predicting relapse or maintained recovery after the discontinuation of antipsychotics.
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Affiliation(s)
- Soyolsaikhan Odkhuu
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Woo-Sung Kim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Korea
| | - Uyanga Tsogt
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Jie Shen
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Sahar Cheraghi
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Ling Li
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Fatima Zahra Rami
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Thi-Hung Le
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Keon-Hak Lee
- Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea
| | - Nam-In Kang
- Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea.
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Korea.
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12
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Speers LJ, Sissons DJ, Cleland L, Bilkey DK. Hippocampal phase precession is preserved under ketamine, but the range of precession across a theta cycle is reduced. J Psychopharmacol 2023; 37:809-821. [PMID: 37515458 PMCID: PMC10399102 DOI: 10.1177/02698811231187339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND Hippocampal phase precession, which depends on the precise spike timing of place cells relative to local theta oscillations, has been proposed to underlie sequential memory. N-methyl-D-asparate (NMDA) receptor antagonists such as ketamine disrupt memory and also reproduce several schizophrenia-like symptoms, including spatial memory impairments and disorganized cognition. It is possible that these impairments result from disruptions to phase precession. AIMS/METHODS We used an ABA design to test whether an acute, subanesthetic dose (7.5 mg/kg) of ketamine disrupted phase precession in CA1 of male rats as they navigated around a rectangular track for a food reward. RESULTS/OUTCOMES Ketamine did not affect the ability of CA1 place cells to precess despite changes to place cell firing rates, local field potential properties and locomotor speed. However, ketamine reduced the range of phase precession that occurred across a theta cycle. CONCLUSION Phase precession is largely robust to acute NMDA receptor antagonism by ketamine, but the reduced range of precession could have important implications for learning and memory.
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Affiliation(s)
| | - Daena J Sissons
- Psychology Department, Otago University Dunedin, New Zealand
- Psychology Department, University of Canterbury, Christchurch, New Zealand
| | - Lana Cleland
- Psychology Department, Otago University Dunedin, New Zealand
- Department Psychological Medicine, Otago University, Christchurch, New Zealand
- Department Population Health, Otago University, Christchurch, New Zealand
| | - David K Bilkey
- Psychology Department, Otago University Dunedin, New Zealand
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13
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Castillo A, Dubois J, Field RM, Fishburn F, Gundran A, Ho WC, Jawhar S, Kates-Harbeck J, M Aghajan Z, Miller N, Perdue KL, Phillips J, Ryan WC, Shafiei M, Scholkmann F, Taylor M. Measuring acute effects of subanesthetic ketamine on cerebrovascular hemodynamics in humans using TD-fNIRS. Sci Rep 2023; 13:11665. [PMID: 37468572 PMCID: PMC10356754 DOI: 10.1038/s41598-023-38258-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023] Open
Abstract
Quantifying neural activity in natural conditions (i.e. conditions comparable to the standard clinical patient experience) during the administration of psychedelics may further our scientific understanding of the effects and mechanisms of action. This data may facilitate the discovery of novel biomarkers enabling more personalized treatments and improved patient outcomes. In this single-blind, placebo-controlled study with a non-randomized design, we use time-domain functional near-infrared spectroscopy (TD-fNIRS) to measure acute brain dynamics after intramuscular subanesthetic ketamine (0.75 mg/kg) and placebo (saline) administration in healthy participants (n = 15, 8 females, 7 males, age 32.4 ± 7.5 years) in a clinical setting. We found that the ketamine administration caused an altered state of consciousness and changes in systemic physiology (e.g. increase in pulse rate and electrodermal activity). Furthermore, ketamine led to a brain-wide reduction in the fractional amplitude of low frequency fluctuations, and a decrease in the global brain connectivity of the prefrontal region. Lastly, we provide preliminary evidence that a combination of neural and physiological metrics may serve as predictors of subjective mystical experiences and reductions in depressive symptomatology. Overall, our study demonstrated the successful application of fNIRS neuroimaging to study the physiological effects of the psychoactive substance ketamine in humans, and can be regarded as an important step toward larger scale clinical fNIRS studies that can quantify the impact of psychedelics on the brain in standard clinical settings.
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Affiliation(s)
| | - Julien Dubois
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Ryan M Field
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Frank Fishburn
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Andrew Gundran
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Wilson C Ho
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Sami Jawhar
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | | | - Zahra M Aghajan
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Naomi Miller
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | | | - Jake Phillips
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Wesley C Ryan
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Mahdi Shafiei
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
| | - Felix Scholkmann
- Scholkmann Data Analysis Services, Scientific Consulting and Physical Engineering, 8057, Zurich, Switzerland
- Neurophotonics and Biosignal Processing Research Group, Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland
| | - Moriah Taylor
- Kernel, 5042 Wilshire Blvd, #26878, Los Angeles, CA, 90036, USA
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14
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Kocsis B, Pittman-Polletta B. Neuropsychiatric consequences of COVID-19 related olfactory dysfunction: could non-olfactory cortical-bound inputs from damaged olfactory bulb also contribute to cognitive impairment? Front Neurosci 2023; 17:1164042. [PMID: 37425004 PMCID: PMC10323442 DOI: 10.3389/fnins.2023.1164042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/24/2023] [Indexed: 07/11/2023] Open
Affiliation(s)
- Bernat Kocsis
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, United States
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15
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Ji JL, Lencz T, Gallego J, Neufeld N, Voineskos A, Malhotra A, Anticevic A. Informing individualized multi-scale neural signatures of clozapine response in patients with treatment-refractory schizophrenia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.10.23286854. [PMID: 36993630 PMCID: PMC10055439 DOI: 10.1101/2023.03.10.23286854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Clozapine is currently the only antipsychotic with demonstrated efficacy in treatment-refractory schizophrenia (TRS). However, response to clozapine differs widely between TRS patients, and there are no available clinical or neural predictive indicators that could be used to increase or accelerate the use of clozapine in patients who stand to benefit. Furthermore, it remains unclear how the neuropharmacology of clozapine contributes to its therapeutic effects. Identifying the mechanisms underlying clozapine's therapeutic effects across domains of symptomatology could be crucial for development of new optimized therapies for TRS. Here, we present results from a prospective neuroimaging study that quantitatively related heterogeneous patterns of clinical clozapine response to neural functional connectivity at baseline. We show that we can reliably capture specific dimensions of clozapine clinical response by quantifying the full variation across item-level clinical scales, and that these dimensions can be mapped to neural features that are sensitive to clozapine-induced symptom change. Thus, these features may act as "failure modes" that can provide an early indication of treatment (non-)responsiveness. Lastly, we related the response-relevant neural maps to spatial expression profiles of genes coding for receptors implicated in clozapine's pharmacology, demonstrating that distinct dimensions of clozapine symptom-informed neural features may be associated with specific receptor targets. Collectively, this study informs prognostic neuro-behavioral measures for clozapine as a more optimal treatment for selected patients with TRS. We provide support for the identification of neuro-behavioral targets linked to pharmacological efficacy that can be further developed to inform optimal early treatment decisions in schizophrenia.
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16
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Driesen NR, Herman P, Rowland MA, Thompson G, Qiu M, He G, Fineberg S, Barron DS, Helgeson L, Lacadie C, Chow R, Gueorguieva R, Straun TC, Krystal JH, Hyder F. Ketamine Effects on Energy Metabolism, Functional Connectivity and Working Memory in Healthy Humans. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.21.529425. [PMID: 36865249 PMCID: PMC9980048 DOI: 10.1101/2023.02.21.529425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Working memory (WM) is a crucial resource for temporary memory storage and the guiding of ongoing behavior. N-methyl-D-aspartate glutamate receptors (NMDARs) are thought to support the neural underpinnings of WM. Ketamine is an NMDAR antagonist that has cognitive and behavioral effects at subanesthetic doses. To shed light on subanesthetic ketamine effects on brain function, we employed a multimodal imaging design, combining gas-free calibrated functional magnetic resonance imaging (fMRI) measurement of oxidative metabolism (CMRO 2 ), resting-state cortical functional connectivity assessed with fMRI, and WM-related fMRI. Healthy subjects participated in two scan sessions in a randomized, double-blind, placebo-controlled design. Ketamine increased CMRO 2 and cerebral blood flow (CBF) in prefrontal cortex (PFC) and other cortical regions. However, resting-state cortical functional connectivity was not affected. Ketamine did not alter CBF-CMRO 2 coupling brain-wide. Higher levels of basal CMRO 2 were associated with lower task-related PFC activation and WM accuracy impairment under both saline and ketamine conditions. These observations suggest that CMRO 2 and resting-state functional connectivity index distinct dimensions of neural activity. Ketamine’s impairment of WM-related neural activity and performance appears to be related to its ability to produce cortical metabolic activation. This work illustrates the utility of direct measurement of CMRO 2 via calibrated fMRI in studies of drugs that potentially affect neurovascular and neurometabolic coupling.
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17
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Qin Y, Mahdavi A, Bertschy M, Anderson PM, Kulikova S, Pinault D. The psychotomimetic ketamine disrupts the transfer of late sensory information in the corticothalamic network. Eur J Neurosci 2023; 57:440-455. [PMID: 36226598 PMCID: PMC10092610 DOI: 10.1111/ejn.15845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/17/2022] [Accepted: 09/01/2022] [Indexed: 02/04/2023]
Abstract
In prodromal and early schizophrenia, disorders of attention and perception are associated with structural and chemical brain abnormalities and with dysfunctional corticothalamic networks exhibiting disturbed brain rhythms. The underlying mechanisms are elusive. The non-competitive NMDA receptor antagonist ketamine simulates the symptoms of prodromal and early schizophrenia, including disturbances in ongoing and task & sensory-related broadband beta-/gamma-frequency (17-29 Hz/30-80 Hz) oscillations in corticothalamic networks. In normal healthy subjects and rodents, complex integration processes, like sensory perception, induce transient, large-scale synchronised beta/gamma oscillations in a time window of a few hundred ms (200-700 ms) after the presentation of the object of attention (e.g., sensory stimulation). Our goal was to use an electrophysiological multisite network approach to investigate, in lightly anesthetised rats, the effects of a single psychotomimetic dose (2.5 mg/kg, subcutaneous) of ketamine on sensory stimulus-induced oscillations. Ketamine transiently increased the power of baseline beta/gamma oscillations and decreased sensory-induced beta/gamma oscillations. In addition, it disrupted information transferability in both the somatosensory thalamus and the related cortex and decreased the sensory-induced thalamocortical connectivity in the broadband gamma range. The present findings support the hypothesis that NMDA receptor antagonism disrupts the transfer of perceptual information in the somatosensory cortico-thalamo-cortical system.
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Affiliation(s)
- Yi Qin
- Université de StrasbourgStrasbourgFrance
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénieStrasbourgFrance
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecineStrasbourgFrance
- Centre de Recherche en Biomédecine de Strasbourg (CRBS)StrasbourgFrance
- Netherlands Institute for NeuroscienceThe Netherlands
| | - Ali Mahdavi
- Université de StrasbourgStrasbourgFrance
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénieStrasbourgFrance
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecineStrasbourgFrance
- Centre de Recherche en Biomédecine de Strasbourg (CRBS)StrasbourgFrance
- The University of Freiburg, Bernstein Center FreiburgFreiburgGermany
| | - Marine Bertschy
- Université de StrasbourgStrasbourgFrance
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénieStrasbourgFrance
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecineStrasbourgFrance
- Centre de Recherche en Biomédecine de Strasbourg (CRBS)StrasbourgFrance
| | - Paul M. Anderson
- Dept. Cognitive Neurobiology, Center for Brain ResearchMedical University ViennaAustria
| | - Sofya Kulikova
- National Research University Higher School of EconomicsPermRussia
| | - Didier Pinault
- Université de StrasbourgStrasbourgFrance
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénieStrasbourgFrance
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecineStrasbourgFrance
- Centre de Recherche en Biomédecine de Strasbourg (CRBS)StrasbourgFrance
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18
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Huang Z, Mashour GA, Hudetz AG. Functional geometry of the cortex encodes dimensions of consciousness. Nat Commun 2023; 14:72. [PMID: 36604428 PMCID: PMC9814511 DOI: 10.1038/s41467-022-35764-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
Consciousness is a multidimensional phenomenon, but key dimensions such as awareness and wakefulness have been described conceptually rather than neurobiologically. We hypothesize that dimensions of consciousness are encoded in multiple neurofunctional dimensions of the brain. We analyze cortical gradients, which are continua of the brain's overarching functional geometry, to characterize these neurofunctional dimensions. We demonstrate that disruptions of human consciousness - due to pharmacological, neuropathological, or psychiatric causes - are associated with a degradation of one or more of the major cortical gradients depending on the state. Network-specific reconfigurations within the multidimensional cortical gradient space are associated with behavioral unresponsiveness of various etiologies, and these spatial reconfigurations correlate with a temporal disruption of structured transitions of dynamic brain states. In this work, we therefore provide a unifying neurofunctional framework for multiple dimensions of human consciousness in both health and disease.
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Affiliation(s)
- Zirui Huang
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA. .,Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
| | - George A Mashour
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Anthony G Hudetz
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, 48109, USA
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19
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Kawazoe K, McGlynn R, Felix W, Sevilla R, Liao S, Kulkarni P, Ferris CF. Dose-dependent effects of esketamine on brain activity in awake mice: A BOLD phMRI study. Pharmacol Res Perspect 2022; 10:e01035. [PMID: 36504448 PMCID: PMC9743060 DOI: 10.1002/prp2.1035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 12/14/2022] Open
Abstract
Pharmacological magnetic resonance imaging (phMRI) is a noninvasive method used to evaluate neural circuitry involved in the behavioral effects of drugs like ketamine, independent of their specific biochemical mechanism. The study was designed to evaluate the immediate effect of esketamine, the S-isomer of (±) ketamine on brain activity in awake mice using blood oxygenation level dependent (BOLD) imaging. It was hypothesized the prefrontal cortex, hippocampus, and brain areas associated with reward and motivation would show a dose-dependent increase in brain activity. Mice were given vehicle, 1.0, 3.3, or 10 mg/kg esketamine I.P. and imaged for 10 min post-treatment. Data for each treatment were registered to a 3D MRI mouse brain atlas providing site-specific information on 134 different brain areas. There was a global change in brain activity for both positive and negative BOLD signal affecting over 50 brain areas. Many areas showed a dose-dependent decrease in positive BOLD signal, for example, cortex, hippocampus, and thalamus. The most common profile when comparing the three doses was a U-shape with the 3.3 dose having the lowest change in signal. At 1.0 mg/kg there was a significant increase in positive BOLD in forebrain areas and hippocampus. The anticipated dose-dependent increase in BOLD was not realized; instead, the lowest dose of 1.0 mg/kg had the greatest effect on brain activity. The prefrontal cortex and hippocampus were significantly activated corroborating previous imaging studies in humans and animals. The unexpected sensitivity to the 1.0 mg/kg dose of esketamine could be explained by imaging in fully awake mice without the confound of anesthesia and/or its greater affinity for the N-methyl-d-aspartate receptor (NMDAR) receptor than (±) ketamine.
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Affiliation(s)
- Kyrsten Kawazoe
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Ryan McGlynn
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Wilder Felix
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Raquel Sevilla
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Siyang Liao
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Praveen Kulkarni
- Center for Translational NeuroimagingNortheastern UniversityMassachusettsBostonUSA
| | - Craig F. Ferris
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
- Center for Translational NeuroimagingNortheastern UniversityMassachusettsBostonUSA
- Department of PsychologyNortheastern UniversityBostonMassachusettsUSA
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20
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Uzungil V, Tran H, Aitken C, Wilson C, Opazo CM, Li S, Payet JM, Mawal CH, Bush AI, Hale MW, Hannan AJ, Renoir T. Novel Antidepressant-Like Properties of the Iron Chelator Deferiprone in a Mouse Model of Depression. Neurotherapeutics 2022; 19:1662-1685. [PMID: 35861925 PMCID: PMC9606181 DOI: 10.1007/s13311-022-01257-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 10/17/2022] Open
Abstract
Depressed individuals who carry the short allele for the serotonin-transporter-linked promotor region of the gene are more vulnerable to stress and have reduced response to first-line antidepressants such as selective serotonin reuptake inhibitors. Since depression severity has been reported to correlate with brain iron levels, the present study aimed to characterise the potential antidepressant properties of the iron chelator deferiprone. Using the serotonin transporter knock-out (5-HTT KO) mouse model, we assessed the behavioural effects of acute deferiprone on the Porsolt swim test (PST) and novelty-suppressed feeding test (NSFT). Brain and blood iron levels were also measured following acute deferiprone. To determine the relevant brain regions activated by deferiprone, we then measured c-Fos expression and applied network-based analyses. We found that deferiprone reduced immobility time in the PST in 5-HTT KO mice and reduced latency to feed in the NSFT in both genotypes, suggesting potential antidepressant-like effects. There was no effect on brain or blood iron levels following deferiprone treatment, potentially indicating an acute iron-independent mechanism. Deferiprone reversed the increase in c-Fos expression induced by swim stress in 5-HTT KO mice in the lateral amygdala. Functional network analyses suggest that hub regions of activity in mice treated with deferiprone include the caudate putamen and prefrontal cortex. The PST-induced increase in network modularity in wild-type mice was not observed in 5-HTT KO mice. Altogether, our data show that the antidepressant-like effects of deferiprone could be acting via an iron-independent mechanism and that these therapeutic effects are underpinned by changes in neuronal activity in the lateral amygdala.
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Affiliation(s)
- Volkan Uzungil
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Harvey Tran
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Connor Aitken
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Carey Wilson
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Carlos M Opazo
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Shanshan Li
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Jennyfer M Payet
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Celeste H Mawal
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Ashley I Bush
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Matthew W Hale
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Anthony J Hannan
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Thibault Renoir
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia.
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia.
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21
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Kamishikiryo T, Okada G, Itai E, Masuda Y, Yokoyama S, Takamura M, Fuchikami M, Yoshino A, Mawatari K, Numata S, Takahashi A, Ohmori T, Okamoto Y. Left DLPFC activity is associated with plasma kynurenine levels and can predict treatment response to escitalopram in major depressive disorder. Psychiatry Clin Neurosci 2022; 76:367-376. [PMID: 35543406 PMCID: PMC9544423 DOI: 10.1111/pcn.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/16/2022] [Accepted: 04/24/2022] [Indexed: 11/27/2022]
Abstract
AIM To establish treatment response biomarkers that reflect the pathophysiology of depression, it is important to use an integrated set of features. This study aimed to determine the relationship between regional brain activity at rest and blood metabolites related to treatment response to escitalopram to identify the characteristics of depression that respond to treatment. METHODS Blood metabolite levels and resting-state brain activity were measured in patients with moderate to severe depression (n = 65) before and after 6-8 weeks of treatment with escitalopram, and these were compared between Responders and Nonresponders to treatment. We then examined the relationship between blood metabolites and brain activity related to treatment responsiveness in patients and healthy controls (n = 36). RESULTS Thirty-two patients (49.2%) showed a clinical response (>50% reduction in the Hamilton Rating Scale for Depression score) and were classified as Responders, and the remaining 33 patients were classified as Nonresponders. The pretreatment fractional amplitude of low-frequency fluctuation (fALFF) value of the left dorsolateral prefrontal cortex (DLPFC) and plasma kynurenine levels were lower in Responders, and the rate of increase of both after treatment was correlated with an improvement in symptoms. Moreover, the fALFF value of the left DLPFC was significantly correlated with plasma kynurenine levels in pretreatment patients with depression and healthy controls. CONCLUSION Decreased resting-state regional activity of the left DLPFC and decreased plasma kynurenine levels may predict treatment response to escitalopram, suggesting that it may be involved in the pathophysiology of major depressive disorder in response to escitalopram treatment.
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Affiliation(s)
- Toshiharu Kamishikiryo
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Go Okada
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Eri Itai
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Yoshikazu Masuda
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Masahiro Takamura
- Department of Neurology, Faculty of MedicineShimane UniversityIzumo‐shiJapan
| | - Manabu Fuchikami
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Atsuo Yoshino
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Kazuaki Mawatari
- Department of Preventive Environment and Nutrition, Institute of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Shusuke Numata
- Department of Psychiatry, Institute of Biomedical ScienceTokushima University Graduate SchoolTokushimaJapan
| | - Akira Takahashi
- Department of Preventive Environment and Nutrition, Institute of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Tetsuro Ohmori
- Department of Psychiatry, Institute of Biomedical ScienceTokushima University Graduate SchoolTokushimaJapan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
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22
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Abram SV, Roach BJ, Fryer SL, Calhoun VD, Preda A, van Erp TGM, Bustillo JR, Lim KO, Loewy RL, Stuart BK, Krystal JH, Ford JM, Mathalon DH. Validation of ketamine as a pharmacological model of thalamic dysconnectivity across the illness course of schizophrenia. Mol Psychiatry 2022; 27:2448-2456. [PMID: 35422467 PMCID: PMC9135621 DOI: 10.1038/s41380-022-01502-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 01/01/2023]
Abstract
N-methyl-D-aspartate receptor (NMDAR) hypofunction is a leading pathophysiological model of schizophrenia. Resting-state functional magnetic resonance imaging (rsfMRI) studies demonstrate a thalamic dysconnectivity pattern in schizophrenia involving excessive connectivity with sensory regions and deficient connectivity with frontal, cerebellar, and thalamic regions. The NMDAR antagonist ketamine, when administered at sub-anesthetic doses to healthy volunteers, induces transient schizophrenia-like symptoms and alters rsfMRI thalamic connectivity. However, the extent to which ketamine-induced thalamic dysconnectivity resembles schizophrenia thalamic dysconnectivity has not been directly tested. The current double-blind, placebo-controlled study derived an NMDAR hypofunction model of thalamic dysconnectivity from healthy volunteers undergoing ketamine infusions during rsfMRI. To assess whether ketamine-induced thalamic dysconnectivity was mediated by excess glutamate release, we tested whether pre-treatment with lamotrigine, a glutamate release inhibitor, attenuated ketamine's effects. Ketamine produced robust thalamo-cortical hyper-connectivity with sensory and motor regions that was not reduced by lamotrigine pre-treatment. To test whether the ketamine thalamic dysconnectivity pattern resembled the schizophrenia pattern, a whole-brain template representing ketamine's thalamic dysconnectivity effect was correlated with individual participant rsfMRI thalamic dysconnectivity maps, generating "ketamine similarity coefficients" for people with chronic (SZ) and early illness (ESZ) schizophrenia, individuals at clinical high-risk for psychosis (CHR-P), and healthy controls (HC). Similarity coefficients were higher in SZ and ESZ than in HC, with CHR-P showing an intermediate trend. Higher ketamine similarity coefficients correlated with greater hallucination severity in SZ. Thus, NMDAR hypofunction, modeled with ketamine, reproduces the thalamic hyper-connectivity observed in schizophrenia across its illness course, including the CHR-P period preceding psychosis onset, and may contribute to hallucination severity.
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Affiliation(s)
- Samantha V Abram
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, and the University of California, San Francisco, CA, USA
- San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Brian J Roach
- San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA
| | - Susanna L Fryer
- San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, 30332, USA
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine Medical Center, 101 The City Dr. S, Orange, CA, 92868, USA
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, 5251 California Ave, Irvine, CA, 92617, USA
- Center for the Neurobiology of Learning and Memory, University of California Irvine, 309 Qureshey Research Lab, Irvine, CA, 92697, USA
| | - Juan R Bustillo
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, 87111, USA
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Barbara K Stuart
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Judith M Ford
- San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Daniel H Mathalon
- San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA.
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.
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23
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Vines L, Sotelo D, Johnson A, Dennis E, Manza P, Volkow ND, Wang GJ. Ketamine use disorder: preclinical, clinical, and neuroimaging evidence to support proposed mechanisms of actions. INTELLIGENT MEDICINE 2022; 2:61-68. [PMID: 35783539 PMCID: PMC9249268 DOI: 10.1016/j.imed.2022.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Ketamine, a noncompetitive NMDA receptor antagonist, has been exclusively used as an anesthetic in medicine and has led to new insights into the pathophysiology of neuropsychiatric disorders. Clinical studies have shown that low subanesthetic doses of ketamine produce antidepressant effects for individuals with depression. However, its use as a treatment for psychiatric disorders has been limited due to its reinforcing effects and high potential for diversion and misuse. Preclinical studies have focused on understanding the molecular mechanisms underlying ketamine's antidepressant effects, but a precise mechanism had yet to be elucidated. Here we review different hypotheses for ketamine's mechanism of action including the direct inhibition and disinhibition of NMDA receptors, AMPAR activation, and heightened activation of monoaminergic systems. The proposed mechanisms are not mutually exclusive, and their combined influence may exert the observed structural and functional neural impairments. Long term use of ketamine induces brain structural, functional impairments, and neurodevelopmental effects in both rodents and humans. Its misuse has increased rapidly in the past 20 years and is one of the most common addictive drugs used in Asia. The proposed mechanisms of action and supporting neuroimaging data allow for the development of tools to identify 'biotypes' of ketamine use disorder (KUD) using machine learning approaches, which could inform intervention and treatment.
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Affiliation(s)
| | | | - Allison Johnson
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Evan Dennis
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Nora D. Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
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24
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Wolf DH, Zheng D, Kohler C, Turetsky BI, Ruparel K, Satterthwaite TD, Elliott MA, March ME, Cross AJ, Smith MA, Zukin SR, Gur RC, Gur RE. Effect of mGluR2 positive allosteric modulation on frontostriatal working memory activation in schizophrenia. Mol Psychiatry 2022; 27:1226-1232. [PMID: 34667261 PMCID: PMC9018886 DOI: 10.1038/s41380-021-01320-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 09/09/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023]
Abstract
Negative symptoms and cognitive deficits contribute strongly to disability in schizophrenia, and are resistant to existing medications. Recent drug development has targeted enhanced NMDA function by increasing mGluR2/3 signaling. However, the clinical utility of such agents remains uncertain, and markers of brain circuit function are critical for clarifying mechanisms and understanding individual differences in efficacy. We conducted a double-blind, placebo-controlled, randomized cross-over (14 day washout) pilot study evaluating adjunctive use of the mGluR2 positive allosteric modulator AZD8529 (80 mg daily for 3 days), in chronic stable patients with schizophrenia (n = 26 analyzed). We focused on 3 T fMRI response in frontostriatal regions during an n-back working memory task, testing the hypothesis that AZD8529 produces fMRI changes that correlate with improvement in negative symptoms and cognition. We found that AZD8529 did not produce significant group-average effects on symptoms or cognitive accuracy. However, AZD8529 did increase n-back fMRI activation in striatum (p < 0.0001) and anterior cingulate/paracingulate (p = 0.002). Greater drug-versus-placebo effects on caudate activation significantly correlated with greater reductions in PANSS negative symptom scores (r = -0.42, p = 0.031), and exploratory correlations suggested broader effects across multiple symptom domains and regions of interest. These findings demonstrate that fMRI responses to mGluR2 positive modulation relate to individual differences in symptom reduction, and could be pursued for future biomarker development. Negative clinical results at the group level should not lead to premature termination of investigation of this mechanism, which may benefit an important subset of individuals with schizophrenia. Imaging biomarkers may reveal therapeutic mechanisms, and help guide treatment toward specific populations.
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Affiliation(s)
- Daniel H. Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - David Zheng
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Christian Kohler
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Bruce I. Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | | | - Mark A. Elliott
- Department of Radiology, University of Pennsylvania, Philadelphia PA 19104
| | - Mary E. March
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Alan J. Cross
- AstraZeneca Pharmaceuticals LP, Wilmington DE, 19850.,Present affiliations: Psy Therapeutics, Thornton PA 19373
| | - Mark A. Smith
- AstraZeneca Pharmaceuticals LP, Wilmington DE, 19850.,Vistagen Therapeutics, South San Francisco CA 94080;,Medical College of Georgia, Augusta, GA 30912
| | - Stephen R. Zukin
- AstraZeneca Pharmaceuticals LP, Wilmington DE, 19850.,PRA Health Sciences, Blue Bell PA 19422
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104.,Department of Radiology, University of Pennsylvania, Philadelphia PA 19104
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104.,Department of Radiology, University of Pennsylvania, Philadelphia PA 19104
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25
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An examination of the relationships between attention/deficit hyperactivity disorder symptoms and functional connectivity over time. Neuropsychopharmacology 2022; 47:704-710. [PMID: 33558680 PMCID: PMC8782893 DOI: 10.1038/s41386-021-00958-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 01/30/2023]
Abstract
Previous cross-sectional work has demonstrated resting-state connectivity abnormalities in children and adolescents with attention/deficit hyperactivity disorder (ADHD) relative to typically developing controls. However, it is unclear to what extent these neural abnormalities confer risk for later symptoms of the disorder, or represent the downstream effects of symptoms on functional connectivity. Here, we studied 167 children and adolescents (mean age at baseline = 10.74 years (SD = 2.54); mean age at follow-up = 13.3 years (SD = 2.48); 56 females) with varying levels of ADHD symptoms, all of whom underwent resting-state functional magnetic resonance imaging and ADHD symptom assessments on two occasions during development. Resting-state functional connectivity was quantified using eigenvector centrality mapping. Using voxelwise cross-lag modeling, we found that less connectivity at baseline within right inferior frontal gyrus was associated with more follow-up symptoms of inattention (significant at an uncorrected cluster-forming threshold of p ≤ 0.001 and a cluster-level familywise error corrected threshold of p < 0.05). Findings suggest that previously reported cross-sectional abnormalities in functional connectivity within inferior frontal gyrus in patients with ADHD may represent a longitudinal risk factor for the disorder, in line with efforts to target this region with novel therapeutic methods.
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26
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Li D, Vlisides PE, Mashour GA. Dynamic reconfiguration of frequency-specific cortical coactivation patterns during psychedelic and anesthetized states induced by ketamine. Neuroimage 2022; 249:118891. [PMID: 35007718 PMCID: PMC8903080 DOI: 10.1016/j.neuroimage.2022.118891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/16/2021] [Accepted: 01/06/2022] [Indexed: 01/08/2023] Open
Abstract
Recent neuroimaging studies have demonstrated that spontaneous brain activity exhibits rich spatiotemporal structure that can be characterized as the exploration of a repertoire of spatially distributed patterns that recur over time. The repertoire of brain states may reflect the capacity for consciousness, since general anesthetics suppress and psychedelic drugs enhance such dynamics. However, the modulation of brain activity repertoire across varying states of consciousness has not yet been studied in a systematic and unified framework. As a unique drug that has both psychedelic and anesthetic properties depending on the dose, ketamine offers an opportunity to examine brain reconfiguration dynamics along a continuum of consciousness. Here we investigated the dynamic organization of cortical activity during wakefulness and during altered states of consciousness induced by different doses of ketamine. Through k-means clustering analysis of the envelope data of source-localized electroencephalographic (EEG) signals, we identified a set of recurring states that represent frequency-specific spatial coactivation patterns. We quantified the effect of ketamine on individual brain states in terms of fractional occupancy and transition probabilities and found that ketamine anesthesia tends to shift the configuration toward brain states with low spatial variability. Furthermore, by assessing the temporal dynamics of the occurrence and transitions of brain states, we showed that subanesthetic ketamine is associated with a richer repertoire, while anesthetic ketamine induces dynamic changes in brain state organization, with the repertoire richness evolving from a reduced level to one comparable to that of normal wakefulness before recovery of consciousness. These results provide a novel description of ketamine's modulation of the dynamic configuration of cortical activity and advance understanding of the neurophysiological mechanism of ketamine in terms of the spatial, temporal, and spectral structures of underlying whole-brain dynamics.
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Affiliation(s)
- Duan Li
- Center for Consciousness Science; Department of Anesthesiology.
| | | | - George A Mashour
- Center for Consciousness Science; Department of Anesthesiology; Neuroscience Graduate Program; Department of Pharmacology, University of Michigan Medical School, Ann Arbor, United States
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27
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Aberrant maturation and connectivity of prefrontal cortex in schizophrenia-contribution of NMDA receptor development and hypofunction. Mol Psychiatry 2022; 27:731-743. [PMID: 34163013 PMCID: PMC8695640 DOI: 10.1038/s41380-021-01196-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 06/02/2021] [Accepted: 06/10/2021] [Indexed: 02/06/2023]
Abstract
The neurobiology of schizophrenia involves multiple facets of pathophysiology, ranging from its genetic basis over changes in neurochemistry and neurophysiology, to the systemic level of neural circuits. Although the precise mechanisms associated with the neuropathophysiology remain elusive, one essential aspect is the aberrant maturation and connectivity of the prefrontal cortex that leads to complex symptoms in various stages of the disease. Here, we focus on how early developmental dysfunction, especially N-methyl-D-aspartate receptor (NMDAR) development and hypofunction, may lead to the dysfunction of both local circuitry within the prefrontal cortex and its long-range connectivity. More specifically, we will focus on an "all roads lead to Rome" hypothesis, i.e., how NMDAR hypofunction during development acts as a convergence point and leads to local gamma-aminobutyric acid (GABA) deficits and input-output dysconnectivity in the prefrontal cortex, which eventually induce cognitive and social deficits. Many outstanding questions and hypothetical mechanisms are listed for future investigations of this intriguing hypothesis that may lead to a better understanding of the aberrant maturation and connectivity associated with the prefrontal cortex.
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28
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Demchenko I, Tassone VK, Kennedy SH, Dunlop K, Bhat V. Intrinsic Connectivity Networks of Glutamate-Mediated Antidepressant Response: A Neuroimaging Review. Front Psychiatry 2022; 13:864902. [PMID: 35722550 PMCID: PMC9199367 DOI: 10.3389/fpsyt.2022.864902] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
Conventional monoamine-based pharmacotherapy, considered the first-line treatment for major depressive disorder (MDD), has several challenges, including high rates of non-response. To address these challenges, preclinical and clinical studies have sought to characterize antidepressant response through monoamine-independent mechanisms. One striking example is glutamate, the brain's foremost excitatory neurotransmitter: since the 1990s, studies have consistently reported altered levels of glutamate in MDD, as well as antidepressant effects following molecular targeting of glutamatergic receptors. Therapeutically, this has led to advances in the discovery, testing, and clinical application of a wide array of glutamatergic agents, particularly ketamine. Notably, ketamine has been demonstrated to rapidly improve mood symptoms, unlike monoamine-based interventions, and the neurobiological basis behind this rapid antidepressant response is under active investigation. Advances in brain imaging techniques, including functional magnetic resonance imaging, magnetic resonance spectroscopy, and positron emission tomography, enable the identification of the brain network-based characteristics distinguishing rapid glutamatergic modulation from the effect of slow-acting conventional monoamine-based pharmacology. Here, we review brain imaging studies that examine brain connectivity features associated with rapid antidepressant response in MDD patients treated with glutamatergic pharmacotherapies in contrast with patients treated with slow-acting monoamine-based treatments. Trends in recent brain imaging literature suggest that the activity of brain regions is organized into coherent functionally distinct networks, termed intrinsic connectivity networks (ICNs). We provide an overview of major ICNs implicated in depression and explore how treatment response following glutamatergic modulation alters functional connectivity of limbic, cognitive, and executive nodes within ICNs, with well-characterized anti-anhedonic effects and the enhancement of "top-down" executive control. Alterations within and between the core ICNs could potentially exert downstream effects on the nodes within other brain networks of relevance to MDD that are structurally and functionally interconnected through glutamatergic synapses. Understanding similarities and differences in brain ICNs features underlying treatment response will positively impact the trajectory and outcomes for adults suffering from MDD and will facilitate the development of biomarkers to enable glutamate-based precision therapeutics.
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Affiliation(s)
- Ilya Demchenko
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Vanessa K Tassone
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sidney H Kennedy
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katharine Dunlop
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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29
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Fiorentini A, Cantù F, Crisanti C, Cereda G, Oldani L, Brambilla P. Substance-Induced Psychoses: An Updated Literature Review. Front Psychiatry 2021; 12:694863. [PMID: 35002789 PMCID: PMC8732862 DOI: 10.3389/fpsyt.2021.694863] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/17/2021] [Indexed: 01/22/2023] Open
Abstract
Background: On the current psychopharmacological panorama, the variety of substances able to provoke an episode of acute psychosis is rapidly increasing. Such psychotic episodes are classified according to the major category of symptoms: positive, negative, or cognitive psychotic episodes. On one hand, the abuse of methamphetamines, cannabis, and cocaine plays a big role in increasing the incidence of episodes resembling a psychotic disorder. On the other hand, the progress in terms of pharmacodynamics knowledge has led to the synthesis of new drugs, such as cannabinoids and cathinone's, which have rapidly entered into the common pool of abusers' habits. Regarding these newly synthesized substances of abuse, further clinical studies are needed to understand their psychogenic properties. The topic of this review is complicated due to the frequent abuse of psychotomimetic drugs by patients affected by psychotic disorders, a fact that makes it extremely difficult to distinguish between an induced psychosis and a re-exacerbation of a previously diagnosed disorder. Methods: The present narrative review summarizes results from clinical studies, thus investigating the psychotogenic properties of abused substances and the psychotic symptoms they can give rise to. It also discusses the association between substance abuse and psychosis, especially with regards to the differential diagnosis between a primary vs. a substance-induced psychotic disorder. Findings: Our findings support the theory that psychosis due to substance abuse is commonly observed in clinical practice. The propensity to develop psychosis seems to be a function of the severity of use and addiction. Of note, from a phenomenological point of view, it is possible to identify some elements that may help clinicians involved in differential diagnoses between primary and substance-induced psychoses. There remains a striking paucity of information on the outcomes, treatments, and best practices of substance-induced psychotic episodes.
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Affiliation(s)
- Alessio Fiorentini
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Filippo Cantù
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Camilla Crisanti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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30
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Kotoula V, Webster T, Stone J, Mehta MA. Resting-state connectivity studies as a marker of the acute and delayed effects of subanaesthetic ketamine administration in healthy and depressed individuals: A systematic review. Brain Neurosci Adv 2021; 5:23982128211055426. [PMID: 34805548 PMCID: PMC8597064 DOI: 10.1177/23982128211055426] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 09/24/2021] [Indexed: 11/15/2022] Open
Abstract
Acute ketamine administration has been widely used in neuroimaging research to mimic psychosis-like symptoms. Within the last two decades, ketamine has also emerged as a potent, fast-acting antidepressant. The delayed effects of the drug, observed 2–48 h after a single infusion, are associated with marked improvements in depressive symptoms. At the systems’ level, several studies have investigated the acute ketamine effects on brain activity and connectivity; however, several questions remain unanswered around the brain changes that accompany the drug’s antidepressant effects and how these changes relate to the brain areas that appear with altered function and connectivity in depression. This review aims to address some of these questions by focusing on resting-state brain connectivity. We summarise the studies that have examined connectivity changes in treatment-naïve, depressed individuals and those studies that have looked at the acute and delayed effects of ketamine in healthy and depressed volunteers. We conclude that brain areas that are important for emotional regulation and reward processing appear with altered connectivity in depression whereas the default mode network presents with increased connectivity in depressed individuals compared to healthy controls. This finding, however, is not as prominent as the literature often assumes. Acute ketamine administration causes an increase in brain connectivity in healthy volunteers. The delayed effects of ketamine on brain connectivity vary in direction and appear to be consistent with the drug normalising the changes observed in depression. The limited number of studies however, as well as the different approaches for resting-state connectivity analysis make it very difficult to draw firm conclusions and highlight the importance of data sharing and larger future studies.
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Affiliation(s)
- Vasileia Kotoula
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Mitul A Mehta
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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31
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Ji JL, Helmer M, Fonteneau C, Burt JB, Tamayo Z, Demšar J, Adkinson BD, Savić A, Preller KH, Moujaes F, Vollenweider FX, Martin WJ, Repovš G, Cho YT, Pittenger C, Murray JD, Anticevic A. Mapping brain-behavior space relationships along the psychosis spectrum. eLife 2021; 10:e66968. [PMID: 34313219 PMCID: PMC8315806 DOI: 10.7554/elife.66968] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/14/2021] [Indexed: 12/29/2022] Open
Abstract
Difficulties in advancing effective patient-specific therapies for psychiatric disorders highlight a need to develop a stable neurobiologically grounded mapping between neural and symptom variation. This gap is particularly acute for psychosis-spectrum disorders (PSD). Here, in a sample of 436 PSD patients spanning several diagnoses, we derived and replicated a dimensionality-reduced symptom space across hallmark psychopathology symptoms and cognitive deficits. In turn, these symptom axes mapped onto distinct, reproducible brain maps. Critically, we found that multivariate brain-behavior mapping techniques (e.g. canonical correlation analysis) do not produce stable results with current sample sizes. However, we show that a univariate brain-behavioral space (BBS) can resolve stable individualized prediction. Finally, we show a proof-of-principle framework for relating personalized BBS metrics with molecular targets via serotonin and glutamate receptor manipulations and neural gene expression maps derived from the Allen Human Brain Atlas. Collectively, these results highlight a stable and data-driven BBS mapping across PSD, which offers an actionable path that can be iteratively optimized for personalized clinical biomarker endpoints.
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Affiliation(s)
- Jie Lisa Ji
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale University School of MedicineNew HavenUnited States
| | - Markus Helmer
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | | | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Jure Demšar
- Department of Psychology, University of LjubljanaLjubljanaSlovenia
- Faculty of Computer and Information Science, University of LjubljanaLjubljanaSlovenia
| | - Brendan D Adkinson
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale University School of MedicineNew HavenUnited States
| | | | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Flora Moujaes
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - William J Martin
- The Janssen Pharmaceutical Companies of Johnson and JohnsonSan FranciscoUnited States
| | - Grega Repovš
- Department of Psychiatry, University of ZagrebZagrebCroatia
| | - Youngsun T Cho
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Child Study Center, Yale University School of MedicineNew HavenUnited States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Child Study Center, Yale University School of MedicineNew HavenUnited States
| | - John D Murray
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale University School of MedicineNew HavenUnited States
- Department of Physics, Yale UniversityNew HavenUnited States
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale University School of MedicineNew HavenUnited States
- Department of Psychology, Yale University School of MedicineNew HavenUnited States
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32
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Kraguljac NV, McDonald WM, Widge AS, Rodriguez CI, Tohen M, Nemeroff CB. Neuroimaging Biomarkers in Schizophrenia. Am J Psychiatry 2021; 178:509-521. [PMID: 33397140 PMCID: PMC8222104 DOI: 10.1176/appi.ajp.2020.20030340] [Citation(s) in RCA: 119] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Schizophrenia is a complex neuropsychiatric syndrome with a heterogeneous genetic, neurobiological, and phenotypic profile. Currently, no objective biological measures-that is, biomarkers-are available to inform diagnostic or treatment decisions. Neuroimaging is well positioned for biomarker development in schizophrenia, as it may capture phenotypic variations in molecular and cellular disease targets, or in brain circuits. These mechanistically based biomarkers may represent a direct measure of the pathophysiological underpinnings of the disease process and thus could serve as true intermediate or surrogate endpoints. Effective biomarkers could validate new treatment targets or pathways, predict response, aid in selection of patients for therapy, determine treatment regimens, and provide a rationale for personalized treatments. In this review, the authors discuss a range of mechanistically plausible neuroimaging biomarker candidates, including dopamine hyperactivity, N-methyl-d-aspartate receptor hypofunction, hippocampal hyperactivity, immune dysregulation, dysconnectivity, and cortical gray matter volume loss. They then focus on the putative neuroimaging biomarkers for disease risk, diagnosis, target engagement, and treatment response in schizophrenia. Finally, they highlight areas of unmet need and discuss strategies to advance biomarker development.
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Affiliation(s)
- Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL,Corresponding Author: Nina Vanessa Kraguljac, MD, Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, SC 501, 1720 7th Ave S, Birmingham, AL 35294-0017, 205-996-7171,
| | - William M. McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Alik S. Widge
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Carolyn I. Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Charles B. Nemeroff
- Department of Psychiatry, University of Texas Dell Medical School, Austin, TX
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33
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Jami SA, Cameron S, Wong JM, Daly ER, McAllister AK, Gray JA. Increased excitation-inhibition balance and loss of GABAergic synapses in the serine racemase knockout model of NMDA receptor hypofunction. J Neurophysiol 2021; 126:11-27. [PMID: 34038186 DOI: 10.1152/jn.00661.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
There is substantial evidence that both N-methyl-D-aspartate receptor (NMDAR) hypofunction and dysfunction of GABAergic neurotransmission contribute to schizophrenia, though the relationship between these pathophysiological processes remains largely unknown. Although models using cell-type-specific genetic deletion of NMDARs have been informative, they display overly pronounced phenotypes extending beyond those of schizophrenia. Here, we used the serine racemase knockout (SRKO) mice, a model of reduced NMDAR activity rather than complete receptor elimination, to examine the link between NMDAR hypofunction and decreased GABAergic inhibition. The SRKO mice, in which there is a >90% reduction in the NMDAR coagonist d-serine, exhibit many of the neurochemical and behavioral abnormalities observed in schizophrenia. We found a significant reduction in inhibitory synapses onto CA1 pyramidal neurons in the SRKO mice. This reduction increases the excitation/inhibition balance resulting in enhanced synaptically driven neuronal excitability without changes in intrinsic excitability. Consistently, significant reductions in inhibitory synapse density in CA1 were observed by immunohistochemistry. We further show, using a single-neuron genetic deletion approach, that the loss of GABAergic synapses onto pyramidal neurons observed in the SRKO mice is driven in a cell-autonomous manner following the deletion of SR in individual CA1 pyramidal cells. These results support a model whereby NMDAR hypofunction in pyramidal cells disrupts GABAergic synapses leading to disrupted feedback inhibition and impaired neuronal synchrony.NEW & NOTEWORTHY Recently, disruption of excitation/inhibition (E/I) balance has become an area of considerable interest for psychiatric research. Here, we report a reduction in inhibition in the serine racemase knockout mouse model of schizophrenia that increases E/I balance and enhances synaptically driven neuronal excitability. This reduced inhibition was driven cell-autonomously in pyramidal cells lacking serine racemase, suggesting a novel mechanism for how chronic NMDA receptor hypofunction can disrupt information processing in schizophrenia.
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Affiliation(s)
- Shekib A Jami
- Center for Neuroscience, University of California, Davis, California
| | - Scott Cameron
- Center for Neuroscience, University of California, Davis, California
| | - Jonathan M Wong
- Center for Neuroscience, University of California, Davis, California
| | - Emily R Daly
- Center for Neuroscience, University of California, Davis, California
| | - A Kimberley McAllister
- Center for Neuroscience, University of California, Davis, California.,Department of Neurobiology, Physiology, and Behavior, University of California, Davis, California.,Department of Neurology, University of California, Davis, California
| | - John A Gray
- Center for Neuroscience, University of California, Davis, California.,Department of Neurology, University of California, Davis, California
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34
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Davis MT, DellaGiogia N, Maruff P, Pietrzak RH, Esterlis I. Acute cognitive effects of single-dose intravenous ketamine in major depressive and posttraumatic stress disorder. Transl Psychiatry 2021; 11:205. [PMID: 33833217 PMCID: PMC8032778 DOI: 10.1038/s41398-021-01327-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/19/2021] [Accepted: 03/17/2021] [Indexed: 02/02/2023] Open
Abstract
Intravenous (IV) subanesthetic doses of ketamine have been shown to reduce psychiatric distress in both major depressive (MDD) and posttraumatic stress disorder (PTSD). However, the effect of ketamine on cognitive function in these disorders is not well understood. To address this gap, we examined the effect of a single dose of IV ketamine on cognition in individuals with MDD and/or PTSD relative to healthy controls (HC). Psychiatric (n = 29; 15 PTSD, 14 MDD) and sex- age- and IQ matched HC (n = 29) groups were recruited from the community. A single subanesthetic dose of IV ketamine was administered. Mood and cognitive measures were collected prior to, 2 h and 1 day post-ketamine administration. MDD/PTSD individuals evidenced a large-magnitude improvement in severity of depressive symptoms at both 2-hours and 1 day post-ketamine administration (p's < .001, Cohen d's = 0.80-1.02). Controlling for baseline performance and years of education, IV ketamine induced declines in attention (ATTN), executive function (EF), and verbal memory (VM) 2 h post-administration, all of which had resolved by 1 day post-ketamine across groups. The magnitude of cognitive decline was significantly larger in MDD/PTSD relative to HC on attention only (p = .012, d = 0.56). Ketamine did not affect working memory (WM) performance. Cognitive function (baseline, change from baseline to post-ketamine) was not associated with antidepressant response to ketamine. Results suggest that while ketamine may have an acute deleterious effect on some cognitive domains in both MDD/PTSD and HC individuals, most notably attention, this reduction is transient and there is no evidence of ketamine-related cognitive dysfunction at 1 day post-administration.
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Affiliation(s)
- Margaret T Davis
- Yale University School of Medicine, Department of Psychiatry, New Haven, USA
- Yale University, Department of Psychology, New Haven, USA
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Washington, DC, USA
| | - Nicole DellaGiogia
- Yale University School of Medicine, Department of Psychiatry, New Haven, USA
| | | | - Robert H Pietrzak
- Yale University School of Medicine, Department of Psychiatry, New Haven, USA
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Washington, DC, USA
| | - Irina Esterlis
- Yale University School of Medicine, Department of Psychiatry, New Haven, USA.
- Yale University, Department of Psychology, New Haven, USA.
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Washington, DC, USA.
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35
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Chung AKK, Chan WM, Law JKC, Tse CY. Ketamine abusers with SLC6A3 rs393795 genotype showed a preliminary association with psychosis and schizophrenia: A pilot case-control study. Schizophr Res 2021; 230:24-25. [PMID: 33667855 DOI: 10.1016/j.schres.2021.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Albert Kar-Kin Chung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Wing-Man Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Johnson Kai-Chun Law
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Cheuk-Yin Tse
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
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36
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Bianciardi B, Uhlhaas PJ. Do NMDA-R antagonists re-create patterns of spontaneous gamma-band activity in schizophrenia? A systematic review and perspective. Neurosci Biobehav Rev 2021; 124:308-323. [PMID: 33581223 DOI: 10.1016/j.neubiorev.2021.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
NMDA-R hypofunctioninig is a core pathophysiological mechanism in schizophrenia. However, it is unclear whether the physiological changes observed following NMDA-R antagonist administration are consistent with gamma-band alterations in schizophrenia. This systematic review examined the effects of NMDA-R antagonists on the amplitude of spontaneous gamma-band activity and functional connectivity obtained from preclinical (n = 24) and human (n = 9) studies and compared these data to resting-state EEG/MEG-measurements in schizophrenia patients (n = 27). Overall, the majority of preclinical and human studies observed increased gamma-band power following acute administration of NMDA-R antagonists. However, the direction of gamma-band power alterations in schizophrenia were inconsistent, which involved upregulation (n = 10), decreases (n = 7), and no changes (n = 8) in spectral power. Five out of 6 preclinical studies observed increased connectivity, while in healthy controls receiving Ketamine and in schizophrenia patients the direction of connectivity results was also inconsistent. Accordingly, the effects of NMDA-R hypofunctioning on gamma-band oscillations are different than pathophysiological signatures observed in schizophrenia. The implications of these findings for current E/I balance models of schizophrenia are discussed.
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Affiliation(s)
- Bianca Bianciardi
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
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37
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How hot is the hot zone? Computational modelling clarifies the role of parietal and frontoparietal connectivity during anaesthetic-induced loss of consciousness. Neuroimage 2021; 231:117841. [PMID: 33577934 DOI: 10.1016/j.neuroimage.2021.117841] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 02/04/2023] Open
Abstract
In recent years, specific cortical networks have been proposed to be crucial for sustaining consciousness, including the posterior hot zone and frontoparietal resting state networks (RSN). Here, we computationally evaluate the relative contributions of three RSNs - the default mode network (DMN), the salience network (SAL), and the central executive network (CEN) - to consciousness and its loss during propofol anaesthesia. Specifically, we use dynamic causal modelling (DCM) of 10 min of high-density EEG recordings (N = 10, 4 males) obtained during behavioural responsiveness, unconsciousness and post-anaesthetic recovery to characterise differences in effective connectivity within frontal areas, the posterior 'hot zone', frontoparietal connections, and between-RSN connections. We estimate - for the first time - a large DCM model (LAR) of resting EEG, combining the three RSNs into a rich club of interconnectivity. Consistent with the hot zone theory, our findings demonstrate reductions in inter-RSN connectivity in the parietal cortex. Within the DMN itself, the strongest reductions are in feed-forward frontoparietal and parietal connections at the precuneus node. Within the SAL and CEN, loss of consciousness generates small increases in bidirectional connectivity. Using novel DCM leave-one-out cross-validation, we show that the most consistent out-of-sample predictions of the state of consciousness come from a key set of frontoparietal connections. This finding also generalises to unseen data collected during post-anaesthetic recovery. Our findings provide new, computational evidence for the importance of the posterior hot zone in explaining the loss of consciousness, highlighting also the distinct role of frontoparietal connectivity in underpinning conscious responsiveness, and consequently, suggest a dissociation between the mechanisms most prominently associated with explaining the contrast between conscious awareness and unconsciousness, and those maintaining consciousness.
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38
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Mkrtchian A, Evans JW, Kraus C, Yuan P, Kadriu B, Nugent AC, Roiser JP, Zarate CA. Ketamine modulates fronto-striatal circuitry in depressed and healthy individuals. Mol Psychiatry 2021; 26:3292-3301. [PMID: 32929215 PMCID: PMC8462973 DOI: 10.1038/s41380-020-00878-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/27/2020] [Accepted: 09/03/2020] [Indexed: 12/18/2022]
Abstract
Ketamine improves motivation-related symptoms in depression but simultaneously elicits similar symptoms in healthy individuals, suggesting that it might have different effects in health and disease. This study examined whether ketamine affects the brain's fronto-striatal system, which is known to drive motivational behavior. The study also assessed whether inflammatory mechanisms-which are known to influence neural and behavioral motivational processes-might underlie some of these changes. These questions were explored in the context of a double-blind, placebo-controlled, crossover trial of ketamine in 33 individuals with treatment-resistant major depressive disorder (TRD) and 25 healthy volunteers (HVs). Resting-state functional magnetic resonance imaging (rsfMRI) was acquired 2 days post-ketamine (final sample: TRD n = 27, HV n = 19) and post-placebo (final sample: TRD n = 25, HV n = 18) infusions and was used to probe fronto-striatal circuitry with striatal seed-based functional connectivity. Ketamine increased fronto-striatal functional connectivity in TRD participants toward levels observed in HVs while shifting the connectivity profile in HVs toward a state similar to TRD participants under placebo. Preliminary findings suggest that these effects were largely observed in the absence of inflammatory (C-reactive protein) changes and were associated with both acute and sustained improvements in symptoms in the TRD group. Ketamine thus normalized fronto-striatal connectivity in TRD participants but disrupted it in HVs independently of inflammatory processes. These findings highlight the potential importance of reward circuitry in ketamine's mechanism of action, which may be particularly relevant for understanding ketamine-induced shifts in motivational symptoms.
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Affiliation(s)
- Anahit Mkrtchian
- Section on the Neurobiology and Treatment of Mood Disorders, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA. .,Neuroscience and Mental Health Group, Institute of Cognitive Neuroscience, University College London, London, UK.
| | - Jennifer W. Evans
- grid.94365.3d0000 0001 2297 5165Section on the Neurobiology and Treatment of Mood Disorders, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Christoph Kraus
- grid.94365.3d0000 0001 2297 5165Section on the Neurobiology and Treatment of Mood Disorders, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Peixiong Yuan
- grid.94365.3d0000 0001 2297 5165Section on the Neurobiology and Treatment of Mood Disorders, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Bashkim Kadriu
- grid.94365.3d0000 0001 2297 5165Section on the Neurobiology and Treatment of Mood Disorders, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Allison C. Nugent
- grid.94365.3d0000 0001 2297 5165Section on the Neurobiology and Treatment of Mood Disorders, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.94365.3d0000 0001 2297 5165Magnetoencephalography Core Facility, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Jonathan P. Roiser
- grid.83440.3b0000000121901201Neuroscience and Mental Health Group, Institute of Cognitive Neuroscience, University College London, London, UK
| | - Carlos A. Zarate
- grid.94365.3d0000 0001 2297 5165Section on the Neurobiology and Treatment of Mood Disorders, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
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Abdallah CG, Ahn KH, Averill LA, Nemati S, Averill CL, Fouda S, Ranganathan M, Morgan PT, D’Souza DC, Mathalon DH, Krystal JH, Driesen NR. A robust and reproducible connectome fingerprint of ketamine is highly associated with the connectomic signature of antidepressants. Neuropsychopharmacology 2021; 46:478-485. [PMID: 32967000 PMCID: PMC7852889 DOI: 10.1038/s41386-020-00864-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/15/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Abstract
Over the past decade, various N-methyl-D-aspartate modulators have failed in clinical trials, underscoring the challenges of developing novel rapid-acting antidepressants based solely on the receptor or regional targets of ketamine. Thus, identifying the effect of ketamine on the brain circuitry and networks is becoming increasingly critical. In this longitudinal functional magnetic resonance imaging study of data from 265 participants, we used a validated predictive model approach that allows the full assessment of brain functional connectivity, without the need for seed selection or connectivity summaries. First, we identified a connectome fingerprint (CFP) in healthy participants (Cohort A, n = 25) during intravenous infusion of a subanesthetic dose of ketamine, compared to normal saline. We then demonstrated the robustness and reproducibility of the discovered ketamine CFP in two separate healthy samples (Cohort B, n = 22; Cohort C, n = 18). Finally, we investigated the ketamine CFP connectivity at 1-week post treatment in major depressive disorder patients randomized to 8 weeks of sertraline or placebo (Cohort D, n = 200). We found a significant, robust, and reproducible ketamine CFP, consistent with reduced connectivity within the primary cortices and within the executive network, but increased connectivity between the executive network and the rest of the brain. Compared to placebo, the ketamine CFP connectivity changes at 1 week predicted response to sertraline at 8 weeks. In each of Cohorts A-C, ketamine significantly increased connectivity in a previously identified antidepressant CFP. Investigating the brain connectivity networks, we successfully identified a robust and reproducible ketamine biomarker that is related to the mechanisms of antidepressants.
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Affiliation(s)
- Chadi G. Abdallah
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA ,grid.413890.70000 0004 0420 5521Michael E. DeBakey VA Medical Center, Houston, TX USA ,grid.39382.330000 0001 2160 926XMenninger Department of Psychiatry, Baylor College of Medicine, Houston, TX USA
| | - Kyung-Heup Ahn
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Lynnette A. Averill
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Samaneh Nemati
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Christopher L. Averill
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Samar Fouda
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Mohini Ranganathan
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Peter T. Morgan
- grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Deepak C. D’Souza
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Daniel H. Mathalon
- grid.266102.10000 0001 2297 6811San Francisco VA Medical Center, University of California, San Francisco, CA USA
| | - John H. Krystal
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Naomi R. Driesen
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
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de la Salle S, Choueiry J, Shah D, Bowers H, McIntosh J, Ilivitsky V, Carroll B, Knott V. Resting-state functional EEG connectivity in salience and default mode networks and their relationship to dissociative symptoms during NMDA receptor antagonism. Pharmacol Biochem Behav 2020; 201:173092. [PMID: 33385439 DOI: 10.1016/j.pbb.2020.173092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 01/28/2023]
Abstract
N-methyl-d-aspartate receptor (NMDAR) antagonists administered to healthy humans results in schizophrenia-like symptoms, which are thought in part to be related to glutamatergically altered electrophysiological connectivity in large-scale intrinsic functional brain networks. Here, we examine resting-state source electroencephalographic (EEG) connectivity within and between the default mode (DMN: for self-related cognitive activity) and salience networks (SN: for detection of salient stimuli in internal and external environments) in 21 healthy volunteers administered a subanesthetic dose of the dissociative anesthetic and NMDAR antagonist, ketamine. In addition to provoking symptoms of dissociation, which are thought to originate from an altered sense of self that is common to schizophrenia, ketamine induces frequency-dependent increases and decreases in connectivity within and between DMN and SN. These altered interactive network couplings together with emergent dissociative symptoms tentatively support an NMDAR-hypofunction hypothesis of disturbed electrophysiologic connectivity in schizophrenia.
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Affiliation(s)
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Hayley Bowers
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Judy McIntosh
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Vadim Ilivitsky
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Brooke Carroll
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Verner Knott
- School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
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Macek TA, Suzuki K, Asin K, Kimura H. Translational Development Strategies for TAK-063, a Phosphodiesterase 10A Inhibitor. Int J Neuropsychopharmacol 2020; 23:524-532. [PMID: 32598478 PMCID: PMC7689203 DOI: 10.1093/ijnp/pyaa042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/13/2020] [Accepted: 06/04/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND TAK-063 is an inhibitor of phosphodiesterase 10A (PDE10A), an enzyme highly expressed in medium spiny neurons of the striatum. PDE10A hydrolyzes both cyclic adenosine monophosphate and cyclic guanosine monophosphate and modulates dopamine signaling downstream of receptor activation in both direct and indirect pathways of the striatum. TAK-063 exhibited antipsychotic-like effects in animal models; however, the translatability of these models to the clinical manifestations of schizophrenia and the meaningfulness for new targets such as PDE10A has not been established. METHODS The TAK-063 phase 1 program included a comprehensive translational development strategy with the main objective of determining whether the antipsychotic-like pharmacodynamic effects seen in nonclinical models would translate to human subjects. To evaluate this objective, we conducted a single-rising dose study (84 healthy subjects), a positron emission tomography (PET) study (12 healthy subjects), a functional magnetic resonance imaging blood oxygen level-dependent (BOLD) study (27 healthy subjects), and a multiple-rising dose study that included people with schizophrenia (30 healthy Japanese subjects and 47 subjects with stable schizophrenia). In addition, assessments of cognition and electroencephalography (27 healthy subjects and 47 subjects with stable schizophrenia) were included. RESULTS PDE10A engagement by TAK-063 was verified with a novel PET radiotracer for use in primates and humans. TAK-063 showed favorable pharmacokinetic and safety profiles in humans, and TAK-063 reduced ketamine-induced changes in electroencephalography and BOLD signaling in animal models and healthy human subjects. In addition, analogous effects on cognition were observed in animal models and human subjects. CONCLUSIONS Overall, the phase 1 results showed some consistent evidence of antipsychotic activity. This translational strategy may be valuable for the future development of novel therapeutic approaches, even when relevant nonclinical models are not available.
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Affiliation(s)
| | | | - Karen Asin
- Takeda Development Center Americas, Inc., Deerfield, IL
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Farnes N, Juel BE, Nilsen AS, Romundstad LG, Storm JF. Increased signal diversity/complexity of spontaneous EEG, but not evoked EEG responses, in ketamine-induced psychedelic state in humans. PLoS One 2020; 15:e0242056. [PMID: 33226992 PMCID: PMC7682856 DOI: 10.1371/journal.pone.0242056] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/27/2020] [Indexed: 01/21/2023] Open
Abstract
How and to what extent electrical brain activity reflects pharmacologically altered states and contents of consciousness, is not well understood. Therefore, we investigated whether measures of evoked and spontaneous electroencephalographic (EEG) signal diversity are altered by sub-anaesthetic levels of ketamine compared to normal wakefulness, and how these measures relate to subjective experience. High-density 62-channel EEG was used to record spontaneous brain activity and responses evoked by transcranial magnetic stimulation (TMS) in 10 healthy volunteers before and during administration of sub-anaesthetic doses of ketamine in an open-label within-subject design. Evoked signal diversity was assessed using the perturbational complexity index (PCI), calculated from EEG responses to TMS perturbations. Signal diversity of spontaneous EEG, with eyes open and eyes closed, was assessed by Lempel Ziv complexity (LZc), amplitude coalition entropy (ACE), and synchrony coalition entropy (SCE). Although no significant difference was found in TMS-evoked complexity (PCI) between the sub-anaesthetic ketamine condition and normal wakefulness, all measures of spontaneous EEG signal diversity (LZc, ACE, SCE) showed significantly increased values in the sub-anaesthetic ketamine condition. This increase in signal diversity correlated with subjective assessment of altered states of consciousness. Moreover, spontaneous signal diversity was significantly higher when participants had eyes open compared to eyes closed, both during normal wakefulness and during influence of sub-anaesthetic ketamine. The results suggest that PCI and spontaneous signal diversity may reflect distinct, complementary aspects of changes in brain properties related to altered states of consciousness: the brain’s capacity for information integration, assessed by PCI, might be indicative of the brain’s ability to sustain consciousness, while spontaneous complexity, as measured by EEG signal diversity, may be indicative of the complexity of conscious content. Thus, sub-anaesthetic ketamine may increase the complexity of the conscious content and the brain activity underlying it, while the level or general capacity for consciousness remains largely unaffected.
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Affiliation(s)
- Nadine Farnes
- Brain Signaling Group, Department of Molecular Medicine, University of Oslo, Oslo, Norway
| | - Bjørn E Juel
- Brain Signaling Group, Department of Molecular Medicine, University of Oslo, Oslo, Norway
| | - André S Nilsen
- Brain Signaling Group, Department of Molecular Medicine, University of Oslo, Oslo, Norway
| | - Luis G Romundstad
- Department of Anaesthesia, and Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Johan F Storm
- Brain Signaling Group, Department of Molecular Medicine, University of Oslo, Oslo, Norway
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Holmes SE, Gallezot JD, Davis MT, DellaGioia N, Matuskey D, Nabulsi N, Krystal JH, Javitch JA, DeLorenzo C, Carson RE, Esterlis I. Measuring the effects of ketamine on mGluR5 using [ 18F]FPEB and PET. J Cereb Blood Flow Metab 2020; 40:2254-2264. [PMID: 31744389 PMCID: PMC7585925 DOI: 10.1177/0271678x19886316] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 01/21/2023]
Abstract
The metabotropic glutamate receptor 5 (mGluR5) is a promising treatment target for psychiatric disorders due to its modulatory effects on glutamate transmission. Using [11C]ABP688, we previously showed that the rapidly acting antidepressant ketamine decreases mGluR5 availability. The mGluR5 radioligand [18F]FPEB offers key advantages over [11C]ABP688; however, its suitability for drug challenge studies is unknown. We evaluated whether [18F]FPEB can be used to capture ketamine-induced effects on mGluR5. Seven healthy subjects participated in three [18F]FPEB scans: a baseline, a same-day post-ketamine, and a 24-h post-ketamine scan. The outcome measure was VT/fP, obtained using a two-tissue compartment model and a metabolite-corrected arterial input function. Dissociative symptoms, heart rate and blood pressure increased following ketamine infusion. [18F]FPEB VT/fP decreased by 9% across the cortex after ketamine infusion, with minimal difference between baseline and 24-h scans. Compared to our previous work using [11C]ABP688, the magnitude of the ketamine-induced change in mGluR5 was smaller using [18F]FPEB; however, effect sizes were similar for the same-day post-ketamine vs. baseline scan (Cohen's d = 0.75 for [18F]FPEB and 0.88 for [11C]ABP688). [18F]FPEB is therefore able to capture some of the effects of ketamine on mGluR5, but [11C]ABP688 appears to be more suitable in drug challenge paradigms designed to probe glutamate transmission.
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Affiliation(s)
- Sophie E Holmes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Margaret T Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Nicole DellaGioia
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - David Matuskey
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Nabeel Nabulsi
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Jonathan A Javitch
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, USA
- Departments of Psychiatry and Pharmacology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry and Behavioral Health, Stony Brook University, New York, NY, USA
| | - Richard E Carson
- Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, USA
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McMillan R, Muthukumaraswamy SD. The neurophysiology of ketamine: an integrative review. Rev Neurosci 2020; 31:457-503. [DOI: 10.1515/revneuro-2019-0090] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/26/2020] [Indexed: 12/13/2022]
Abstract
AbstractThe drug ketamine has been extensively studied due to its use in anaesthesia, as a model of psychosis and, most recently, its antidepressant properties. Understanding the physiology of ketamine is complex due to its rich pharmacology with multiple potential sites at clinically relevant doses. In this review of the neurophysiology of ketamine, we focus on the acute effects of ketamine in the resting brain. We ascend through spatial scales starting with a complete review of the pharmacology of ketamine and then cover its effects on in vitro and in vivo electrophysiology. We then summarise and critically evaluate studies using EEG/MEG and neuroimaging measures (MRI and PET), integrating across scales where possible. While a complicated and, at times, confusing picture of ketamine’s effects are revealed, we stress that much of this might be caused by use of different species, doses, and analytical methodologies and suggest strategies that future work could use to answer these problems.
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Affiliation(s)
- Rebecca McMillan
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Suresh D. Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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Preller KH, Duerler P, Burt JB, Ji JL, Adkinson B, Stämpfli P, Seifritz E, Repovš G, Krystal JH, Murray JD, Anticevic A, Vollenweider FX. Psilocybin Induces Time-Dependent Changes in Global Functional Connectivity. Biol Psychiatry 2020; 88:197-207. [PMID: 32111343 DOI: 10.1016/j.biopsych.2019.12.027] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/23/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of psilocybin in scientific and experimental clinical contexts has triggered renewed interest in the mechanism of action of psychedelics. However, its time-dependent systems-level neurobiology remains sparsely investigated in humans. METHODS We conducted a double-blind, randomized, counterbalanced, crossover study comprising 23 healthy human participants who received placebo and 0.2 mg/kg of psilocybin orally on 2 different test days. Participants underwent magnetic resonance imaging at 3 time points between administration and peak effects: 20 minutes, 40 minutes, and 70 minutes after administration. Resting-state functional connectivity was quantified via a data-driven global brain connectivity method and compared with cortical gene expression maps. RESULTS Psilocybin reduced associative, but concurrently increased sensory, brain-wide connectivity. This pattern emerged over time from administration to peak effects. Furthermore, we showed that baseline connectivity is associated with the extent of psilocybin-induced changes in functional connectivity. Lastly, psilocybin-induced changes correlated in a time-dependent manner with spatial gene expression patterns of the 5-HT2A (5-hydroxytryptamine 2A) and 5-HT1A (5-hydroxytryptamine 1A) receptors. CONCLUSIONS These results suggest that the integration of functional connectivity in sensory regions and the disintegration in associative regions may underlie the psychedelic state and pinpoint the critical role of the serotonin 2A and 1A receptor systems. Furthermore, baseline connectivity may represent a predictive marker of the magnitude of changes induced by psilocybin and may therefore contribute to a personalized medicine approach within the potential framework of psychedelic treatment.
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Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging Unit, University Hospital for Psychiatry Zurich, Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Patricia Duerler
- Neuropsychopharmacology and Brain Imaging Unit, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Joshua B Burt
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Physics, Yale University, New Haven, Connecticut
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Brendan Adkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Grega Repovš
- Mind and Brain Laboratory, Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut; Department of Physics, Yale University, New Haven, Connecticut
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging Unit, University Hospital for Psychiatry Zurich, Zurich, Switzerland
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Yang J, Pu W, Wu G, Chen E, Lee E, Liu Z, Palaniyappan L. Connectomic Underpinnings of Working Memory Deficits in Schizophrenia: Evidence From a replication fMRI study. Schizophr Bull 2020; 46:916-926. [PMID: 32016430 PMCID: PMC7345823 DOI: 10.1093/schbul/sbz137] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Working memory (WM) deficit is a key feature of schizophrenia that relates to a generalized neural inefficiency of extensive brain areas. To date, it remains unknown how these distributed regions are systemically organized at the connectome level and how the disruption of such organization brings about the WM impairment seen in schizophrenia. METHODS We used graph theory to examine the neural efficiency of the functional connectome in different granularity in 155 patients with schizophrenia and 96 healthy controls during a WM task. These analyses were repeated in another independent dataset (81 patients and 54 controls). Linear regression analysis was used to test associations of altered graph properties, clinical symptoms, and WM accuracy in patients. A machine-learning approach was adopted to study the ability of multivariate connectome features from one dataset to discriminate patients from controls in the second dataset. RESULTS Small-worldness of the whole-brain connectome was significantly increased in schizophrenia during the WM task; this increase is related to better (though subpar) WM accuracy in patients with more severe negative symptom burden. There was a shift in the degree distribution to a more homogeneous form in patients. The machine-learning approach classified a new set of patients from controls with 84.3% true-positivity rate for schizophrenia and 71.6% overall accuracy. CONCLUSIONS We demonstrate a putative mechanistic link between connectome topology, hub redistribution, and impaired n-back performance in schizophrenia. The task-dependent modulation of the connectome relates to, but remains inefficient in, improving the performance above par in the presence of severe negative symptoms.
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Affiliation(s)
- Jie Yang
- Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Weidan Pu
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, P.R. China
- Medical Psychological Institute of Central South University, Changsha, P.R. China
| | - Guowei Wu
- Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Eric Chen
- Department of Psychiatry, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Edwin Lee
- Department of Psychiatry, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Zhening Liu
- Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Lena Palaniyappan
- Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha, PR China
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
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Pharmacodynamic elucidation of glutamate & dopamine in ketamine-induced anaesthesia. Chem Biol Interact 2020; 327:109164. [PMID: 32524992 DOI: 10.1016/j.cbi.2020.109164] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/26/2020] [Accepted: 06/05/2020] [Indexed: 12/30/2022]
Abstract
General anaesthetics are some of the most widely used and essential therapeutic agents. However, despite over a century of research, the molecular mechanisms of general anaesthesia in the central nervous system remain elusive. Ketamine (ketamine hydrochloride) has been approved for use in general anaesthesia either alone or in combination with other medications. It is a superb drug for use in short-term medical procedures that do not require skeletal muscle relaxation, and it has approval for the induction of general anaesthesia as a pre-anaesthetic to other general anaesthetic agents. However, Several questions remain unsolved, including the exact identification of the neural substrate of consciousness and its components, the pharmacodynamic interactions between anaesthetic agents, the mechanisms of cognitive alterations that follow an anaesthetic procedure, the identification of an eventual unitary mechanism of anaesthesia-induced alteration of consciousness, the relationship between network effects and the biochemical targets of anaesthetic agents, leading to difficulties in between-studies comparisons. Thus, the glutamate and dopamine systems play distinct roles in terms of neuronal signalling, yet both have proposed to contribute significantly to the pathophysiology of neuropsychiatric diseases. Imaging of the glutamate system and other aspects of research on the dopamine system have produced less consistent findings, potentially due to methodological limitations and the heterogeneity of the disorder. In this review, we discuss the neural circuits through which the two systems interact and how their disruption may cause psychotic symptoms. We also summarize from a molecular perspective of mechanisms of action of ketamine as general anaesthetics on ligand-gated ion channels mediated modulation of dopamine in the brain region.
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Moghimi P, Jimenez NT, McLoon LK, Netoff TI, Lee MS, MacDonald A, Miller RF. Electoretinographic evidence of retinal ganglion cell-dependent function in schizophrenia. Schizophr Res 2020; 219:34-46. [PMID: 31615740 PMCID: PMC7442157 DOI: 10.1016/j.schres.2019.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 02/02/2023]
Abstract
Schizophrenia is a complex disorder that is diagnosed mainly with clinical observation and evaluation. Recent studies suggest that many people with schizophrenia have abnormalities in the function of the N-methyl-d-aspartate receptor (NMDAR). The retina is part of the central nervous system and expresses the NMDAR, raising the possibility of the early detection of NMDAR-related schizophrenia by detecting differences in retinal function. As a first-step, we used two non-invasive outpatient tests of retinal function, the photopic negative response (PhNR) of the light-adapted flash-electroretinogram (PhNR-fERG) and the pattern ERG (PERG), to test individuals with schizophrenia and controls to determine if there were measurable differences between the two populations. The PhNR-fERG showed that males with schizophrenia had a significant increase in the variability of the overall response, which was not seen in the females with schizophrenia. Additionally at the brightest flash strength, there were significant increases in the PhNR amplitude in people with schizophrenia that were maximal in controls. Our results show measurable dysfunction of retinal ganglion cells (RGCs) in schizophrenia using the PhNR-fERG, with a good deal of variability in the retinal responses of people with schizophrenia. The PhNR-fERG holds promise as a method to identify individuals more at risk for developing schizophrenia, and may help understand heterogeneity in etiology and response to treatment.
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Affiliation(s)
- Pantea Moghimi
- Department of Neurobiology, University of Chicago, Chicago, IL, United States of America
| | - Nathalia Torres Jimenez
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, United States of America
| | - Linda K. McLoon
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, United States of America
| | - Theoden I. Netoff
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States of America
| | - Michael S. Lee
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, United States of America
| | - Angus MacDonald
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States of America; Departments of Psychology and Psychiatry, University of Minnesota, Minneapolis, MN, United States of America.
| | - Robert F. Miller
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States of America,Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, United States of America
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Beck K, Hindley G, Borgan F, Ginestet C, McCutcheon R, Brugger S, Driesen N, Ranganathan M, D’Souza DC, Taylor M, Krystal JH, Howes OD. Association of Ketamine With Psychiatric Symptoms and Implications for Its Therapeutic Use and for Understanding Schizophrenia: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e204693. [PMID: 32437573 PMCID: PMC7243091 DOI: 10.1001/jamanetworkopen.2020.4693] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/29/2020] [Indexed: 12/16/2022] Open
Abstract
Importance Ketamine hydrochloride is increasingly used to treat depression and other psychiatric disorders but can induce schizophrenia-like or psychotomimetic symptoms. Despite this risk, the consistency and magnitude of symptoms induced by ketamine or what factors are associated with these symptoms remain unknown. Objective To conduct a meta-analysis of the psychopathological outcomes associated with ketamine in healthy volunteers and patients with schizophrenia and the experimental factors associated with these outcomes. Data Sources MEDLINE, Embase, and PsychINFO databases were searched for within-participant, placebo-controlled studies reporting symptoms using the Brief Psychiatric Rating Scale (BPRS) or the Positive and Negative Syndrome Scale (PANSS) in response to an acute ketamine challenge in healthy participants or patients with schizophrenia. Study Selection Of 8464 citations retrieved, 36 studies involving healthy participants were included. Inclusion criteria were studies (1) including healthy participants; (2) reporting symptoms occurring in response to acute administration of subanesthetic doses of ketamine (racemic ketamine, s-ketamine, r-ketamine) intravenously; (3) containing a placebo condition with a within-subject, crossover design; (4) measuring total positive or negative symptoms using BPRS or PANSS; and (5) providing data allowing the estimation of the mean difference and deviation between the ketamine and placebo condition. Data Extraction and Synthesis Two independent investigators extracted study-level data for a random-effects meta-analysis. Total, positive, and negative BPRS and PANSS scores were extracted. Subgroup analyses were conducted examining the effects of blinding status, ketamine preparation, infusion method, and time between ketamine and placebo conditions. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Main Outcomes and Measures Standardized mean differences (SMDs) were used as effect sizes for individual studies. Standardized mean differences between ketamine and placebo conditions were calculated for total, positive, and negative BPRS and PANSS scores. Results The overall sample included 725 healthy volunteers (mean [SD] age, 28.3 [3.6] years; 533 [73.6%] male) exposed to the ketamine and placebo conditions. Racemic ketamine or S-ketamine was associated with a statistically significant increase in transient psychopathology in healthy participants for total (SMD = 1.50 [95% CI, 1.23-1.77]; P < .001), positive (SMD = 1.55 [95% CI, 1.29-1.81]; P < .001), and negative (SMD = 1.16 [95% CI, 0.96-1.35]; P < .001) symptom ratings relative to the placebo condition. The effect size for this association was significantly greater for positive than negative symptoms of psychosis (estimate, 0.36 [95% CI, 0.12-0.61]; P = .004). There was significant inconsistency in outcomes between studies (I2 range, 77%-83%). Bolus followed by constant infusion increased ketamine's association with positive symptoms relative to infusion alone (effect size, 1.63 [95% CI, 1.36-1.90] vs 0.84 [95% CI, 0.35-1.33]; P = .006). Single-day study design increased ketamine's ability to generate total symptoms (effect size, 2.29 [95% CI, 1.69-2.89] vs 1.39 [95% CI, 1.12-1.66]; P = .007), but age and sex did not moderate outcomes. Insufficient studies were available for meta-analysis of studies in schizophrenia. Of these studies, 2 found a statistically significant increase in symptoms with ketamine administration in total and positive symptoms. Only 1 study found an increase in negative symptom severity with ketamine. Conclusions and Relevance This study found that acute ketamine administration was associated with schizophrenia-like or psychotomimetic symptoms with large effect sizes, but there was a greater increase in positive than negative symptoms and when a bolus was used. These findings suggest that bolus doses should be avoided in the therapeutic use of ketamine to minimize the risk of inducing transient positive (psychotic) symptoms.
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Affiliation(s)
- Katherine Beck
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, MRC (Medical Research Council) London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom
- South London and Maudsley NHS (National Health Service) Foundation Trust, London, United Kingdom
| | - Guy Hindley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Faith Borgan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Cedric Ginestet
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Robert McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, MRC (Medical Research Council) London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom
- South London and Maudsley NHS (National Health Service) Foundation Trust, London, United Kingdom
| | - Stefan Brugger
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Division of Psychiatry, University College London, London, United Kingdom
- Cardiff University Brain Research Imaging Centre, Cardiff, United Kingdom
| | - Naomi Driesen
- Yale University Medical School, Veterans Affairs Connecticut Health Care System, West Haven
| | - Mohini Ranganathan
- Yale University Medical School, Veterans Affairs Connecticut Health Care System, West Haven
- Department of Psychiatry and National Center for Posttraumatic Stress Disorder (PTSD), Veterans Affairs Connecticut Healthcare System, West Haven
| | - Deepak Cyril D’Souza
- Yale University Medical School, Veterans Affairs Connecticut Health Care System, West Haven
- Department of Psychiatry and National Center for Posttraumatic Stress Disorder (PTSD), Veterans Affairs Connecticut Healthcare System, West Haven
| | - Matthew Taylor
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- University Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
| | - John H. Krystal
- Yale University Medical School, Veterans Affairs Connecticut Health Care System, West Haven
- Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, Veterans Affairs Connecticut Healthcare System, West Haven
| | - Oliver D. Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, MRC (Medical Research Council) London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom
- South London and Maudsley NHS (National Health Service) Foundation Trust, London, United Kingdom
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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50
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Nugent AC, Ballard ED, Gilbert JR, Tewarie PK, Brookes MJ, Zarate CA. The Effect of Ketamine on Electrophysiological Connectivity in Major Depressive Disorder. Front Psychiatry 2020; 11:519. [PMID: 32655423 PMCID: PMC7325927 DOI: 10.3389/fpsyt.2020.00519] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/21/2020] [Indexed: 01/06/2023] Open
Abstract
Major depressive disorder (MDD) is highly prevalent and frequently disabling. Only about 30% of patients respond to a first-line antidepressant treatment, and around 30% of patients are classified as "treatment-resistant" after failing to respond to multiple adequate trials. While most antidepressants target monoaminergic targets, ketamine is an N-methyl-D-aspartate (NMDA) antagonist that has shown rapid antidepressant effects when delivered intravenously or intranasally. While there is evidence that ketamine exerts its effects via enhanced α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) throughput, its mechanism for relieving depressive symptoms is largely unknown. This study acquired resting-state magnetoencephalography (MEG) recordings after both ketamine and placebo infusions and investigated functional connectivity using a multilayer amplitude-amplitude correlation technique spanning the canonical frequency bands. Twenty-four healthy volunteers (HVs) and 27 unmedicated participants with MDD took part in a double-blind, placebo-controlled, crossover trial of 0.5 mg/kg IV ketamine. Order of infusion was randomized, and participants crossed over to receive the second infusion after two weeks. The results indicated widespread ketamine-induced reductions in connectivity in the alpha and beta bands that did not correlate with magnitude of antidepressant response. In contrast, the magnitude of ketamine's antidepressant effects in MDD participants was associated with cross-frequency connectivity for delta-alpha and delta-gamma bands, with HVs and ketamine non-responders showing connectivity decreases post-ketamine and ketamine responders demonstrating small increases in connectivity. These results may indicate functional subtypes of MDD and also suggest that neural responses to ketamine are fundamentally different between responders and non-responders.
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Affiliation(s)
- Allison C Nugent
- MEG Core Facility, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States.,Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Jessica R Gilbert
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Prejaas K Tewarie
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
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