101
|
Yu L, An C, Jia L, Li Y, Chen Q, Zhen F, Wang S, Wang M. Combination Therapy of Salvianolic Acid and Fluoxetine Improves the Cognitive Function of Rats with Chronic Stress-induced Depression. World Neurosurg 2015; 86:173-80. [PMID: 26431735 DOI: 10.1016/j.wneu.2015.09.071] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To establish the beneficial effects of salvianolic acid and fluoxetine on the improvement of cognitive function and amelioration of depression-like symptoms of rats with chronic stress-induced depression. METHODS Ninety-nine male Sprague-Dawley rats were randomly divided into 5 groups--a control group with no stress challenge and 4 chronic stress groups. Rats assigned to chronic stress groups were exposed to stress for 3 weeks, and then were given placebo, fluoxetine (20 mg/kg), salvianolic acid (40 mg/kg), or combined fluoxetine and salvianolic acid. Body weight of each rat was recorded throughout the study. Sucrose preference test and water maze experiment were performed after chronic stress challenge and after drug treatment to assess the effect of drug treatments on depressive-like symptoms and cognitive function. The sucrose preference test was also performed before chronic stress exposure for baseline measurement. RESULTS Exposure of rats to chronic stress for 3 weeks significantly reduced body weight and sucrose preference values compared with the no stress control. The water maze experiment showed that chronic stress impaired the spatial learning of rats as well. Treatment of stress-challenged rats with fluoxetine and fluoxetine combined with salvianolic acid resulted in shorter training latency and longer time spent in the target quadrant during the exploration stage of the water maze experiment compared with placebo treatment. Effect of the combined regimen was found more obvious. CONCLUSIONS Combination therapy of salvianolic acid and fluoxetine could alleviate depression-like symptoms and cognitive deficit induced by chronic stress.
Collapse
Affiliation(s)
- Lulu Yu
- Department of Psychiatry, The First Hospital of Hebei Medical University and Institute of Mental Health, Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Cuixia An
- Department of Psychiatry, The First Hospital of Hebei Medical University and Institute of Mental Health, Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Lina Jia
- Department of Psychiatry, The First Hospital of Hebei Medical University and Institute of Mental Health, Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Yunpeng Li
- Department of Psychiatry, The First Hospital of Hebei Medical University and Institute of Mental Health, Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Qianqian Chen
- Department of Psychiatry, The First Hospital of Hebei Medical University and Institute of Mental Health, Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Fengya Zhen
- Department of Psychiatry, The First Hospital of Hebei Medical University and Institute of Mental Health, Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Shuo Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University and Institute of Mental Health, Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Mingwei Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China; Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China.
| |
Collapse
|
102
|
Neuroprotection and reduced gliosis by atomoxetine pretreatment in a gerbil model of transient cerebral ischemia. J Neurol Sci 2015; 359:373-80. [DOI: 10.1016/j.jns.2015.11.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/06/2015] [Accepted: 11/15/2015] [Indexed: 11/23/2022]
|
103
|
Faour-Nmarne C, Azab AN. Effects of olanzapine on LPS-induced inflammation in rat primary glia cells. Innate Immun 2015; 22:40-50. [PMID: 26542836 DOI: 10.1177/1753425915613425] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 09/30/2015] [Indexed: 12/27/2022] Open
Abstract
Olanzapine (OLZ) is an atypical antipsychotic drug that also has mood-stabilizing effects. The mechanism of action of OLZ is not fully understood. Accumulating data suggest that inflammation plays a role in the pathophysiology of mental disorders and that psychotropic drugs exhibit some anti-inflammatory properties. This study was undertaken to examine the effects of OLZ on LPS-induced inflammation in rat primary glia cells. Glia cells were extracted from newborn rat brains. OLZ (1 or 50 µM) was added to culture medium at 6 or 72 h before addition of LPS for another 18 h, and levels of IL-10, prostaglandin (PG) E2, NO and TNF-α, and expression of cyclo-oxygensase (COX)-2 and inducible NO synthase (iNOS) were determined. Treatment with 50 µM OLZ (but not 1 µM) significantly decreased LPS-induced secretion of IL-10, PGE2 and TNF-α. In contrast, 50 µM OLZ significantly increased NO levels. OLZ did not alter the expression of COX-2 or iNOS in LPS-treated cells. These results suggest that OLZ differently affects the secretion of inflammatory mediators. Most of the significant effects of OLZ were obtained when 50 µM was used, which is a high and probably therapeutically irrelevant concentration. Therefore, under the conditions used in the present study OLZ seemed to lack a potent anti-inflammatory effect.
Collapse
Affiliation(s)
- Caroline Faour-Nmarne
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Abed N Azab
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| |
Collapse
|
104
|
Alterations of the Ceramide Metabolism in the Peri-Infarct Cortex Are Independent of the Sphingomyelinase Pathway and Not Influenced by the Acid Sphingomyelinase Inhibitor Fluoxetine. Neural Plast 2015; 2015:503079. [PMID: 26605090 PMCID: PMC4641186 DOI: 10.1155/2015/503079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/06/2015] [Indexed: 01/01/2023] Open
Abstract
Ceramides induce important intracellular signaling pathways, modulating proliferation, migration, apoptosis, and inflammation. However, the relevance of the ceramide metabolism in the reconvalescence phase after stroke is unclear. Besides its well-known property as a selective serotonin reuptake inhibitor, fluoxetine has been reported to inhibit the acid sphingomyelinase (ASM), a key regulator of ceramide levels which derives ceramide from sphingomyelin. Furthermore, fluoxetine has shown therapeutic potential in a randomized controlled rehabilitation trial in stroke patients. Our aim was to investigate and modulate ceramide concentrations in the peri-infarct cortex, whose morphological and functional properties correlate with long-term functional outcome in stroke. We show that certain ceramide species are modulated after experimental stroke and that these changes do not result from alterations of ASM activity, but rather from nontranscriptional induction of the ceramide de novo pathway. Unexpectedly, although reducing lesion size, fluoxetine did not improve functional outcome in our model and had no significant influence on ASM activity or the concentration of ceramides. The ceramide metabolism could emerge as a potential therapeutic target in the reconvalescence phase after stroke, as its accumulation in the peri-infarct cortex potentially influences membrane functions as well as signaling events in the tissue essential for neurological recovery.
Collapse
|
105
|
Jafary L, Reisi P, Naghsh N. Effects of fluoxetine on memory under forced treadmill exercise conditions in male rats. Adv Biomed Res 2015; 4:235. [PMID: 26645020 PMCID: PMC4647126 DOI: 10.4103/2277-9175.167962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 08/19/2015] [Indexed: 11/05/2022] Open
Abstract
Background: Studies show inconsistent effects of forced exercise on cognitive processes. These differences are probably due to the stress of coercion in forced exercise. Because fluoxetine is used to treat complications caused by stress, this study aimed to evaluate the effects of fluoxetine on memory in rats under forced treadmill exercise. Materials and Methods: Experimental groups were the control, the control exercise, the fluoxetine, and the fluoxetine exercise. The exercise program was treadmill running at 22 m/min, 0° inclination for 50 min/day, 6 days/week, for 4 weeks. Fluoxetine (5 mg/kg) was injected 30 min before treadmill. Morris water maze and passive avoidance learning tests were used for evaluation of memory. Acquisition phase of both tests were performed before interventions and memory was evaluated 1-day and 1-week after the last session of exercise and treatments. Results: Our data showed that forced exercise impaired performance in passive avoidance learning test (P < 0.05 and P < 0.01, 1-day and 1-week after the last session of exercise and treatments, respectively). Spatial memory was only impaired after 1-week in the exercise group. Fluoxetine improved spatial memory after 1-day in the control group. However, it had no significant effects on memory in the exercise group. Conclusion: The data correspond to the possibility that forced treadmill exercise can cause stress, and thereby cause damage to memory. The present results suggest that although fluoxetine may improve memory in intact rats but it cannot prevent damages that are caused by forced exercise.
Collapse
Affiliation(s)
- Leila Jafary
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Parham Reisi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran ; Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Biosensor Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nooshin Naghsh
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| |
Collapse
|
106
|
Blatteau JE, de Maistre S, Lambrechts K, Abraini J, Risso JJ, Vallée N. Fluoxetine stimulates anti-inflammatory IL-10 cytokine production and attenuates sensory deficits in a rat model of decompression sickness. J Appl Physiol (1985) 2015; 119:1393-9. [PMID: 26494447 DOI: 10.1152/japplphysiol.00602.2015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/15/2015] [Indexed: 11/22/2022] Open
Abstract
Despite "gold standard" hyperbaric oxygen treatment, 30% of patients suffering from neurological decompression sickness still exhibit incomplete recovery, including sensory impairments. Fluoxetine, a well-known antidepressant, is recognized as having anti-inflammatory effects in the setting of cerebral ischemia. In this study, we focused on the assessment of sensory neurological deficits and measurement of circulating cytokines after decompression in rats treated or not with fluoxetine. Seventy-eight rats were divided into a clinical (n = 38) and a cytokine (n = 40) group. In both groups, the rats were treated with fluoxetine (30 mg/kg po, 6 h beforehand) or with a saccharine solution. All of the rats were exposed to 90 m seawater for 45 min before staged decompression. In the clinical group, paw withdrawal force after mechanical stimulation and paw withdrawal latency after thermal stimulation were evaluated before and 1 and 48 h after surfacing. At 48 h, a dynamic weight-bearing device was used to assess postural stability, depending on the time spent on three or four paws. For cytokine analysis, blood samples were collected from the vena cava 1 h after surfacing. Paw withdrawal force and latency were increased after surfacing in the controls, but not in the fluoxetine group. Dynamic weight-bearing assessment highlighted a better stability on three paws for the fluoxetine group. IL-10 levels were significantly decreased after decompression in the controls, but maintained at baseline level with fluoxetine. This study suggests that fluoxetine has a beneficial effect on sensory neurological recovery. We hypothesize that the observed effect is mediated through maintained anti-inflammatory cytokine IL-10 production.
Collapse
Affiliation(s)
- Jean-Eric Blatteau
- Institut de Recherche Biomédicale des Armées, Équipe de Recherche Subaquatique Opérationnelle, Toulon, France;
| | - Sébastien de Maistre
- Institut de Recherche Biomédicale des Armées, Équipe de Recherche Subaquatique Opérationnelle, Toulon, France
| | - Kate Lambrechts
- Institut de Recherche Biomédicale des Armées, Équipe de Recherche Subaquatique Opérationnelle, Toulon, France; Laboratoire Motricité Humaine, Éducation, Sport, Santé (LAMHESS), Université de Toulon UFR STAPS, La Garde, France
| | - Jacques Abraini
- Département d'Anesthésiologie, Université Laval, Québec, Canada; and Normandie-Université, Université de Caen-Basse Normandie, Caen, France
| | - Jean-Jacques Risso
- Institut de Recherche Biomédicale des Armées, Équipe de Recherche Subaquatique Opérationnelle, Toulon, France
| | - Nicolas Vallée
- Institut de Recherche Biomédicale des Armées, Équipe de Recherche Subaquatique Opérationnelle, Toulon, France
| |
Collapse
|
107
|
Ng KL, Gibson EM, Hubbard R, Yang J, Caffo B, O'Brien RJ, Krakauer JW, Zeiler SR. Fluoxetine Maintains a State of Heightened Responsiveness to Motor Training Early After Stroke in a Mouse Model. Stroke 2015; 46:2951-60. [PMID: 26294676 PMCID: PMC4934654 DOI: 10.1161/strokeaha.115.010471] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/16/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Data from both humans and animal models suggest that most recovery from motor impairment after stroke occurs in a sensitive period that lasts only weeks and is mediated, in part, by an increased responsiveness to training. Here, we used a mouse model of focal cortical stroke to test 2 hypotheses. First, we investigated whether responsiveness to training decreases over time after stroke. Second, we tested whether fluoxetine, which can influence synaptic plasticity and stroke recovery, can prolong the period over which large training-related gains can be elicited after stroke. METHODS Mice were trained to perform a skilled prehension task to an asymptotic level of performance after which they underwent stroke induction in the caudal forelimb area. The mice were then retrained after a 1- or 7-day delay with and without fluoxetine. RESULTS Recovery of prehension after a caudal forelimb area stroke was complete if training was initiated 1 day after stroke but incomplete if it was delayed by 7 days. In contrast, if fluoxetine was administered at 24 hours after stroke, then complete recovery of prehension was observed even with the 7-day training delay. Fluoxetine seemed to mediate its beneficial effect by reducing inhibitory interneuron expression in intact premotor cortex rather than through effects on infarct volume or cell death. CONCLUSIONS There is a gradient of diminishing responsiveness to motor training over the first week after stroke. Fluoxetine can overcome this gradient and maintain maximal levels of responsiveness to training even 7 days after stroke.
Collapse
Affiliation(s)
- Kwan L Ng
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Ellen M Gibson
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Robert Hubbard
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Juemin Yang
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Brian Caffo
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Richard J O'Brien
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - John W Krakauer
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Steven R Zeiler
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.).
| |
Collapse
|
108
|
Siepmann T, Penzlin AI, Kepplinger J, Illigens BM, Weidner K, Reichmann H, Barlinn K. Selective serotonin reuptake inhibitors to improve outcome in acute ischemic stroke: possible mechanisms and clinical evidence. Brain Behav 2015; 5:e00373. [PMID: 26516608 PMCID: PMC4614057 DOI: 10.1002/brb3.373] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/13/2015] [Accepted: 07/19/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several clinical studies have indicated that selective serotonin reuptake inhibitors (SSRIs) administered in patients after acute ischemic stroke can improve clinical recovery independently of depression. Due to small sample sizes and heterogeneous study designs interpretability was limited in these studies. The mechanisms of action whereby SSRI might improve recovery from acute ischemic stroke are not fully elucidated. METHODS We searched MEDLINE using the PubMed interface to identify evidence of SSRI mediated improvement of recovery from acute ischemic stroke and reviewed the literature on the potential underlying mechanisms of action. RESULTS Among identified clinical studies, a well-designed randomized, double-blind, and placebo-controlled study (FLAME - fluoxetine for motor recovery after acute ischemic stroke) demonstrated improved recovery of motor function in stroke patients receiving fluoxetine. The positive effects of SSRIs on stroke recovery were further supported by a meta-analysis of 52 trials in a total of 4060 participants published by the Cochrane collaboration. Based on animal models, the mechanisms whereby SSRIs might ameliorate functional and structural ischemic-brain damage were suggested to include stimulation of neurogenesis with migration of newly generated cells toward ischemic-brain regions, anti-inflammatory neuroprotection, improved regulation of cerebral blood flow, and modulation of the adrenergic neurohormonal system. However, to date, it remains speculative if and to what degree these mechanisms convert into humans and randomized controlled trials in large populations of stroke patients comparing different SSRIs are still lacking. CONCLUSION In addition to the need of comprehensive-clinical evidence, further elucidation of the beneficial mechanisms whereby SSRIs may improve structural and functional recovery from ischemic-brain damage is needed to form a basis for translation into clinical practice.
Collapse
Affiliation(s)
- Timo Siepmann
- Department of NeurologyUniversity Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
- Department of Psychotherapy and Psychosomatic MedicineUniversity Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Ana Isabel Penzlin
- Institute of Clinical PharmacologyUniversity Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Jessica Kepplinger
- Department of NeurologyUniversity Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Ben Min‐Woo Illigens
- Department of NeurologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusetts
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic MedicineUniversity Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Heinz Reichmann
- Department of NeurologyUniversity Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| | - Kristian Barlinn
- Department of NeurologyUniversity Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
| |
Collapse
|
109
|
So you think you can jump? A novel long jump assessment to detect deficits in stroked mice. J Neurosci Methods 2015; 256:212-9. [PMID: 26365334 DOI: 10.1016/j.jneumeth.2015.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Stroke survivors suffer from persistent disability, as well as severe sensorimotor and cognitive deficits. The preclinical assessment of such deficits is important for the development of novel interventions and therapeutics. NEW METHOD The aim of this study was to develop a quantitative behavioral measure of hindlimb functionality in rodents, which could be used to assess deficits after a neural injury, such as stroke. Here we introduce a test to measure long jump behavior in mice. RESULTS Using this test we first showed that while male and female mice exhibited no differences in jump success rate, the female mice showed lower baseline jumping latencies. Next we demonstrated that the induction of a cerebral stroke via middle cerebral artery occlusion (MCAO) for 45min did not affect the jump success rate in either group; however, it did significantly increase jump latencies in both male and female mice. Finally, we used therapeutic interventions to explore mechanisms that may be involved in producing this increase in jump latency by administering the anti-depressant fluoxetine prior to the long jump assay, and also tested for potential changes in anxiety levels after stroke. COMPARISON WITH EXISTING METHODS Other methods to assess hindlimb functionality are not specific, because they measure behaviors that rely not only on hindlimbs, but also on forelimbs and tail. CONCLUSIONS This study introduces a novel assay that can be used to measure a stroke induced behavioral deficit with great sensitivity, and raises interesting questions about potential mechanisms regulating this effect.
Collapse
|
110
|
McAllister BB, Spanswick SC, Patel PP, Barneto AA, Dyck RH. The effects of chronic fluoxetine treatment following injury of medial frontal cortex in mice. Behav Brain Res 2015; 290:102-16. [DOI: 10.1016/j.bbr.2015.04.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 04/20/2015] [Accepted: 04/27/2015] [Indexed: 11/27/2022]
|
111
|
Abstract
Priming is a type of implicit learning wherein a stimulus prompts a change in behavior. Priming has been long studied in the field of psychology. More recently, rehabilitation researchers have studied motor priming as a possible way to facilitate motor learning. For example, priming of the motor cortex is associated with changes in neuroplasticity that are associated with improvements in motor performance. Of the numerous motor priming paradigms under investigation, only a few are practical for the current clinical environment, and the optimal priming modalities for specific clinical presentations are not known. Accordingly, developing an understanding of the various types of motor priming paradigms and their underlying neural mechanisms is an important step for therapists in neurorehabilitation. Most importantly, an understanding of the methods and their underlying mechanisms is essential for optimizing rehabilitation outcomes. The future of neurorehabilitation is likely to include these priming methods, which are delivered prior to or in conjunction with primary neurorehabilitation therapies. In this Special Interest article, we discuss those priming paradigms that are supported by the greatest amount of evidence, including (i) stimulation-based priming, (ii) motor imagery and action observation, (iii) sensory priming, (iv) movement-based priming, and (v) pharmacological priming.Video Abstract available. (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A86) for more insights from the authors.
Collapse
|
112
|
Mead G, Hackett ML, Lundström E, Murray V, Hankey GJ, Dennis M. The FOCUS, AFFINITY and EFFECTS trials studying the effect(s) of fluoxetine in patients with a recent stroke: a study protocol for three multicentre randomised controlled trials. Trials 2015; 16:369. [PMID: 26289352 PMCID: PMC4545865 DOI: 10.1186/s13063-015-0864-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/14/2015] [Indexed: 12/18/2022] Open
Abstract
Background Several small trials have suggested that fluoxetine improves neurological recovery from stroke. FOCUS, AFFINITY and EFFECTS are a family of investigator-led, multicentre, parallel group, randomised, placebo-controlled trials that aim to determine whether routine administration of fluoxetine (20 mg daily) for 6 months after acute stroke improves patients’ functional outcome. Methods/Design The three trial investigator teams have collaboratively developed a core protocol. Minor variations have been tailored to the national setting in the UK (FOCUS), Australia and New Zealand (AFFINITY) and Sweden (EFFECTS). Each trial is run and funded independently and will report its own results. A prospectively planned individual patient data meta-analysis of all three trials will subsequently provide the most precise estimate of the overall effect of fluoxetine after stroke and establish whether any effects differ between trials and subgroups of patients. The trials include patients ≥18 years old with a clinical diagnosis of stroke, persisting focal neurological deficits at randomisation between 2 and 15 days after stroke onset. Patients are randomised centrally via web-based randomisation systems using a common minimisation algorithm. Patients are allocated fluoxetine 20 mg once daily or matching placebo capsules for 6 months. Our primary outcome measure is the modified Rankin scale (mRS) at 6 months. Secondary outcomes include the Stroke Impact Scale, EuroQol (EQ5D-5 L), the vitality subscale of the Short-Form 36, diagnosis of depression, adherence to medication, adverse events and resource use. Outcomes are collected at 6 and 12 months. The methods of collecting these data are tailored to the national setting. If FOCUS, AFFINITY and EFFECTS combined enrol 6000 participants as planned, they would have 90 % power (alpha 5 %) to detect a common odds ratio of 1.16, equivalent to a 3.7 % absolute difference in percentage with mRS 0–2 (44.0 % to 47.7 %). This is based on an ordinal analysis of mRS adjusted for baseline variables included in the minimisation algorithm. Discussion If fluoxetine is safe and effective in promoting functional recovery, it could be rapidly, widely and affordably implemented in routine clinical practice and reduce the burden of disability due to stroke. Trial registration FOCUS: ISRCTN83290762 (23/05/2012), AFFINITY: ACTRN12611000774921 (22/07/2011). EFFECTS: ISRCTN13020412 (19/12/2014). Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0864-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Gillian Mead
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellors Building FU303h, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
| | - Maree L Hackett
- The George Institute for Global Health, University of Sydney, Sydney, Australia.
| | - Erik Lundström
- Department of Neurology, Karolinska University Hospital, Solna, Sweden.
| | | | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
| | - Martin Dennis
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellors Building FU303h, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
| |
Collapse
|
113
|
Siepmann T, Kepplinger J, Zerna C, Schatz U, Penzlin AI, Pallesen LP, Illigens BMW, Weidner K, Reichmann H, Puetz V, Bodechtel U, Barlinn K. The Effects of Pretreatment versus De Novo Treatment with Selective Serotonin Reuptake Inhibitors on Short-term Outcome after Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2015; 24:1886-92. [PMID: 26099557 DOI: 10.1016/j.jstrokecerebrovasdis.2015.04.033] [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] [Received: 01/30/2015] [Revised: 04/13/2015] [Accepted: 04/28/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Selective serotonin reuptake inhibitors (SSRIs) administered in patients following acute ischemic stroke have shown to improve clinical recovery independently of changes in depression. Animal studies have demonstrated that sustained SSRI treatment is superior to short-term SSRI in evoking neurogenesis but how this benefit translates into humans remains to be answered. We hypothesized that in acute ischemic stroke patients, SSRI treatment started before the event leads to improved short-term outcomes compared to de novo SSRI treatment poststroke. METHODS We performed an exploratory analysis in consecutive acute ischemic stroke patients and compared patients already receiving fluoxetine, citalopram, or escitalopram with those who started treatment de novo. RESULTS Of 2653 screened patients, 239 were included (age, 69 ± 14 years; 42% men, baseline median National Institutes of Health Stroke Scale score, 7 [IQR, 10]). Of these patients, 51 started treatment with SSRI before stroke and 188 were prescribed newly SSRIs during hospitalization. In the adjusted multivariate logistic regression models, SSRI pretreatment was associated with favorable functional outcome at discharge defined as a modified Rankin Scale score of 2 or less (odds ratio [OR], 4.00; 95% confidence interval [CI], 1.68-9.57; P < .005), improved early clinical recovery (OR, 2.35; 95% CI, 1.15-4.81; P = .02), and a trend toward prediction of superior motor recovery (OR, 1.82; 95% CI, .90-3.68; P < .01). CONCLUSIONS Our data suggest that SSRI pretreatment may improve clinical outcomes in the early stages of acute ischemic stroke supporting the hypothesis that prolonged SSRI treatment started prestroke is superior to poststroke SSRI.
Collapse
Affiliation(s)
- Timo Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Jessica Kepplinger
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Charlotte Zerna
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ulrike Schatz
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ana Isabel Penzlin
- Institute of Clinical Pharmacology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Lars-Peder Pallesen
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ben Min-Woo Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Heinz Reichmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Volker Puetz
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ulf Bodechtel
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kristian Barlinn
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
114
|
Fluvoxamine alleviates seizure activity and downregulates hippocampal GAP-43 expression in pentylenetetrazole-kindled mice. Behav Pharmacol 2015; 26:369-82. [DOI: 10.1097/fbp.0000000000000127] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
115
|
Direct inhibition of retinoic acid catabolism by fluoxetine. J Neural Transm (Vienna) 2015; 122:1329-38. [PMID: 25981674 DOI: 10.1007/s00702-015-1407-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/04/2015] [Indexed: 12/31/2022]
Abstract
Recent evidence from animal and human studies suggests neuroprotective effects of the SSRI fluoxetine, e.g., in the aftermath of stroke. The underlying molecular mechanisms remain to be fully defined. Because of its effects on the cytochrome P450 system (CYP450), we hypothesized that neuroprotection by fluoxetine is related to altered metabolism of retinoic acid (RA), whose CYP450-mediated degradation in brain tissue constitutes an important step in the regulation of its site-specific auto- and paracrine actions. Using traditional pharmacological in vitro assays, the effects of fluoxetine on RA degradation were probed in crude synaptosomes from rat brain and human-derived SH-SY5Y cells, and in cultures of neuron-like SH-SY5Y cells. Furthermore, retinoid-dependent effects of fluoxetine on neuronal survival following glutamate exposure were investigated in rat primary neurons cells using specific retinoid receptor antagonists. Experiments revealed dose-dependent inhibition of synaptosomal RA degradation by fluoxetine along with dose-dependent increases in RA levels in cell cultures. Furthermore, fluoxetine's neuroprotective effects against glutamate excitotoxicity in rat primary neurons were demonstrated to partially depend on RA signaling. Taken together, these findings demonstrate for the first time that the potent, pleiotropic antidepressant fluoxetine directly interacts with RA homeostasis in brain tissue, thereby exerting its neuroprotective effects.
Collapse
|
116
|
Ramirez K, Shea DT, McKim DB, B.F. R, Sheridan JF. Imipramine attenuates neuroinflammatory signaling and reverses stress-induced social avoidance. Brain Behav Immun 2015; 46:212-20. [PMID: 25701613 PMCID: PMC4414808 DOI: 10.1016/j.bbi.2015.01.016] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/29/2015] [Accepted: 01/31/2015] [Indexed: 12/18/2022] Open
Abstract
Psychosocial stress is associated with altered immunity, anxiety and depression. Previously we showed that repeated social defeat (RSD) promoted microglia activation and social avoidance behavior that persisted for 24days after cessation of RSD. The aim of the present study was to determine if imipramine (a tricyclic antidepressant) would reverse RSD-inducedsocial avoidance and ameliorate neuroinflammatory responses. To test this, C57BL/6 mice were divided into treatment groups. One group from RSD and controls received daily injections of imipramine for 24days, following 6 cycles of RSD. Two other groups were treated with saline. RSD mice spent significantly less time in the interaction zone when an aggressor was present in the cage. Administration of imipramine reversed social avoidance behavior, significantly increasing the interaction time, so that it was similar to that of control mice. Moreover, 24days of imipramine treatment in RSD mice significantly decreased stress-induced mRNA levels for IL-6 in brain microglia. Following ex vivo LPS stimulation, microglia from mice exposed to RSD, had higher mRNA expression of IL-6, TNF-α, and IL-1β, and this was reversed by imipramine treatment. In a second experiment, imipramine was added to drinking water confirming the reversal of social avoidant behavior and decrease in mRNA expression of IL-6 in microglia. These data suggest that the antidepressant imipramine may exert its effect, in part, by down-regulating microglial activation.
Collapse
Affiliation(s)
- Karol Ramirez
- Division of Biosciences, The Ohio State University College of Dentistry, Columbus, OH 43210, USA; Facultad de Odontología, Universidad de Costa Rica, San Pedro, San José 11501-2060, Costa Rica.
| | - Daniel T. Shea
- Institute for Behavioral Medicine Research, The Ohio State University Medical Center, Columbus, OH 43210, USA
| | - Daniel B. McKim
- Division of Biosciences, The Ohio State University College of Dentistry, Columbus, OH 43210, USA,Institute for Behavioral Medicine Research, The Ohio State University Medical Center, Columbus, OH 43210, USA
| | - Reader B.F.
- Institute for Behavioral Medicine Research, The Ohio State University Medical Center, Columbus, OH 43210, USA
| | - John F. Sheridan
- Division of Biosciences, The Ohio State University College of Dentistry, Columbus, OH 43210, USA,Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University Medical Center, Columbus, OH 43210, USA,Institute for Behavioral Medicine Research, The Ohio State University Medical Center, Columbus, OH 43210, USA,Corresponding author at: College of Dentistry, Division of Biosciences, PO BOX 182357, Columbus, OH 43218-2357, USA, Tel.: +1 614 688 4629, fax: +1 614 292 6087
| |
Collapse
|
117
|
Kraglund KL, Mortensen JK, Grove EL, Johnsen SP, Andersen G. TALOS: a multicenter, randomized, double-blind, placebo-controlled trial to test the effects of citalopram in patients with acute stroke. Int J Stroke 2015; 10:985-7. [PMID: 25854537 DOI: 10.1111/ijs.12485] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 02/18/2015] [Indexed: 11/26/2022]
Abstract
RATIONALE Selective Serotonin Reuptake Inhibitors (SSRI) are effective in the treatment of post-stroke depression and may have potential neuroprotective and vascular effects. Data from registry studies have further indicated a protective effect against recurrent ischemic events, but also an increased risk of bleeding in patients with ischemic stroke. Therefore, prospective studies are needed to determine the effects of SSRI treatment after acute ischemic stroke. AIMS AND DESIGN TALOS is an investigator-initiated, national multicenter randomized- and placebo-controlled, double-blind trial testing citalopram in acute ischemic stroke. We hypothesize that citalopram treatment initiated in the acute phase after ischemic stroke will improve outcome assessed by the modified Rankin Score (mRS) and reduce the risk of death from vascular causes, transient ischemic attack (TIA)/stroke and myocardial infarction. STUDY OUTCOMES There are two co-primary effect variables: (i) Functional status at six-months, measured by the modified Rankin Scale, and (ii) Vascular death, TIA/stroke and myocardial infarction. Secondary effect variables include: (i) Single primary outcomes; (ii) The Barthel Index; (iii) Mini Mental State Examination at six-months; (iv) Final infarct size (Magnetic Resonance Imaging). DISCUSSION SSRI treatment is well tolerated and overall beneficial in the wake of stroke; it may also be neuroprotective and prevent new vascular events.
Collapse
Affiliation(s)
| | | | | | - Søren Paaske Johnsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Grethe Andersen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
118
|
Liechti FD, Grandgirard D, Leib SL. The antidepressant fluoxetine protects the hippocampus from brain damage in experimental pneumococcal meningitis. Neuroscience 2015; 297:89-94. [PMID: 25839149 DOI: 10.1016/j.neuroscience.2015.03.056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 03/13/2015] [Accepted: 03/24/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND High mortality and morbidity rates are observed in patients with bacterial meningitis (BM) and urge for new adjuvant treatments in addition to standard antibiotic therapies. In BM the hippocampal dentate gyrus is injured by apoptosis while in cortical areas ischemic necrosis occurs. Experimental therapies aimed at reducing the inflammatory response and brain damage have successfully been evaluated in animal models of BM. Fluoxetine (FLX) is an anti-depressant of the selective serotonin reuptake inhibitors (SSRI) and was previously shown to be neuroprotective in vitro and in vivo. We therefore assessed the neuroprotective effect of FLX in experimental pneumococcal meningitis. METHODS Infant rats were infected intracisternally with live Streptococcus pneumoniae. Intraperitoneal treatment with FLX (10mgkg(-1)d(-1)) or an equal volume of NaCl was initiated 15min later. 18, 27, and 42h after infection, the animals were clinically (weight, clinical score, mortality) evaluated and subject to a cisternal puncture and inflammatory parameters (i.e., cyto-/chemokines, myeloperoxidase activity, matrix metalloproteinase concentrations) were measured in cerebrospinal fluid (CSF) samples. At 42h after infection, animals were sacrificed and the brains collected for histomorphometrical analysis of brain damage. RESULTS A significant lower number of animals treated with FLX showed relevant hippocampal apoptosis when compared to littermates (9/19 animals vs 18/23, P=0.038). A trend for less damage in cortical areas was observed in FLX-treated animals compared to controls (13/19 vs 13/23, P=ns). Clinical and inflammatory parameters were not affected by FLX treatment. CONCLUSION A significant neuroprotective effect of FLX on the hippocampus was observed in acute pneumococcal meningitis in infant rats.
Collapse
Affiliation(s)
- F D Liechti
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland.
| | - D Grandgirard
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland.
| | - S L Leib
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland; Biology Division, Spiez Laboratory, Swiss Federal Office for Civil Protection, Austrasse, Spiez CH-3700, Switzerland.
| |
Collapse
|
119
|
Lee JY, Kang SR, Yune TY. Fluoxetine prevents oligodendrocyte cell death by inhibiting microglia activation after spinal cord injury. J Neurotrauma 2015; 32:633-44. [PMID: 25366938 DOI: 10.1089/neu.2014.3527] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Oligodendrocyte cell death and axon demyelination after spinal cord injury (SCI) are known to be important secondary injuries contributing to permanent neurological disability. Thus, blocking oligodendrocyte cell death should be considered for therapeutic intervention after SCI. Here, we demonstrated that fluoxetine, an antidepressant drug, alleviates oligodendrocyte cell death by inhibiting microglia activation after SCI. After injury at the T9 level with a Precision Systems and Instrumentation (Lexington, KY) device, fluoxetine (10 mg/kg, intraperitoneal) was administered once a day for the indicated time points. Immunostaining with CD11b (OX-42) antibody and quantification analysis showed that microglia activation was significantly inhibited by fluoxetine at 5 days after injury. Fluoxetine also significantly inhibited activation of p38 mitogen-activated protein kinase (p38-MAPK) and expression of pro-nerve growth factor (pro-NGF), which is known to mediate oligodendrocyte cell death through the p75 neurotrophin receptor after SCI. In addition, fluoxetine attenuated activation of Ras homolog gene family member A and decreased the level of phosphorylated c-Jun and, ultimately, alleviated caspase-3 activation and significantly reduced cell death of oligodendrocytes at 5 days after SCI. Further, the decrease of myelin basic protein, myelin loss, and axon loss in white matter was also significantly blocked by fluoxetine, as compared to vehicle control. These results suggest that fluoxetine inhibits oligodendrocyte cell death by inhibiting microglia activation and p38-MAPK activation, followed by pro-NGF production after SCI, and provide a potential usage of fluoxetine for a therapeutic agent after acute SCI in humans.
Collapse
Affiliation(s)
- Jee Y Lee
- 1 Age-Related and Brain Diseases Research Center, Kyung Hee University , Seoul, Korea
| | | | | |
Collapse
|
120
|
Su F, Yi H, Xu L, Zhang Z. Fluoxetine and S-citalopram inhibit M1 activation and promote M2 activation of microglia in vitro. Neuroscience 2015; 294:60-8. [PMID: 25711936 DOI: 10.1016/j.neuroscience.2015.02.028] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 12/27/2022]
Abstract
Increasing evidence has suggested that microglia dysfunction plays an important role in the pathogenesis of depression. Both classical activation (M1 activation) and alternative activation (M2 activation) may be involved in the process. M1-activated microglia secrete various pro-inflammatory cytokines and neurotoxic mediators, which may contribute to the development of depression, while M2-activated microglia promote tissue reconstruction by releasing anti-inflammatory cytokines involved in the process of depression. Selective serotonin reuptake inhibitors (SSRIs) are first-line treatments for depression, and their effects on immune system modulation have recently gained attention. Several studies have suggested that SSRIs affect the M1 activation of microglia, but results have varied. In addition, little is known about the effect of SSRIs on M2 activation in depression. The aim of this study was to investigate the effects of fluoxetine and S-citalopram, two widely used SSRIs in clinical, on both the M1 and M2 activation of microglia (the murine BV2 cell line and mouse primary microglia cell). The indexes of activation were measured by real-time polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA) and Western blot. The present results showed that both fluoxetine and S-citalopram significantly down-regulated the indexes of M1 activation and up-regulated the M2 activation indexes on mRNA and protein levels either in cell line or primary cells. Taken together, the results suggested that fluoxetine and S-citalopram modulated the immune system by inhibiting M1 activation and by improving M2 activation of microglia and that the immune system modulation may partially mediate the therapeutic effects of antidepressant drugs-SSRIs.
Collapse
Affiliation(s)
- F Su
- The Department of Neurology of Affiliated ZhongDa Hospital, The Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing, China
| | - H Yi
- The Department of Neurology of Affiliated ZhongDa Hospital, The Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing, China
| | - L Xu
- Laboratory of Learning and Memory, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Z Zhang
- The Department of Neurology of Affiliated ZhongDa Hospital, The Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing, China.
| |
Collapse
|
121
|
The influence of microglia activation on the efficacy of amitriptyline, doxepin, milnacipran, venlafaxine and fluoxetine in a rat model of neuropathic pain. Eur J Pharmacol 2015; 749:115-23. [DOI: 10.1016/j.ejphar.2014.11.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 11/12/2014] [Accepted: 11/17/2014] [Indexed: 01/18/2023]
|
122
|
Norden DM, Devine R, Bicer S, Jing R, Reiser PJ, Wold LE, Godbout JP, McCarthy DO. Fluoxetine prevents the development of depressive-like behavior in a mouse model of cancer related fatigue. Physiol Behav 2014; 140:230-5. [PMID: 25554480 DOI: 10.1016/j.physbeh.2014.12.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 12/16/2014] [Accepted: 12/22/2014] [Indexed: 02/06/2023]
Abstract
Cancer patients frequently suffer from fatigue, a complex syndrome associated with tiredness and depressed mood. Cancer-related fatigue (CRF) can be present at the time of diagnosis, escalates during treatment, and can persist for years after treatment. CRF negatively influences quality of life, limits functional independence, and is associated with decreased survival in patients with incurable disease. We have previously shown that increased pro-inflammatory cytokine expression in the brain contributes to depressive- and fatigue-like behaviors in a mouse model of CRF. Inflammatory cytokines increase the activity of indoleamine 2,3-dioxygenase (IDO) and kynurenine 3-monooxygenase (KMO), which competitively reduce serotonin synthesis. Reduced serotonin availability in the brain and increased production of alternative neuroactive metabolites of tryptophan are thought to contribute to the development of depression and fatigue. The purpose of this study was to determine the effects of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), on brain cytokines and behavioral measures of fatigue and depression in tumor-bearing mice. Here we show that tumor growth increased brain expression of pro-inflammatory cytokines and KMO. Treatment with fluoxetine had no effect on tumor growth, muscle wasting, fatigue behavior, or cytokine expression in the brain. Fluoxetine, however, reduced depressive-like behaviors in tumor bearing mice. In conclusion, our data confirm that increased brain expression of pro-inflammatory cytokines is associated with tumor-induced fatigue- and depressive-like behaviors. However, it is possible to separate the effects of tumor growth on mood and fatigue-like behaviors using SSRIs such as fluoxetine.
Collapse
Affiliation(s)
- Diana M Norden
- Department of Neuroscience, The Ohio State University, 333 W. 10th Ave., Columbus, OH, United States
| | - Raymond Devine
- Department of Physiology and Cell Biology, 370 W. 9th Ave., The Ohio State University, Columbus, OH, United States
| | - Sabahattin Bicer
- Division of Biosciences, College of Dentistry, The Ohio State University, 305 W. 12th Ave., Columbus, OH, United States
| | - Runfeng Jing
- College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, United States
| | - Peter J Reiser
- Division of Biosciences, College of Dentistry, The Ohio State University, 305 W. 12th Ave., Columbus, OH, United States
| | - Loren E Wold
- Department of Physiology and Cell Biology, 370 W. 9th Ave., The Ohio State University, Columbus, OH, United States; College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, United States
| | - Jonathan P Godbout
- Department of Neuroscience, The Ohio State University, 333 W. 10th Ave., Columbus, OH, United States; Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Dr. Columbus, OH, United States
| | - Donna O McCarthy
- College of Nursing, Marquette University Milwaukee, WI, United States.
| |
Collapse
|
123
|
|
124
|
Chollet F, Tardy J, Albucher JF, Raposo N, Acket B, Sattler V, Pariente J, Loubinoux I. Monoaminergic drugs for motor recovery after ischemic stroke. Ann Phys Rehabil Med 2014; 57:509-519. [DOI: 10.1016/j.rehab.2014.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 08/06/2014] [Indexed: 11/26/2022]
|
125
|
Aksu U, Guner I, Yaman OM, Erman H, Uzun D, Sengezer-Inceli M, Sahin A, Yelmen N, Gelisgen R, Uzun H, Sahin G. Fluoxetine ameliorates imbalance of redox homeostasis and inflammation in an acute kidney injury model. J Physiol Biochem 2014; 70:925-34. [PMID: 25270428 DOI: 10.1007/s13105-014-0361-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/22/2014] [Indexed: 10/24/2022]
Abstract
Ischemia-reperfusion (IR) has been reported to be associated with augmented reactive oxygen radicals and cytokines. Currently, we aimed to examine the influence of fluoxetine, which is already used as a preoperative anxiolytic, in the context of IR induced by occlusion of infrarenal abdominal aorta (60 min of ischemia) and its effects on renal oxidative status, inflammation, renal function, and cellular integrity in reperfusion (120 min post-ischemia). Male rats were randomly assigned as control, IR, and pretreated groups. The pretreated group animals received fluoxetine (20 mg/kg, i.p.) once daily for 3 days. Renal tissue oxidative stress, myeloperoxidase activity, proinflammatory cytokines (tumor necrosis factor-α, interleukin-1β, interleukin-6), histology, and function were assessed. As an anti-inflammatory cytokine, interleukin-10 was also assessed. IR led to a significant increase in lipid hydroperoxide, malondialdehyde, and pro-oxidant antioxidant balance and decrease in superoxide dismutase activity and ferric reducing/antioxidant power level (p < 0.05), but fluoxetine was able to restore these parameters. High concentrations of tumor necrosis factor-α, interleukin-1β, interleukin-6, and myeloperoxidase activity caused by IR were significantly decreased in kidney tissue with fluoxetine. In addition, interleukin-10 levels were high in fluoxetine pretreated group. IR resulted in disrupted cellular integrity, infiltration of tissue with leukocytes, and decreased serum creatinine-urea levels (p < 0.05). Fluoxetine significantly restored impaired redox balance and inflammation parameters of rats subjected to IR to baseline values. This beneficial effect of fluoxetine on redox balance might be addressed to an improvement in renal function.
Collapse
Affiliation(s)
- Ugur Aksu
- Department of Biology, Science Faculty, Istanbul University, Istanbul, Turkey
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
126
|
Zarei G, Reisi P, Alaei H, Javanmard SH. Effects of amitriptyline and fluoxetine on synaptic plasticity in the dentate gyrus of hippocampal formation in rats. Adv Biomed Res 2014; 3:199. [PMID: 25337529 PMCID: PMC4202498 DOI: 10.4103/2277-9175.142044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 05/01/2013] [Indexed: 12/03/2022] Open
Abstract
Background: Several studies have been shown that antidepressant drugs have contradictory effects on cognitive processes. Therefore, the aim of this study was to investigate the effects of amitriptyline and fluoxetine on synaptic plasticity in the dentate gyrus (DG) of the hippocampal formation in rat. Materials and Methods: Experimental groups were the control, the fluoxetine, and amitriptyline. The rats were treated for 21 days and then, paired pulse facilitation/inhibition (PPF/I) and long-term potentiation (LTP) in perforant path-DG synapses were assessed (by 400 Hz tetanization). Field excitatory post-synaptic potential (fEPSP) slope and population spike (PS) amplitude were measured. Results: The results of PPF/I showed that PS amplitude ratios were increased in 10-70 ms inter-stimulus intervals in the amitriptyline group compared to the control group. In the fluoxetine group, EPSP slope ratios were decreased in intervals 30, 40, and 50 ms inter-stimulus intervals compared to the control group. The PS-LTP was significantly lower in the fluoxetine and the amitriptyline groups with respect to the control group. Conclusion: The results showed that fluoxetine and amitriptyline affect synaptic plasticity in the hippocampus and these effects is probably due to the impact on the number of active neurons.
Collapse
Affiliation(s)
- Ghasem Zarei
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parham Reisi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran ; Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Biosensor Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hojjatallah Alaei
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh Haghjooye Javanmard
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran ; Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
127
|
Meulendyke KA, Queen SE, Engle EL, Shirk EN, Liu J, Steiner JP, Nath A, Tarwater PM, Graham DR, Mankowski JL, Zink MC. Combination fluconazole/paroxetine treatment is neuroprotective despite ongoing neuroinflammation and viral replication in an SIV model of HIV neurological disease. J Neurovirol 2014; 20:591-602. [PMID: 25227932 DOI: 10.1007/s13365-014-0283-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 08/14/2014] [Indexed: 12/20/2022]
Abstract
Effective combined antiretroviral therapy (cART) in HIV-infected patients has made HIV a treatable infection; however, debilitating HIV-associated neurocognitive disorders (HAND) can still affect approximately 50% of HIV-infected individuals even under cART. While cART has greatly reduced the prevalence of the most severe form of HAND, milder forms have increased in prevalence, leaving the total proportion of HIV-infected individuals suffering from HAND relatively unchanged. In this study, an in vitro drug screen identified fluconazole and paroxetine as protective compounds against HIV gp120 and Tat neurotoxicity. Using an accelerated, consistent SIV/macaque model of HIV-associated CNS disease, we tested the in vivo neuroprotective capabilities of combination fluconazole/paroxetine (FluPar) treatment. FluPar treatment protected macaques from SIV-induced neurodegeneration, as measured by neurofilament light chain in the CSF, APP accumulation in axons, and CaMKIIα in the frontal cortex, but did not significantly reduce markers of neuroinflammation or plasma or CNS viral loads. Since HIV and SIV neurodegeneration is often attributed to accompanying neuroinflammation, this study provides proof of concept that neuroprotection can be achieved even in the face of ongoing neuroinflammation and viral replication.
Collapse
Affiliation(s)
- Kelly A Meulendyke
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, 733 North Broadway Street, MRB 819, Baltimore, MD, 21205, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
128
|
McCann SK, Irvine C, Mead GE, Sena ES, Currie GL, Egan KE, Macleod MR, Howells DW. Efficacy of antidepressants in animal models of ischemic stroke: a systematic review and meta-analysis. Stroke 2014; 45:3055-63. [PMID: 25184357 DOI: 10.1161/strokeaha.114.006304] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND PURPOSE Poststroke depression is a prevalent complication of stroke with unclear pathogenesis. The benefits of antidepressants in this context and their effects on stroke recovery other than effects on mood are not clearly defined, with some studies suggesting efficacy in improving functional outcome in both depressed and nondepressed stroke patients. We have analyzed the preclinical animal data on antidepressant treatment in focal cerebral ischemia, modeled±depression, to help inform clinical trial design. METHODS We performed a systematic review and meta-analysis of data from experiments testing the efficacy of antidepressants versus no treatment to reduce infarct volume or improve neurobehavioral or neurogenesis outcomes in animal models of stroke. We used random-effects metaregression to test the impact of study quality and design characteristics and used trim and fill to assess publication bias. RESULTS We identified 44 publications describing the effects of 22 antidepressant drugs. The median quality checklist score was 5 of a possible 10 (interquartile range, 4-7). Overall, antidepressants reduced infarct volume by 27.3% (95% confidence interval, 20.7%-33.8%) and improved neurobehavioral outcomes by 53.7% (46.4%-61.1%). There was little evidence for an effect of selective serotonin reuptake inhibitors on infarct volume. For neurobehavioral outcomes there was evidence of publication bias. Selective serotonin reuptake inhibitors were the most frequently studied antidepressant subtype and improved neurobehavioral outcome by 51.8% (38.6%-64.9%) and increased neurogenesis by 2.2 SD (1.3-3.0). CONCLUSIONS In line with current clinical data and despite some limitations, antidepressant treatments seem to improve infarct volume and neurobehavioral outcome in animal models of ischemic stroke.
Collapse
Affiliation(s)
- Sarah K McCann
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Cadi Irvine
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Gillian E Mead
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Emily S Sena
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Gillian L Currie
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Kieren E Egan
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| | - Malcolm R Macleod
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M).
| | - David W Howells
- From The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (S.K.M., E.S.S., D.W.H.); and Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (C.I., G.E.M., E.S.S., G.L.C., K.E.E., M.R.M)
| |
Collapse
|
129
|
Sacchetti M, Della Marca G. Are stroke cases affected by sleep disordered breathings all the same? Med Hypotheses 2014; 83:217-23. [DOI: 10.1016/j.mehy.2014.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/10/2014] [Accepted: 04/16/2014] [Indexed: 01/14/2023]
|
130
|
Kronenberg G, Gertz K, Heinz A, Endres M. Of mice and men: modelling post-stroke depression experimentally. Br J Pharmacol 2014; 171:4673-89. [PMID: 24838087 DOI: 10.1111/bph.12775] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/21/2014] [Accepted: 05/04/2014] [Indexed: 12/14/2022] Open
Abstract
At least one-third of stroke survivors suffer from depression. The development of comorbid depression after stroke is clinically highly significant because post-stroke depression is associated with increased mortality, slows recovery and leads to worse functional outcomes. Here, we review the evidence that post-stroke depression can be effectively modelled in experimental rodents via a variety of approaches. This opens an exciting new window onto the neurobiology of depression and permits probing potential underlying mechanisms such as disturbed cellular plasticity, neuroendocrine dysregulation, neuroinflammation, and neurodegeneration in a novel context. From the point of view of translational stroke research, extending the scope of experimental investigations beyond the study of short-term end points and, in particular, acute lesion size, may help improve the relevance of preclinical results to human disease. Furthermore, accumulating evidence from both clinical and experimental studies offers the tantalizing prospect of 5-hydroxytryptaminergic antidepressants as the first pharmacological therapy for stroke that would be available during the subacute and chronic phases of recovery. Interdisciplinary neuropsychiatric research will be called on to dissect the mechanisms underpinning the beneficial effects of antidepressants on stroke recovery.
Collapse
Affiliation(s)
- G Kronenberg
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Berlin, Germany; Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | |
Collapse
|
131
|
Yang JM, Rui BB, Chen C, Chen H, Xu TJ, Xu WP, Wei W. Acetylsalicylic acid enhances the anti-inflammatory effect of fluoxetine through inhibition of NF-κB, p38-MAPK and ERK1/2 activation in lipopolysaccharide-induced BV-2 microglia cells. Neuroscience 2014; 275:296-304. [PMID: 24952332 DOI: 10.1016/j.neuroscience.2014.06.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 01/08/2023]
Abstract
The latest advancements in neurobiological research provide increasing evidence that inflammatory and neurodegenerative pathways play an important role in depression. According to the cytokine hypothesis, depression could be due to the increased production of pro-inflammatory cytokines by microglia activation. Thus, using the BV-2 microglial cell line, the aim of the present study was to investigate whether fluoxetine (FLX) or acetylsalicylic acid (ASA) could inhibit this microglia activation and could achieve better results in combination. Our results showed that FLX could attenuate lipopolysaccharide (LPS)-induced production of interleukin-1β (IL-1β), the expression of the indoleamine 2,3 dioxygenase (IDO) enzyme and the depletion of 5-HT. Moreover, FLX could inhibit phosphorylation of nuclear factor-κB (NF-κB) and phosphorylation of p38 mitogen-activated protein kinase (MAPK), and the combined use with ASA could enhance these effects. Notably, the adjunctive agent ASA could also inhibit phosphorylation of extracellular-regulated kinase 1/2 (ERK1/2). Taken together, our results suggest that FLX may have some anti-inflammatory effects by modulating microglia activation and that ASA served as an effective adjunctive agent by enhancing these therapeutic effects.
Collapse
Affiliation(s)
- J M Yang
- Anhui Provincial Cancer Hospital, Hefei, Anhui Province, China
| | - B B Rui
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine of China Education Ministry, Hefei, Anhui Province, China
| | - C Chen
- High Magnetic Field Laboratory, Chinese Academy of Sciences, Hefei, Anhui Province, China
| | - H Chen
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine of China Education Ministry, Hefei, Anhui Province, China
| | - T J Xu
- Anhui Provincial Hospital, Hefei, Anhui Province, China
| | - W P Xu
- Anhui Provincial Hospital, Hefei, Anhui Province, China.
| | - W Wei
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine of China Education Ministry, Hefei, Anhui Province, China.
| |
Collapse
|
132
|
Karaoulanis SE, Rizouli KA, Rizoulis AA, Angelopoulos NV. Lack of association of acute phase response proteins with hormone levels and antidepressant medication in perimenopausal depression. BMC Psychiatry 2014; 14:164. [PMID: 24894416 PMCID: PMC4084572 DOI: 10.1186/1471-244x-14-164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 05/19/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Major depression is associated with higher plasma levels of positive acute-phase proteins, as well as with lower plasma levels of negative acute-phase proteins. The aim of this study is to examine the levels of acute-phase response proteins and whether these levels are influenced by reproductive hormones and antidepressant medication in the perimenopausal depression. METHODS Sixty-five women (age range: 40-58 years old) participated in this study. All women were in the perimenopausal phase. The diagnosis of depression was made through a psychiatric interview and with the aid of Hamilton Depression Rating Scale 17 (HAM-D 17). The acute-phase response proteins, such as haptoglobin (HP), transferrine (TRf), α1-antitrypsin, complement protein 3 (C3), complement protein 4 (C4) and C-reactive protein (CRP) and the reproductive hormones, for example follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), were analyzed using standard laboratory methods. Pearson's correlations were applied to evaluate the relationship between acute-phase proteins and hormones. RESULTS Perimenopausal women were divided into three groups. The first group consisted of normal controls, the second one involved depressed perimenopausal women, who were taking selective serotonin reuptake inhibitors (SSRIs), and the third one included depressed women that were not treated with SSRIs. Depressed women in perimenopause, when being compared to non-depressed women, did not differ as to serum levels of acute-phase proteins. There was a positive correlation between HP and E2 in depressed perimenopausal women, who were not taking SSRIs. CONCLUSIONS The lack of association between acute-phase proteins and depressive mood mentioned in this study does not support previous findings in patients with major depression. This negative finding in perimenopausal depression indicates either the absence or a more complex nature of the interactions between acute-phase proteins, low-grade inflammation and depression. The hormonal profile of women is a part of this complexity, because it seems that in perimenopause the hormonal changes are accompanied by changes of acute-phase response proteins. Particularly, in perimenopausal depression, there is an interaction between HP and E2. Therefore, it seems that perimenopause is a period of a woman's life during which hormonal, immune and metabolic changes occur and interact with each other making women vulnerable to depression.
Collapse
Affiliation(s)
- Sokratis E Karaoulanis
- Department of Psychiatry, University Hospital of Larissa, University of Thessalia, Mezourlo, Larissa, P,O, Box 41110, Greece.
| | - Katerina A Rizouli
- Department of Immunology, University Hospital of Larissa, University of Thessalia, Larissa, Greece
| | - Andreas A Rizoulis
- Department of Endocrinology, University Hospital of Larissa, University of Thessalia, Larissa, Greece
| | - Nikiforos V Angelopoulos
- Department of Psychiatry, University Hospital of Larissa, University of Thessalia, Mezourlo, Larissa, P.O. Box 41110, Greece
| |
Collapse
|
133
|
Guner I, Yaman MO, Aksu U, Uzun D, Erman H, Inceli M, Gelisgen R, Yelmen N, Uzun H, Sahin G. The effect of fluoxetine on ischemia–reperfusion after aortic surgery in a rat model. J Surg Res 2014; 189:96-105. [DOI: 10.1016/j.jss.2014.02.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 01/22/2014] [Accepted: 02/19/2014] [Indexed: 01/07/2023]
|
134
|
Hellmann-Regen J, Regen F, Heuser I, Endres M, Otte C. Diagnostik und Therapie der Post-Stroke-Depression. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s15202-014-0753-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
135
|
Mangus DB, Huang L, Applegate PM, Gatling JW, Zhang J, Applegate RL. A systematic review of neuroprotective strategies after cardiac arrest: from bench to bedside (Part I - Protection via specific pathways). Med Gas Res 2014; 4:9. [PMID: 24808942 PMCID: PMC4012247 DOI: 10.1186/2045-9912-4-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 03/25/2014] [Indexed: 01/04/2023] Open
Abstract
Neurocognitive deficits are a major source of morbidity in survivors of cardiac arrest. Treatment options that could be implemented either during cardiopulmonary resuscitation or after return of spontaneous circulation to improve these neurological deficits are limited. We conducted a literature review of treatment protocols designed to evaluate neurologic outcome and survival following cardiac arrest with associated global cerebral ischemia. The search was limited to investigational therapies that were utilized to treat global cerebral ischemia associated with cardiac arrest. In this review we discuss potential mechanisms of neurologic protection following cardiac arrest including actions of several medical gases such as xenon, argon, and nitric oxide. The 3 included mechanisms are: 1. Modulation of neuronal cell death; 2. Alteration of oxygen free radicals; and 3. Improving cerebral hemodynamics. Only a few approaches have been evaluated in limited fashion in cardiac arrest patients and results show inconclusive neuroprotective effects. Future research focusing on combined neuroprotective strategies that target multiple pathways are compelling in the setting of global brain ischemia resulting from cardiac arrest.
Collapse
Affiliation(s)
- Dustin B Mangus
- Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda University Medical Center, Room 2532, 11234 Anderson Street, Loma Linda, CA 92354, USA
| | - Lei Huang
- Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda University Medical Center, Room 2532, 11234 Anderson Street, Loma Linda, CA 92354, USA ; Department of Basic Sciences, Division of Physiology, Loma Linda University School of Medicine, 11041 Campus Street, Loma Linda, CA, USA
| | - Patricia M Applegate
- Department of Cardiology, Loma Linda University School of Medicine, 11201 Benton St, Loma Linda, CA 92354, USA
| | - Jason W Gatling
- Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda University Medical Center, Room 2532, 11234 Anderson Street, Loma Linda, CA 92354, USA
| | - John Zhang
- Department of Basic Sciences, Division of Physiology, Loma Linda University School of Medicine, 11041 Campus Street, Loma Linda, CA, USA ; Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda University Medical Center, Room 2532, 11234 Anderson Street, Loma Linda, CA 92354, USA ; Department of Neurosurgery, Loma Linda University School of Medicine, 11041 Campus Street, Loma Linda, CA 92354, USA
| | - Richard L Applegate
- Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda University Medical Center, Room 2532, 11234 Anderson Street, Loma Linda, CA 92354, USA
| |
Collapse
|
136
|
Lee JY, Lee HE, Kang SR, Choi HY, Ryu JH, Yune TY. Fluoxetine inhibits transient global ischemia-induced hippocampal neuronal death and memory impairment by preventing blood–brain barrier disruption. Neuropharmacology 2014; 79:161-71. [DOI: 10.1016/j.neuropharm.2013.11.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 11/06/2013] [Accepted: 11/18/2013] [Indexed: 12/19/2022]
|
137
|
Obuchowicz E, Bielecka AM, Paul-Samojedny M, Pudełko A, Kowalski J. Imipramine and fluoxetine inhibit LPS-induced activation and affect morphology of microglial cells in the rat glial culture. Pharmacol Rep 2014; 66:34-43. [DOI: 10.1016/j.pharep.2013.08.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 06/28/2013] [Accepted: 08/02/2013] [Indexed: 01/22/2023]
|
138
|
Valera E, Ubhi K, Mante M, Rockenstein E, Masliah E. Antidepressants reduce neuroinflammatory responses and astroglial alpha-synuclein accumulation in a transgenic mouse model of multiple system atrophy. Glia 2013; 62:317-37. [PMID: 24310907 DOI: 10.1002/glia.22610] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 11/01/2013] [Accepted: 11/14/2013] [Indexed: 12/13/2022]
Abstract
Multiple system atrophy (MSA) is a neurodegenerative disease characterized by the pathological accumulation of alpha-synuclein (α-syn) within oligodendroglial cells. This accumulation is accompanied by neuroinflammation with astrogliosis and microgliosis, that leads to neuronal death and subsequent parkinsonism and dysautonomia. Antidepressants have been explored as neuroprotective agents as they normalize neurotrophic factor levels, increase neurogenesis and reduce neurodegeneration, but their anti-inflammatory properties have not been fully characterized. We analyzed the anti-inflammatory profiles of three different antidepressants (fluoxetine, olanzapine and amitriptyline) in the MBP1-hα-syn transgenic (tg) mouse model of MSA. We observed that antidepressant treatment decreased the number of α-syn-positive cells in the basal ganglia of 11-month-old tg animals. This reduction was accompanied with a similar decrease in the colocalization of α-syn with astrocyte markers in this brain structure. Consistent with these results, antidepressants reduced astrogliosis in the hippocampus and basal ganglia of the MBP1-hα-syn tg mice, and modulated the expression levels of key cytokines that were dysregulated in the tg mouse model, such as IL-1β. In vitro experiments in the astroglial cell line C6 confirmed that antidepressants inhibited NF-κB translocation to the nucleus and reduced IL-1β protein levels. We conclude that the anti-inflammatory properties of antidepressants in the MBP1-hα-syn tg mouse model of MSA might be related to their ability to inhibit α-syn propagation from oligodendrocytes to astroglia and to regulate transcription factors involved in cytokine expression. Our results suggest that antidepressants might be of interest as anti-inflammatory and α-syn-reducing agents for MSA and other α-synucleinopathies.
Collapse
Affiliation(s)
- Elvira Valera
- Department of Neurosciences, University of California, San Diego, La Jolla, California
| | | | | | | | | |
Collapse
|
139
|
ROS and brain diseases: the good, the bad, and the ugly. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:963520. [PMID: 24381719 PMCID: PMC3871919 DOI: 10.1155/2013/963520] [Citation(s) in RCA: 243] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/04/2013] [Accepted: 11/05/2013] [Indexed: 12/31/2022]
Abstract
The brain is a major metabolizer of oxygen and yet has relatively feeble protective antioxidant mechanisms. This paper reviews the Janus-faced properties of reactive oxygen species. It will describe the positive aspects of moderately induced ROS but it will also outline recent research findings concerning the impact of oxidative and nitrooxidative stress on neuronal structure and function in neuropsychiatric diseases, including major depression. A common denominator of all neuropsychiatric diseases including schizophrenia and ADHD is an increased inflammatory response of the brain caused either by an exposure to proinflammatory agents during development or an accumulation of degenerated neurons, oxidized proteins, glycated products, or lipid peroxidation in the adult brain. Therefore, modulation of the prooxidant-antioxidant balance provides a therapeutic option which can be used to improve neuroprotection in response to oxidative stress. We also discuss the neuroprotective role of the nuclear factor erythroid 2-related factor (Nrf2) in the aged brain in response to oxidative stressors and nanoparticle-mediated delivery of ROS-scavenging drugs. The antioxidant therapy is a novel therapeutic strategy. However, the available drugs have pleiotropic actions and are not fully characterized in the clinic. Additional clinical trials are needed to assess the risks and benefits of antioxidant therapies for neuropsychiatric disorders.
Collapse
|
140
|
Martín A, Szczupak B, Gómez-Vallejo V, Plaza S, Padró D, Cano A, Llop J. PET imaging of serotoninergic neurotransmission with [(11)C]DASB and [(18)F]altanserin after focal cerebral ischemia in rats. J Cereb Blood Flow Metab 2013; 33:1967-75. [PMID: 23982048 PMCID: PMC3851906 DOI: 10.1038/jcbfm.2013.156] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 08/02/2013] [Accepted: 08/05/2013] [Indexed: 11/09/2022]
Abstract
The use of selective serotonin reuptake inhibitors has shown functional improvement after stroke. Despite this, the role of serotoninergic neurotransmission after cerebral ischemia evolution and its involvement in functional recovery processes are still largely unknown. For this purpose, we performed in parallel in vivo magnetic resonance imaging and positron emission tomography (PET) with [(11)C]DASB and [(18)F]altanserin at 1, 3, 7, 14, 21, and 28 days after middle cerebral artery occlusion (MCAO) in rats. In the ischemic territory, PET with [(11)C]DASB and [(18)F]altanserin showed a dramatic decline in serotonin transporter (SERT) and 5-HT2A binding potential in the cortex and striatum after cerebral ischemia. Interestingly, a slight increase in [(11)C]DASB binding was observed from days 7 to 21 followed by the uppermost binding at day 28 in the ipsilateral midbrain. In contrast, no changes were observed in the contralateral hemisphere by using both radiotracers. Likewise, both functional and behavior testing showed major impaired outcome at day 1 after ischemia onset followed by a recovery of the sensorimotor function and dexterity from day 21 to day 28 after cerebral ischemia. Taken together, these results might evidence that SERT changes in the midbrain could have a key role in the functional recovery process after cerebral ischemia.
Collapse
Affiliation(s)
- Abraham Martín
- Molecular Imaging Unit, CIC biomaGUNE, San Sebastian, Spain
| | | | | | | | | | | | | |
Collapse
|
141
|
Gharzi M, Dolatabadi HRD, Reisi P, Javanmard SH. Effects of different doses of doxepin on passive avoidance learning in rats. Adv Biomed Res 2013; 2:66. [PMID: 24223381 PMCID: PMC3814585 DOI: 10.4103/2277-9175.115823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 12/30/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Studies have shown that Doxepin has anti-inflammatory effects and reduces oxidative stress. Due to the fact that other tricyclic antidepressants have been shown to have neuroprotective effects, this study aimed to investigate the effects of different doses of doxepin on passive avoidance learning in rats. MATERIALS AND METHODS Old male Wistar rats were used in this study. Doxepin was administered intraperitoneally (1, 5 and 10 mg/kg) for 21 days. Passive avoidance learning test was used for evaluation of learning and memory. Rats received foot electrical shock on fifteen day, and step through latencies were evaluated one week after the electrical shock in retention phase. RESULTS Administration of Doxepin considerably increased the step through latencies in the rats that received the doses of 1 and 5 mg/kg (P < 0.05). However, in the dose of 10 mg/kg, there wasn't any significant change comparing to control group. CONCLUSION These results indicate that Doxepin has desirable effects on cognitive functions in low doses. Therefore, Doxepin can be considered as memory enhancers that understanding the underling mechanisms need further investigation.
Collapse
Affiliation(s)
- Mahsa Gharzi
- Applied Physiology Research Center, Isfahan, Iran
| | | | | | | |
Collapse
|
142
|
The effect of fluoxetine on progression in progressive multiple sclerosis: a double-blind, randomized, placebo-controlled trial. ISRN NEUROLOGY 2013; 2013:370943. [PMID: 23984093 PMCID: PMC3747490 DOI: 10.1155/2013/370943] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/16/2013] [Indexed: 01/22/2023]
Abstract
Preclinical studies suggest that fluoxetine may have neuroprotective properties. In this pilot study forty-two patients with secondary or primary progressive MS were randomized to receive fluoxetine 20 mg twice daily or placebo for 2 years. Every 3 months the Expanded Disability Status Scale (EDSS), 9-hole peg test (9-HPT) and ambulation index (AI) were assessed. Brain MRI scans, Multiple Sclerosis Functional Composite, Fatigue Impact Scale, Guy's neurological disability Scale and SF-36 were performed at baseline, year 1 and year 2. Seven out of 20 (35%) patients in the fluoxetine group and 7 out of 22 (32%) patients in the placebo group had sustained progression on the EDSS, 9-HPT, or AI at 2 years. No differences were identified between the 2 treatment groups with respect to secondary clinical outcomes and T2 lesion load, grey matter volume and white matter volume. An unanticipated low rate of disability progression in the placebo group decreased the statistical power. At least 200 patients would have been needed to detect a 50% treatment effect. This trial shows that fluoxetine was generally well tolerated, but no assumptions can be made about a possible treatment effect. An adequately powered controlled trial of fluoxetine in progressive MS is still warranted. This trial is registered with Current Controlled Trials ISRCTN38456328.
Collapse
|
143
|
Adams HP, Nudo RJ. Management of patients with stroke: is it time to expand treatment options? Ann Neurol 2013; 74:4-10. [PMID: 23720339 PMCID: PMC3962816 DOI: 10.1002/ana.23948] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 05/14/2013] [Accepted: 05/17/2013] [Indexed: 12/21/2022]
Abstract
Approximately 700,000 people in the United States have an ischemic stroke annually. Substantial research has tested therapies for the very early treatment of ischemic stroke but, to date, only intravenous thrombolysis and intra-arterial measures to restore perfusion have shown success. Despite a 15-year effort to increase the use of these therapies, only approximately 5% of patients with stroke are currently being treated. Although most patients with stroke have some neurological recovery, more than half of stroke survivors have residual impairments that lead to disability or long-term institutionalized care. Laboratory research has demonstrated several mechanisms that help the brain to recover after a stroke. New pharmacological and cell-based approaches that are known to promote brain plasticity are emerging from laboratory studies and may soon expand the window for stroke treatment to restore function. It is time to build on this knowledge and to translate the understanding of recovery after stroke into the clinical setting. Measures that might augment recovery should become a major focus of clinical research in stroke in the 21st century.
Collapse
Affiliation(s)
- Harold P. Adams
- Division of Cerebrovascular Diseases, Department of Neurology, UIHC Stroke Center, University of Iowa, Iowa City, Iowa
| | - Randolph J. Nudo
- Landon Center on Aging and Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| |
Collapse
|
144
|
Chollet F, Acket B, Raposo N, Albucher JF, Loubinoux I, Pariente J. Use of antidepressant medications to improve outcomes after stroke. Curr Neurol Neurosci Rep 2013; 13:318. [PMID: 23263791 DOI: 10.1007/s11910-012-0318-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Interest in the use of antidepressants after stroke has been renewed by better knowledge of poststroke depression, but mainly by the capacity of some of them to promote functional recovery of nondepressed subjects. Recombinant tissue plasminogen activator thrombolysis within the first few hours after the stroke is currently the only validated treatment able to improve the spontaneous--and most of the time incomplete--recovery of neurological functions after stroke. However, we have learned from research over the last decade, in part based on the considerable improvement of neuroimaging techniques, that spontaneous recovery of neurological functions is associated with a large intracerebral reorganization of the damaged human brain. The question of whether lesioned-brain plasticity can be modulated by external factors such as pharmacological antidepressant agents is now being addressed with the aim of improving recovery and reducing the final disability of patients. Poststroke depression is known to be frequent and deleterious for patient outcome. We review the interest in the use of antidepressants after stroke in classic but often neglected poststroke depression and we strongly underline the action of some antidepressants in promoting functional recovery of nondepressed patients after stroke.
Collapse
Affiliation(s)
- F Chollet
- Department of Neurology, Université Paul Sabatier, Purpan Hospital, Place Baylac, 31059, Toulouse, France.
| | | | | | | | | | | |
Collapse
|
145
|
Abstract
Adult neurogenesis in the hippocampal subgranular zone (SGZ) and the anterior subventricular zone (SVZ) is regulated by multiple factors, including neurotransmitters, hormones, stress, aging, voluntary exercise, environmental enrichment, learning, and ischemia. Chronic treatment with selective serotonin reuptake inhibitors (SSRIs) modulates adult neurogenesis in the SGZ, the neuronal area that is hypothesized to mediate the antidepressant effects of these substances. Layer 1 inhibitory neuron progenitor cells (L1-INP cells) were recently identified in the adult cortex, but it remains unclear what factors other than ischemia affect the neurogenesis of L1-INP cells. Here, we show that chronic treatment with an SSRI, fluoxetine (FLX), stimulated the neurogenesis of γ-aminobutyric acid (GABA)ergic interneurons from L1-INP cells in the cortex of adult mice. Immunofluorescence and genetic analyses revealed that FLX treatment increased the number of L1-INP cells in all examined cortical regions in a dose-dependent manner. Furthermore, enhanced Venus reporter expression driven by the synapsin I promoter demonstrated that GABAergic interneurons were derived from retrovirally labeled L1-INP cells. In order to assess if these new GABAergic interneurons possess physiological function, we examined their effect on apoptosis surrounding areas following ischemia. Intriguingly, the number of neurons expressing the apoptotic marker, active caspase-3, was significantly lower in adult mice pretreated with FLX. Our findings indicate that FLX stimulates the neurogenesis of cortical GABAergic interneurons, which might have, at least, some functions, including a suppressive effect on apoptosis induced by ischemia.
Collapse
|
146
|
Dodd S, Maes M, Anderson G, Dean OM, Moylan S, Berk M. Putative neuroprotective agents in neuropsychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2013. [PMID: 23178231 DOI: 10.1016/j.pnpbp.2012.11.007] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In many individuals with major neuropsychiatric disorders including depression, bipolar disorder and schizophrenia, their disease characteristics are consistent with a neuroprogressive illness. This includes progressive structural brain changes, cognitive and functional decline, poorer treatment response and an increasing vulnerability to relapse with chronicity. The underlying molecular mechanisms of neuroprogression are thought to include neurotrophins and regulation of neurogenesis and apoptosis, neurotransmitters, inflammatory, oxidative and nitrosative stress, mitochondrial dysfunction, cortisol and the hypothalamic-pituitary-adrenal axis, and epigenetic influences. Knowledge of the involvement of each of these pathways implies that specific agents that act on some or multiple of these pathways may thus block this cascade and have neuroprotective properties. This paper reviews the potential of the most promising of these agents, including lithium and other known psychotropics, aspirin, minocycline, statins, N-acetylcysteine, leptin and melatonin. These agents are putative neuroprotective agents for schizophrenia and mood disorders.
Collapse
Affiliation(s)
- Seetal Dodd
- School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
| | | | | | | | | | | |
Collapse
|
147
|
Loubinoux I, Kronenberg G, Endres M, Schumann-Bard P, Freret T, Filipkowski RK, Kaczmarek L, Popa-Wagner A. Post-stroke depression: mechanisms, translation and therapy. J Cell Mol Med 2013; 16:1961-9. [PMID: 22348642 PMCID: PMC3822966 DOI: 10.1111/j.1582-4934.2012.01555.x] [Citation(s) in RCA: 222] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The interaction between depression and stroke is highly complex. Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of stroke. Depression also negatively impacts stroke outcome with increased morbidity, mortality and poorer functional recovery. Antidepressants such as the commonly prescribed selective serotonin reuptake inhibitors improve stroke outcome, an effect that may extend far beyond depression, e.g., to motor recovery. The main biological theory of PSD is the amine hypothesis. Conceivably, ischaemic lesions interrupt the projections ascending from midbrain and brainstem, leading to a decreased bioavailability of the biogenic amines – serotonin (5HT), dopamine (DA) and norepinephrine (NE). Acetylcholine would also be involved. So far, preclinical and translational research on PSD is largely lacking. The implementation and characterization of suitable animal models is clearly a major prerequisite for deeper insights into the biological basis of post-stroke mood disturbances. Equally importantly, experimental models may also pave the way for the discovery of novel therapeutic targets. If we cannot prevent stroke, we shall try to limit its long-term consequences. This review therefore presents animal models of PSD and summarizes potential underlying mechanisms including genomic signatures, neurotransmitter and neurotrophin signalling, hippocampal neurogenesis, cellular plasticity in the ischaemic lesion, secondary degenerative changes, activation of the hypothalamo-pituitary-adrenal (HPA) axis and neuroinflammation. As stroke is a disease of the elderly, great clinical benefit may especially accrue from deciphering and targeting basic mechanisms underlying PSD in aged animals.
Collapse
Affiliation(s)
- Isabelle Loubinoux
- INSERM, Cerebral imaging and neurological handicaps UMR825, Toulouse, France
| | | | | | | | | | | | | | | |
Collapse
|
148
|
Wigmore P. The effect of systemic chemotherapy on neurogenesis, plasticity and memory. Curr Top Behav Neurosci 2013; 15:211-240. [PMID: 23239468 DOI: 10.1007/7854_2012_235] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Chemotherapy has been enormously successful in treating many forms of cancer and improving patient survival rates. With the increasing numbers of survivors, a number of cognitive side effects have become apparent. These have been called "chemobrain" or "chemofog" among patient groups, who describe the symptoms as a decline in memory, concentration and executive functions. Changes which, although subtle, can cause significant distress among patients and prevent a return to the quality of life experienced before treatment. This cognitive side effect of chemotherapy was not anticipated as it had been assumed that chemotherapy agents, administered systematically, could not cross the blood-brain barrier and that the brain was therefore protected from their action. It is now realised that low concentrations of many chemotherapy agents cross the blood-brain barrier and even those that are completely prevented from doing so, can induce the production of inflammatory cytokines in peripheral tissues which in turn can cross the blood-brain barrier and impact on the brain. A large number of patient studies have shown that cognitive decline is found in a proportion of patients treated with a variety of chemotherapy agents for different types of cancer. The deficits experienced by these patients can last for up to several years and have a deleterious effect on educational attainment and ability to return to work. Imaging studies of patients after systemic chemotherapy show that this treatment produces structural and functional changes in the brain some of which seem to persist even when the cognitive deficits have ceased. This suggests that, with time, brain plasticity may be able to compensate for the deleterious effects of chemotherapy treatment. A number of mechanisms have been suggested for the changes in brain structure and function found after chemotherapy. These include both central and peripheral inflammatory changes, demyelination of white matter tracts, a reduction in stem cell proliferation in both the hippocampal neurogenic region and by oligodendrocyte precursors as well as changes in hormonal or growth factor levels. A number of possible treatments have been suggested which range from pharmacological interventions to cognitive behavioural therapies. Some of these have only been tested in animal models while others have produced varying degrees of improvement in patient populations. Currently, there is no recognised treatment and a greater understanding of the causes of the cognitive decline experienced after chemotherapy will be key to finding ways of preventing or treating the effects of chemobrain.
Collapse
Affiliation(s)
- Peter Wigmore
- School of Biomedical Sciences, Queen's Medical Centre, Nottingham, NG7 2UH, UK,
| |
Collapse
|
149
|
Abstract
The evolution in the understanding of the neurobiology of most prevalent mental disorders such as major depressive disorder (MDD), bipolar disorder or schizophrenia has not gone hand in hand with the synthesis and clinical use of new drugs that would represent a therapeutic revolution such as that brought about by selective serotonin reuptake inhibitors (SSRIs) or atypical antipsychotics. Although scientists are still a long way from understanding its true aetiology, the neurobiological concept of depression has evolved from receptor regulation disorder, to a neurodegenerative disorder with a hippocampal volume decrease with the controversial reduction in neurotrophins such as BDNF, to current hypotheses that consider depression to be an inflammatory and neuroprogressive process. As regards antidepressants, although researchers are still far from knowing their true mechanism of action, they have gone from monoaminergic hypotheses, in which serotonin was the main protagonist, to emphasising the anti-inflammatory action of some of these drugs, or the participation of p11 protein in their mechanism of action.In the same way, according to the inflammatory hypothesis of depression, it has been proposed that some NSAIDS such as aspirin or drugs like simvastatin that have an anti-inflammatory action could be useful in some depressive patients. Despite the fact that there may be some data to support their clinical use, common sense and the evidence advise us to use already tested protocols and wait for the future to undertake new therapeutic strategies.
Collapse
Affiliation(s)
- Juan Gibert Rahola
- Department of Neurosciences, Faculty of Medicine, University of Cadiz, CIBER of Mental Health-CIBERSAM
| |
Collapse
|
150
|
Mead GE, Hsieh CF, Lee R, Kutlubaev MA, Claxton A, Hankey GJ, Hackett ML. Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. Cochrane Database Syst Rev 2012; 11:CD009286. [PMID: 23152272 PMCID: PMC6465036 DOI: 10.1002/14651858.cd009286.pub2] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Stroke is the major cause of adult disability. Selective serotonin reuptake inhibitors (SSRIs) have been used for many years to manage depression. Recently, small trials have demonstrated that SSRIs might improve recovery after stroke, even in people who are not depressed. Systematic reviews and meta-analyses are the least biased way to bring together data from several trials. Given the promising effect of SSRIs on stroke recovery seen in small trials, a systematic review and meta-analysis is needed. OBJECTIVES To determine whether SSRIs improve recovery after stroke, and whether treatment with SSRIs was associated with adverse effects. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (August 2011), Cochrane Depression Anxiety and Neurosis Group Trials Register (November 2011), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 8), MEDLINE (from 1948 to August 2011), EMBASE (from 1980 to August 2011), CINAHL (from 1982 to August 2011), AMED (Allied and Complementary Medicine) (from 1985 to August 2011), PsycINFO (from 1967 to August 2011) and PsycBITE (Pyschological Database for Brain Impairment Treatment Efficacy) (March 2012). To identify further published, unpublished and ongoing trials we searched trials registers, pharmaceutical websites, reference lists, contacted experts and performed citation tracking of included studies. SELECTION CRITERIA We included randomised controlled trials that recruited stroke survivors (ischaemic or haemorrhagic) at any time within the first year. The intervention was any SSRI, given at any dose, for any period. We excluded drugs with mixed pharmacological effects. The comparator was usual care or placebo. In order to be included, trials had to collect data on at least one of our primary (dependence and disability) or secondary (impairments, depression, anxiety, quality of life, fatigue, healthcare cost, death, adverse events and leaving the trial early) outcomes. DATA COLLECTION AND ANALYSIS We extracted data on demographics, type of stroke, time since stroke, our primary and secondary outcomes, and sources of bias. For trials in English, two review authors independently extracted data. For Chinese papers, one review author extracted data. We used standardised mean differences (SMD) to estimate treatment effects for continuous variables, and risk ratios (RR) for dichotomous effects, with their 95% confidence intervals (CIs). MAIN RESULTS We identified 56 completed trials of SSRI versus control, of which 52 trials (4059 participants) provided data for meta-analysis. There were statistically significant benefits of SSRI on both of the primary outcomes: RR for reducing dependency at the end of treatment was 0.81 (95% CI 0.68 to 0.97) based on one trial, and for disability score, the SMD was 0.91 (95% CI 0.60 to 1.22) (22 trials involving 1343 participants) with high heterogeneity between trials (I(2) = 87%; P < 0.0001). For neurological deficit, depression and anxiety, there were statistically significant benefits of SSRIs. For neurological deficit score, the SMD was -1.00 (95% CI -1.26 to -0.75) (29 trials involving 2011 participants) with high heterogeneity between trials (I(2) = 86%; P < 0.00001). For dichotomous depression scores, the RR was 0.43 (95% CI 0.24 to 0.77) (eight trials involving 771 participants) with high heterogeneity between trials (I(2) = 77%; P < 0.0001). For continuous depression scores, the SMD was -1.91 (95% CI -2.34 to -1.48) (39 trials involving 2728 participants) with high heterogeneity between trials (I(2) = 95%; P < 0.00001). For anxiety, the SMD was -0.77 (95% CI -1.52 to -0.02) (eight trials involving 413 participants) with high heterogeneity between trials (I(2) = 92%; P < 0.00001). There was no statistically significant benefit of SSRI on cognition, death, motor deficits and leaving the trial early. For cognition, the SMD was 0.32 (95% CI -0.23 to 0.86), (seven trials involving 425 participants) with high heterogeneity between trials (I(2) = 86%; P < 0.00001). The RR for death was 0.76 (95% CI 0.34 to 1.70) (46 trials involving 3344 participants) with no heterogeneity between trials (I(2) = 0%; P = 0.85). For motor deficits, the SMD was -0.33 (95% CI -1.22 to 0.56) (two trials involving 145 participants). The RR for leaving the trial early was 1.02 (95% CI 0.86 to 1.21) in favour of control, with no heterogeneity between trials. There was a non-significant excess of seizures (RR 2.67; 95% CI 0.61 to 11.63) (seven trials involving 444 participants), a non-significant excess of gastrointestinal side effects (RR 1.90; 95% CI 0.94 to 3.85) (14 trials involving 902 participants) and a non-significant excess of bleeding (RR 1.63; 95% CI 0.20 to 13.05) (two trials involving 249 participants) in those allocated SSRIs. Data were not available on quality of life, fatigue or healthcare costs.There was no clear evidence from subgroup analyses that one SSRI was consistently superior to another, or that time since stroke or depression at baseline had a major influence on effect sizes. Sensitivity analyses suggested that effect sizes were smaller when we excluded trials at high or unclear risk of bias.Only eight trials provided data on outcomes after treatment had been completed; the effect sizes were generally in favour of SSRIs but CIs were wide. AUTHORS' CONCLUSIONS SSRIs appeared to improve dependence, disability, neurological impairment, anxiety and depression after stroke, but there was heterogeneity between trials and methodological limitations in a substantial proportion of the trials. Large, well-designed trials are now needed to determine whether SSRIs should be given routinely to patients with stroke.
Collapse
Affiliation(s)
- Gillian E Mead
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | | | | | | | | | | | | |
Collapse
|