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Serpa MH, Doshi J, Erus G, Chaim-Avancini TM, Cavallet M, van de Bilt MT, Sallet PC, Gattaz WF, Davatzikos C, Busatto GF, Zanetti MV. State-dependent microstructural white matter changes in drug-naïve patients with first-episode psychosis. Psychol Med 2017; 47:2613-2627. [PMID: 28826419 DOI: 10.1017/s0033291717001015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies have consistently shown white matter (WM) microstructural abnormalities in schizophrenia. Whether or not such alterations could vary depending on clinical status (i.e. acute psychosis v. remission) remains to be investigated. METHODS Twenty-five treatment-naïve first-episode psychosis (FEP) patients and 51 healthy-controls (HC) underwent MRI scanning at baseline. Twenty-one patients were re-scanned as soon as they achieved sustained remission of symptoms; 36 HC were also scanned twice. Rate-of-change maps of longitudinal DTI changes were calculated for in order to examine WM alterations associated with changes in clinical status. We conducted voxelwise analyses of fractional anisotropy (FA) and trace (TR) maps. RESULTS At baseline, FEP presented reductions of FA in comparison with HC [p < 0.05, false-discovery rate (FDR)-corrected] affecting fronto-limbic WM and associative, projective and commissural fasciculi. After symptom remission, patients showed FA increase over time (p < 0.001, uncorrected) in some of the above WM tracts, namely the right anterior thalamic radiation, right uncinate fasciculus/inferior fronto-occipital fasciculus, and left inferior fronto-occipital fasciculus/inferior longitudinal fasciculus. We also found significant correlations between reductions in PANSS scores and FA increases over time (p < 0.05, FDR-corrected). CONCLUSIONS WM changes affecting brain tracts critical to the integration of perceptual information, cognition and emotions are detectable soon after the onset of FEP and may partially reverse in direct relation to the remission of acute psychotic symptoms. Our findings reinforce the view that WM abnormalities in brain tracts are a key neurobiological feature of acute psychotic disorders, and recovery from such WM pathology can lead to amelioration of symptoms.
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Affiliation(s)
- M H Serpa
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - J Doshi
- Section of Biomedical Image Analysis (SBIA), Department of Radiology,University of Pennsylvania,3600 Market St,Suite 380, Philadelphia, PA,USA
| | - G Erus
- Section of Biomedical Image Analysis (SBIA), Department of Radiology,University of Pennsylvania,3600 Market St,Suite 380, Philadelphia, PA,USA
| | - T M Chaim-Avancini
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - M Cavallet
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - M T van de Bilt
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - P C Sallet
- Laboratory of Neuroscience, LIM-27,Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Instituto de Psiquiatria,3o andar, LIM-27,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - W F Gattaz
- Laboratory of Neuroscience, LIM-27,Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Instituto de Psiquiatria,3o andar, LIM-27,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - C Davatzikos
- Section of Biomedical Image Analysis (SBIA), Department of Radiology,University of Pennsylvania,3600 Market St,Suite 380, Philadelphia, PA,USA
| | - G F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - M V Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
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Choi MH, Na JE, Yoon YR, Lee HJ, Yoon S, Rhyu IJ, Baik JH. Role of Dopamine D2 Receptor in Stress-Induced Myelin Loss. Sci Rep 2017; 7:11654. [PMID: 28912499 PMCID: PMC5599541 DOI: 10.1038/s41598-017-10173-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 08/04/2017] [Indexed: 12/24/2022] Open
Abstract
Dopaminergic systems play a major role in reward-related behavior and dysregulation of dopamine (DA) systems can cause several mental disorders, including depression. We previously reported that dopamine D2 receptor knockout (D2R-/-) mice display increased anxiety and depression-like behaviors upon chronic stress. Here, we observed that chronic stress caused myelin loss in wild-type (WT) mice, while the myelin level in D2R-/- mice, which was already lower than that in WT mice, was not affected upon stress. Fewer mature oligodendrocytes (OLs) were observed in the corpus callosum of stressed WT mice, while in D2R-/- mice, both the control and stressed group displayed a decrease in the number of mature OLs. We observed a decrease in the number of active β-catenin (ABC)-expressing and TCF4-expressing cells among OL lineage cells in the corpus callosum of stressed WT mice, while such regulation was not found in D2R-/- mice. Administration of lithium normalized the behavioral impairments and myelin damage induced by chronic stress in WT mice, and restored the number of ABC-positive and TCF4-positive OLs, while such effect was not found in D2R-/- mice. Together, our findings indicate that chronic stress induces myelin loss through the Wnt/β-catenin signaling pathway in association with DA signaling through D2R.
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Affiliation(s)
- Mi-Hyun Choi
- Molecular Neurobiology Laboratory, Department of Life Sciences, Korea University, Seoul, 02841, Korea
| | - Ji Eun Na
- Department of Anatomy, College of Medicine, Korea University, Seoul, 02841, Korea
| | - Ye Ran Yoon
- Molecular Neurobiology Laboratory, Department of Life Sciences, Korea University, Seoul, 02841, Korea
| | - Hyo Jin Lee
- Molecular Neurobiology Laboratory, Department of Life Sciences, Korea University, Seoul, 02841, Korea
| | - Sehyoun Yoon
- Molecular Neurobiology Laboratory, Department of Life Sciences, Korea University, Seoul, 02841, Korea
| | - Im Joo Rhyu
- Department of Anatomy, College of Medicine, Korea University, Seoul, 02841, Korea
| | - Ja-Hyun Baik
- Molecular Neurobiology Laboratory, Department of Life Sciences, Korea University, Seoul, 02841, Korea.
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53
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Kochunov P, Coyle TR, Rowland LM, Jahanshad N, Thompson PM, Kelly S, Du X, Sampath H, Bruce H, Chiappelli J, Ryan M, Fisseha F, Savransky A, Adhikari B, Chen S, Paciga SA, Whelan CD, Xie Z, Hyde CL, Chen X, Schubert CR, O’Donnell P, Hong LE. Association of White Matter With Core Cognitive Deficits in Patients With Schizophrenia. JAMA Psychiatry 2017; 74:958-966. [PMID: 28768312 PMCID: PMC5710230 DOI: 10.1001/jamapsychiatry.2017.2228] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Efforts to remediate the multiple cognitive function impairments in schizophrenia should consider white matter as one of the underlying neural mechanisms. OBJECTIVE To determine whether altered structural brain connectivity is responsible for 2 of the core cognitive deficits in schizophrenia- reduced information processing speed and impaired working memory. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study design took place in outpatient clinics from August 1, 2004, to August 31, 2015. Participants included 166 patients with schizophrenia and 213 healthy control individuals. These participants were from 3 independent cohorts, each of which had its own healthy control group. No participant had current or past neurological conditions or major medical conditions. Patients were diagnosed with either schizophrenia or schizoaffective disorder as defined by the DSM-IV. Controls had no Axis I psychiatric disorder. MAIN OUTCOMES AND MEASURES Mediation analyses and structural equation modeling were used to analyze the associations among processing speed, working memory, and white matter microstructures. Whole-brain and regional diffusion tensor imaging fractional anisotropy were used to measure white matter microstructures. RESULTS Of the study participants, the 166 patients with schizophrenia had a mean (SD) age of 38.2 (13.3) years and the 213 healthy controls had a mean (SD) age of 39.2 (14.0) years. There were significantly more male patients than controls in each of the 3 cohorts (117 [70%] vs 91 [43%]), but there were no significant differences in sex composition among the 3 cohorts. Patients had significantly reduced processing speed (Cohen d = 1.24; P = 6.91 × 10-30) and working memory deficits (Cohen d = 0.83; P = 1.10 × 10-14) as well as a significant whole-brain fractional anisotropy deficit (Cohen d = 0.63; P = 2.20 × 10-9). In schizophrenia, working memory deficit was mostly accounted for by processing speed deficit, but this deficit remained when accounting for working memory (Cohen d = 0.89; P = 2.21 × 10-17). Mediation analyses showed a significant association pathway from fractional anisotropy to processing speed to working memory (P = 5.01 × 10-7). The strength of this brain-to-cognition pathway in different white matter tracts was strongly associated with the severity of schizophrenia-associated fractional anisotropy deficits in the corresponding white matter tracts as determined by a meta-analysis (r = 0.85-0.94; all P < .001). The same pattern was observed in patients and controls either jointly or independently. CONCLUSIONS AND RELEVANCE Study findings suggest that (1) processing speed contributes to the association between white matter microstructure and working memory in schizophrenia and (2) white matter impairment in schizophrenia is regional tract-specific, particularly in tracts normally supporting processing speed performance.
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Thomas R. Coyle
- Department of Psychology, The University of Texas at San Antonio
| | - Laura M. Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Neda Jahanshad
- Imaging Genetics Center, Keck School of Medicine of the University of Southern California, Marina del Rey
| | - Paul M. Thompson
- Imaging Genetics Center, Keck School of Medicine of the University of Southern California, Marina del Rey
| | - Sinead Kelly
- Imaging Genetics Center, Keck School of Medicine of the University of Southern California, Marina del Rey
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Hemalatha Sampath
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Meghann Ryan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Feven Fisseha
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Anya Savransky
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Bhim Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Sara A. Paciga
- Worldwide Research and Development, Pfizer Inc, Cambridge, Massachusetts
| | | | - Zhiyong Xie
- Worldwide Research and Development, Pfizer Inc, Cambridge, Massachusetts
| | - Craig L. Hyde
- Worldwide Research and Development, Pfizer Inc, Cambridge, Massachusetts
| | - Xing Chen
- Worldwide Research and Development, Pfizer Inc, Cambridge, Massachusetts
| | | | - Patricio O’Donnell
- Worldwide Research and Development, Pfizer Inc, Cambridge, Massachusetts
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
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Palaniyappan L, Das T, Dempster K. The neurobiology of transition to psychosis: clearing the cache. J Psychiatry Neurosci 2017; 42:294-299. [PMID: 28834527 PMCID: PMC5573571 DOI: 10.1503/jpn.170137] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The prepsychotic phase of schizophrenia is not only important for indicated prevention strategies, but also crucial for developing mechanistic models of the emergence of frank psychosis (transition). This commentary highlights the work of Dukart and colleagues, published in this issue of the Journal of Psychiatry and Neurosicence, who sought to identify MRI-based anatomic endophenotypes of psychosis in a well-characterized sample of patients with at-risk mental state (ARMS) and first-episode psychosis (FEP). Conceptual and translational challenges in clarifying the neurobiology of transitional prepsychotic states are discussed. A role of intracortical myelin in the neurobiology of transition is proposed. Transition may not be an outcome of "progressive structural deficits"; it may occur due to inadequate compensatory responses in the predisposed. The need to revise our current "deficit-oriented" models of neurobiology of psychosis in the wake of burgeoning evidence indicating a dynamic process of cortical reorganization is emphasized.
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Affiliation(s)
- Lena Palaniyappan
- Correspondence to: L. Palaniyappan, Prevention & Early Intervention Program for Psychoses (PEPP), A2-636, LHSC-VH, 800 Commissioners Road, London, Ont., Canada N6A 5W9;
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Kurumaji A, Itasaka M, Uezato A, Takiguchi K, Jitoku D, Hobo M, Nishikawa T. A distinctive abnormality of diffusion tensor imaging parameters in the fornix of patients with bipolar II disorder. Psychiatry Res Neuroimaging 2017; 266:66-72. [PMID: 28609689 DOI: 10.1016/j.pscychresns.2017.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 12/01/2022]
Abstract
Diffusion tensor imaging (DTI) studies have revealed a changed integrity in the white matter of bipolar disorder. However, only a few investigations have examined bipolar II disorder (BP-II). A cross-sectional study was conducted to compare thirty-eight patients with BP-II (mean age = 38.26 years, F/M = 19/19) with thirty-eight age- and gender-matched healthy controls (mean age = 34.45 years, F/M = 18/20). Tract Based Spatial Statistics (TBSS) analysis of the fractional anisotropy (FA) was done with age, gender and education years as covariates, then a complementary atlas-based region-of-interest (ROI) analysis including the axial diffusivity (AD) and radial diffusivity (RD) was conducted to obtain further information. The patients with BP-II showed a significant decrease in FA in the corpus callosum (commissure fibers), fornix (association fibers) and right anterior corona radiata (projection fibers) compared to the controls. Moreover, a significant increase in the RD was observed in all of the fibers of the BP-II patients, while the AD significantly increased only in the fornix of the patients. Thus, in addition to the abnormal integrity of the commissure and projection fibers, the present study suggested an involvement of the limbic association fibers in the pathophysiology of BP-II induced by a distinctive neuropathology.
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Affiliation(s)
- Akeo Kurumaji
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Michio Itasaka
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Akihito Uezato
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kazuo Takiguchi
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Daisuke Jitoku
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Mizue Hobo
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Toru Nishikawa
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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56
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Farrelly L, Rosato-Siri MV, Föcking M, Codagnone M, Reines A, Dicker P, Wynne K, Farrell M, Cannon M, Cagney G, Pasquini JM, Cotter DR. The Effects of Prenatal Iron Deficiency and Risperidone Treatment on the Rat Frontal Cortex: A Proteomic Analysis. Proteomics 2017; 17. [PMID: 28762254 DOI: 10.1002/pmic.201600407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 06/12/2017] [Indexed: 11/11/2022]
Abstract
Prenatal iron deficiency (pID) has been described to increase the risk for neurodevelopmental disorders such as autism and schizophrenia; however, the precise molecular mechanisms are still unknown. Here, we utilized high-throughput MS to examine the proteomic effects of pID in adulthood on the rat frontal cortex area (FCA). In addition, the FCA proteome was examined in adulthood following risperidone treatment in adolescence to see if these effects could be prevented. We identified 1501 proteins of which 100 were significantly differentially expressed in the FCA at postnatal day 90. Pathway analysis of proteins affected by pID revealed changes in metabolic processes, including the tricyclic acid cycle, mitochondrial dysfunction, and P13K/Akt signaling. Interestingly, most of these protein changes were not present in the adult pID offspring who received risperidone in adolescence. Considering the link between pID and several neurodevelopmental disorders such as autism and schizophrenia these presented results bring new perspectives to understand the role of iron in metabolic pathways and provide novel biomarkers for future studies of pID.
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Affiliation(s)
- Lorna Farrelly
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Maria Victoria Rosato-Siri
- Department of Biological Chemistry, IQUIFIB, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Martin Codagnone
- De Robertis Institute, University of Buenos Aires, Buenos Aires, Argentina
| | - Analia Reines
- De Robertis Institute, University of Buenos Aires, Buenos Aires, Argentina
| | - Patrick Dicker
- Departments of Epidemiology & Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kieran Wynne
- School of Biomolecular and Biomedical Research, Conway Institute, University College Dublin, Dublin, Ireland
| | - Michael Farrell
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Gerard Cagney
- School of Biomolecular and Biomedical Research, Conway Institute, University College Dublin, Dublin, Ireland
| | - Juana Maria Pasquini
- Department of Biological Chemistry, IQUIFIB, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
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Newville J, Valenzuela CF, Li L, Jantzie LL, Cunningham LA. Acute oligodendrocyte loss with persistent white matter injury in a third trimester equivalent mouse model of fetal alcohol spectrum disorder. Glia 2017; 65:1317-1332. [PMID: 28518477 DOI: 10.1002/glia.23164] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 04/03/2017] [Accepted: 04/20/2017] [Indexed: 12/12/2022]
Abstract
Alcohol exposure during central nervous system (CNS) development can lead to fetal alcohol spectrum disorder (FASD). Human imaging studies have revealed significant white matter (WM) abnormalities linked to cognitive impairment in children with FASD; however, the underlying mechanisms remain unknown. Here, we evaluated both the acute and long-term impacts of alcohol exposure on oligodendrocyte number and WM integrity in a third trimester-equivalent mouse model of FASD, in which mouse pups were exposed to alcohol during the first 2 weeks of postnatal development. Our results demonstrate a 58% decrease in the number of mature oligodendrocytes (OLs) and a 75% decrease in the number of proliferating oligodendrocyte progenitor cells (OPCs) within the corpus callosum of alcohol-exposed mice at postnatal day 16 (P16). Interestingly, neither mature OLs nor OPCs derived from the postnatal subventricular zone (SVZ) were numerically affected by alcohol exposure, indicating heterogeneity in susceptibility based on OL ontogenetic origin. Although mature OL and proliferating OPC numbers recovered by postnatal day 50 (P50), abnormalities in myelin protein expression and microstructure within the corpus callosum of alcohol-exposed subjects persisted, as assessed by western immunoblotting of myelin basic protein (MBP; decreased expression) and MRI diffusion tensor imaging (DTI; decreased fractional anisotropy). These results indicate that third trimester-equivalent alcohol exposure leads to an acute, albeit recoverable, decrease in OL lineage cell numbers, accompanied by enduring WM injury. Additionally, our finding of heterogeneity in alcohol susceptibility based on the developmental origin of OLs may have therapeutic implications in FASD and other disorders of WM development.
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Affiliation(s)
- Jessie Newville
- Department of Neurosciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | | | - Lu Li
- Department of Neurosciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Lauren L Jantzie
- Department of Neurosciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.,Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Lee Anna Cunningham
- Department of Neurosciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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Choi JL, Kao PF, Itriago E, Zhan Y, Kozubek JA, Hoss AG, Banigan MG, Vanderburg CR, Rezvani AH, Latourelle JC, Cabral H, Delalle I. miR-149 and miR-29c as candidates for bipolar disorder biomarkers. Am J Med Genet B Neuropsychiatr Genet 2017; 174:315-323. [PMID: 28190298 DOI: 10.1002/ajmg.b.32518] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 11/30/2016] [Indexed: 11/11/2022]
Abstract
Bipolar disorder (BD) is a common, recurring psychiatric illness with unknown pathogenesis. Recent studies suggest that microRNA (miRNA) levels in brains of BD patients are significantly altered, and these changes may offer insight into BD pathology or etiology. Previously, we observed significant alterations of miR-29c levels in extracellular vesicles (EVs) extracted from prefrontal cortex (Brodmann area 9, BA9) of BD patients. In this study, we show that EVs extracted from the anterior cingulate cortex (BA24), a crucial area for modulating emotional expression and affect, have increased levels of miR-149 in BD patients compared to controls. Because miR-149 has been shown to inhibit glial proliferation, increased miR-149 expression in BA24-derived EVs is consistent with the previously reported reduced glial cell numbers in BA24 of patients diagnosed with either familial BD or familial major depressive disorder. qPCR analysis of laser-microdissected neuronal and glial cells from BA24 cortical samples of BD patients verified that the glial, but not neuronal, population exhibits significantly increased miR-149 expression. Finally, we report altered expression of both miR-149 and miR-29c in EVs extracted from brains of Flinders Sensitive Line rats, a well-validated animal model exhibiting depressive-like behaviors and glial (astrocytic) dysfunction. These findings warrant future investigations into the potential of using EV miRNA signatures as biomarkers to further enhance the biological definition of BD. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jason L Choi
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Patricia F Kao
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Elena Itriago
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Yougen Zhan
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - James A Kozubek
- Broad Institute, Cambridge, Boston, Massachusetts.,Brigham and Women's Hospital, Boston, Massachusetts
| | - Andrew G Hoss
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Meredith G Banigan
- Advanced Tissue Resource Center, Harvard NeuroDiscovery Center, Charlestown, Massachusetts
| | - Charles R Vanderburg
- Advanced Tissue Resource Center, Harvard NeuroDiscovery Center, Charlestown, Massachusetts
| | - Amir H Rezvani
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Jeanne C Latourelle
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health and Boston University Clinical and Translational Science Institute, Boston, Massachusetts
| | - Ivana Delalle
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
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Abnormal Trajectory of Intracortical Myelination in Schizophrenia Implicates White Matter in Disease Pathophysiology and the Therapeutic Mechanism of Action of Antipsychotics. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 3:454-462. [PMID: 29735155 DOI: 10.1016/j.bpsc.2017.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/08/2017] [Accepted: 03/05/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Postmortem and imaging studies provide converging evidence that the frontal lobe myelination trajectory is dysregulated in schizophrenia (SZ) and suggest that early in treatment, antipsychotic medications increase intracortical myelin (ICM). We used magnetic resonance imaging to examine whether the ICM trajectory in SZ is dysregulated and altered by antipsychotic treatment. METHODS We examined 93 subjects with SZ (64 men and 29 women) taking second-generation oral antipsychotics with medication exposures of 0-333 months in conjunction with 80 healthy control subjects (52 men and 28 women). Frontal lobe ICM volume was estimated using a novel dual contrast magnetic resonance imaging method that combines two images that track different tissue components. RESULTS When plotted against oral antipsychotic exposure duration, ICM of subjects with SZ was higher as a function of medication exposure during the first year of treatment but declined thereafter. In the age range examined, ICM of subjects with SZ was lower with increased age, while ICM of healthy control subjects was not. CONCLUSIONS In adults with SZ, the relationship between length of exposure to oral second-generation antipsychotics and ICM was positive during the first year of treatment but was negative after this initial period, consistent with suboptimal later adherence after initial adherence. This ICM trajectory resembles clinically observed antipsychotic response trajectory with high rates of remission in the first year followed by progressively lower response rates. The results support postmortem evidence that SZ pathophysiology involves ICM deficits and suggest that correcting these deficits may be an important mechanism of action for antipsychotics.
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Rong W, Pan YW, Cai X, Song F, Zhao Z, Xiao SH, Zhang C. The mechanism of Naringin-enhanced remyelination after spinal cord injury. Neural Regen Res 2017; 12:470-477. [PMID: 28469664 PMCID: PMC5399727 DOI: 10.4103/1673-5374.202923] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Our previous study revealed that intragastric administration of naringin improved remyelination in rats with spinal cord injury and promoted the recovery of neurological function of the injured spinal cord. This study sought to reveal the mechanisms by which naringin improves oligodendrocyte precursor cell differentiation and maturation, and promotes remyelination. Spinal cord injury was induced in rats by the weight-drop method. Naringin was intragastrically administered daily (20, 40 mg/kg) for 4 weeks after spinal cord injury induction. Behavioral assessment, histopathological staining, immunofluorescence spectroscopy, ultrastructural analysis and biochemical assays were employed. Naringin treatment remarkably mitigated demyelination in the white matter, increased the quality of myelinated nerve fibers and myelin sheath thickness, promoted oligodendrocyte precursor cell differentiation by upregulating the expression of NKx2.2 and 2′3′-cyclic nucleotide 3′-phosphodiesterase, and inhibited β-catenin expression and glycogen synthase kinase-3β (GSK-3β) phosphorylation. These findings indicate that naringin treatment regulates oligodendrocyte precursor cell differentiation and promotes remyelination after spinal cord injury through the β-catenin/GSK-3β signaling pathway.
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Affiliation(s)
- Wei Rong
- Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing Key Laboratory of Bioelectromagnetism, Beijing, China
| | - Yong-Wei Pan
- Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing Key Laboratory of Bioelectromagnetism, Beijing, China
| | - Xu Cai
- Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing Key Laboratory of Bioelectromagnetism, Beijing, China
| | - Fei Song
- Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing Key Laboratory of Bioelectromagnetism, Beijing, China
| | - Zhe Zhao
- Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing Key Laboratory of Bioelectromagnetism, Beijing, China
| | - Song-Hua Xiao
- Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing Key Laboratory of Bioelectromagnetism, Beijing, China
| | - Cheng Zhang
- Beijing Key Laboratory of Bioelectromagnetism, Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China
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Chew LJ, DeBoy CA. Pharmacological approaches to intervention in hypomyelinating and demyelinating white matter pathology. Neuropharmacology 2016; 110:605-625. [PMID: 26116759 PMCID: PMC4690794 DOI: 10.1016/j.neuropharm.2015.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 06/10/2015] [Accepted: 06/17/2015] [Indexed: 12/17/2022]
Abstract
White matter disease afflicts both developing and mature central nervous systems. Both cell intrinsic and extrinsic dysregulation result in profound changes in cell survival, axonal metabolism and functional performance. Experimental models of developmental white matter (WM) injury and demyelination have not only delineated mechanisms of signaling and inflammation, but have also paved the way for the discovery of pharmacological approaches to intervention. These reagents have been shown to enhance protection of the mature oligodendrocyte cell, accelerate progenitor cell recruitment and/or differentiation, or attenuate pathological stimuli arising from the inflammatory response to injury. Here we highlight reports of studies in the CNS in which compounds, namely peptides, hormones, and small molecule agonists/antagonists, have been used in experimental animal models of demyelination and neonatal brain injury that affect aspects of excitotoxicity, oligodendrocyte development and survival, and progenitor cell function, and which have been demonstrated to attenuate damage and improve WM protection in experimental models of injury. The molecular targets of these agents include growth factor and neurotransmitter receptors, morphogens and their signaling components, nuclear receptors, as well as the processes of iron transport and actin binding. By surveying the current evidence in non-immune targets of both the immature and mature WM, we aim to better understand pharmacological approaches modulating endogenous oligodendroglia that show potential for success in the contexts of developmental and adult WM pathology. This article is part of the Special Issue entitled 'Oligodendrocytes in Health and Disease'.
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Affiliation(s)
- Li-Jin Chew
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC, USA.
| | - Cynthia A DeBoy
- Biology Department, Trinity Washington University, Washington, DC, USA
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Haarman BCM'B, Riemersma-Van der Lek RF, Burger H, de Groot JC, Drexhage HA, Nolen WA, Cerliani L. Diffusion tensor imaging in euthymic bipolar disorder - A tract-based spatial statistics study. J Affect Disord 2016; 203:281-291. [PMID: 27317921 DOI: 10.1016/j.jad.2016.05.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/22/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND In the current DTI study we compared euthymic bipolar I disorder (BD-I) patients and healthy controls (HC). We subsequently divided the total patient group into lithium-users and non-lithium-users and estimated differences across the three groups. METHODS Twenty-one euthymic BD-I patients and twenty-two HC participants were included in psychiatric interviews and MRI image acquisition (diffusion-weighted (DW) and T1-weighted scans). Fractional anisotropy (FA), radial, mean and axial diffusivity (RD, MD, AD) were estimated from the DW data, using DTI. These measures were then compared between groups using FSL Tract Based Spatial Statistics (TBSS). Correlations with age at onset, number of episodes and depression score were analyzed. RESULTS A difference in FA, MD, RD and AD between the whole sample of euthymic BD-I patients and healthy controls could not be detected. Amongst others, lithium-using patients demonstrated a higher FA and lower RD when compared to non-lithium-using BD-I patients in the corpus callosum and left anterior corona radiata. Widespread clusters demonstrated negative FA associations and positive RD and MD associations with minor depressive symptoms. LIMITATIONS Patients were naturalistically treated. Although the sample size is comparable to several other DTI studies, a larger sample size would have been benificial. TBSS and DTI have their own limitations. CONCLUSION Our findings support the theory that previously described DTI-based microstructural differences between HC and BD patients could be less pronounced in euthymic BD patients. Differences in FA between patients using and not using lithium suggest a counteracting effect of lithium on white matter microstructural disturbances.
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Affiliation(s)
- Bartholomeus C M 'Benno' Haarman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands; Radiology Morphological Solutions, Berkel en Rodenrijs, The Netherlands.
| | - Rixt F Riemersma-Van der Lek
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Huibert Burger
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, The Netherlands
| | - Jan Cees de Groot
- University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, The Netherlands
| | - Hemmo A Drexhage
- Erasmus MC, Department of Immunology, Rotterdam, The Netherlands
| | - Willem A Nolen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Leonardo Cerliani
- University of Groningen, Neuroimaging Center, Groningen, The Netherlands; Institute du Cerveau et de la Moelle épinière, Paris, France
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Ferensztajn-Rochowiak E, Tarnowski M, Samochowiec J, Michalak M, Ratajczak MZ, Rybakowski JK. Increased mRNA expression of peripheral glial cell markers in bipolar disorder: The effect of long-term lithium treatment. Eur Neuropsychopharmacol 2016; 26:1516-1521. [PMID: 27474686 DOI: 10.1016/j.euroneuro.2016.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/05/2016] [Accepted: 07/13/2016] [Indexed: 01/13/2023]
Abstract
Neuroinflammation, with microglial activation as an important element, plays a role in the pathogenesis of bipolar disorder (BD). Also, in mood disorders, pathological changes have been demonstrated in macroglial cells, such as astrocyctes and oligodendrocytes. Postmortem brain studies of BD patients to assess glial cells, such as astrocytes and oligodendrocytes and their markers such as glial fibrillary acidic protein (GFAP), Olig1 and Olig2, produced controversial results. On the other hand, investigation of these markers in the peripheral blood of such patients has not been performed so far. In this study, we examined the mRNA levels of GFAP, Olig1 and Olig2, in the peripheral blood of three groups: 15 BD subjects with a duration of illness at least 10 years (mean 20±9 years) but never treated with lithium, 15 subjects with BD treated continuously with lithium for 8-40 years (mean 16±8 years), and 15 control subjects. The groups were age-and sex-matched. Expression of mRNA markers was measured by real-time quantitative reverse transcription PCR (RQ-PCR). We observed increased mRNA levels of the Olig1 and Olig 2 glial markers studied in the BD patients not taking lithium, compared with the control subjects and increased mRNA level of GFAP, compared with lithium-treated patients. In the lithium-treated BD patients GFAP and Olig1 expression was at similar levels to that in the control group. However, Olig 2 expression was even higher than in the BD patients not taking lithium. The possible mechanisms concerning the higher expression of peripheral mRNA markers in BD patients may involve ongoing inflammatory process, compensatory mechanisms and regenerative responses. The beneficial effect of lithium may be related to its anti-inflammatory properties.
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Affiliation(s)
| | - Maciej Tarnowski
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian University of Medicine, Szczecin, Poland
| | - Michal Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariusz Z Ratajczak
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland; Stem Cell Biology Program at the James Graham Brown Cancer Center, University of Louisville, Louisville, KY 40202, USA
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
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Marcoli M, Agnati LF, Benedetti F, Genedani S, Guidolin D, Ferraro L, Maura G, Fuxe K. On the role of the extracellular space on the holistic behavior of the brain. Rev Neurosci 2016; 26:489-506. [PMID: 26103627 DOI: 10.1515/revneuro-2015-0007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 04/11/2015] [Indexed: 12/18/2022]
Abstract
Multiple players are involved in the brain integrative action besides the classical neuronal and astrocyte networks. In the past, the concept of complex cellular networks has been introduced to indicate that all the cell types in the brain can play roles in its integrative action. Intercellular communication in the complex cellular networks depends not only on well-delimited communication channels (wiring transmission) but also on diffusion of signals in physically poorly delimited extracellular space pathways (volume transmission). Thus, the extracellular space and the extracellular matrix are the main players in the intercellular communication modes in the brain. Hence, the extracellular matrix is an 'intelligent glue' that fills the brain and, together with the extracellular space, contributes to the building-up of the complex cellular networks. In addition, the extracellular matrix is part of what has been defined as the global molecular network enmeshing the entire central nervous system, and plays important roles in synaptic contact homeostasis and plasticity. From these premises, a concept is introduced that the global molecular network, by enmeshing the central nervous system, contributes to the brain holistic behavior. Furthermore, it is suggested that plastic 'brain compartments' can be detected in the central nervous system based on the astrocyte three-dimensional tiling of the brain volume and on the existence of local differences in cell types and extracellular space fluid and extracellular matrix composition. The relevance of the present view for neuropsychiatry is discussed. A glossary box with terms and definitions is provided.
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Ajmone-Cat MA, D'Urso MC, di Blasio G, Brignone MS, De Simone R, Minghetti L. Glycogen synthase kinase 3 is part of the molecular machinery regulating the adaptive response to LPS stimulation in microglial cells. Brain Behav Immun 2016; 55:225-235. [PMID: 26593276 DOI: 10.1016/j.bbi.2015.11.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/31/2015] [Accepted: 11/20/2015] [Indexed: 12/31/2022] Open
Abstract
Repeated stimulation of TLR4 signaling by lipopolysaccharide (LPS) in microglia induces a state of tolerance/sensitization consisting in the reprogramming of the expression of pro-inflammatory genes in favor of anti-inflammatory ones. The molecular mechanisms underlying this adaptive response are far to be elucidated. Glycogen synthase kinase 3 (GSK3) has emerged as crucial regulator of TLR signaling, mediating the balance between pro- and anti-inflammatory functions in both periphery and central nervous system. The present study extends this notion identifying GSK3 as part of the molecular machinery regulating the LPS-adaptive response in microglial cells, by using primary microglial cultures and organotypic hippocampal slices (OHSCs). We found that lithium chloride (LiCl), a widely used GSK3 inhibitor and the mainstay treatment for bipolar disorder, reinforced the LPS adaptive response by enhancing both downregulation of pro-inflammatory genes (inducible nitric oxide synthase, interleukin 1β, interleukin 6, tumor necrosis factor α), and upregulation of genes typically associated to anti-inflammatory functions (interleukin 10 and MRC1). The effects of GSK3 inhibition were mimicked by Wnt3a, added exogenously, and reversed by Inhibitor of Wnt-Response-1-endo, a pharmacological disruptor of the canonical Wnt/β-catenin pathway, and GW9662, a selective peroxisome proliferator activated receptor γ antagonist, suggesting that these two pathways are involved in the regulation of LPS-tolerance/sensitization by GSK. Finally, LiCl treatment of OHSCs enhanced the protective functional consequences of the microglial adaptive response to LPS on oligodendrocyte maturation, as indicated by MBP mRNA upregulation. These results further indicate GSK3 as key component in the orchestration of neuroinflammation and target for neuroprotective strategies.
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Affiliation(s)
| | - Maria Cristina D'Urso
- Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | - Giorgia di Blasio
- Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | | | - Roberta De Simone
- Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | - Luisa Minghetti
- Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità, Rome, Italy.
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Abstract
Despite a lack of recent progress in the treatment of schizophrenia, our understanding of its genetic and environmental causes has considerably improved, and their relationship to aberrant patterns of neurodevelopment has become clearer. This raises the possibility that 'disease-modifying' strategies could alter the course to - and of - this debilitating disorder, rather than simply alleviating symptoms. A promising window for course-altering intervention is around the time of the first episode of psychosis, especially in young people at risk of transition to schizophrenia. Indeed, studies performed in both individuals at risk of developing schizophrenia and rodent models for schizophrenia suggest that pre-diagnostic pharmacotherapy and psychosocial or cognitive-behavioural interventions can delay or moderate the emergence of psychosis. Of particular interest are 'hybrid' strategies that both relieve presenting symptoms and reduce the risk of transition to schizophrenia or another psychiatric disorder. This Review aims to provide a broad-based consideration of the challenges and opportunities inherent in efforts to alter the course of schizophrenia.
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67
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Ebdrup BH, Raghava JM, Nielsen MØ, Rostrup E, Glenthøj B. Frontal fasciculi and psychotic symptoms in antipsychotic-naive patients with schizophrenia before and after 6 weeks of selective dopamine D2/3 receptor blockade. J Psychiatry Neurosci 2016; 41:133-41. [PMID: 26599135 PMCID: PMC4764482 DOI: 10.1503/jpn.150030] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Psychotic symptoms are core clinical features of schizophrenia. We tested recent hypotheses proposing that psychotic, or positive, symptoms stem from irregularities in long-range white matter tracts projecting into the frontal cortex, and we predicted that selective dopamine D2/3 receptor blockade would restore white matter. METHODS Between December 2008 and July 2011, antipsychotic-naive patients with first-episode schizophrenia and matched healthy controls underwent baseline examination with 3 T MRI diffusion tensor imaging and clinical assessments. We assessed group differences of fractional anisotropy (FA) using voxelwise tract-based spatial statistics (TBSS) and anatomic region of interest (ROI)-based analyses. Subsequently, patients underwent 6 weeks of antipsychotic monotherapy with amisulpride. We repeated the examinations after 6 weeks. RESULTS We included 38 patients with first-episode schizophrenia and 38 controls in our analysis, and 28 individuals in each group completed the study. At baseline, whole brain TBSS analyses revealed lower FA in patients in the right anterior thalamic radiation (ATR), right cingulum, right inferior longitudinal fasciculus and right corticospinal tract (CT). Fractional anisotropy in the right ATR correlated with positive symptoms (z = 2.64, p= 0.008). The ROI analyses showed significant associations between positive symptoms and FA of the frontal fasciculi, specifically the right arcuate fasciculus (z = 2.83, p= 0.005) and right superior longitudinal fasciculus (z = -3.31, p= 0.001). At re-examination, all correlations between positive symptoms and frontal fasciculi had resolved. Fractional anisotropy in the ATR increased more in patients than in controls (z = -4.92, p< 0.001). The amisulpride dose correlated positively with FA changes in the right CT (t= 2.52, p= 0.019). LIMITATIONS Smoking and a previous diagnosis of substance abuse were potential confounders. Long-term effects of amisulpride on white matter were not evaluated. CONCLUSION Antipsychotic-naive patients with schizophrenia displayed subtle deficits in white matter, and psychotic symptoms appeared specifically associated with frontal fasciculi integrity. Six weeks of amisulpride treatment normalized white matter. Potential remyelinating effects of dopamine D2/3 receptor antagonism warrant further clarification.
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Affiliation(s)
- Bjørn H. Ebdrup
- Correspondence to: B.H. Ebdrup, Centre for Neuropsychiatric Schizophrenia Research, CNSR & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Copenhagen University Hospital, Mental Health Centre, Glostrup, Nordre Ringvej 29-67, DK-2600 Glostrup, Denmark;
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Medema S, Mocking RJT, Koeter MWJ, Vaz FM, Meijer C, de Haan L, van Beveren NJM, Kahn R, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I. Levels of Red Blood Cell Fatty Acids in Patients With Psychosis, Their Unaffected Siblings, and Healthy Controls. Schizophr Bull 2016; 42:358-68. [PMID: 26385764 PMCID: PMC4753602 DOI: 10.1093/schbul/sbv133] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Two recent meta-analyses showed decreased red blood cell (RBC) polyunsaturated fatty acids (FA) in schizophrenia and related disorders. However, both these meta-analyses report considerable heterogeneity, probably related to differences in patient samples between studies. Here, we investigated whether variations in RBC FA are associated with psychosis, and thus may be an intermediate phenotype of the disorder. METHODS For the present study, a total of 215 patients (87% outpatients), 187 siblings, and 98 controls were investigated for multiple FA analyses. Based on previous studies, we investigated docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), arachidonic acid (AA), linoleic acid (LA), nervonic acid (NA), and eicasopentaenoic acid (EPA). On an exploratory basis, a large number of additional FA were investigated. Multilevel mixed models were used to compare the FA between the 3 groups. RESULTS Compared to controls, both patients and siblings showed significantly increased DHA, DPA, AA, and NA. LA was significantly higher in siblings compared to controls. EPA was not significantly different between the 3 groups. Also the exploratory FA were increased in patients and siblings. CONCLUSIONS We found increased RBC FA DHA, DPA, AA, and NA in patients and siblings compared to controls. The direction of change is similar in both patients and siblings, which may suggest a shared environment and/or an intermediate phenotype. Differences between patient samples reflecting stage of disorder, dietary patterns, medication use, and drug abuse are possible modifiers of FA, contributing to the heterogeneity in findings concerning FA in schizophrenia patients.
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Affiliation(s)
- Suzanne Medema
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Roel J T Mocking
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Maarten W J Koeter
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Frédéric M Vaz
- Laboratory of Genetic and Metabolic Diseases, Academic Medical Center, Amsterdam, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Nico J M van Beveren
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands; Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands;
| | - René Kahn
- Department of Psychiatry, University Medical Centre Utrecht, Rudolf Magnus Institute of Neuroscience, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Center, The Netherlands
| | - Durk Wiersma
- Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Centre Utrecht, Rudolf Magnus Institute of Neuroscience, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands
| | - Inez Myin-Germeys
- Department of Psychiatry and Psychology, Maastricht University Medical Center, The Netherlands
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Magioncalda P, Martino M, Ely BA, Inglese M, Stern ER. Microstructural white-matter abnormalities and their relationship with cognitive dysfunction in obsessive-compulsive disorder. Brain Behav 2016; 6:e00442. [PMID: 27099803 PMCID: PMC4831422 DOI: 10.1002/brb3.442] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/29/2015] [Accepted: 12/30/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In recent years, diffusion tensor imaging (DTI) studies have detected subtle microstructural abnormalities of white matter (WM) in obsessive-compulsive disorder (OCD). However, findings have been inconsistent, and it is unclear whether WM abnormalities are related to cognitive processes. The aim of this study was to explore the relationship of WM alterations with cognitive variables in OCD in order to investigate the structural correlates of behaviorally relevant features of the disorder. METHODS We compared DTI-derived fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) measures between OCD patients (n = 16) and healthy controls (n = 18) using a whole-brain tract-based spatial statistics (TBSS) approach. We also explored the correlations of WM alterations with clinical and cognitive variables. RESULTS Patients with OCD demonstrated increases in MD in the bilateral posterior corona radiata; left anterior corona radiata; bilateral superior longitudinal fasciculus; genu, body, and splenium of the corpus callosum; and left posterior limb of the internal capsule. An increase in RD values was also found in some of the same tracts (right posterior corona radiata, right superior longitudinal fasciculus, left anterior corona radiata, and corpus callosum). Furthermore, increased MD value in the internal capsule was correlated with the percentage of errors made during a target detection task, which was greater in the OCD group overall. CONCLUSIONS These findings indicate that OCD patients show greater diffusivity in several white-matter regions. The correlation between cognitive performance and diffusivity in the internal capsule suggests that microstructural WM alternations may have functional consequences for the disorder.
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Affiliation(s)
- Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health Section of Psychiatry University of Genoa Genoa Italy
| | - Matteo Martino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health Section of Psychiatry University of Genoa Genoa Italy
| | - Benjamin A Ely
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York City New York
| | - Matilde Inglese
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York City New York; Department of Neurology Icahn School of Medicine at Mount Sinai New York City New York
| | - Emily R Stern
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York City New York; Department of Psychiatry Icahn School of Medicine at Mount Sinai New York City New York
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Kim MK, Kim B, Lee KS, Kim CM, Bang SY, Choi TK, Lee SH. White-matter connectivity related to paliperidone treatment response in patients with schizophrenia. J Psychopharmacol 2016; 30:294-302. [PMID: 26755544 DOI: 10.1177/0269881115625114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The objective of this study was to examine whether white-matter (WM) connectivity of patients with schizophrenia at early stage of treatment is related to treatment response after paliperidone extended-release (ER) treatment. Forty-one patients with schizophrenia and 17 age- and sex-matched healthy control subjects were included in this study. Brain magnetic resonance scans at 3 Tesla were conducted at early stage of treatment. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics. At baseline and eight weeks after paliperidone treatment, patients were assessed using the Positive and Negative Syndrome Scale, the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms. Among the patients with schizophrenia, the FA values of the corpus callosum, corona radiata, internal capsule, external capsule, superior longitudinal fasciculus and fronto-temporal WM regions showed significant negative correlations with scores of the treatment response. The current study suggests that the treatment response after paliperidone ER treatment may be associated with the fronto-temporo-limbic WM connectivity at early stage of treatment in patients with schizophrenia, and it could be used as a predictor of treatment response to paliperidone ER treatment after studies with large samples verify these results.
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Affiliation(s)
- Min-Kyoung Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Chan Mo Kim
- Department of Business Administration, Kwangwoon University, Seoul, Republic of Korea
| | - Seong Yun Bang
- Department of Public Health, Graduate School of Health and Welfare, CHA University, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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Tomassy GS, Dershowitz LB, Arlotta P. Diversity Matters: A Revised Guide to Myelination. Trends Cell Biol 2016; 26:135-147. [PMID: 26442841 PMCID: PMC4727993 DOI: 10.1016/j.tcb.2015.09.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/28/2015] [Accepted: 09/01/2015] [Indexed: 11/28/2022]
Abstract
The evolutionary success of the vertebrate nervous system is largely due to a unique structural feature--the myelin sheath, a fatty envelope that surrounds the axons of neurons. By increasing the speed by which electrical signals travel along axons, myelin facilitates neuronal communication between distant regions of the nervous system. We review the cellular and molecular mechanisms that regulate the development of myelin as well as its homeostasis in adulthood. We discuss how finely tuned neuron-oligodendrocyte interactions are central to myelin formation during development and in the adult, and how these interactions can have profound implications for the plasticity of the adult brain. We also speculate how the functional diversity of both neurons and oligodendrocytes may impact on the myelination process in both health and disease.
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Affiliation(s)
- Giulio Srubek Tomassy
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA 02138, USA.
| | - Lori Bowe Dershowitz
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA 02138, USA
| | - Paola Arlotta
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA 02138, USA.
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Landek-Salgado MA, Faust TE, Sawa A. Molecular substrates of schizophrenia: homeostatic signaling to connectivity. Mol Psychiatry 2016; 21:10-28. [PMID: 26390828 PMCID: PMC4684728 DOI: 10.1038/mp.2015.141] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 06/24/2015] [Accepted: 06/25/2015] [Indexed: 02/06/2023]
Abstract
Schizophrenia (SZ) is a devastating psychiatric condition affecting numerous brain systems. Recent studies have identified genetic factors that confer an increased risk of SZ and participate in the disease etiopathogenesis. In parallel to such bottom-up approaches, other studies have extensively reported biological changes in patients by brain imaging, neurochemical and pharmacological approaches. This review highlights the molecular substrates identified through studies with SZ patients, namely those using top-down approaches, while also referring to the fruitful outcomes of recent genetic studies. We have subclassified the molecular substrates by system, focusing on elements of neurotransmission, targets in white matter-associated connectivity, immune/inflammatory and oxidative stress-related substrates, and molecules in endocrine and metabolic cascades. We further touch on cross-talk among these systems and comment on the utility of animal models in charting the developmental progression and interaction of these substrates. Based on this comprehensive information, we propose a framework for SZ research based on the hypothesis of an imbalance in homeostatic signaling from immune/inflammatory, oxidative stress, endocrine and metabolic cascades that, at least in part, underlies deficits in neural connectivity relevant to SZ. Thus, this review aims to provide information that is translationally useful and complementary to pathogenic hypotheses that have emerged from genetic studies. Based on such advances in SZ research, it is highly expected that we will discover biomarkers that may help in the early intervention, diagnosis or treatment of SZ.
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Affiliation(s)
- M A Landek-Salgado
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - T E Faust
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Neuroscience, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Sawa
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD, USA
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73
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Bellani M, Boschello F, Delvecchio G, Dusi N, Altamura CA, Ruggeri M, Brambilla P. DTI and Myelin Plasticity in Bipolar Disorder: Integrating Neuroimaging and Neuropathological Findings. Front Psychiatry 2016; 7:21. [PMID: 26973545 PMCID: PMC4771723 DOI: 10.3389/fpsyt.2016.00021] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/09/2016] [Indexed: 02/06/2023] Open
Abstract
Bipolar disorder (BD) is a major psychiatric illness with a chronic recurrent course, ranked among the worldwide leading disabling diseases. Its pathophysiology is still not completely understood and findings are still inconclusive, though a great interest on the topic has been constantly raised by magnetic resonance imaging, genetic and neuropathological studies. In recent years, diffusion tensor imaging (DTI) investigations have prompted interest in the key role of white matter (WM) abnormalities in BD. In this report, we summarize and comment recent findings from DTI studies in BD, reporting fractional anisotropy as putative measure of WM integrity, as well as recent data from neuropathological studies focusing on oligodendrocyte involvement in WM alterations in BD. DTI research indicates that BD is most commonly associated with a WM disruption within the fronto-limbic network, which may be accompanied by other WM changes spread throughout temporal and parietal regions. Neuropathological studies, mainly focused on the fronto-limbic network, have repeatedly shown a loss in cortical and subcortical oligodendrocyte cell count, although an increased subcortical oligodendrocyte density has been also documented suggesting a putative role in remyelination processes for oligodendrocytes in BD. According to our review, a greater integration between DTI and morphological findings is needed in order to elucidate processes affecting WM, either glial loss or myelin plasticity, on the basis of a more targeted research in BD.
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Affiliation(s)
- Marcella Bellani
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona , Verona , Italy
| | | | | | - Nicola Dusi
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona , Verona , Italy
| | - Carlo Alfredo Altamura
- Department of Neurosciences and Mental Health, Ospedale Maggiore Policlinico, Fondazione IRCCS Ca' Granda, University of Milan , Milan , Italy
| | - Mirella Ruggeri
- Section of Psychiatry, University of Verona , Verona , Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Ospedale Maggiore Policlinico, Fondazione IRCCS Ca' Granda, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA
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Berry M, Ahmed Z, Morgan-Warren P, Fulton D, Logan A. Prospects for mTOR-mediated functional repair after central nervous system trauma. Neurobiol Dis 2015; 85:99-110. [PMID: 26459109 DOI: 10.1016/j.nbd.2015.10.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/09/2015] [Accepted: 10/08/2015] [Indexed: 02/07/2023] Open
Abstract
Recent research has suggested that the growth of central nervous system (CNS) axons during development is mediated through the PI3K/Akt/mammalian target of rapamycin (mTOR) intracellular signalling axis and that suppression of activity in this pathway occurs during maturity as levels of the phosphatase and tensin homologue (PTEN) rise and inhibit PI3K activation of mTOR, accounting for the failure of axon regeneration in the injured adult CNS. This hypothesis is supported by findings confirming that suppression of PTEN in experimental adult animals promotes impressive axon regeneration in the injured visual and corticospinal motor systems. This review focuses on these recent developments, discussing the therapeutic potential of a mTOR-based treatment aimed at promoting functional recovery in CNS trauma patients, recognising that to fulfil this ambition, the new therapy should aim to promote not only axon regeneration but also remyelination of regenerated axons, neuronal survival and re-innervation of denervated targets through accurate axonal guidance and synaptogenesis, all with minimal adverse effects. The translational challenges presented by the implementation of this new axogenic therapy are also discussed.
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Affiliation(s)
- Martin Berry
- Neurotrauma Research Group, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Zubair Ahmed
- Neurotrauma Research Group, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Peter Morgan-Warren
- Neurotrauma Research Group, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Daniel Fulton
- Neurotrauma Research Group, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Ann Logan
- Neurotrauma Research Group, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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75
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Svatkova A, Mandl RC, Scheewe TW, Cahn W, Kahn RS, Hulshoff Pol HE. Physical Exercise Keeps the Brain Connected: Biking Increases White Matter Integrity in Patients With Schizophrenia and Healthy Controls. Schizophr Bull 2015; 41:869-78. [PMID: 25829377 PMCID: PMC4466190 DOI: 10.1093/schbul/sbv033] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
It has been shown that learning a new skill leads to structural changes in the brain. However, it is unclear whether it is the acquisition or continuous practicing of the skill that causes this effect and whether brain connectivity of patients with schizophrenia can benefit from such practice. We examined the effect of 6 months exercise on a stationary bicycle on the brain in patients with schizophrenia and healthy controls. Biking is an endemic skill in the Netherlands and thus offers an ideal situation to disentangle the effects of learning vs practice. The 33 participating patients with schizophrenia and 48 healthy individuals were assigned to either one of two conditions, ie, physical exercise or life-as-usual, balanced for diagnosis. Diffusion tensor imaging brain scans were made prior to and after intervention. We demonstrate that irrespective of diagnosis regular physical exercise of an overlearned skill, such as bicycling, significantly increases the integrity, especially of motor functioning related, white matter fiber tracts whereas life-as-usual leads to a decrease in fiber integrity. Our findings imply that exercise of an overlearned physical skill improves brain connectivity in patients and healthy individuals. This has important implications for understanding the effect of fitness programs on the brain in both healthy subjects and patients with schizophrenia. Moreover, the outcome may even apply to the nonphysical realm.
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Affiliation(s)
- Alena Svatkova
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;,Multimodal and Functional Neuroimaging Research Group, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - René C.W. Mandl
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas W. Scheewe
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wiepke Cahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - René S. Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hilleke E. Hulshoff Pol
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;,To whom correspondence should be addressed; Hilleke E. Hulshoff Pol, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; tel: 31-88-75-56019, fax: 31-88-75-554-43, e-mail:
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76
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Millan MJ, Goodwin GM, Meyer-Lindenberg A, Ove Ögren S. Learning from the past and looking to the future: Emerging perspectives for improving the treatment of psychiatric disorders. Eur Neuropsychopharmacol 2015; 25:599-656. [PMID: 25836356 DOI: 10.1016/j.euroneuro.2015.01.016] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 01/28/2015] [Indexed: 02/06/2023]
Abstract
Modern neuropsychopharmacology commenced in the 1950s with the serendipitous discovery of first-generation antipsychotics and antidepressants which were therapeutically effective yet had marked adverse effects. Today, a broader palette of safer and better-tolerated agents is available for helping people that suffer from schizophrenia, depression and other psychiatric disorders, while complementary approaches like psychotherapy also have important roles to play in their treatment, both alone and in association with medication. Nonetheless, despite considerable efforts, current management is still only partially effective, and highly-prevalent psychiatric disorders of the brain continue to represent a huge personal and socio-economic burden. The lack of success in discovering more effective pharmacotherapy has contributed, together with many other factors, to a relative disengagement by pharmaceutical firms from neuropsychiatry. Nonetheless, interest remains high, and partnerships are proliferating with academic centres which are increasingly integrating drug discovery and translational research into their traditional activities. This is, then, a time of transition and an opportune moment to thoroughly survey the field. Accordingly, the present paper, first, chronicles the discovery and development of psychotropic agents, focusing in particular on their mechanisms of action and therapeutic utility, and how problems faced were eventually overcome. Second, it discusses the lessons learned from past successes and failures, and how they are being applied to promote future progress. Third, it comprehensively surveys emerging strategies that are (1), improving our understanding of the diagnosis and classification of psychiatric disorders; (2), deepening knowledge of their underlying risk factors and pathophysiological substrates; (3), refining cellular and animal models for discovery and validation of novel therapeutic agents; (4), improving the design and outcome of clinical trials; (5), moving towards reliable biomarkers of patient subpopulations and medication efficacy and (6), promoting collaborative approaches to innovation by uniting key partners from the regulators, industry and academia to patients. Notwithstanding the challenges ahead, the many changes and ideas articulated herein provide new hope and something of a framework for progress towards the improved prevention and relief of psychiatric and other CNS disorders, an urgent mission for our Century.
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Affiliation(s)
- Mark J Millan
- Pole for Innovation in Neurosciences, IDR Servier, 125 chemin de ronde, 78290 Croissy sur Seine, France.
| | - Guy M Goodwin
- University Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, England, UK
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, D-68159 Mannheim, Germany
| | - Sven Ove Ögren
- Department of Neuroscience, Karolinska Institutet, Retzius väg 8, S-17177 Stockholm, Sweden
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Gildengers AG, Butters MA, Aizenstein HJ, Marron MM, Emanuel J, Anderson SJ, Weissfeld LA, Becker JT, Lopez OL, Mulsant BH, Reynolds CF. Longer lithium exposure is associated with better white matter integrity in older adults with bipolar disorder. Bipolar Disord 2015; 17:248-56. [PMID: 25257942 PMCID: PMC4374042 DOI: 10.1111/bdi.12260] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 07/24/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Bipolar disorder (BD) is associated with cognitive dysfunction and structural brain abnormalities. In human and non-human studies, lithium has been related to neuroprotective and neurotrophic effects. We explored whether lithium treatment is related to better brain integrity and cognitive function in older adults with BD. METHODS We examined cognitive and neuroimaging data in 58 individuals with BD [mean (standard deviation) age = 64.5 (9.8) years] and 21 mentally healthy comparators (controls) of similar age and education. Subjects received comprehensive neurocognitive assessment and structural brain imaging, examining total gray matter volume, overall white matter integrity (fractional anisotropy), and total white matter hyperintensity burden. RESULTS In comparison to controls, subjects with BD had worse overall cognitive performance, lower total gray matter volume, and lower white matter integrity. Among subjects with BD, longer duration of lithium treatment was related to higher white matter integrity after controlling for age and vascular disease burden, but not with better cognitive performance. CONCLUSIONS Lithium treatment appears to be related to better brain integrity in older individuals with BD, in particular, in those who take lithium long-term. While intriguing, these findings need to be confirmed in a larger sample.
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Affiliation(s)
- Ariel G. Gildengers
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA,Corresponding author: Dr. Gildengers, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Phone 412-246-6002; Fax 412-246-6030.
| | - Meryl A. Butters
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Howard J. Aizenstein
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Megan M. Marron
- University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
| | - James Emanuel
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Stewart J. Anderson
- University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
| | - Lisa A. Weissfeld
- University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
| | - James T. Becker
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Oscar L. Lopez
- University of Pittsburgh School of Medicine, Department of Neurology, Pittsburgh, PA, USA
| | - Benoit H. Mulsant
- Centre for Addiction and Mental Health and the University of Toronto, Department of Psychiatry, Toronto, ON, Canada
| | - Charles F. Reynolds
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
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78
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Chung T, Ferrell R, Clark DB. Indirect association of DAT1 genotype with executive function through white matter volume in orbitofrontal cortex. Psychiatry Res 2015; 232:76-83. [PMID: 25704259 PMCID: PMC4404197 DOI: 10.1016/j.pscychresns.2015.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/03/2014] [Accepted: 01/26/2015] [Indexed: 01/14/2023]
Abstract
The dopamine transporter (DAT1) gene has been associated with impulsivity and executive functioning. Further, DAT1 has been associated with brain structural characteristics and resting state connectivity. This study tested an indirect effect model in which DAT1 genotype (9-repeat (9R) carriers vs 10-repeat (10R) homozygotes) is linked to phenotypes representing impulsivity and executive function (planning behavior) through effects on white matter (WM) volumes in prefrontal cortex (PFC), particularly orbitofrontal cortex (OFC). Adolescents (ages 14-18, n=38) were recruited from substance use treatment (n=22) and the community (n=16) to increase phenotype variation. Results indicated that DAT1 10/10 genotype was associated with lower WM volume in the PFC, specifically the left OFC. Further, lower WM volume in the left OFC predicted more difficulties in self-reported planning behavior, but not impulsivity. Indirect effect analysis indicated that lower WM volume in the left OFC mediated the association between DAT1 10/10 genotype and difficulties in planning behavior. Results suggest a brain structural mechanism, involving lower WM volume in the left OFC, as a link in the association between DAT1 genotype and a specific aspect of executive function. Genetic effects on regional WM volume that are linked to behavioral outcomes could ultimately inform the development of tailored interventions that address an individual׳s unique risk factors.
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Affiliation(s)
- Tammy Chung
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Robert Ferrell
- Department of Human Genetics, University of Pittsburgh Pittsburgh, Pennsylvania, USA
| | - Duncan B. Clark
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania, USA
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79
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Bollettini I, Barberi I, Poletti S, Radaelli D, Pirovano A, Lorenzi C, Falini A, Cavallaro R, Smeraldi E, Benedetti F. Sterol Regulatory Element Binding Transcription Factor-1 Gene Variation and Medication Load Influence White Matter Structure in Schizophrenia. Neuropsychobiology 2015; 71:112-119. [PMID: 25871767 DOI: 10.1159/000370076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 11/11/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies have shown a widespread disruption of white matter (WM) microstructure in schizophrenia. Furthermore, higher fractional anisotropy (FA) has been consistently correlated with the severity of psychotic symptoms. Antipsychotic drugs (APDs) affect lipid homeostasis. Gene polymorphisms in sterol regulatory element binding transcription factor (SREBF)-1 and SREBF-2 have been associated with schizophrenia. METHODS In a sample of 65 patients affected by chronic schizophrenia, we investigated the effect of ongoing APD medication, SREBF-1 rs11868035 polymorphism and SREBF-2 rs1052717 polymorphism on the WM microstructure, using tract-based spatial statistics with threshold-free cluster enhancement. RESULTS We reported increased FA associated with the risk rs11868035 G/G genotype in several WM tracts, mainly located in the left hemisphere, and opposite effects of the APD medication load, with reduced FA and generally increased diffusivity. These opposite effects overlapped in the forceps minor, cingulum, uncinate fasciculus, the superior and inferior longitudinal fasciculi, the corticospinal tract, inferior fronto-occipital fasciculus and the anterior thalamic radiation. CONCLUSION We suggest that changes of WM structure could be an as yet poorly explored biomarker of the effects of APDs, to be further investigated in prospective studies correlating long-term clinical effects with changes of DTI measures in specific WM tracts contributing to the functional integrity of the brain. © 2015 S. Karger AG, Basel.
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Affiliation(s)
- Irene Bollettini
- Centro di Eccellenza Risonanza Magnetica ad Alto Campo, University Vita Salute San Raffaele, Milan, Italy
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Koch M, Schmiedt-Fehr C, Mathes B. Neuropharmacology of altered brain oscillations in schizophrenia. Int J Psychophysiol 2015; 103:62-8. [PMID: 25681533 DOI: 10.1016/j.ijpsycho.2015.02.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Impairments in spatial and temporal integration of brain network activity are a core feature of schizophrenia. Neural network oscillatory activity is considered to be fundamentally important in coordinating neural activity throughout the brain. Hence, exploration of brain oscillations has become an indispensible tool to study the neural basis of mental illnesses. However, most of the studies in schizophrenia include medicated patients. This implicates the question to what extent are changes in the electrophysiological parameters genuine illness effects, genuine drug effects or a mixture of both. We here provide a short overview of the neuropharmacology of brain oscillations with respect to schizophrenia. The core assumption of the so-called "pharmaco-EEG" approach is that drug effects on mental and cognitive functions are reflected in changes in quantitative EEG parameters. Hence, clinical efficacy of drugs might be predicted on the basis of the neuropharmacology of electrophysiological measures, such as brain oscillations. Vice versa, knowledge of drug effects on brain oscillations can be of essence in understanding schizophrenia. However, the current literature lacks systematic findings, because of at least two problems. First, the pharmacology of most antipsychotic drugs is complex including interactions with several transmitter receptors. Second, the neuropathology of schizophrenia still has no pathognomonic signature. Even though it is presently not possible to clearly dissociate drug- and illness effects in neural oscillations, this review emphasizes future studies to foster the understanding of this relationship in schizophrenia and other neuropsychiatric diseases.
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Affiliation(s)
- Michael Koch
- Brain Research Institute, Dept. of Neuropharmacology, University of Bremen, Hochschulring 18, 28359 Bremen, Germany.
| | - Christina Schmiedt-Fehr
- Institute of Psychology and Cognition Research, University of Bremen, Grazerstr. 4, 28359 Bremen, Germany
| | - Birgit Mathes
- Institute of Psychology and Cognition Research, University of Bremen, Grazerstr. 4, 28359 Bremen, Germany
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Kedracka-Krok S, Swiderska B, Jankowska U, Skupien-Rabian B, Solich J, Buczak K, Dziedzicka-Wasylewska M. Clozapine influences cytoskeleton structure and calcium homeostasis in rat cerebral cortex and has a different proteomic profile than risperidone. J Neurochem 2015; 132:657-76. [DOI: 10.1111/jnc.13007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/18/2014] [Accepted: 11/25/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Sylwia Kedracka-Krok
- Department of Physical Biochemistry; Faculty of Biochemistry; Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
- Malopolska Centre of Biotechnology; Department of Structural Biology; Krakow Poland
| | - Bianka Swiderska
- Department of Physical Biochemistry; Faculty of Biochemistry; Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
- Malopolska Centre of Biotechnology; Department of Structural Biology; Krakow Poland
| | - Urszula Jankowska
- Department of Physical Biochemistry; Faculty of Biochemistry; Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
- Malopolska Centre of Biotechnology; Department of Structural Biology; Krakow Poland
| | - Bozena Skupien-Rabian
- Department of Physical Biochemistry; Faculty of Biochemistry; Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
- Malopolska Centre of Biotechnology; Department of Structural Biology; Krakow Poland
| | - Joanna Solich
- Institute of Pharmacology; Polish Academy of Sciences; Krakow Poland
| | - Katarzyna Buczak
- Department of Physical Biochemistry; Faculty of Biochemistry; Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
| | - Marta Dziedzicka-Wasylewska
- Department of Physical Biochemistry; Faculty of Biochemistry; Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
- Institute of Pharmacology; Polish Academy of Sciences; Krakow Poland
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Glial cells as key players in schizophrenia pathology: recent insights and concepts of therapy. Schizophr Res 2015; 161:4-18. [PMID: 24948484 DOI: 10.1016/j.schres.2014.03.035] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 02/27/2014] [Accepted: 03/01/2014] [Indexed: 02/07/2023]
Abstract
The past decade has witnessed an explosion of knowledge on the impact of glia for the neurobiological foundation of schizophrenia. A plethora of studies have shown structural and functional abnormalities in all three types of glial cells. There is convincing evidence of reduced numbers of oligodendrocytes, impaired cell maturation and altered gene expression of myelin/oligodendrocyte-related genes that may in part explain white matter abnormalities and disturbed inter- and intra-hemispheric connectivity, which are characteristic signs of schizophrenia. Earlier reports of astrogliosis could not be confirmed by later studies, although the expression of a variety of astrocyte-related genes is abnormal in psychosis. Since astrocytes play a key role in the synaptic metabolism of glutamate, GABA, monoamines and purines, astrocyte dysfunction may contribute to certain aspects of disturbed neurotransmission in schizophrenia. Finally, increased densities of microglial cells and aberrant expression of microglia-related surface markers in schizophrenia suggest that immunological/inflammatory factors are of considerable relevance for the pathophysiology of psychosis. This review describes current evidence for the multifaceted role of glial cells in schizophrenia and discusses efforts to develop glia-directed therapies for the treatment of the disease.
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Stelzhammer V, Ozcan S, Gottschalk MG, Steeb H, Hodes GE, Guest PC, Rahmoune H, Wong EH, Russo SJ, Bahn S. Central and peripheral changes underlying susceptibility and resistance to social defeat stress – A proteomic profiling study. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.dineu.2015.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The nicotinic cholinergic system function in the human brain. Neuropharmacology 2014; 96:289-301. [PMID: 25446570 DOI: 10.1016/j.neuropharm.2014.10.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/28/2014] [Accepted: 10/21/2014] [Indexed: 12/22/2022]
Abstract
Research on the nicotinic cholinergic system function in the brain was previously mainly derived from animal studies, yet, research in humans is growing. Up to date, findings allow significant advances on the understanding of nicotinic cholinergic effects on human cognition, emotion and behavior using a range of functional brain imaging approaches such as pharmacological functional magnetic resonance imaging or positron emission tomography. Studies provided insights across various mechanistic psychological domains using different tasks as well as at rest in both healthy individuals and patient populations, with so far partly mixed results reporting both enhancements and decrements of neural activity related to the nicotinic cholinergic system. Moreover, studies on the relation between brain structure and the nicotinic cholinergic system add important information in this context. The present review summarizes the current status of human brain imaging studies and presents the findings within a theoretical and clinical perspective as they may be useful not only for an advancement of the understanding of basic nicotinic cholinergic-related mechanisms, but also for the development and integration of psychological and pharmacological treatment approaches. Patterns of functional neuroanatomy and neural circuitry across various cognitive and emotional domains may be used as neuropsychological markers of mental disorders such as addiction, Alzheimer's disease, Parkinson disease or schizophrenia, where nicotinic cholinergic system changes are characteristic. This article is part of the Special Issue entitled 'The Nicotinic Acetylcholine Receptor: From Molecular Biology to Cognition'.
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85
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Phillips O, Squitieri F, Sanchez-Castaneda C, Elifani F, Caltagirone C, Sabatini U, Di Paola M. Deep white matter in Huntington's disease. PLoS One 2014; 9:e109676. [PMID: 25340651 PMCID: PMC4207674 DOI: 10.1371/journal.pone.0109676] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022] Open
Abstract
White matter (WM) abnormalities have already been shown in presymptomatic (Pre-HD) and symptomatic HD subjects using Magnetic Resonance Imaging (MRI). In the present study, we examined the microstructure of the long-range large deep WM tracts by applying two different MRI approaches: Diffusion Tensor Imaging (DTI) -based tractography, and T2*weighted (iron sensitive) imaging. We collected Pre-HD subjects (n = 25), HD patients (n = 25) and healthy control subjects (n = 50). Results revealed increased axial (AD) and radial diffusivity (RD) and iron levels in Pre-HD subjects compared to controls. Fractional anisotropy decreased between the Pre-HD and HD phase and AD/RD increased and although impairment was pervasive in HD, degeneration occurred in a pattern in Pre-HD. Furthermore, iron levels dropped for HD patients. As increased iron levels are associated with remyelination, the data suggests that Pre-HD subjects attempt to repair damaged deep WM years before symptoms occur but this process fails with disease progression.
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Affiliation(s)
- Owen Phillips
- Clinical and Behavioural Neurology Dept, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | | | | | - Carlo Caltagirone
- Clinical and Behavioural Neurology Dept, IRCCS Santa Lucia Foundation, Rome, Italy
- Neuroscience Dept, University of Rome “Tor Vergata”, Rome, Italy
| | | | - Margherita Di Paola
- Clinical and Behavioural Neurology Dept, IRCCS Santa Lucia Foundation, Rome, Italy
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86
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Benedetti F, Bollettini I, Radaelli D, Poletti S, Locatelli C, Falini A, Smeraldi E, Colombo C. Adverse childhood experiences influence white matter microstructure in patients with bipolar disorder. Psychol Med 2014; 44:3069-3082. [PMID: 25065766 DOI: 10.1017/s0033291714000506] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with adverse childhood experiences (ACE), which worsen the lifetime course of illness, and with signs of widespread disruption of white matter (WM) integrity in adult life. ACE are associated with changes in WM microstructure in healthy humans. METHOD We tested the effects of ACE on diffusion-tensor imaging (DTI) measures of WM integrity in 80 in-patients affected by a major depressive episode in the course of BD. We used whole-brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial and mean diffusivity, and fractional anisotropy. RESULTS ACE hastened the onset of illness. We observed an inverse correlation between the severity of ACE and DTI measures of axial diffusivity in several WM fibre tracts contributing to the functional integrity of the brain and including the corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus and uncinate fasciculus. CONCLUSIONS Axial diffusivity reflects the integrity of axons and myelin sheaths, and correlates with functional connectivity and with higher-order abilities such as reasoning and experience of emotions. In patients with BD axial diffusivity is increased by lithium treatment. ACE might contribute to BD pathophysiology by hampering structural connectivity in critical cortico-limbic networks.
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Affiliation(s)
- F Benedetti
- Department of Clinical Neurosciences,Scientific Institute Ospedale San Raffaele,Milan,Italy
| | - I Bollettini
- Department of Clinical Neurosciences,Scientific Institute Ospedale San Raffaele,Milan,Italy
| | - D Radaelli
- Department of Clinical Neurosciences,Scientific Institute Ospedale San Raffaele,Milan,Italy
| | - S Poletti
- Department of Clinical Neurosciences,Scientific Institute Ospedale San Raffaele,Milan,Italy
| | - C Locatelli
- Department of Clinical Neurosciences,Scientific Institute Ospedale San Raffaele,Milan,Italy
| | - A Falini
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo),University Vita-Salute San Raffaele,Milan,Italy
| | - E Smeraldi
- Department of Clinical Neurosciences,Scientific Institute Ospedale San Raffaele,Milan,Italy
| | - C Colombo
- Department of Clinical Neurosciences,Scientific Institute Ospedale San Raffaele,Milan,Italy
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87
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Gildengers AG, Chung KH, Huang SH, Begley A, Aizenstein HJ, Tsai SY. Neuroprogressive effects of lifetime illness duration in older adults with bipolar disorder. Bipolar Disord 2014; 16:617-23. [PMID: 24716786 PMCID: PMC4149863 DOI: 10.1111/bdi.12204] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 10/16/2013] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The aim of the present study was to examine the long-term effects of bipolar disorder (BD) on brain structure (gray matter volumes). METHODS Fifty-four adults with BD [mean (standard deviation) age = 64.4 (5.4) years] underwent brain MR imaging along with comprehensive clinical assessment. Total gray matter, hippocampal, and amygdala volumes were extracted using methods developed through the Geriatric Neuroimaging Laboratory at the University of Pittsburgh (Pittsburgh, PA, USA). RESULTS Lower total gray matter volumes were related to longer duration of BD, even when controlling for current age and cerebrovascular accident (CVA) risk/burden. Additionally, longer exposure to antipsychotic medication was related to lower gray matter volumes. Lower hippocampal volumes were related to total years of antipsychotic agent exposure and CVA risk/burden scores. Older age was related to lower total gray matter, hippocampal, and amgydala volumes. CONCLUSIONS Our study of older adults with BD supports the understanding that BD is a neuroprogressive disorder with a longer duration of illness and more antipsychotic agent exposure related to lower gray matter volume.
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Affiliation(s)
- Ariel G Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kuo-Hsuan Chung
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shou-Hung Huang
- Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Amy Begley
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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88
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Haroutunian V, Katsel P, Roussos P, Davis KL, Altshuler LL, Bartzokis G. Myelination, oligodendrocytes, and serious mental illness. Glia 2014; 62:1856-77. [DOI: 10.1002/glia.22716] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 06/20/2014] [Accepted: 06/20/2014] [Indexed: 02/06/2023]
Affiliation(s)
- V. Haroutunian
- Department of Psychiatry; The Icahn School of Medicine at Mount Sinai; New York New York
- Department of Neuroscience; The Icahn School of Medicine at Mount Sinai; New York New York
- MIRECC-JJ Peters VA Medical Center; Bronx New York
| | - P. Katsel
- Department of Psychiatry; The Icahn School of Medicine at Mount Sinai; New York New York
| | - P. Roussos
- Department of Psychiatry; The Icahn School of Medicine at Mount Sinai; New York New York
- MIRECC-JJ Peters VA Medical Center; Bronx New York
| | - K. L. Davis
- Department of Psychiatry; The Icahn School of Medicine at Mount Sinai; New York New York
- Department of Neuroscience; The Icahn School of Medicine at Mount Sinai; New York New York
| | - L. L. Altshuler
- Department of Psychiatry; Semel Institute for Neuroscience and Human Behavior, The David Geffen School of Medicine at UCLA; Los Angeles California
- The Brain Research Institute, The David Geffen School of Medicine at UCLA; Los Angeles California
- Greater Los Angeles VA Healthcare System; West Los Angeles California
| | - G. Bartzokis
- Department of Psychiatry; Semel Institute for Neuroscience and Human Behavior, The David Geffen School of Medicine at UCLA; Los Angeles California
- The Brain Research Institute, The David Geffen School of Medicine at UCLA; Los Angeles California
- Greater Los Angeles VA Healthcare System; West Los Angeles California
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89
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Goldstein MR, Mascitelli L. Regarding long-term statin therapy: are we trading stronger hearts for weaker brains? Med Hypotheses 2014; 83:346-51. [PMID: 24986644 DOI: 10.1016/j.mehy.2014.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 06/01/2014] [Accepted: 06/09/2014] [Indexed: 12/17/2022]
Abstract
Ideally, the benefits of long-term statin therapy should outweigh the risks in all populations. However, some data suggest that long-term statin therapy might promote cerebral small vessel disease and impair myelination, perhaps resulting from cholesterol depletion and pleiotropic effects on amyloid-β metabolism and oligodendrocyte function. The clinical ramifications can be problematic and have a negative impact on the quality of life. Questions are proposed and the answers should be found by analysis of randomized prospective trials specifically investigating the effects of statin therapy on brain structure and function. Those trials should not be funded by drug companies and the investigators should not have financial ties to the pharmaceutical industry. The relevance of the aforementioned is amplified in light of the new cardiovascular guidelines that might culminate in more than a billion people receiving statin therapy worldwide.
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Affiliation(s)
- Mark R Goldstein
- NCH Physician Group, 1845 Veterans Park Drive, Suite 110, Naples, FL 34109, USA.
| | - Luca Mascitelli
- Comando Brigata Alpina "Julia"/Multinational Land Force, Medical Service, 8 Via S. Agostino, Udine 33100, Italy.
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90
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A hypothesis-driven pathway analysis reveals myelin-related pathways that contribute to the risk of schizophrenia and bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2014; 51:140-5. [PMID: 24447946 DOI: 10.1016/j.pnpbp.2014.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 01/03/2014] [Accepted: 01/06/2014] [Indexed: 11/23/2022]
Abstract
Schizophrenia (SZ) and bipolar disorder (BD) are both severe neuropsychiatric disorders with a strong and potential overlapping genetic background. Multiple lines of evidence, including genetic studies, gene expression studies and neuroimaging studies, have suggested that both disorders are closely related to myelin and oligodendrocyte dysfunctions. In the current study, we hypothesized that the holistic effect of the myelin-related pathway contributes to the genetic susceptibility to both SZ and BD. We extracted pathway data from the canonical pathway database, Gene Ontology (GO), and selected a 'compiled' pathway based on previous literature. We then performed hypothesis-driven pathway analysis on GWAS data from the Psychiatric Genomics Consortium (PGC). As a result, we identified three myelin-related pathways with a joint effect significantly associated with both disorders: 'Myelin sheath' pathway (P(SZ) = 2.45E-7, P(BD) = 1.22E-3), 'Myelination' pathway (P(SZ) = 2.10E-4, P(BD) = 2.53E-24), and 'Compiled' pathway (P(SZ) = 4.57E-8, P(BD) = 2.61E-9). In comparing the SNPs and genes in these three pathways across the two diseases, we identified a substantial overlap in nominally associated SNPs and genes, which could be susceptibility SNPs and genes for both disorders. From these observations, we propose that myelin-related pathways may be involved in the etiologies of both SZ and BD.
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91
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Meffre D, Grenier J, Bernard S, Courtin F, Dudev T, Shackleford G, Jafarian-Tehrani M, Massaad C. Wnt and lithium: a common destiny in the therapy of nervous system pathologies? Cell Mol Life Sci 2014; 71:1123-48. [PMID: 23749084 PMCID: PMC11113114 DOI: 10.1007/s00018-013-1378-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/26/2013] [Accepted: 05/16/2013] [Indexed: 02/07/2023]
Abstract
Wnt signaling is required for neurogenesis, the fate of neural progenitors, the formation of neuronal circuits during development, neuron positioning and polarization, axon and dendrite development and finally for synaptogenesis. This signaling pathway is also implicated in the generation and differentiation of glial cells. In this review, we describe the mechanisms of action of Wnt signaling pathways and their implication in the development and correct functioning of the nervous system. We also illustrate how a dysregulated Wnt pathway could lead to psychiatric, neurodegenerative and demyelinating pathologies. Lithium, used for the treatment of bipolar disease, inhibits GSK3β, a central enzyme of the Wnt/β-catenin pathway. Thus, lithium could, to some extent, mimic Wnt pathway. We highlight the possible dialogue between lithium therapy and modulation of Wnt pathway in the treatment of the diseases of the nervous system.
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Affiliation(s)
- Delphine Meffre
- UMR 8194 CNRS, University Paris Descartes, 45 rue des Saints-Pères, 75270 Paris Cedex 6, France
| | - Julien Grenier
- UMR 8194 CNRS, University Paris Descartes, 45 rue des Saints-Pères, 75270 Paris Cedex 6, France
| | - Sophie Bernard
- UMR 8194 CNRS, University Paris Descartes, 45 rue des Saints-Pères, 75270 Paris Cedex 6, France
| | - Françoise Courtin
- UMR 8194 CNRS, University Paris Descartes, 45 rue des Saints-Pères, 75270 Paris Cedex 6, France
| | - Todor Dudev
- Institute of Biomedical Sciences, Academia Sinica, 11529 Taipei, Taiwan, R.O.C
- Faculty of Chemistry and Pharmacy, University of Sofia, 1 James Bourchier Avenue, 1164 Sofia, Bulgaria
| | | | | | - Charbel Massaad
- UMR 8194 CNRS, University Paris Descartes, 45 rue des Saints-Pères, 75270 Paris Cedex 6, France
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Marlinge E, Bellivier F, Houenou J. White matter alterations in bipolar disorder: potential for drug discovery and development. Bipolar Disord 2014; 16:97-112. [PMID: 24571279 DOI: 10.1111/bdi.12135] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Accepted: 05/24/2013] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Brain white matter (WM) alterations have recently emerged as potentially relevant in bipolar disorder. New techniques such as diffusion tensor imaging allow precise exploration of these WM microstructural alterations in bipolar disorder. Our objective was to critically review WM alterations in bipolar disorder, using neuroimaging and neuropathological studies, in the context of neural models and the potential for drug discovery and development. METHODS We conducted a systematic PubMed and Google Scholar search of the WM and bipolar disorder literature up to and including January 2013. RESULTS Findings relating to WM alterations are consistent in neuroimaging and neuropathology studies of bipolar disorder, especially in regions involved in emotional processing such as the anterior frontal lobe, corpus callosum, cingulate cortex, and in fronto-limbic connections. Some of the structural alterations are related to genetic risk factors for bipolar disorder and may underlie the dysfunctional emotional processing described in recent neurobiological models of bipolar disorder. Medication effects in bipolar disorder, from lithium and other mood stabilizers, might impact myelinating processes, particularly by inhibition of glycogen synthase kinase-3 beta. CONCLUSIONS Pathways leading to WM alterations in bipolar disorder represent potential targets for the development and discovery of new drugs. Myelin damage in bipolar disorder suggests that the effects of existing pro-myelinating drugs should also be evaluated to improve our understanding and treatment of this disease.
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Affiliation(s)
- Emeline Marlinge
- AP-HP, Groupe Henri Mondor-Albert Chenevier, Pôle de Psychiatrie, Paris, France; Inserm, U955, Equipe 15 (Psychiatrie Génétique), Paris, France; Fondation Fondamental, Créteil, France; Neurospin, I2BM, CEA, Gif-Sur-Yvette, France
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93
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Kroken RA, Løberg EM, Drønen T, Grüner R, Hugdahl K, Kompus K, Skrede S, Johnsen E. A critical review of pro-cognitive drug targets in psychosis: convergence on myelination and inflammation. Front Psychiatry 2014; 5:11. [PMID: 24550848 PMCID: PMC3912739 DOI: 10.3389/fpsyt.2014.00011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 01/20/2014] [Indexed: 12/19/2022] Open
Abstract
Antipsychotic drugs have thus far focused on dopaminergic antagonism at the D2 receptors, as counteracting the hyperdopaminergia in nigrostriatal and mesolimbic projections has been considered mandatory for the antipsychotic action of the drugs. Current drugs effectively target the positive symptoms of psychosis such as hallucinations and delusions in the majority of patients, whereas effect sizes are smaller for negative symptoms and cognitive dysfunctions. With the understanding that neurocognitive dysfunction associated with schizophrenia have a greater impact on functional outcome than the positive symptoms, the focus in pharmacotherapy for schizophrenia has shifted to the potential effect of future drugs on cognitive enhancement. A major obstacle is, however, that the biological underpinnings of cognitive dysfunction remain largely unknown. With the availability of increasingly sophisticated techniques in molecular biology and brain imaging, this situation is about to change with major advances being made in identifying the neuronal substrates underlying schizophrenia, and putative pro-cognitive drug targets may be revealed. In relation to cognitive effects, this review focuses on evidence from basic neuroscience and clinical studies, taking two separate perspectives. One perspective is the identification of previously under-recognized treatment targets for existing antipsychotic drugs, including myelination and mediators of inflammation. A second perspective is the development of new drugs or novel treatment targets for well-known drugs, which act on recently discovered treatment targets for cognitive enhancement, and which may complement the existing drugs. This might pave the way for personalized treatment regimens for patients with schizophrenia aimed at improved functional outcome. The review also aims at identifying major current constraints for pro-cognitive drug development for patients with schizophrenia.
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Affiliation(s)
- Rune A. Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Tore Drønen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Renate Grüner
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Department of Physics and Technology, University of Bergen, Bergen, Norway
| | - Kenneth Hugdahl
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- NORMENT Center of Excellence, University of Bergen, Bergen, Norway
| | - Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Silje Skrede
- NORMENT Center of Excellence, University of Bergen, Bergen, Norway
- Dr. Einar Martens’ Research Group for Biological Psychiatry, Centre for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Schwann cells but not olfactory ensheathing cells inhibit CNS myelination via the secretion of connective tissue growth factor. J Neurosci 2014; 33:18686-97. [PMID: 24259589 DOI: 10.1523/jneurosci.3233-13.2013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Cell transplantation is a promising strategy to promote CNS repair and has been studied for several decades with a focus on glial cells. Promising candidates include Schwann cells (SCs) and olfactory ensheathing cells (OECs). Both cell types are thought to be neural crest derived and share many properties in common, although OECs appear to be a better candidate for transplantation by evoking less astrogliosis. Using CNS mixed myelinating rat cultures plated on to a monolayer of astrocytes, we demonstrated that SCs, but not OECs, secrete a heat labile factor(s) that inhibits oligodendrocyte myelination. Comparative qRT-PCR and ELISA showed that SCs expressed higher levels of mRNA and protein for connective tissue growth factor (CTGF) than OECs. Anti-CTGF reversed the SCM-mediated effects on myelination. Both SCM and CTGF inhibited the differentiation of purified rat oligodendrocyte precursor cells (OPCs). Furthermore, pretreatment of astrocyte monolayers with SCM inhibited CNS myelination and led to transcriptional changes in the astrocyte, corresponding to upregulation of bone morphogenic protein 4 mRNA and CTGF mRNA (inhibitors of OPC differentiation) and the downregulation of insulin-like growth factor 2 mRNA (promoter of OPC differentiation). CTGF pretreatment of astrocytes increased their expression of CTGF, suggesting that this inhibitory factor can be positively regulated in astrocytes. These data provide evidence for the advantages of using OECs, and not mature SCs, for transplant-mediated repair and provide more evidence that they are a distinct and unique glial cell type.
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95
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Shevelkin AV, Ihenatu C, Pletnikov MV. Pre-clinical models of neurodevelopmental disorders: focus on the cerebellum. Rev Neurosci 2014; 25:177-94. [PMID: 24523305 PMCID: PMC4052755 DOI: 10.1515/revneuro-2013-0049] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/31/2013] [Indexed: 12/24/2022]
Abstract
Recent studies have advanced our understanding of the role of the cerebellum in non-motor behaviors. Abnormalities in the cerebellar structure have been demonstrated to produce changes in emotional, cognitive, and social behaviors resembling clinical manifestations observed in patients with autism spectrum disorders (ASD) and schizophrenia. Several animal models have been used to evaluate the effects of relevant environmental and genetic risk factors on the cerebellum development and function. However, very few models of ASD and schizophrenia selectively target the cerebellum and/or specific cell types within this structure. In this review, we critically evaluate the strength and weaknesses of these models. We will propose that the future progress in this field will require time- and cell type-specific manipulations of disease-relevant genes, not only selectively in the cerebellum, but also in frontal brain areas connected with the cerebellum. Such information can advance our knowledge of the cerebellar contribution to non-motor behaviors in mental health and disease.
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Reis Marques T, Taylor H, Chaddock C, Dell'acqua F, Handley R, Reinders AATS, Mondelli V, Bonaccorso S, Diforti M, Simmons A, David AS, Murray RM, Pariante CM, Kapur S, Dazzan P. White matter integrity as a predictor of response to treatment in first episode psychosis. ACTA ACUST UNITED AC 2013; 137:172-82. [PMID: 24253201 PMCID: PMC3891445 DOI: 10.1093/brain/awt310] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The integrity of brain white matter connections is central to a patient's ability to respond to pharmacological interventions. This study tested this hypothesis using a specific measure of white matter integrity, and examining its relationship to treatment response using a prospective design in patients within their first episode of psychosis. Diffusion tensor imaging data were acquired in 63 patients with first episode psychosis and 52 healthy control subjects (baseline). Response was assessed after 12 weeks and patients were classified as responders or non-responders according to treatment outcome. At this second time-point, they also underwent a second diffusion tensor imaging scan. Tract-based spatial statistics were used to assess fractional anisotropy as a marker of white matter integrity. At baseline, non-responders showed lower fractional anisotropy than both responders and healthy control subjects (P < 0.05; family-wise error-corrected), mainly in the uncinate, cingulum and corpus callosum, whereas responders were indistinguishable from healthy control subjects. After 12 weeks, there was an increase in fractional anisotropy in both responders and non-responders, positively correlated with antipsychotic exposure. This represents one of the largest, controlled investigations of white matter integrity and response to antipsychotic treatment early in psychosis. These data, together with earlier findings on cortical grey matter, suggest that grey and white matter integrity at the start of treatment is an important moderator of response to antipsychotics. These findings can inform patient stratification to anticipate care needs, and raise the possibility that antipsychotics may restore white matter integrity as part of the therapeutic response.
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Affiliation(s)
- Tiago Reis Marques
- 1 Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
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Benitez A, Fieremans E, Jensen JH, Falangola MF, Tabesh A, Ferris SH, Helpern JA. White matter tract integrity metrics reflect the vulnerability of late-myelinating tracts in Alzheimer's disease. NEUROIMAGE-CLINICAL 2013; 4:64-71. [PMID: 24319654 PMCID: PMC3853114 DOI: 10.1016/j.nicl.2013.11.001] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 11/01/2013] [Accepted: 11/03/2013] [Indexed: 12/21/2022]
Abstract
Post-mortem and imaging studies have observed that white matter (WM) degenerates in a pattern inverse to myelin development, suggesting preferential regional vulnerabilities influencing cognitive decline in AD. This study applied novel WM tract integrity (WMTI) metrics derived from diffusional kurtosis imaging (DKI) to examine WM tissue properties in AD within this framework. Using data from amnestic mild cognitive impairment (aMCI, n = 12), AD (n = 14), and normal control (NC; n = 15) subjects, mixed models revealed interaction effects: specific WMTI metrics of axonal density and myelin integrity (i.e. axonal water fraction, radial extra-axonal diffusivity) in late-myelinating tracts (i.e. superior and inferior longitudinal fasciculi) changed in the course of disease, but were stable in the initial stages for early-myelinating tracts (i.e. posterior limb of the internal capsule, cerebral peduncles). WMTI metrics in late-myelinating tracts correlated with semantic verbal fluency, a cognitive function known to decline in AD. These findings corroborate the preferential vulnerability of late-myelinating tracts, and illustrate an application of WMTI metrics to characterizing the regional course of WM changes in AD. We investigated the vulnerability of late-myelinating tracts in AD using WMTI metrics. WMTI metrics are derived from the biophysical modeling of the DKI signal. These metrics indicate pathological features like axonal density and myelin integrity. WMTI metrics were largely stable in early-myelinating tracts through the course of AD. Axonal density loss & myelin breakdown were observed in late-myelinating tracts.
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Key Words
- AD, Alzheimer's disease
- AWF, axonal water fraction
- Alzheimer's disease
- CP, cerebral peduncle
- DKI, diffusional kurtosis imaging
- DTI, diffusion tensor imaging
- Daxon, intrinsic axonal diffusivity
- De,∥, axial extra-axonal diffusivity
- De,⊥, radial extra-axonal diffusivity
- Diffusion MRI
- Diffusional kurtosis imaging
- FA, fractional anisotropy
- ILF, inferior longitudinal fasciculus
- NC, normal control
- PLIC, posterior limb of the internal capsule
- SLF, superior longitudinal fasciculus
- Verbal fluency
- WM, white matter
- WMTI, white matter tract integrity
- White matter
- aMCI, amnestic mild cognitive impairment
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Affiliation(s)
- Andreana Benitez
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29425, USA ; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC 29425, USA
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Alphs L, Berwaerts J, Turkoz I. Limited utility of number needed to treat and the polarity index for bipolar disorder to characterize treatment response. Eur Neuropsychopharmacol 2013; 23:1597-9. [PMID: 23347971 DOI: 10.1016/j.euroneuro.2012.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 12/28/2012] [Accepted: 12/30/2012] [Indexed: 11/29/2022]
Abstract
The medical community increasingly supports the use of simplifying constructs or ratios to facilitate incorporation of evidence-based medicine into clinical practice such as number needed to treat (NNT) and polarity index (PI). Clinicians and teachers find them to be an appealing, easy-to remember integer that can be readily translated into clinical practice. However, serious questions have been raised with respect to the validity, reliability and value of these descriptors of response. This commentary identifies some of the specific limitations of the NNT and PI constructs when applied to treatments of bipolar disorder.
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Affiliation(s)
- Larry Alphs
- Janssen Scientific Affairs, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ 08560-2000, USA.
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99
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Kochunov P, Du X, Moran LV, Sampath H, Wijtenburg SA, Yang Y, Rowland LM, Stein EA, Hong LE. Acute nicotine administration effects on fractional anisotropy of cerebral white matter and associated attention performance. Front Pharmacol 2013; 4:117. [PMID: 24065920 PMCID: PMC3776159 DOI: 10.3389/fphar.2013.00117] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 08/29/2013] [Indexed: 11/16/2022] Open
Abstract
Introduction: Nicotinic acetylcholine receptors are present in the cerebral white matter (WM). We hypothesized that WM response to nicotine can be detected by diffusion tensor imaging (DTI); and that such responses may be associated with nicotine-led cognitive enhancement in sustained attention. Methods: A randomized, nicotine-placebo patch, crossover, double-blind clinical trial in two non-overlapping cohorts of smokers was used to test the hypothesis. The discovery cohort consisted of 39 subjects (N = 20/19 controls/schizophrenic patients, age = 36.8 ± 10.1 years) and the replication cohorts consisted of 38 healthy smokers (31.7 ± 10.5 years). WM integrity was measured by fractional anisotropy (FA) values for the whole brain and nine preselected WM tracts using tract-based-spatial-statistics. Results: Nicotine significantly enhanced FA values for the genu of corpus callosum compared with placebo (ΔFAgenu) (p = 0.01) in smokers with low recent smoking exposure as measured by low average cotinine level. This finding was replicated in the second cohort (p = 0.02). ΔFAgenu values explained 22% of variance in performance of a sustained attention task during the nicotine session (p = 0.006). However, this effect was limited to schizophrenia patients (r = 0.62 and 0.09; p = 0.003 and 0.7 for patients and controls, respectively). Conclusion: Acute pharmacological influence of nicotine patch on WM integrity appeared present, but was dependent on nicotine intake from recent smoking. Change in the WM integrity in the genu of corpus callosum was associated with a significant proportion of variability of nicotine-led changes in sustained attention/working memory of the smokers. Further studies will be necessary to understand biophysical underpinning of the nicotine-related changes in FA.
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Affiliation(s)
- Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine Baltimore, MD, USA ; Department of Physics, University of Maryland Baltimore County, MD, USA
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100
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Di Benedetto B, Rupprecht R. Targeting glia cells: novel perspectives for the treatment of neuropsychiatric diseases. Curr Neuropharmacol 2013; 11:171-85. [PMID: 23997752 PMCID: PMC3637671 DOI: 10.2174/1570159x11311020004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/30/2012] [Accepted: 11/02/2012] [Indexed: 12/28/2022] Open
Abstract
Neuropsychiatric disorders are devastating mental illnesses with a high economic burden. The additional morbidity associated with social issues that arises along with the course of these diseases increases the need for a clear understanding of their etiopathogenesis to allow an implementation of novel pharmacological strategies. Yet a poor knowledge about interactions occurring at the glia-neuron interface in health and disease still hampers innovative discoveries, despite the fact that glia cells have been long described to actively participate in the regulation of brain circuits. The purpose of this review was to collect the scattered literature on the involvement of glia cells in neuropsychiatric disorders and to describe how also these cells besides neurons might be responsive to current pharmacological interventions. We hope thereby to offer alternative approaches for investigations that may open avenues to search for new potential targets for drug discovery.
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Affiliation(s)
- B Di Benedetto
- Max Planck Institute of Psychiatry, Munich, Germany ; Department of Psychiatry and Psychotherapy, Regensburg University, Germany
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