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Murrough JW, Abdallah CG, Mathew SJ. Targeting glutamate signalling in depression: progress and prospects. Nat Rev Drug Discov 2017; 16:472-486. [PMID: 28303025 DOI: 10.1038/nrd.2017.16] [Citation(s) in RCA: 307] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Major depressive disorder (MDD) is severely disabling, and current treatments have limited efficacy. The glutamate N-methyl-D-aspartate receptor (NMDAR) antagonist ketamine was recently repurposed as a rapidly acting antidepressant, catalysing the vigorous investigation of glutamate-signalling modulators as novel therapeutic agents for depressive disorders. In this Review, we discuss the progress made in the development of such modulators for the treatment of depression, and examine recent preclinical and translational studies that have investigated the mechanisms of action of glutamate-targeting antidepressants. Fundamental questions remain regarding the future prospects of this line of drug development, including questions concerning safety and tolerability, efficacy, dose-response relationships and therapeutic mechanisms.
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Affiliation(s)
- James W Murrough
- Mood and Anxiety Disorders Program, Department of Psychiatry; Fishberg Department of Neuroscience; and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - Chadi G Abdallah
- Clinical Neuroscience Division, VA National Center for PTSD; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - Sanjay J Mathew
- Mental Health Care Line, Michael E. DeBakey VA Medical Center; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas 77030, USA
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Torres-Sanchez S, Perez-Caballero L, Berrocoso E. Cellular and molecular mechanisms triggered by Deep Brain Stimulation in depression: A preclinical and clinical approach. Prog Neuropsychopharmacol Biol Psychiatry 2017; 73:1-10. [PMID: 27644164 DOI: 10.1016/j.pnpbp.2016.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/09/2016] [Accepted: 09/15/2016] [Indexed: 12/20/2022]
Abstract
Deep Brain Stimulation (DBS) was originally developed as a therapeutic approach to manage movement disorders, in particular Parkinson's Disease. However, DBS also seems to be an effective treatment against refractory depression when patients fail to respond satisfactorily to conventional therapies. Thus, DBS targeting specific brain areas can produce an antidepressant response that improves depressive symptomatology, these areas including the subcallosal cingulate region, nucleus accumbens, ventral capsule/ventral striatum, medial forebrain bundle, the inferior thalamic peduncle and lateral habenula. Although the efficacy and safety of this therapy has been demonstrated in some clinical trials and preclinical studies, the intrinsic mechanisms underlying its antidepressant effect remain poorly understood. This review aims to provide a comprehensive overview of DBS, focusing on the molecular and cellular changes reported after its use that could shed light on the mechanisms underpinning its antidepressant effect. Several potential mechanisms of action of DBS are considered, including monoaminergic and glutamatergic neurotransmission, neurotrophic and neuroinflammatory mechanisms, as well as potential effects on certain intracellular signaling pathways. Although future studies will be necessary to determine the key molecular events underlying the antidepressant effect of DBS, the findings presented provide an insight into some of its possible modes of action.
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Affiliation(s)
- S Torres-Sanchez
- Department of Neuroscience, Pharmacology and Psychiatry, University of Cádiz, Neuropsychopharmacology & Psychobiology Research Group, CIBER for Mental Health (CIBERSAM), Spain
| | - L Perez-Caballero
- Department of Psychology, Area of Psychobiology, University of Cádiz, Neuropsychopharmacology & Psychobiology Research Group, CIBER for Mental Health (CIBERSAM), Spain
| | - E Berrocoso
- Department of Psychology, Area of Psychobiology, University of Cádiz, Neuropsychopharmacology & Psychobiology Research Group, CIBER for Mental Health (CIBERSAM), Spain.
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Glial GLT-1 blockade in infralimbic cortex as a new strategy to evoke rapid antidepressant-like effects in rats. Transl Psychiatry 2017; 7:e1038. [PMID: 28221365 PMCID: PMC5438036 DOI: 10.1038/tp.2017.7] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/02/2016] [Accepted: 12/22/2016] [Indexed: 12/28/2022] Open
Abstract
Ketamine and deep brain stimulation produce rapid antidepressant effects in humans and rodents. An increased AMPA receptor (AMPA-R) signaling in medial prefrontal cortex (mPFC) has been suggested to mediate these responses. However, little research has addressed the direct effects of enhancing glutamate tone or AMPA-R stimulation in mPFC subdivisions. The current study investigates the behavioral and neurochemical consequences of glutamate transporter-1 (GLT-1) blockade or s-AMPA microinfusion in the infralimbic (IL) and prelimbic (PrL) cortex. Owing to the connectivity between the mPFC and raphe nuclei, the role of serotonin is also explored. The bilateral microinfusion of the depolarizing agent veratridine into IL -but not PrL- of rats evoked immediate antidepressant-like responses. The same regional selectivity was observed after microinfusion of dihydrokainic acid (DHK), a selective inhibitor of GLT-1, present in astrocytes. The DHK-evoked antidepressant-like responses appear to be mediated by an AMPA-R-driven enhancement of serotonergic activity, as (i) they were prevented by NBQX 2,3-dioxo-6-nitro-1,2,3,4-tetrahydrobenzo[f]quinoxaline-7-sulfonamide disodium salt) and mimicked by s-AMPA; (ii) DHK and s-AMPA elevated similarly extracellular glutamate in IL and PrL, although extracellular 5-HT and c-fos expression in the midbrain dorsal raphe increased only when these agents were applied in IL; and (iii) DHK antidepressant-like responses were prevented by 5-HT synthesis inhibition and mimicked by citalopram microinfusion in IL. These results indicate that an acute increase of glutamatergic neurotransmission selectively in IL triggers immediate antidepressant-like responses in rats, likely mediated by the activation of IL-raphe pathways, which then results in a fast increase of serotonergic activity.
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Cervera-Ferri A, Teruel-Martí V, Barceló-Molina M, Martínez-Ricós J, Luque-García A, Martínez-Bellver S, Adell A. Characterization of oscillatory changes in hippocampus and amygdala after deep brain stimulation of the infralimbic prefrontal cortex. Physiol Rep 2016; 4:4/14/e12854. [PMID: 27449812 PMCID: PMC4962070 DOI: 10.14814/phy2.12854] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 06/16/2016] [Indexed: 01/14/2023] Open
Abstract
Deep brain stimulation (DBS) is a new investigational therapy that has generated positive results in refractory depression. Although the neurochemical and behavioral effects of DBS have been examined, less attention has been paid to the influence of DBS on the network dynamics between different brain areas, which could contribute to its therapeutic effects. Herein, we set out to identify the effects of 1 h DBS in the infralimbic cortex (IL) on the oscillatory network dynamics between hippocampus and basolateral amygdala (BLA), two regions implicated in depression and its treatment. Urethane-anesthetized rats with bilaterally implanted electrodes in the IL were exposed to 1 h constant stimulation of 130 Hz of frequency, 60 μA of constant current intensity and biphasic pulse width of 80 μsec. After a period of baseline recording, local field potentials (LFP) were recorded with formvar-insulated stainless steel electrodes. DBS of the IL increased the power of slow wave (SW, <1.5 Hz) and theta (3-12 Hz) frequencies in the hippocampus and BLA Furthermore, IL DBS caused a precise coupling in different frequency bands between both brain structures. The increases in SW band synchronization in hippocampus and BLA after DBS suggest that these changes may be important for the improvement of depressive behavior. In addition, the augmentation in theta synchrony might contribute to improvement in emotional and cognitive processes.
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Affiliation(s)
- Ana Cervera-Ferri
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embriology, Faculty of Medicine and Odontology University of Valencia, Valencia, 46010, Spain
| | - Vicent Teruel-Martí
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embriology, Faculty of Medicine and Odontology University of Valencia, Valencia, 46010, Spain
| | - Moises Barceló-Molina
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embriology, Faculty of Medicine and Odontology University of Valencia, Valencia, 46010, Spain Instituto de Investigación Sanitaria La Fe, Valencia, 46026, Spain
| | - Joana Martínez-Ricós
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embriology, Faculty of Medicine and Odontology University of Valencia, Valencia, 46010, Spain
| | - Aina Luque-García
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embriology, Faculty of Medicine and Odontology University of Valencia, Valencia, 46010, Spain Instituto de Investigación Sanitaria La Fe, Valencia, 46026, Spain
| | - Sergio Martínez-Bellver
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embriology, Faculty of Medicine and Odontology University of Valencia, Valencia, 46010, Spain Department of Cell Biology and Parasitology, Faculty of Medicine and Odontology University of Valencia, Valencia, 46010, Spain
| | - Albert Adell
- Institute of Biomedicine and Biotechnology of Cantabria, IBBTEC (CSIC University of Cantabria), Santander, 39011, Spain
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Deep Brain Stimulation for Depression: Is It a Gray or White "Matter"? Biol Psychiatry 2016; 80:e43-e44. [PMID: 26987628 DOI: 10.1016/j.biopsych.2015.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 11/22/2022]
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