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Hurwitz T, Ching G, Bogod NM, Honey CR. Bilateral Anterior Capsulotomy for Treatment-Resistant Obsessive-Compulsive Disorder. Stereotact Funct Neurosurg 2024:1-15. [PMID: 39182480 DOI: 10.1159/000540503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/18/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION Ablative surgery is an intervention of last resort for treatment-resistant obsessive-compulsive disorder (TROCD). Our center has been using bilateral anterior capsulotomy (BAC) for the past 20 years for patients eligible for limbic surgery. This report details our experience with BAC for TROCD. METHOD Five patients with OCD met eligibility criteria for BAC. Entry protocols were complex and took around 6 months to complete. Stereotactic radiofrequency was used to produce the capsulotomies. Lesion length varied between 5.7 and 16.9 mm in the coronal plane. Patients were followed between 4 and 20 years. RESULTS All 5 patients (100%) were responders as defined by the widely accepted criteria of a reduction of ≥35% in Yale-Brown Obsessive Compulsive Scale (YBOCS) score at 18-month follow-up. Four patients remained responders at the 48 months. One patient was lost to follow-up. Responder status when viewed from the perspective of the YBOCS was sustained over the 4- to 20-year follow-up with one relapse 19 years postsurgery when medications were discontinued. Real-world psychiatric outcomes were different as other vulnerabilities surfaced illustrating the multifactorial determinants of mental health. No patient had any significant long-term neurocognitive or physical side effects. CONCLUSION BAC should remain an option of last resort for patients with severe OCD who remain unresponsive to all other interventions.
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Affiliation(s)
- Trevor Hurwitz
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Geoffrey Ching
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Mark Bogod
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher R Honey
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
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Zhang YD, Shi DD, Wang Z. Neurobiology of Obsessive-Compulsive Disorder from Genes to Circuits: Insights from Animal Models. Neurosci Bull 2024:10.1007/s12264-024-01252-9. [PMID: 38982026 DOI: 10.1007/s12264-024-01252-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/27/2024] [Indexed: 07/11/2024] Open
Abstract
Obsessive-compulsive disorder (OCD) is a chronic, severe psychiatric disorder that has been ranked by the World Health Organization as one of the leading causes of illness-related disability, and first-line interventions are limited in efficacy and have side-effect issues. However, the exact pathophysiology underlying this complex, heterogeneous disorder remains unknown. This scenario is now rapidly changing due to the advancement of powerful technologies that can be used to verify the function of the specific gene and dissect the neural circuits underlying the neurobiology of OCD in rodents. Genetic and circuit-specific manipulation in rodents has provided important insights into the neurobiology of OCD by identifying the molecular, cellular, and circuit events that induce OCD-like behaviors. This review will highlight recent progress specifically toward classic genetic animal models and advanced neural circuit findings, which provide theoretical evidence for targeted intervention on specific molecular, cellular, and neural circuit events.
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Affiliation(s)
- Ying-Dan Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Dong-Dong Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 201108, China.
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 201108, China.
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center, Shanghai, 200030, China.
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Li G, Lu C, Yin M, Wang P, Zhang P, Wu J, Wang W, Wang D, Wang M, Liu J, Lin X, Zhang JX, Wang Z, Yu Y, Zhang YF. Neural substrates for regulating self-grooming behavior in rodents. J Zhejiang Univ Sci B 2024:1-16. [PMID: 38993075 DOI: 10.1631/jzus.b2300562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/11/2023] [Indexed: 07/13/2024]
Abstract
Grooming, as an evolutionarily conserved repetitive behavior, is common in various animals, including humans, and serves essential functions including, but not limited to, hygiene maintenance, thermoregulation, de-arousal, stress reduction, and social behaviors. In rodents, grooming involves a patterned and sequenced structure, known as the syntactic chain with four phases that comprise repeated stereotyped movements happening in a cephalocaudal progression style, beginning from the nose to the face, to the head, and finally ending with body licking. The context-dependent occurrence of grooming behavior indicates its adaptive significance. This review briefly summarizes the neural substrates responsible for rodent grooming behavior and explores its relevance in rodent models of neuropsychiatric disorders and neurodegenerative diseases with aberrant grooming phenotypes. We further emphasize the utility of rodent grooming as a reliable measure of repetitive behavior in neuropsychiatric models, holding promise for translational psychiatry. Herein, we mainly focus on rodent self-grooming. Allogrooming (grooming being applied on one animal by its conspecifics via licking or carefully nibbling) and heterogrooming (a form of grooming behavior directing towards another animal, which occurs in other contexts, such as maternal, sexual, aggressive, or social behaviors) are not covered due to space constraints.
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Affiliation(s)
- Guanqing Li
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
- School of Life Sciences, Hebei University, Baoding 071002, China
| | - Chanyi Lu
- State Key Laboratory of Molecular Development Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Miaomiao Yin
- Department of Rehabilitation Medicine, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Peng Wang
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100101, China
| | - Pengbo Zhang
- Department of Gastrointestinal Surgery, the People's Hospital of Zhaoyuan City, Zhaoyuan 265400, China
| | - Jialiang Wu
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Wenqiang Wang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
- School of Life Sciences, Hebei University, Baoding 071002, China
| | - Ding Wang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Mengyue Wang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
- School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Jiahan Liu
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
- School of Life Sciences, Hebei University, Baoding 071002, China
| | - Xinghan Lin
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Jian-Xu Zhang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Zhenshan Wang
- School of Life Sciences, Hebei University, Baoding 071002, China.
| | - Yiqun Yu
- Department of Otolaryngology, Eye, Ear, Nose & Throat Hospital, Fudan University, Shanghai 200031, China. ,
- Ear, Nose & Throat Institute, Eye, Ear, Nose & Throat Hospital, Fudan University, Shanghai 200031, China. ,
- Clinical and Research Center for Olfactory Disorders, Eye, Ear, Nose & Throat Hospital, Fudan University, Shanghai 200031, China. ,
| | - Yun-Feng Zhang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China. ,
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China. ,
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Piantadosi SC, Manning EE, Chamberlain BL, Hyde J, LaPalombara Z, Bannon NM, Pierson JL, K Namboodiri VM, Ahmari SE. Hyperactivity of indirect pathway-projecting spiny projection neurons promotes compulsive behavior. Nat Commun 2024; 15:4434. [PMID: 38789416 PMCID: PMC11126597 DOI: 10.1038/s41467-024-48331-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Compulsive behaviors are a hallmark symptom of obsessive compulsive disorder (OCD). Striatal hyperactivity has been linked to compulsive behavior generation in correlative studies in humans and causal studies in rodents. However, the contribution of the two distinct striatal output populations to the generation and treatment of compulsive behavior is unknown. These populations of direct and indirect pathway-projecting spiny projection neurons (SPNs) have classically been thought to promote or suppress actions, respectively, leading to a long-held hypothesis that increased output of direct relative to indirect pathway promotes compulsive behavior. Contrary to this hypothesis, here we find that indirect pathway hyperactivity is associated with compulsive grooming in the Sapap3-knockout mouse model of OCD-relevant behavior. Furthermore, we show that suppression of indirect pathway activity using optogenetics or treatment with the first-line OCD pharmacotherapy fluoxetine is associated with reduced grooming in Sapap3-knockouts. Together, these findings highlight the striatal indirect pathway as a potential treatment target for compulsive behavior.
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Affiliation(s)
- Sean C Piantadosi
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Elizabeth E Manning
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Brittany L Chamberlain
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - James Hyde
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biology, Southern Arkansas University, Magnolia, AK, USA
| | - Zoe LaPalombara
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nicholas M Bannon
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jamie L Pierson
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Susanne E Ahmari
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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Chou T, Kochanowski BJ, Hayden A, Borron BM, Barbeiro MC, Xu J, Kim JW, Zhang X, Bouchard RR, Phan KL, Goodman WK, Dougherty DD. A Low-Intensity Transcranial Focused Ultrasound Parameter Exploration Study of the Ventral Capsule/Ventral Striatum. Neuromodulation 2024:S1094-7159(24)00067-9. [PMID: 38691076 DOI: 10.1016/j.neurom.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is effective for treatment-resistant obsessive-compulsive disorder (OCD); however, DBS is associated with neurosurgical risks. Transcranial focused ultrasound (tFUS) is a newer form of noninvasive (ie, nonsurgical) stimulation that can modulate deeper regions, such as the VC/VS. tFUS parameters have just begun to be studied and have often not been compared in the same participants. We explored the effects of three VC/VS tFUS protocols and an entorhinal cortex (ErC) tFUS session on the VC/VS and cortico-striato-thalamo-cortical circuit (CSTC) in healthy individuals for later application to patients with OCD. MATERIALS AND METHODS Twelve individuals participated in a total of 48 sessions of tFUS in this exploratory multisite, within-subject parameter study. We collected resting-state, reward task, and arterial spin-labeled (ASL) magnetic resonance imaging scans before and after ErC tFUS and three VC/VS tFUS sessions with different pulse repetition frequencies (PRFs), pulse widths (PWs), and duty cycles (DCs). RESULTS VC/VS protocol A (PRF = 10 Hz, PW = 5 ms, 5% DC) was associated with increased putamen activation during a reward task (p = 0.003), and increased VC/VS resting-state functional connectivity (rsFC) with the anterior cingulate cortex (p = 0.022) and orbitofrontal cortex (p = 0.004). VC/VS protocol C (PRF = 125 Hz, PW = 4 ms, 50% DC) was associated with decreased VC/VS rsFC with the putamen (p = 0.017), and increased VC/VS rsFC with the globus pallidus (p = 0.008). VC/VS protocol B (PRF = 125 Hz, PW = 0.4 ms, 5% DC) was not associated with changes in task-related CSTC activation or rsFC. None of the protocols affected CSTC ASL perfusion. CONCLUSIONS This study began to explore the multidimensional parameter space of an emerging form of noninvasive brain stimulation, tFUS. Our preliminary findings in a small sample suggest that VC/VS tFUS should continue to be investigated for future noninvasive treatment of OCD.
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Affiliation(s)
- Tina Chou
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA.
| | - Brian J Kochanowski
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Ashley Hayden
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Benjamin M Borron
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Miguel C Barbeiro
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Junqian Xu
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Joo-Won Kim
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Xuefeng Zhang
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Richard R Bouchard
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kinh Luan Phan
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA
| | - Wayne K Goodman
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
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Hurwitz TA, Avecillas-Chasin JM, Bogod NM, Honey CR. Ventral targeted anterior capsulotomy for treatment-resistant depression and obsessive-compulsive disorder: A treatment method with cases. J Affect Disord 2024; 350:887-894. [PMID: 38272366 DOI: 10.1016/j.jad.2024.01.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Ablative surgery using bilateral anterior capsulotomy (BAC) is an option for treatment resistant depression (TRD) and obsessive-compulsive disorder (TROCD). The location and extent of the lesion within anterior limb of the internal capsule (ALIC) remains uncertain. Accumulating evidence has suggested that the lesion should be located ventrally while limiting the dorsal extent. Our center is now targeting specific fiber tracts within the lower half of the ALIC. METHOD Presurgical diffusion tensor Magnetic Resonance Imaging (MRI) was used to identify individual fibre tracts within the ventral aspect of the ALIC in the last two patients who underwent BAC at our center. One patient had TRD and the other had both TROCD and TRD. Radiofrequency-induced thermal lesions were created in the identified targets with lesion volumes between 20 and 229 mm3 (average 95 mm3). FINDINGS Both patients were responders with neither experiencing significant side effects including compromised executive functions. LIMITATIONS The generalizability of our findings is limited because the outcome is based on two subjects. CONCLUSION This work suggests that BAC can be individually tailored and more limited to the ventral aspect of the ALIC and is effective and safe for TRD and TROCD. Accumulating data also suggests that to be clinically effective the length of the capsulotomy should be about 10mm. BAC's use may increase with the growing utilization and mastery of magnetic resonance guided focused ultrasound.
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Affiliation(s)
- Trevor A Hurwitz
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | | | - Nicholas M Bogod
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada.
| | - Christopher R Honey
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
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Kar SK, Agrawal A, Silva-Dos-Santos A, Gupta Y, Deng ZD. The Efficacy of Transcranial Magnetic Stimulation in the Treatment of Obsessive-Compulsive Disorder: An Umbrella Review of Meta-Analyses. CNS Spectr 2024; 29:109-118. [PMID: 38053347 DOI: 10.1017/s1092852923006387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) has been increasingly used for treating obsessive-compulsive disorder (OCD). Although several meta-analyses have explored its effectiveness and safety, there is no umbrella review specifically focused on rTMS for OCD. This umbrella review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and analyzed relevant meta-analyses on rTMS for OCD. METHODS Twenty-three articles were identified from PubMed, and after screening, 12 meta-analyses were included in the review. The studies analyzed in the meta-analyses ranged from 10 to 27, with total participants ranging from 282 to 791. The most commonly studied regions were the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and orbito-frontal cortex (OFC). RESULT The majority of the meta-analyses consistently supported the effectiveness of rTMS in reducing OCD symptoms when applied to the DLPFC and SMA. Encouraging results were also observed when targeting the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC) through deep transcranial magnetic stimulation (dTMS). However, there was a high level of heterogeneity in the findings of nine out of 12 meta-analyses. CONCLUSION In conclusion, existing evidence suggests that rTMS targeting the DLPFC and SMA consistently reduces OCD symptoms, but targeting the mPFC and ACC through dTMS shows variable results. However, the high heterogeneity in the study findings indicates a need for further research and standardization in the field.
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Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Aditya Agrawal
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Amílcar Silva-Dos-Santos
- Neuroscience Unit, CUF Tejo Hospital, Lisbon, Portugal
- Mental Health Department, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Department of Psychiatry, Universidade do Mindelo, Mindelo, Cape Verde
- Psychiatry Unit, Hospital de Cascais, Cascais, Portugal
| | - Yogesh Gupta
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Zhi-De Deng
- Computational Neurostimulation Research Program, Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Palmieri R, Albano V, Guerriero S, Craig F, La Torre F, Filoni S, Sardella D, Petruzzelli MG, Lecce P, De Giacomo A. Beyond Diagnosis: Preliminary Study of Impact on Children and Parents in Neurodevelopmental Disorders and Juvenile Idiopathic Arthritis-Associated Uveitis. Diagnostics (Basel) 2024; 14:275. [PMID: 38337791 PMCID: PMC10855410 DOI: 10.3390/diagnostics14030275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Chronic diseases are a growing problem for global health due to the large number of people they involve, the repercussions they have on the mental and physical well-being of those affected, and the costs to society. Particularly, chronic illnesses of childhood have important psychological implications, not only for affected children but also for their parents. Among these pathologies, neurodevelopmental disorders (NDDs) and uveitis associated with juvenile idiopathic arthritis (JIA-U) may affect mental and physical health, emotions, memory, learning, and socializing. This study evaluates the psychological and behavioral/emotional impact of NDDs and JIA-U on children and parents. Specifically, 30 children with active JIA-U and 30 children with NDDs and their parents completed the Child Behavior Checklist (CBCL) and Parent Stress Index-Short Form (PSI) questionnaires. Children with NDDs have statistically significant differences in all the emotional and behavioral variables compared to JIA-U children, and parents of children with NDDs experience an increased stress load compared to parents of children with JIA-U. This study emphasizes the wide range of emotional and behavioral challenges that parents face with NDDs. This study emphasizes that parents of children with NDDs not only experience higher levels of stress compared to parents of normally developing children but also experience higher levels of stress compared to parents of children with potentially debilitating chronic diseases such as JIA-U.
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Affiliation(s)
- Roberta Palmieri
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.S.); (M.G.P.); (P.L.); (A.D.G.)
| | - Valeria Albano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Institute of Ophthalmology, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy; (V.A.); (S.G.)
| | - Silvana Guerriero
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Institute of Ophthalmology, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy; (V.A.); (S.G.)
| | - Francesco Craig
- Department of Cultures, Education and Society (DICES), University of Calabria, 87036 Cosenza, Italy;
| | - Francesco La Torre
- Department of Pediatrics, Pediatric Rheumatology Center, “Giovanni XXIII”, Pediatric Hospital, Via Giovanni Amendola 207, 70126 Bari, Italy;
| | - Serena Filoni
- I.R.C.C.S. Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Dario Sardella
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.S.); (M.G.P.); (P.L.); (A.D.G.)
| | - Maria Giuseppina Petruzzelli
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.S.); (M.G.P.); (P.L.); (A.D.G.)
| | - Paola Lecce
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.S.); (M.G.P.); (P.L.); (A.D.G.)
| | - Andrea De Giacomo
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.S.); (M.G.P.); (P.L.); (A.D.G.)
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Tsuchiyagaito A, Misaki M, Cochran G, Philip NS, Paulus MP, Guinjoan SM. Thalamo-cortical circuits associated with trait- and state-repetitive negative thinking in major depressive disorder. J Psychiatr Res 2023; 168:184-192. [PMID: 37913745 PMCID: PMC10872862 DOI: 10.1016/j.jpsychires.2023.10.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/10/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Repetitive negative thinking (RNT), often referred to as rumination in the mood disorders literature, is a symptom dimension associated with poor prognosis and suicide in major depressive disorder (MDD). Given the transdiagnostic nature of RNT, this study aimed to evaluate the hypothesis that neurobiological substrates of RNT in MDD may share the brain mechanisms underlying obsessions, particularly those involving cortico-striatal-thalamic-cortical (CSTC) circuits. METHODS Thirty-nine individuals with MDD underwent RNT induction during fMRI. Trait-RNT was measured by the Ruminative Response Scale (RRS) and state-RNT was measured by a visual analogue scale. We employed a connectome-wide association analysis examining the association between RNT intensity with striatal and thalamic connectivity. RESULTS A greater RRS score was associated with hyperconnectivity of the right mediodorsal thalamus with prefrontal cortex, including lateral orbitofrontal cortex, along with Wernicke's area and posterior default mode network nodes (t = 4.66-6.70). A greater state-RNT score was associated with hyperconnectivity of the right laterodorsal thalamus with bilateral primary sensory and motor cortices, supplementary motor area, and Broca's area (t = 4.51-6.57). Unexpectedly, there were no significant findings related to the striatum. CONCLUSIONS The present results suggest RNT in MDD is subserved by abnormal connectivity between right thalamic nuclei and cortical regions involved in both visceral and higher order cognitive processing. Emerging deep-brain neuromodulation methods may be useful to establish causal relationships between dysfunction of right thalamic-cortical circuits and RNT in MDD.
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Affiliation(s)
- Aki Tsuchiyagaito
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA; Research Center for Child Mental Development, Chiba University, Chiba, Japan.
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Gabe Cochran
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Noah S Philip
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
| | | | - Salvador M Guinjoan
- Laureate Institute for Brain Research, Tulsa, OK, USA; Department of Psychiatry, Oklahoma University Health Sciences Center at Tulsa, Tulsa, OK, USA; Laureate Psychiatric Hospital and Clinic, Tulsa, OK, USA
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10
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Malgady JM, Baez A, Hobel ZB, Jimenez K, Goldfried J, Prager EM, Wilking JA, Zhang Q, Feng G, Plotkin JL. Pathway-specific alterations in striatal excitability and cholinergic modulation in a SAPAP3 mouse model of compulsive motor behavior. Cell Rep 2023; 42:113384. [PMID: 37934666 PMCID: PMC10872927 DOI: 10.1016/j.celrep.2023.113384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 09/06/2023] [Accepted: 10/22/2023] [Indexed: 11/09/2023] Open
Abstract
Deletion of the obsessive-compulsive disorder (OCD)-associated gene SAP90/PSD-95-associated protein 3 (Sapap3), which encodes a postsynaptic anchoring protein at corticostriatal synapses, causes OCD-like motor behaviors in mice. While corticostriatal synaptic dysfunction is central to this phenotype, the striatum efficiently adapts to pathological changes, often in ways that expand upon the original circuit impairment. Here, we show that SAPAP3 deletion causes non-synaptic and pathway-specific alterations in dorsolateral striatum circuit function. While somatic excitability was elevated in striatal projection neurons (SPNs), dendritic excitability was exclusively enhanced in direct pathway SPNs. Layered on top of this, cholinergic modulation was altered in opposing ways: striatal cholinergic interneuron density and evoked acetylcholine release were elevated, while basal muscarinic modulation of SPNs was reduced. These data describe how SAPAP3 deletion alters the striatal landscape upon which impaired corticostriatal inputs will act, offering a basis for how pathological synaptic integration and unbalanced striatal output underlying OCD-like behaviors may be shaped.
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Affiliation(s)
- Jeffrey M Malgady
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA; Graduate Program in Neuroscience, College of Arts & Sciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - Alexander Baez
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA; Medical Scientist Training Program, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Zachary B Hobel
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA; Graduate Program in Neuroscience, College of Arts & Sciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - Kimberly Jimenez
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA
| | - Jack Goldfried
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA
| | - Eric M Prager
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA
| | - Jennifer A Wilking
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA
| | - Qiangge Zhang
- Yang Tan Collective and McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Guoping Feng
- Yang Tan Collective and McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Joshua L Plotkin
- Department of Neurobiology & Behavior, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA; Center for Nervous System Disorders, Stony Brook University, Stony Brook, NY 11794, USA.
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11
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Zeisler ZR, London L, Janssen WG, Fredericks JM, Elorette C, Fujimoto A, Zhan H, Russ BE, Clem RL, Hof PR, Stoll FM, Rudebeck PH. Single basolateral amygdala neurons in macaques exhibit distinct connectional motifs with frontal cortex. Neuron 2023; 111:3307-3320.e5. [PMID: 37857091 PMCID: PMC10593429 DOI: 10.1016/j.neuron.2023.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/14/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023]
Abstract
Basolateral amygdala (BLA) projects widely across the macaque frontal cortex, and amygdalo-frontal projections are critical for appropriate emotional responding and decision making. While it is appreciated that single BLA neurons branch and project to multiple areas in frontal cortex, the organization and frequency of this branching has yet to be fully characterized. Here, we determined the projection patterns of more than 3,000 macaque BLA neurons. We found that one-third of BLA neurons had two or more distinct projection targets in frontal cortex and subcortical structures. The patterns of single BLA neuron projections to multiple areas were organized into repeating motifs that targeted distinct sets of areas in medial and ventral frontal cortex, indicative of separable BLA networks. Our findings begin to reveal the rich structure of single-neuron connections in the non-human primate brain, providing a neuroanatomical basis for the role of BLA in coordinating brain-wide responses to valent stimuli.
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Affiliation(s)
- Zachary R Zeisler
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Liza London
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - William G Janssen
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Microscopy and Advanced Bioimaging CoRE, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - J Megan Fredericks
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Catherine Elorette
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Atsushi Fujimoto
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Huiqing Zhan
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Syosset, NY 11791, USA
| | - Brian E Russ
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA; Department of Psychiatry, New York University at Langone, One, 8 Park Avenue, New York, NY 10016, USA
| | - Roger L Clem
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Patrick R Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Frederic M Stoll
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Peter H Rudebeck
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA; Lipschultz Center for Cognitive Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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12
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Perkes IE, Morris RW, Griffiths KR, Quail S, Waters F, O’Brien M, Hazell PL, Balleine BW. The Motivational Determinants of Human Action, Their Neural Bases and Functional Impact in Adolescents With Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:1062-1072. [PMID: 37881550 PMCID: PMC10593889 DOI: 10.1016/j.bpsgos.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Background Establishing the motivational influences on human action is essential for understanding choice and decision making in health and disease. Here we used tests of value-based decision making, manipulating both predicted and experienced reward values to assess the motivational control of goal-directed action in healthy adolescents and those with obsessive-compulsive disorder (OCD). Methods After instrumental training on a two action-two outcome probabilistic task, adolescents (n = 21) underwent Pavlovian conditioning using distinct stimuli predicting either the instrumental outcomes, a third outcome, or nothing. We then assessed functional magnetic resonance imaging during choice tests in which we varied the predicted value, using specific and general Pavlovian-instrumental transfer, and the experienced value, using outcome devaluation. To establish functional significance, we tested a matched cohort of adolescents with OCD (n = 20). Results In healthy adolescents, both predicted and experienced values influenced the performance of goal-directed actions, mediated by distinct orbitofrontal-striatal circuits involving the lateral orbitofrontal cortex (OFC) and medial OFC, respectively. However, in adolescents with OCD, choice was insensitive to changes in either predicted or experienced values. These impairments were related to hypoactivity in the lateral OFC and hyperactivity in the medial OFC during specific Pavlovian-instrumental transfer and hypoactivity in the anterior prefrontal cortex, caudate nucleus, and their connectivity in the devaluation test. Conclusions We found that predicted and experienced values exerted a potent influence on the performance of goal-directed actions in adolescents via distinct orbitofrontal- and prefrontal-striatal circuits. Furthermore, the influence of these motivational processes was severely blunted in OCD, as was the functional segregation of circuits involving medial and lateral OFC, producing dysregulated action control.
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Affiliation(s)
- Iain E. Perkes
- Decision Neuroscience Laboratory, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia
- Discipline of Psychiatry and Mental Health and Discipline of Paediatrics and Children’s Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Department of Psychological Medicine, Sydney Children’s Hospital Network, Sydney, New South Wales, Australia
| | - Richard W. Morris
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Kristi R. Griffiths
- Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Stephanie Quail
- Decision Neuroscience Laboratory, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia
| | - Felicity Waters
- Child and Adolescent Mental Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Margot O’Brien
- Child and Adolescent Mental Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Philip L. Hazell
- Child and Adolescent Mental Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
- Specialty of Psychiatry, The University of Sydney, Sydney, New South Wales, Australia
| | - Bernard W. Balleine
- Decision Neuroscience Laboratory, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia
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13
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Shivakumar AB, Kumari S, Mehak SF, Gangadharan G. Compulsive-like Behaviors in Amyloid-β 1-42-Induced Alzheimer's Disease in Mice Are Associated With Hippocampo-cortical Neural Circuit Dysfunction. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:773-784. [PMID: 37881551 PMCID: PMC10593884 DOI: 10.1016/j.bpsgos.2023.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
Background In addition to memory deficits, patients with Alzheimer's disease (AD) experience neuropsychiatric disturbances. Recent studies have suggested the association of obsessive-compulsive disorder with the early stages of AD. However, there is a lack of understanding of the neurobiological underpinnings of compulsive-like behaviors at the neuronal circuit level and their relationship with AD. Methods We have addressed this issue in an amyloid-β 1-42-induced mouse model of AD by studying compulsive-like behaviors. Next, we compared the hippocampal and medial prefrontal cortex (mPFC) local field potential pattern and coherence between these regions of control and AD mice. We also assessed the expression pattern of acetylcholine and glutamatergic signaling in these regions, using quantitative polymerase chain reaction. Results Our findings show that AD mice exhibit compulsive-like behaviors, as evidenced by enhanced marble burying, nest building, and burrowing. Furthermore, AD mice exhibited hippocampo-cortical circuit dysfunction demonstrated by decreased power of rhythmic oscillations at the theta (4-12 Hz) and gamma (25-50 Hz) frequencies in the hippocampus and mPFC, two functionally interconnected brain regions involved both in AD and compulsive behaviors. Importantly, coherence between the hippocampus and mPFC in the theta band of AD animals was significantly reduced. Furthermore, we found reduced cholinergic and glutamatergic neurotransmission in the hippocampus and mPFC of AD mice. Conclusions We conclude that the hippocampo-cortical functional alterations may play a significant role in mediating the compulsive-like behaviors observed in AD mice. These findings may help in understanding the underlying circuit mechanisms of obsessive-compulsive disorder-like phenotypes associated with AD.
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Affiliation(s)
- Apoorva Bettagere Shivakumar
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sparsha Kumari
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sonam Fathima Mehak
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Gireesh Gangadharan
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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14
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Cui H, Zhang Y, Zhao Y, Zhao Y, Ding Q, Chen R, Manssuer L, Zhang C, Liu W, Li D, Sun B, Voon V. Mechanisms underlying capsulotomy for refractory obsessive-compulsive disorder: neural correlates of negative affect processing overlap with deep brain stimulation targets. Mol Psychiatry 2023; 28:3063-3074. [PMID: 36878966 PMCID: PMC10615758 DOI: 10.1038/s41380-023-01989-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 03/08/2023]
Abstract
Ablative procedures such as anterior capsulotomy are potentially effective in refractory obsessive-compulsive disorder (OCD). Converging evidence suggests the ventral internal capsule white matter tracts traversing the rostral cingulate and ventrolateral prefrontal cortex and thalamus is the optimal target for clinical efficacy across multiple deep brain stimulation targets for OCD. Here we ask which prefrontal regions and underlying cognitive processes might be implicated in the effects of capsulotomy by using both task fMRI and neuropsychological tests assessing OCD-relevant cognitive mechanisms known to map across prefrontal regions connected to the tracts targeted in capsulotomy. We tested OCD patients at least 6 months post-capsulotomy (n = 27), OCD controls (n = 33) and healthy controls (n = 34). We used a modified aversive monetary incentive delay paradigm with negative imagery and a within session extinction trial. Post-capsulotomy OCD subjects showed improved OCD symptoms, disability and quality of life with no differences in mood or anxiety or cognitive task performance on executive, inhibition, memory and learning tasks. Task fMRI revealed post-capsulotomy decreases in the nucleus accumbens during negative anticipation, and in the left rostral cingulate and left inferior frontal cortex during negative feedback. Post-capsulotomy patients showed attenuated accumbens-rostral cingulate functional connectivity. Rostral cingulate activity mediated capsulotomy improvement on obsessions. These regions overlap with optimal white matter tracts observed across multiple stimulation targets for OCD and might provide insights into further optimizing neuromodulation approaches. Our findings also suggest that aversive processing theoretical mechanisms may link ablative, stimulation and psychological interventions.
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Affiliation(s)
- Hailun Cui
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Yingying Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Neural and Intelligence Engineering Centre, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Yijie Zhao
- Neural and Intelligence Engineering Centre, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Ying Zhao
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Qiong Ding
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Ruiqin Chen
- Neural and Intelligence Engineering Centre, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Luis Manssuer
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjuan Liu
- Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Dianyou Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
- Neural and Intelligence Engineering Centre, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
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15
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Wise T, Robinson OJ, Gillan CM. Identifying Transdiagnostic Mechanisms in Mental Health Using Computational Factor Modeling. Biol Psychiatry 2023; 93:690-703. [PMID: 36725393 PMCID: PMC10017264 DOI: 10.1016/j.biopsych.2022.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 02/03/2023]
Abstract
Most psychiatric disorders do not occur in isolation, and most psychiatric symptom dimensions are not uniquely expressed within a single diagnostic category. Current treatments fail to work for around 25% to 40% of individuals, perhaps due at least in part to an overreliance on diagnostic categories in treatment development and allocation. In this review, we describe ongoing efforts in the field to surmount these challenges and precisely characterize psychiatric symptom dimensions using large-scale studies of unselected samples via remote, online, and "citizen science" efforts that take a dimensional, mechanistic approach. We discuss the importance that efforts to identify meaningful psychiatric dimensions be coupled with careful computational modeling to formally specify, test, and potentially falsify candidate mechanisms that underlie transdiagnostic symptom dimensions. We refer to this approach, i.e., where symptom dimensions are identified and validated against computationally well-defined neurocognitive processes, as computational factor modeling. We describe in detail some recent applications of this method to understand transdiagnostic cognitive processes that include model-based planning, metacognition, appetitive processing, and uncertainty estimation. In this context, we highlight how computational factor modeling has been used to identify specific associations between cognition and symptom dimensions and reveal previously obscured relationships, how findings generalize to smaller in-person clinical and nonclinical samples, and how the method is being adapted and optimized beyond its original instantiation. Crucially, we discuss next steps for this area of research, highlighting the value of more direct investigations of treatment response that bridge the gap between basic research and the clinic.
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Affiliation(s)
- Toby Wise
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Oliver J Robinson
- Neuroscience and Mental Health Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Research Department of Clinical Education and Health Psychology, University College London, London, United Kingdom
| | - Claire M Gillan
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin 2, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland.
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16
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Becker H, Liu Y, Hanna GL, Bilek E, Block SR, Hardee JE, Heitzeg MM, Pagliaccio D, Marsh R, Fitzgerald KD. Error-related brain activity associated with obsessive-compulsive symptoms in youth. Brain Behav 2023; 13:e2941. [PMID: 36919195 PMCID: PMC10097091 DOI: 10.1002/brb3.2941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Subclinical obsessive-compulsive symptoms (OCS) are common in children, and increase risk for later onset of obsessive-compulsive disorder (OCD). In pediatric patients with OCD, neuroimaging research implicates altered neural mechanisms for error-processing, but whether abnormal brain response occurs with subclinical OCS remains poorly understood. METHODS Using functional magnetic resonance imaging (fMRI), 113 youth (8-18 years; 45 female) from a community sample were scanned during an error-eliciting Go/No-Go task. OCS were assessed dimensionally using the obsessive-compulsive subscale of the Child Behavior Checklist. The association between OCS scores and error-related brain activity was examined at the whole-brain level. RESULTS Lower OCS scores associated with stronger response to errors in dorsal anterior cingulate cortex (dACC), caudate, putamen, thalamus, and occipital cortex. Additionally, lower OCS related to higher capacity for inhibitory control, as indexed by greater accuracy on No-Go trials during fMRI scanning. The relationship between lower OCS and better accuracy on No-Go trials was mediated by greater error-related dACC activity. CONCLUSIONS The inverse relationship between OCS and error-related activity in the dACC and extended cortical-striatal-thalamic circuitry may index an adaptive process by which subclinical OCS are minimized in youth. Further, these results identify an observable pattern of brain activity that tracks with subclinical OCS severity. Understanding the link between neural networks for error processing and the normal to abnormal range of OCS may pave the way for brain-based strategies to identify children who are more likely to develop OCD and enable the targeting of preventive strategies to reduce risk.
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Affiliation(s)
- Hannah Becker
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Bilek
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Jillian E Hardee
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Addiction Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Addiction Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - David Pagliaccio
- New York State Psychiatric Institute, Columbia University, New York, New York, USA
| | - Rachel Marsh
- New York State Psychiatric Institute, Columbia University, New York, New York, USA
| | - Kate D Fitzgerald
- New York State Psychiatric Institute, Columbia University, New York, New York, USA
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17
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Fridgeirsson EA, Bais MN, Eijsker N, Thomas RM, Smit DJA, Bergfeld IO, Schuurman PR, van den Munckhof P, de Koning P, Vulink N, Figee M, Mazaheri A, van Wingen GA, Denys D. Patient specific intracranial neural signatures of obsessions and compulsions in the ventral striatum. J Neural Eng 2023; 20. [PMID: 36827705 DOI: 10.1088/1741-2552/acbee1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 02/24/2023] [Indexed: 02/26/2023]
Abstract
Objective. Deep brain stimulation is a treatment option for patients with refractory obsessive-compulsive disorder. A new generation of stimulators hold promise for closed loop stimulation, with adaptive stimulation in response to biologic signals. Here we aimed to discover a suitable biomarker in the ventral striatum in patients with obsessive compulsive disorder using local field potentials.Approach.We induced obsessions and compulsions in 11 patients undergoing deep brain stimulation treatment using a symptom provocation task. Then we trained machine learning models to predict symptoms using the recorded intracranial signal from the deep brain stimulation electrodes.Main results.Average areas under the receiver operating characteristics curve were 62.1% for obsessions and 78.2% for compulsions for patient specific models. For obsessions it reached over 85% in one patient, whereas performance was near chance level when the model was trained across patients. Optimal performances for obsessions and compulsions was obtained at different recording sites.Significance. The results from this study suggest that closed loop stimulation may be a viable option for obsessive-compulsive disorder, but that intracranial biomarkers are patient and not disorder specific.Clinical Trial:Netherlands trial registry NL7486.
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Affiliation(s)
- Egill A Fridgeirsson
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Melisse N Bais
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Nadine Eijsker
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Rajat M Thomas
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Dirk J A Smit
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Isidoor O Bergfeld
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - P Richard Schuurman
- Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Pelle de Koning
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Nienke Vulink
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Ali Mazaheri
- School of Psychology, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Guido A van Wingen
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands.,The Netherlands institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
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18
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Zeisler ZR, London L, Janssen WG, Fredericks JM, Elorette C, Fujimoto A, Zhan H, Russ BE, Clem RL, Hof PR, Stoll FM, Rudebeck PH. High-throughput sequencing of macaque basolateral amygdala projections reveals dissociable connectional motifs with frontal cortex. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.18.524407. [PMID: 36711708 PMCID: PMC9882200 DOI: 10.1101/2023.01.18.524407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The basolateral amygdala (BLA) projects widely across the macaque frontal cortex1-4, and amygdalo-frontal projections are critical for optimal emotional responding5 and decision-making6. Yet, little is known about the single-neuron architecture of these projections: namely, whether single BLA neurons project to multiple parts of the frontal cortex. Here, we use MAPseq7 to determine the projection patterns of over 3000 macaque BLA neurons. We found that one-third of BLA neurons have two or more distinct targets in parts of frontal cortex and of subcortical structures. Further, we reveal non-random structure within these branching patterns such that neurons with four targets are more frequently observed than those with two or three, indicative of widespread networks. Consequently, these multi-target single neurons form distinct networks within medial and ventral frontal cortex consistent with their known functions in regulating mood and decision-making. Additionally, we show that branching patterns of single neurons shape functional networks in the brain as assessed by fMRI-based functional connectivity. These results provide a neuroanatomical basis for the role of the BLA in coordinating brain-wide responses to valent stimuli8 and highlight the importance of high-resolution neuroanatomical data for understanding functional networks in the brain.
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Affiliation(s)
- Zachary R Zeisler
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - Liza London
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - William G Janssen
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
- Microscopy and Advanced Bioimaging CoRE, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - J Megan Fredericks
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - Catherine Elorette
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - Atsushi Fujimoto
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - Huiqing Zhan
- Cold Spring Harbor Laboratory, 1 Bungtown Rd, Syosset, NY 11791
| | - Brian E Russ
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
- Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute, 140 Old Orangeburg Road, 10 Orangeburg, NY 10962
- Department of Psychiatry, New York University at Langone, One, 8 Park Ave, New York, NY 10016
| | - Roger L Clem
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - Patrick R Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - Frederic M Stoll
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
| | - Peter H Rudebeck
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029
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19
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van Roessel PJ, Grassi G, Aboujaoude EN, Menchón JM, Van Ameringen M, Rodríguez CI. Treatment-resistant OCD: Pharmacotherapies in adults. Compr Psychiatry 2023; 120:152352. [PMID: 36368186 DOI: 10.1016/j.comppsych.2022.152352] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/20/2022] [Accepted: 10/24/2022] [Indexed: 12/13/2022] Open
Abstract
Serotonin reuptake inhibitor (SRI) medications are well established as first-line pharmacotherapeutic treatment for Obsessive-Compulsive Disorder (OCD). However, despite the excellent safety profile and demonstrated efficacy of these medications, a substantial proportion of individuals with OCD fail to attain sufficient benefit from SRIs. In this narrative review, we discuss clinical features of OCD that have been associated with poorer response to SRIs, and we present pharmacotherapeutic interventions that have been explored as augmenting or alternative treatments for treatment-resistant OCD. We additionally highlight non-SRI interventions for OCD that are currently under investigation. Pharmacotherapeutic interventions were identified via expert consensus. To assess the evidence base for individual pharmacotherapies, targeted searches for relevant English-language publications were performed on standard biomedical research databases, including MEDLINE. Information relevant to ongoing registered clinical trials in OCD was obtained by search of ClinicalTrials.gov. Pharmacotherapies are grouped for review in accordance with the general principles of Neuroscience-based Nomenclature (NbN). Clinical features of OCD that may suggest poorer response to SRI treatment include early age of onset, severity of illness, duration of untreated illness, and the presence of symmetry/ordering or hoarding-related symptoms. Based on evolving pathophysiologic models of OCD, diverse agents engaging serotonin, dopamine, norepinephrine, glutamate, and anti-inflammatory pathways have been explored as alternative or adjunctive therapies for treatment-resistant OCD and have at least preliminary evidence of efficacy. Medications with dopamine antagonist activity remain the most robustly evidence-based of augmenting interventions, yet dopamine antagonists benefit only a minority of those who try them and carry elevated risks of adverse effects. Interventions targeting glutamatergic and anti-inflammatory pathways are less well evidenced, but may offer more favorable benefit to risk profiles. Ongoing research should explore whether specific interventions may benefit individuals with particular features of treatment-resistant OCD.
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Affiliation(s)
- Peter J van Roessel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.
| | | | - Elias N Aboujaoude
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Michael Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Carolyn I Rodríguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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20
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Petrelli F, Zehnder T, Laugeray A, Mondoloni S, Calì C, Pucci L, Molinero Perez A, Bondiolotti BM, De Oliveira Figueiredo E, Dallerac G, Déglon N, Giros B, Magrassi L, Mothet JP, Mameli M, Simmler LD, Bezzi P. Disruption of Astrocyte-Dependent Dopamine Control in the Developing Medial Prefrontal Cortex Leads to Excessive Grooming in Mice. Biol Psychiatry 2022; 93:966-975. [PMID: 36958999 DOI: 10.1016/j.biopsych.2022.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 10/21/2022] [Accepted: 11/04/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Astrocytes control synaptic activity by modulating perisynaptic concentrations of ions and neurotransmitters including dopamine (DA) and, as such, could be involved in the modulating aspects of mammalian behavior. METHODS We produced a conditional deletion of the vesicular monoamine transporter 2 (VMAT2) specifically in astrocytes (aVMTA2cKO mice) and studied the effects of the lack of VMAT2 in prefrontal cortex (PFC) astrocytes on the regulation of DA levels, PFC circuit functions, and behavioral processes. RESULTS We found a significant reduction of medial PFC (mPFC) DA levels and excessive grooming and compulsive repetitive behaviors in aVMAT2cKO mice. The mice also developed a synaptic pathology, expressed through increased relative AMPA versus NMDA receptor currents in synapses of the dorsal striatum receiving inputs from the mPFC. Importantly, behavioral and synaptic phenotypes were rescued by re-expression of mPFC VMAT2 and L-DOPA treatment, showing that the deficits were driven by mPFC astrocytes that are critically involved in developmental DA homeostasis. By analyzing human tissue samples, we found that VMAT2 is expressed in human PFC astrocytes, corroborating the potential translational relevance of our observations in mice. CONCLUSIONS Our study shows that impairment of the astrocytic control of DA in the mPFC leads to symptoms resembling obsessive-compulsive spectrum disorders such as trichotillomania and has a profound impact on circuit function and behaviors.
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Affiliation(s)
- Francesco Petrelli
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | - Tamara Zehnder
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | - Anthony Laugeray
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | - Sarah Mondoloni
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | - Corrado Calì
- Department of Neuroscience, University of Torino, Torino, Italy
| | - Luca Pucci
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | - Alicia Molinero Perez
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | | | | | - Glenn Dallerac
- Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, Aix-Marseille Université UMR7286 CNRS, Marseille, France
| | - Nicole Déglon
- Neurosciences Research Center, Laboratory of Neurotherapies and Neuromodulation, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bruno Giros
- Department of Psychiatry, Douglas Hospital Research Center, McGill University, Montreal, Quebec, Canada
| | - Lorenzo Magrassi
- Neurosurgery, Dipartimento di Scienze Clinico-Chirurgiche e Pediatriche, Università degli Studi di Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Jean-Pierre Mothet
- Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille, Aix-Marseille Université UMR7286 CNRS, Marseille, France; "Biophotonics and Synapse Physiopathology" Team, UMR9188 CNRS - ENS Paris Saclay, Orsay, France
| | - Manuel Mameli
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | - Linda D Simmler
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland.
| | - Paola Bezzi
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland; Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.
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21
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Szechtman H, Dvorkin-Gheva A, Gomez-Marin A. A virtual library for behavioral performance in standard conditions-rodent spontaneous activity in an open field during repeated testing and after treatment with drugs or brain lesions. Gigascience 2022; 11:giac092. [PMID: 36261217 PMCID: PMC9581716 DOI: 10.1093/gigascience/giac092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/31/2022] [Accepted: 09/06/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Beyond their specific experiment, video records of behavior have future value-for example, as inputs for new experiments or for yet unknown types of analysis of behavior-similar to tissue or blood sample banks in life sciences where clinically derived or otherwise well-described experimental samples are stored to be available for some unknown potential future purpose. FINDINGS Research using an animal model of obsessive-compulsive disorder employed a standardized paradigm where the behavior of rats in a large open field was video recorded for 55 minutes on each test. From 43 experiments, there are 19,976 such trials that amount to over 2 years of continuous recording. In addition to videos, there are 2 video-derived raw data objects: XY locomotion coordinates and plots of animal trajectory. To motivate future use, the 3 raw data objects are annotated with a general schema-one that abstracts the data records from their particular experiment while providing, at the same time, a detailed list of independent variables bearing on behavioral performance. The raw data objects are deposited as 43 datasets but constitute, functionally, a library containing 1 large dataset. CONCLUSIONS Size and annotation schema give the library high reuse potential: in applications using machine learning techniques, statistical evaluation of subtle factors, simulation of new experiments, or as educational resource. Ultimately, the library can serve both as the seed and as the test bed to create a machine-searchable virtual library of linked open datasets for behavioral performance in defined conditions.
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Affiliation(s)
- Henry Szechtman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | - Anna Dvorkin-Gheva
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | - Alex Gomez-Marin
- Department of Systems Neurobiology, Instituto de Neurociencias (CSIC-UMH), 03550 Sant Joan d'Alacant, Alicante, Spain
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22
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Kajs BL, van Roessel PJ, Davis GL, Williams LM, Rodriguez CI, Gunaydin LA. Valence processing alterations in SAPAP3 knockout mice and human OCD. J Psychiatr Res 2022; 151:657-666. [PMID: 35661523 DOI: 10.1016/j.jpsychires.2022.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/02/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
Abstract
Abnormalities in valence processing - the processing of aversive or appetitive stimuli - may be an underrecognized component of obsessive-compulsive disorder (OCD). Preclinical rodent models have been critical in furthering pathophysiological understanding of OCD, yet there is a dearth of investigations examining whether rodent models of compulsive behavior show alterations in valence systems congruent with those seen in individuals with OCD. In this study, we sought to assess valence processing in a preclinical rodent model of compulsive behavior, the SAPAP3 knockout (KO) mouse model, and compare our preclinical findings to similar behavioral phenomena in OCD patients. In SAPAP3 KO mice, we used auditory fear conditioning and extinction to examine alterations in negative valence processing and reward-based operant conditioning to examine alterations in positive valence processing. We find that SAPAP3 KO mice show evidence of heightened negative valence processing through enhanced fear learning and impaired fear extinction. SAPAP3 KO mice also show deficits in reward acquisition and goal-directed behavior, suggesting impaired positive valence processing. In OCD patients, we used validated behavioral tests to assess explicit and implicit processing of fear-related facial expressions (negative valence) and socially-rewarding happy expressions (positive valence). We find similar trends towards enhanced negative and impaired positive valence processing in OCD patients. Overall, our results reveal valence processing abnormalities in a preclinical rodent model of compulsive behavior similar to those seen in OCD patients, with implications for valence processing alterations as novel therapeutic targets across a translational research spectrum.
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Affiliation(s)
- Bridget L Kajs
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, 94158, USA
| | - Peter J van Roessel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA; Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - Gwynne L Davis
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, 94158, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA; Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA.
| | - Lisa A Gunaydin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, 94158, USA; Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, CA, 94158, USA.
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23
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Seok D, Tadayonnejad R, Wong WW, O'Neill J, Cockburn J, Bari AA, O'Doherty JP, Feusner JD. Neurocircuit dynamics of arbitration between decision-making strategies across obsessive-compulsive and related disorders. Neuroimage Clin 2022; 35:103073. [PMID: 35689978 PMCID: PMC9192960 DOI: 10.1016/j.nicl.2022.103073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/11/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022]
Abstract
Obsessive-compulsive and related disorders (OCRD) include OCD and BDD. Neural differences in decision-making arbitration may underlie OCRD symptoms. Resting-state effective connectivity was used to assess arbitration circuitry. Greater left putamen inhibition via left ventrolateral prefrontal cortex in OCRD. Stronger left putamen inhibition was correlated with less severe symptoms.
Obsessions and compulsions are central components of obsessive–compulsive disorder (OCD) and obsessive–compulsive related disorders such as body dysmorphic disorder (BDD). Compulsive behaviours may result from an imbalance of habitual and goal-directed decision-making strategies. The relationship between these symptoms and the neural circuitry underlying habitual and goal-directed decision-making, and the arbitration between these strategies, remains unknown. This study examined resting state effective connectivity between nodes of these systems in two cohorts with obsessions and compulsions, each compared with their own corresponding healthy controls: OCD (nOCD = 43; nhealthy = 24) and BDD (nBDD = 21; nhealthy = 16). In individuals with OCD, the left ventrolateral prefrontal cortex, a node of the arbitration system, exhibited more inhibitory causal influence over the left posterolateral putamen, a node of the habitual system, compared with controls. Inhibitory causal influence in this connection showed a trend for a similar pattern in individuals with BDD compared with controls. Those with stronger negative connectivity had lower obsession and compulsion severity in both those with OCD and those with BDD. These relationships were not evident within the habitual or goal-directed circuits, nor were they associated with depressive or anxious symptomatology. These results suggest that abnormalities in the arbitration system may represent a shared neural phenotype across these two related disorders that is specific to obsessive–compulsive symptoms. In addition to nosological implications, these results identify potential targets for novel, circuit-specific treatments.
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Affiliation(s)
- Darsol Seok
- Division of Cognitive Neuroscience, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA
| | - Reza Tadayonnejad
- Division of Neuromodulation, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA; Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, 1200 E. California Blvd., Code 228-77, Pasadena, CA 91125, USA
| | - Wan-Wa Wong
- Division of Cognitive Neuroscience, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA
| | - Joseph O'Neill
- Division of Child and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA
| | - Jeff Cockburn
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, 1200 E. California Blvd., Code 228-77, Pasadena, CA 91125, USA
| | - Ausaf A Bari
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - John P O'Doherty
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, 1200 E. California Blvd., Code 228-77, Pasadena, CA 91125, USA; Computation & Neural Systems Program, California Institute of Technology, Pasadena, CA, 1200 East California Boulevard, Pasadena, CA 91125, USA
| | - Jamie D Feusner
- Division of Cognitive Neuroscience, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA; Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Temerty Faculty of Medicine, Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada; Department of Women's and Children's Health, The Karolinska Institute, Tomtebodavägen 18A, 171 77 Solna, Sweden.
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24
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Fremont R, Dworkin J, Manoochehri M, Krueger F, Huey E, Grafman J. Damage to the dorsolateral prefrontal cortex is associated with repetitive compulsive behaviors in patients with penetrating brain injury. BMJ Neurol Open 2022; 4:e000229. [PMID: 35519903 PMCID: PMC9020295 DOI: 10.1136/bmjno-2021-000229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/18/2022] [Indexed: 11/03/2022] Open
Abstract
Background Damage to cortico-striato-thalamo-cortical (CSTC) circuits is associated with the development of repetitive behaviours in animals and humans. However, the types of repetitive behaviours that are developed after injury to these structures are poorly defined. This study examines the effect of damage to separate elements of CSTC circuits sustained by veterans of the Vietnam War on obsessions, compulsions, and tics. Methods We performed partial correlations (correcting for cognition, age, education, and global brain damage) between volume loss from traumatic brain injury in specific elements of CSTC circuits (lateral and medial orbitofrontal and dorsolateral prefrontal cortices, anterior cingulate cortex, thalamus, and basal ganglia) and scores on a modified version of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist and the Yale Global Tic Severity Scale in 83 Vietnam war veterans with penetrating brain injuries at different sites throughout the brain. Results We found that volume loss in the left dorsolateral prefrontal cortex was associated with the development of compulsive behaviours (r=0.32, padj<0.05) whereas volume loss in the basal ganglia was associated with the development of tics (r=0.33, padj<0.05). Conclusion Our findings indicate that damage to specific CSTC elements can be associated with the development of compulsive behaviours and tics that are not necessarily accompanied by obsessions.
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Affiliation(s)
- Rachel Fremont
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA
| | - Jordan Dworkin
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA
| | - Masood Manoochehri
- Taub Insitute, Columbia University Medical Center, New York, New York, USA
| | - Frank Krueger
- Molecular Neuroscience Department, George Mason University, Fairfax, Virginia, USA
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| | - Edward Huey
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA
- Department of Neurology, Columbia University, New York, New York, USA
| | - Jordan Grafman
- Brain Injury Research, Rehabilitation Institute of Chicago, Chicago, Illinois, USA
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25
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Chohan MO, Kopelman JM, Yueh H, Fazlali Z, Greene N, Harris AZ, Balsam PD, Leonardo ED, Kramer ER, Veenstra-VanderWeele J, Ahmari SE. Developmental impact of glutamate transporter overexpression on dopaminergic neuron activity and stereotypic behavior. Mol Psychiatry 2022; 27:1515-1526. [PMID: 35058566 PMCID: PMC9106836 DOI: 10.1038/s41380-021-01424-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/30/2021] [Accepted: 12/16/2021] [Indexed: 11/09/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a disabling condition that often begins in childhood. Genetic studies in OCD have pointed to SLC1A1, which encodes the neuronal glutamate transporter EAAT3, with evidence suggesting that increased expression contributes to risk. In mice, midbrain Slc1a1 expression supports repetitive behavior in response to dopaminergic agonists, aligning with neuroimaging and pharmacologic challenge studies that have implicated the dopaminergic system in OCD. These findings suggest that Slc1a1 may contribute to compulsive behavior through altered dopaminergic transmission; however, this theory has not been mechanistically tested. To examine the developmental impact of Slc1a1 overexpression on compulsive-like behaviors, we, therefore, generated a novel mouse model to perform targeted, reversible overexpression of Slc1a1 in dopaminergic neurons. Mice with life-long overexpression of Slc1a1 showed a significant increase in amphetamine (AMPH)-induced stereotypy and hyperlocomotion. Single-unit recordings demonstrated that Slc1a1 overexpression was associated with increased firing of dopaminergic neurons. Furthermore, dLight1.1 fiber photometry showed that these behavioral abnormalities were associated with increased dorsal striatum dopamine release. In contrast, no impact of overexpression was observed on anxiety-like behaviors or SKF-38393-induced grooming. Importantly, overexpression solely in adulthood failed to recapitulate these behavioral phenotypes, suggesting that overexpression during development is necessary to generate AMPH-induced phenotypes. However, doxycycline-induced reversal of Slc1a1/EAAT3 overexpression in adulthood normalized both the increased dopaminergic firing and AMPH-induced responses. These data indicate that the pathologic effects of Slc1a1/EAAT3 overexpression on dopaminergic neurotransmission and AMPH-induced stereotyped behavior are developmentally mediated, and support normalization of EAAT3 activity as a potential treatment target for basal ganglia-mediated repetitive behaviors.
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Affiliation(s)
- Muhammad O Chohan
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jared M Kopelman
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Hannah Yueh
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Zeinab Fazlali
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Natasha Greene
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychology, Barnard College of Columbia University, New York, NY, USA
| | - Alexander Z Harris
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Peter D Balsam
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychology, Barnard College of Columbia University, New York, NY, USA
| | - E David Leonardo
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Edgar R Kramer
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, Devon, UK
| | - Jeremy Veenstra-VanderWeele
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Susanne E Ahmari
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA, USA.
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26
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Dorsal striatal dopamine induces fronto-cortical hypoactivity and attenuates anxiety and compulsive behaviors in rats. Neuropsychopharmacology 2022; 47:454-464. [PMID: 34725486 PMCID: PMC8559920 DOI: 10.1038/s41386-021-01207-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 12/22/2022]
Abstract
Dorsal striatal dopamine transmission engages the cortico-striato-thalamo-cortical (CSTC) circuit, which is implicated in many neuropsychiatric diseases, including obsessive-compulsive disorder (OCD). Yet it is unknown if dorsal striatal dopamine hyperactivity is the cause or consequence of changes elsewhere in the CSTC circuit. Classical pharmacological and neurotoxic manipulations of the CSTC and other brain circuits suffer from various drawbacks related to off-target effects and adaptive changes. Chemogenetics, on the other hand, enables a highly selective targeting of specific neuronal populations within a given circuit. In this study, we developed a chemogenetic method for selective activation of dopamine neurons in the substantia nigra, which innervates the dorsal striatum in the rat. We used this model to investigate effects of targeted dopamine activation on CSTC circuit function, especially in fronto-cortical regions. We found that chemogenetic activation of these neurons increased movement (as expected with increased dopamine release), rearings and time spent in center, while also lower self-grooming. Furthermore, this activation increased prepulse inhibition of the startle response in females. Remarkably, we observed reduced [18F]FDG metabolism in the frontal cortex, following dopamine activation in the dorsal striatum, while total glutamate levels- in this region were increased. This result is in accord with clinical studies of increased [18F]FDG metabolism and lower glutamate levels in similar regions of the brain of people with OCD. Taken together, the present chemogenetic model adds a mechanistic basis with behavioral and translational relevance to prior clinical neuroimaging studies showing deficits in fronto-cortical glucose metabolism across a variety of clinical populations (e.g. addiction, risky decision-making, compulsivity or obesity).
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Ahmari SE, Rauch SL. The prefrontal cortex and OCD. Neuropsychopharmacology 2022; 47:211-224. [PMID: 34400778 PMCID: PMC8617188 DOI: 10.1038/s41386-021-01130-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 01/03/2023]
Abstract
Obsessive Compulsive Disorder (OCD) is a highly prevalent and severe neuropsychiatric disorder, with an incidence of 1.5-3% worldwide. However, despite the clear public health burden of OCD and relatively well-defined symptom criteria, effective treatments are still limited, spotlighting the need for investigation of the neural substrates of the disorder. Human neuroimaging studies have consistently highlighted abnormal activity patterns in prefrontal cortex (PFC) regions and connected circuits in OCD during both symptom provocation and performance of neurocognitive tasks. Because of recent technical advances, these findings can now be leveraged to develop novel targeted interventions. Here we will highlight current theories regarding the role of the prefrontal cortex in the generation of OCD symptoms, discuss ways in which this knowledge can be used to improve treatments for this often disabling illness, and lay out challenges in the field for future study.
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Affiliation(s)
- Susanne E Ahmari
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA, USA.
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Optogenetic inhibition of indirect pathway neurons in the dorsomedial striatum reduces excessive grooming in Sapap3-knockout mice. Neuropsychopharmacology 2022; 47:477-487. [PMID: 34417544 PMCID: PMC8674346 DOI: 10.1038/s41386-021-01161-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/07/2021] [Accepted: 08/13/2021] [Indexed: 02/07/2023]
Abstract
Excessive grooming of Sapap3-KO mice has been used as a model of obsessive-compulsive disorder (OCD). Previous studies suggest that dysregulation of cortico-striatal circuits is critically important in the generation of compulsive behaviors, and it has been proposed that the alteration in the activity patterns of striatal circuitry underlies the excessive grooming observed in Sapap3-KO mice. To test this hypothesis, we used in-vivo calcium imaging of individual cells to record striatal activity in these animals and optogenetic inhibition to manipulate this activity. We identified striatal neurons that are modulated during grooming behavior and found that their proportion is significantly larger in Sapap3-KO mice compared to wild-type littermates. Inhibition of striatal cells in Sapap3-KO mice increased the number of grooming episodes observed. Remarkably, the specific inhibition of indirect pathway neurons decreased the occurrence of grooming events. Our results indicate that there is striatal neural activity related to excessive grooming engagement in Sapap3-KO mice. We also demonstrate, for the first time, that specific inhibition of striatal indirect pathway neurons reduces this compulsive phenotype, suggesting that treatments that alleviate compulsive symptoms in OCD patients may exert their effects through this specific striatal population.
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Rasmussen SA, Goodman WK. The prefrontal cortex and neurosurgical treatment for intractable OCD. Neuropsychopharmacology 2022; 47:349-360. [PMID: 34433915 PMCID: PMC8616947 DOI: 10.1038/s41386-021-01149-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/14/2021] [Accepted: 07/29/2021] [Indexed: 01/03/2023]
Abstract
Over the past two decades, circuit-based neurosurgical procedures have gained increasing acceptance as a safe and efficacious approach to the treatment of the intractable obsessive-compulsive disorder (OCD). Lesions and deep brain stimulation (DBS) of the longitudinal corticofugal white matter tracts connecting the prefrontal cortex with the striatum, thalamus, subthalamic nucleus (STN), and brainstem implicate orbitofrontal, medial prefrontal, frontopolar, and ventrolateral cortical networks in the symptoms underlying OCD. The highly parallel distributed nature of these networks may explain the relative lack of adverse effects observed following surgery. Additional pre-post studies of cognitive tasks in more surgical patients are needed to confirm the role of these networks in OCD and to define therapeutic responses to surgical intervention.
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Affiliation(s)
- Steven A. Rasmussen
- grid.40263.330000 0004 1936 9094Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI USA ,grid.40263.330000 0004 1936 9094Carney Brain Science Institute, Brown University, Providence, RI USA
| | - Wayne K. Goodman
- grid.39382.330000 0001 2160 926XMenninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
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Ketamine increases activity of a fronto-striatal projection that regulates compulsive behavior in SAPAP3 knockout mice. Nat Commun 2021; 12:6040. [PMID: 34654803 PMCID: PMC8519915 DOI: 10.1038/s41467-021-26247-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/17/2021] [Indexed: 12/03/2022] Open
Abstract
Obsessive-Compulsive Disorder (OCD), characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions), is associated with dysfunction in fronto-striatal circuits. There are currently no fast-acting pharmacological treatments for OCD. However, recent clinical studies demonstrated that an intravenous infusion of ketamine rapidly reduces OCD symptoms. To probe mechanisms underlying ketamine’s therapeutic effect on OCD-like behaviors, we used the SAPAP3 knockout (KO) mouse model of compulsive grooming. Here we recapitulate the fast-acting therapeutic effect of ketamine on compulsive behavior, and show that ketamine increases activity of dorsomedial prefrontal neurons projecting to the dorsomedial striatum in KO mice. Optogenetically mimicking this increase in fronto-striatal activity reduced compulsive grooming behavior in KO mice. Conversely, inhibiting this circuit in wild-type mice increased grooming. Finally, we demonstrate that ketamine blocks the exacerbation of grooming in KO mice caused by optogenetically inhibiting fronto-striatal activity. These studies demonstrate that ketamine increases activity in a fronto-striatal circuit that causally controls compulsive grooming behavior, suggesting this circuit may be important for ketamine’s therapeutic effects in OCD. Intravenous infusion of ketamine rapidly reduces obsessive-compulsive disorder symptoms. Here, the authors show in mice that ketamine acts by increasing activity in a fronto-striatal circuit that causally controls compulsive grooming behaviour.
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Cooper SE, Dunsmoor JE. Fear conditioning and extinction in obsessive-compulsive disorder: A systematic review. Neurosci Biobehav Rev 2021; 129:75-94. [PMID: 34314751 PMCID: PMC8429207 DOI: 10.1016/j.neubiorev.2021.07.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/04/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for anxiety-related disorders. Yet, there is limited basic research on fear conditioning and extinction in obsessive-compulsive disorder (OCD). This is surprising because exposure-based treatments based on associative learning principles are among the most popular and effective treatment options for OCD. Here, we systematically review and critically assess existing aversive conditioning and extinction studies of OCD. Across 12 studies, there was moderate evidence that OCD is associated with abnormal acquisition of conditioned responses that differ from comparison groups. There was relatively stronger evidence of OCD's association with impaired extinction processes. This included multiple studies finding elevated conditioned responses during extinction learning and poorer threat/safety discrimination during recall, although a minority of studies yielded results inconsistent with this conclusion. Overall, the conditioning model holds value for OCD research, but more work is necessary to clarify emerging patterns of results and increase clinical translational utility to the level seen in other anxiety-related disorders. We detail limitations in the literature and suggest next steps, including modeling OCD with more complex conditioning methodology (e.g., semantic/conceptual generalization, avoidance) and improving individual-differences assessment with dimensional techniques.
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Affiliation(s)
- Samuel E Cooper
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
| | - Joseph E Dunsmoor
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
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Khaledi-Nasab A, Kromer JA, Tass PA. Long-Lasting Desynchronization Effects of Coordinated Reset Stimulation Improved by Random Jitters. Front Physiol 2021; 12:719680. [PMID: 34630142 PMCID: PMC8497886 DOI: 10.3389/fphys.2021.719680] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/12/2021] [Indexed: 12/30/2022] Open
Abstract
Abnormally strong synchronized activity is related to several neurological disorders, including essential tremor, epilepsy, and Parkinson's disease. Chronic high-frequency deep brain stimulation (HF DBS) is an established treatment for advanced Parkinson's disease. To reduce the delivered integral electrical current, novel theory-based stimulation techniques such as coordinated reset (CR) stimulation directly counteract the abnormal synchronous firing by delivering phase-shifted stimuli through multiple stimulation sites. In computational studies in neuronal networks with spike-timing-dependent plasticity (STDP), it was shown that CR stimulation down-regulates synaptic weights and drives the network into an attractor of a stable desynchronized state. This led to desynchronization effects that outlasted the stimulation. Corresponding long-lasting therapeutic effects were observed in preclinical and clinical studies. Computational studies suggest that long-lasting effects of CR stimulation depend on the adjustment of the stimulation frequency to the dominant synchronous rhythm. This may limit clinical applicability as different pathological rhythms may coexist. To increase the robustness of the long-lasting effects, we study randomized versions of CR stimulation in networks of leaky integrate-and-fire neurons with STDP. Randomization is obtained by adding random jitters to the stimulation times and by shuffling the sequence of stimulation site activations. We study the corresponding long-lasting effects using analytical calculations and computer simulations. We show that random jitters increase the robustness of long-lasting effects with respect to changes of the number of stimulation sites and the stimulation frequency. In contrast, shuffling does not increase parameter robustness of long-lasting effects. Studying the relation between acute, acute after-, and long-lasting effects of stimulation, we find that both acute after- and long-lasting effects are strongly determined by the stimulation-induced synaptic reshaping, whereas acute effects solely depend on the statistics of administered stimuli. We find that the stimulation duration is another important parameter, as effective stimulation only entails long-lasting effects after a sufficient stimulation duration. Our results show that long-lasting therapeutic effects of CR stimulation with random jitters are more robust than those of regular CR stimulation. This might reduce the parameter adjustment time in future clinical trials and make CR with random jitters more suitable for treating brain disorders with abnormal synchronization in multiple frequency bands.
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Affiliation(s)
- Ali Khaledi-Nasab
- Department of Neurosurgery, Stanford University, Stanford, CA, United States
| | - Justus A Kromer
- Department of Neurosurgery, Stanford University, Stanford, CA, United States
| | - Peter A Tass
- Department of Neurosurgery, Stanford University, Stanford, CA, United States
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Lafferty CK, Christinck TD, Britt JP. All-optical approaches to studying psychiatric disease. Methods 2021; 203:46-55. [PMID: 34314828 DOI: 10.1016/j.ymeth.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
Improvements in all-optical means of monitoring and manipulating neural activity have generated new ways of studying psychiatric disease. The combination of calcium imaging techniques with optogenetics to concurrently record and manipulate neural activity has been used to create new disease models that link distinct circuit abnormalities to specific disease dimensions. These approaches represent a new path towards the development of more effective treatments, as they allow researchers to identify circuit manipulations that normalize pathological network activity. In this review we highlight the utility of all-optical approaches to generate new psychiatric disease models where the specific circuit abnormalities associated with disease symptomology can be assessed in vivo and in response to manipulations designed to normalize disease states. We then outline the principles underlying all-optical interrogations of neural circuits and discuss practical considerations for experimental design.
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Affiliation(s)
- Christopher K Lafferty
- Department of Psychology, McGill University, Montreal, QC, Canada; Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada
| | - Thomas D Christinck
- Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Jonathan P Britt
- Department of Psychology, McGill University, Montreal, QC, Canada; Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada.
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Optogenetically-inspired neuromodulation: Translating basic discoveries into therapeutic strategies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 159:187-219. [PMID: 34446246 DOI: 10.1016/bs.irn.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Optogenetic tools allow for the selective activation, inhibition or modulation of genetically-defined neural circuits with incredible temporal precision. Over the past decade, application of these tools in preclinical models of psychiatric disease has advanced our understanding the neural circuit basis of maladaptive behaviors in these disorders. Despite their power as an investigational tool, optogenetics cannot yet be applied in the clinical for the treatment of neurological and psychiatric disorders. To date, deep brain stimulation (DBS) is the only clinical treatment that can be used to achieve circuit-specific neuromodulation in the context of psychiatric. Despite its increasing clinical indications, the mechanisms underlying the therapeutic effects of DBS for psychiatric disorders are poorly understood, which makes optimization difficult. We discuss the variety of optogenetic tools available for preclinical research, and how these tools have been leveraged to reverse-engineer the mechanisms underlying DBS for movement and compulsive disorders. We review studies that have used optogenetics to induce plasticity within defined basal ganglia circuits, to alter neural circuit function and evaluate the corresponding effects on motor and compulsive behaviors. While not immediately applicable to patient populations, the translational power of optogenetics is in inspiring novel DBS protocols by providing a rationale for targeting defined neural circuits to ameliorate specific behavioral symptoms, and by establishing optimal stimulation paradigms that could selectively compensate for pathological synaptic plasticity within these defined neural circuits.
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Starkweather CK, Bick SK, McHugh JM, Dougherty DD, Williams ZM. Lesion location and outcome following cingulotomy for obsessive-compulsive disorder. J Neurosurg 2021; 136:221-230. [PMID: 34243154 DOI: 10.3171/2020.11.jns202211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/11/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) is among the most debilitating and medically refractory psychiatric disorders. While cingulotomy is an anatomically targeted neurosurgical treatment that has shown significant promise in treating OCD-related symptoms, the precise underlying neuroanatomical basis for its beneficial effects has remained poorly understood. Therefore, the authors sought to determine whether lesion location is related to responder status following cingulotomy. METHODS The authors reviewed the records of 18 patients who had undergone cingulotomy. Responders were defined as patients who had at least a 35% improvement in the Yale-Brown Obsessive Compulsive Scale (YBOCS) score. The authors traced the lesion sites on T1-weighted MRI scans and used an anatomical registration matrix generated by the imaging software FreeSurfer to superimpose these lesions onto a template brain. Lesion placement was compared between responders and nonresponders. The placement of lesions relative to various anatomical regions was also compared. RESULTS A decrease in postoperative YBOCS score was significantly correlated with more superiorly placed lesions (decrease -0.52, p = 0.0012). While all lesions were centered within 6 mm of the cingulate sulcus, responder lesions were placed more superiorly and posteriorly along the cingulate sulcus (1-way ANOVA, p = 0.003). The proportions of the cingulum bundle, cingulate gyrus, and paracingulate cortex affected by the lesions were the same between responders and nonresponders. However, all responders had lesions covering a larger subregion of Brodmann area (BA) 32. In particular, responder lesions covered a significantly greater proportion of the posterior BA32 (1-way ANOVA, p = 0.0064). CONCLUSIONS Lesions in patients responsive to cingulotomy tended to be located more superiorly and posteriorly and share greater coverage of a posterior subregion of BA32 than lesions in patients not responsive to this treatment.
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Williams NR, Sudheimer KD, Cole EJ, Varias AD, Goldstein-Piekarski AN, Stetz P, Lombardi A, Filippou-Frye M, van Roessel P, Anderson K, McCarthy EA, Wright B, Sandhu T, Menon S, Jo B, Koran L, Williams LM, Rodriguez CI. Accelerated neuromodulation therapy for Obsessive-Compulsive Disorder. Brain Stimul 2021; 14:435-437. [PMID: 33631349 DOI: 10.1016/j.brs.2021.02.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 01/17/2023] Open
Affiliation(s)
- Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
| | - Keith D Sudheimer
- Department of Anatomy, Southern Illinois University School of Medicine, Carbondale, IL, USA
| | - Eleanor J Cole
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Andrea D Varias
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Andrea N Goldstein-Piekarski
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Patrick Stetz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Anthony Lombardi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Maria Filippou-Frye
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Peter van Roessel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Kelley Anderson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Elizabeth A McCarthy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Brianna Wright
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Thasveen Sandhu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Sindu Menon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Lorrin Koran
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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Gandhi T, Lee CC. Neural Mechanisms Underlying Repetitive Behaviors in Rodent Models of Autism Spectrum Disorders. Front Cell Neurosci 2021; 14:592710. [PMID: 33519379 PMCID: PMC7840495 DOI: 10.3389/fncel.2020.592710] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/09/2020] [Indexed: 12/15/2022] Open
Abstract
Autism spectrum disorder (ASD) is comprised of several conditions characterized by alterations in social interaction, communication, and repetitive behaviors. Genetic and environmental factors contribute to the heterogeneous development of ASD behaviors. Several rodent models display ASD-like phenotypes, including repetitive behaviors. In this review article, we discuss the potential neural mechanisms involved in repetitive behaviors in rodent models of ASD and related neuropsychiatric disorders. We review signaling pathways, neural circuits, and anatomical alterations in rodent models that display robust stereotypic behaviors. Understanding the mechanisms and circuit alterations underlying repetitive behaviors in rodent models of ASD will inform translational research and provide useful insight into therapeutic strategies for the treatment of repetitive behaviors in ASD and other neuropsychiatric disorders.
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Affiliation(s)
- Tanya Gandhi
- Department of Comparative Biomedical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, LA, United States
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Abstract
Effective pharmacological and psychotherapeutic treatments are well established for obsessive-compulsive disorder (OCD). Serotonin reuptake inhibitors (SRIs) are first-line treatment and are of benefit to about half of patients. Augmentation of SRI treatment with low-dose neuroleptics is an evidence-based second-line strategy. Specialty psychotherapy is also used as both first-line and second-line treatment and can benefit many. However, a substantial number of patients do not respond to these treatments. New alternatives are urgently needed. This review summarizes evidence for these established pharmacotherapeutic strategies, and for others that have been investigated in refractory disease but are not supported by the same level of evidence. We focus on three neurotransmitter systems in the brain: serotonin, dopamine, and glutamate. We summarize evidence from genetic, neuroimaging, animal model, and other lines of investigation that probe these three systems in patients with OCD. We also review recent work on predictors of response to current treatments. While many studies suggest abnormalities that may provide insight into the pathophysiology of the disorder, most studies have been small, and non-replication of reported findings has been common. Nevertheless, the gradual accrual of evidence for neurotransmitter dysregulation may in time lead the way to new pharmacological strategies.
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Brain micro-architecture and disinhibition: a latent phenotyping study across 33 impulsive and compulsive behaviours. Neuropsychopharmacology 2021; 46:423-431. [PMID: 32919402 PMCID: PMC7116462 DOI: 10.1038/s41386-020-00848-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/31/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022]
Abstract
Impulsive and compulsive symptoms are common, tend to co-occur, and collectively account for a substantive global disease burden. Latent phenotyping offers a promising approach to elucidate common neural mechanisms conferring vulnerability to such symptoms in the general population. We utilised the Neuroscience in Psychiatry Network (NSPN), a cohort of young people (aged 18-29 years) in the United Kingdom, who provided questionnaire data and Magnetic Resonance Imaging scans. Partial Least Squares was used to identify brain regions in which intra-cortical myelination (measured using Magnetisation Transfer, MT) was significantly associated with a disinhibition phenotype, derived from bi-factor modelling of 33 impulsive and compulsive problem behaviours. The neuroimaging sample comprised 126 participants, mean 22.8 (2.7 SD) years old, being 61.1% female. Disinhibition scores were significantly and positively associated with higher MT in the bilateral frontal and parietal lobes. 1279 genes associated with disinhibition-related brain regions were identified, which were significantly enriched for functional biological interactions reflecting receptor signalling pathways. This study indicates common microstructural brain abnormalities contributing to a multitude of related, prevalent, problem behaviours characterised by disinhibition. Such a latent phenotyping approach provides insights into common neurobiological pathways, which may help to improve disease models and treatment approaches. Now that this latent phenotyping model has been validated in a general population sample, it can be extended into patient settings.
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Abstract
Obsessive-compulsive disorder (OCD) is a common, chronic, and oftentimes disabling disorder. The only established first-line treatments for OCD are exposure and response prevention, and serotonin reuptake inhibitor medications (SRIs). However, a subset of patients fails to respond to either modality, and few experience complete remission. Beyond SRI monotherapy, antipsychotic augmentation is the only medication approach for OCD with substantial empirical support. Our incomplete understanding of the neurobiology of OCD has hampered efforts to develop new treatments or enhance extant interventions. This review focuses on several promising areas of research that may help elucidate the pathophysiology of OCD and advance treatment. Multiple studies support a significant genetic contribution to OCD, but pinpointing the specific genetic determinants requires additional investigation. The preferential efficacy of SRIs in OCD has neither led to discovery of serotonergic abnormalities in OCD nor to development of new serotonergic medications for OCD. Several lines of preclinical and clinical evidence suggest dysfunction of the glutamatergic system in OCD, prompting testing of several promising glutamate modulating agents. Functional imaging studies in OCD show consistent evidence for increased activity in brain regions that form a cortico-striato-thalamo-cortical (CSTC) loop. Neuromodulation treatments with either noninvasive devices (e.g., transcranial magnetic stimulation) or invasive procedures (e.g., deep brain stimulation) provide further support for the CSTC model of OCD. A common substrate for various interventions (whether drug, behavioral, or device) may be modulation (at different nodes or connections) of the CSTC circuit that mediates the symptoms of OCD.
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Affiliation(s)
- Wayne K. Goodman
- Menninger Department of Psychiatry and Behavioral Sciences (all authors) and Department of Neurosurgery (Sheth), Baylor College of Medicine, Houston
| | - Eric A. Storch
- Menninger Department of Psychiatry and Behavioral Sciences (all authors) and Department of Neurosurgery (Sheth), Baylor College of Medicine, Houston
| | - Sameer A. Sheth
- Menninger Department of Psychiatry and Behavioral Sciences (all authors) and Department of Neurosurgery (Sheth), Baylor College of Medicine, Houston
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Abstract
It becomes increasingly clear that (non-)invasive neurostimulation is an effective treatment for obsessive-compulsive disorder (OCD). In this chapter we review the available evidence on techniques and targets, clinical results including a meta-analysis, mechanisms of action, and animal research. We focus on deep brain stimulation (DBS), but also cover non-invasive neurostimulation including transcranial magnetic stimulation (TMS). Data shows that most DBS studies target the ventral capsule/ventral striatum (VC/VS), with an overall 76% response rate in treatment-refractory OCD. Also TMS holds clinical promise. Increased insight in the normalizing effects of neurostimulation on cortico-striatal-thalamic-cortical (CSTC) loops - through neuroimaging and animal research - provides novel opportunities to further optimize treatment strategies. Advancing clinical implementation of neurostimulation techniques is essential to ameliorate the lives of the many treatment-refractory OCD patients.
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tDCS as a treatment for anxiety and related cognitive deficits. Int J Psychophysiol 2020; 158:172-177. [PMID: 33129848 DOI: 10.1016/j.ijpsycho.2020.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/07/2020] [Accepted: 10/16/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Anxiety is characterized by psychological, physiological, and cognitive complaints. Current treatments have significant limitations, and often overlook any potential benefits to common cognitive symptoms, notably attention and executive function issues. The current study aimed to investigate the use of transcranial direct current stimulation (tDCS) on both common anxiety symptoms and executive function abilities in a college aged sample. METHOD As this is one of the first large scale anxiety studies utilizing tDCS, participants were given a single session of tDCS (anodal, cathodal, or sham) for 20 min at 2 mA over the left dorsolateral prefrontal cortex (lDLPFC). Participants also completed a series of self-reported anxiety measures and measures of executive functioning (Rey-O Copy and Wisconsin Card Sorting Task). RESULTS While there were no differences in anxiety between tDCS groups, a trend was noted demonstrating better performance on Rey-O Copy for the cathodal group. Anxiety increased pre to post for all groups. CONCLUSION Overall, results suggest that while anodal stimulation of the lDLPFC may benefit cognitive abilities for this population, targeting psychological symptoms of anxiety likely requires stimulation over other cortex, possibly right DLPFC. Further, the use of tDCS, whether active or sham, may be distressing to patients.
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Peris TS, Piacentini J, Vreeland A, Salgari G, Levitt JG, Alger JR, Posse S, McCracken JT, O'Neill J. Neurochemical correlates of behavioral treatment of pediatric trichotillomania. J Affect Disord 2020; 273:552-561. [PMID: 32560953 DOI: 10.1016/j.jad.2020.04.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/30/2020] [Accepted: 04/27/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trichotillomania (TTM) is a chronic and impairing psychiatric disorder with suspected dysfunctional cortico-striato-thalamo-cortical (CSTC) circuit activity reflecting excitatory/inhibitory signaling imbalance. TTM neurochemistry is understudied, with no prior research using magnetic resonance spectroscopy (MRS). This pilot investigation examined associations between TTM diagnosis, symptom severity, and response to behavioral treatment with MRS neurometabolites glutamate (Glu) and γ-aminobutyric acid (GABA) in CSTC structures. METHODS Proton echo-planar spectroscopic imaging (PEPSI) MRS was acquired from bilateral pregenual anterior cingulate cortex (pACC), caudate, putamen, globus pallidus, thalamus, and proximal white matter in 10 unmedicated girls with TTM, ages 9-17 years, before and after treatment, and from 13 age- and sex-matched healthy controls. RESULTS Nine of 10 TTM patients were treatment responders. Pretreatment mean Glu and GABA did not differ significantly between participants and controls. Pretreatment TTM symptoms were correlated with Glu in (left + right) pACC (r = 0.88, p = 0.02) and thalamus (r = 0.82, p = 0.012), and were negatively correlated with pACC GABA (r = -0.84, p = 0.034). Mean GABA in putamen increased 69% (baseline to post-treatment) (p = 0.027). Higher pretreatment Glu in caudate, putamen, globus pallidus, and thalamus predicted greater symptom decreases with treatment (all r < -0.6, p < 0.05); higher caudate GABA predicted less treatment-related symptom decline (r = 0.86, p = 0.014). LIMITATIONS Small sample, GABA quantified with spectral fitting rather than editing. CONCLUSION Consistent with other neuroimaging, MRS reveals discrete CSTC chemical changes with effective behavior therapy, and possibly with TTM etiology. TTM symptoms relate to excess excitatory versus inhibitory signaling in pACC and thalamus; symptom improvement may reflect reduced excitatory drive of the CSTC direct-pathway activity.
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Affiliation(s)
- Tara S Peris
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024, USA
| | - John Piacentini
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024, USA
| | - Allison Vreeland
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024, USA
| | - Giulia Salgari
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024, USA
| | - Jennifer G Levitt
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024, USA
| | - Jeffrey R Alger
- UCLA Departments of Neurology and Radiological Sciences, Los Angeles, CA 90024, USA
| | - Stefan Posse
- Departments of Electrical and Computer Engineering, Neurology, and Physics and Astronomy, University of New Mexico, Albuquerque, NM 87106, USA
| | - James T McCracken
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024, USA
| | - Joseph O'Neill
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024, USA.
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The Necessity of Preventing Obsessive-Compulsive Disorder During the COVID-19 Pandemic. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2020. [DOI: 10.5812/ijpbs.104749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Harika-Germaneau G, Heit D, Chatard A, Thirioux B, Langbour N, Jaafari N. Treating refractory obsessive-compulsive disorder with transcranial direct current stimulation: An open label study. Brain Behav 2020; 10:e01648. [PMID: 32406608 PMCID: PMC7375126 DOI: 10.1002/brb3.1648] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a complex disorder with 40%-60% of patients' refractory to treatment. Transcranial direct current stimulation (tDCS) has been shown to induce potent and long-lasting effects on cortical excitability. The aim of the present clinical trial was to evaluate the therapeutic efficacy and tolerability of cathodal tDCS over the supplementary motor area (SMA) in treatment-resistant OCD patients. METHODS Twenty-one treatment-resistant OCD outpatients received 10 sessions of tDCS. Each treatment session consisted of 2 mA stimuli for 30 min. The cathode was positioned over the bilateral SMA and the anode over the right supraorbital area. Patients were evaluated at baseline, end of treatment, one-month follow-up, and three-month follow-up. Response to treatment was defined as at least a decrease of 35% on the Yale-Brown Obsessive-Compulsive Scale (YBOCS) and a score of 2 or less on the Clinical Global Impressions-Improvement (CGI-I) between baseline and 1-month follow-up. RESULTS There was a significant decrease of YBOCS scores between baseline and one-month assessment. At one month, five patients (24%) were considered as responders and 3 (15%) at 3 months. We also observed concomitant changes in depressive symptoms, and insight. The treatment was well tolerated. Short-lasting side effects were reported as localized tingling sensation and skin redness. CONCLUSION Our results suggest that the use of cathodal tDCS over the SMA and anodal tDCS over the right supraorbital area in OCD treatment-refractory patients is safe and promising to improve obsessive and compulsive symptoms. Large randomized controlled trials are needed to confirm this positive result.
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Affiliation(s)
- Ghina Harika-Germaneau
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France.,Université de Poitiers, Poitiers, France.,Laboratoire de Neurosciences Expérimentales et Cliniques, INSERM U 1084, Poitiers, France
| | - Damien Heit
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Armand Chatard
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France.,Université de Poitiers, Poitiers, France.,Laboratoire CeRCA, CNRS 7295, Poitiers, France
| | - Berangere Thirioux
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nicolas Langbour
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nemat Jaafari
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France.,Université de Poitiers, Poitiers, France.,Laboratoire de Neurosciences Expérimentales et Cliniques, INSERM U 1084, Poitiers, France
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Lustberg D, Iannitelli AF, Tillage RP, Pruitt M, Liles LC, Weinshenker D. Central norepinephrine transmission is required for stress-induced repetitive behavior in two rodent models of obsessive-compulsive disorder. Psychopharmacology (Berl) 2020; 237:1973-1987. [PMID: 32313981 PMCID: PMC7961804 DOI: 10.1007/s00213-020-05512-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/26/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE Obsessive-compulsive disorder (OCD) is characterized by repetitive behaviors exacerbated by stress. Many OCD patients do not respond to available pharmacotherapies, but neurosurgical ablation of the anterior cingulate cortex (ACC) can provide symptomatic relief. Although the ACC receives noradrenergic innervation and expresses adrenergic receptors (ARs), the involvement of norepinephrine (NE) in OCD has not been investigated. OBJECTIVE To determine the effects of genetic or pharmacological disruption of NE neurotransmission on marble burying (MB) and nestlet shredding (NS), two animal models of OCD. METHODS We assessed NE-deficient (Dbh -/-) mice and NE-competent (Dbh +/-) controls in MB and NS tasks. We also measured the effects of anti-adrenergic drugs on NS and MB in control mice and the effects of pharmacological restoration of central NE in Dbh -/- mice. Finally, we compared c-fos induction in the locus coeruleus (LC) and ACC of Dbh -/- and control mice following both tasks. RESULTS Dbh -/- mice virtually lacked MB and NS behaviors seen in control mice but did not differ in the elevated zero maze (EZM) model of general anxiety-like behavior. Pharmacological restoration of central NE synthesis in Dbh -/- mice completely rescued NS behavior, while NS and MB were suppressed in control mice by anti-adrenergic drugs. Expression of c-fos in the ACC was attenuated in Dbh -/- mice after MB and NS. CONCLUSION These findings support a role for NE transmission to the ACC in the expression of stress-induced compulsive behaviors and suggest further evaluation of anti-adrenergic drugs for OCD is warranted.
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Affiliation(s)
- Daniel Lustberg
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - Alexa F Iannitelli
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - Rachel P Tillage
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - Molly Pruitt
- University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - L Cameron Liles
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - David Weinshenker
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA.
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Kang S, Noh HJ, Bae SH, Kim YS, Lew H, Lim J, Kim SJ, Hong KS, Rah JC, Kim CH. Clozapine generates obsessive compulsive disorder-like behavior in mice. Mol Brain 2020; 13:84. [PMID: 32471517 PMCID: PMC7257162 DOI: 10.1186/s13041-020-00621-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/12/2020] [Indexed: 11/23/2022] Open
Abstract
Clozapine is thought to induce obsessive compulsive symptoms (OCS) in schizophrenic patients. However, because OCS are often comorbid with schizophrenia regardless of clozapine treatment, it remains unclear whether clozapine can generate OCS de novo. Thus, it has been difficult to establish a causal link between clozapine and OCS in human studies. To address this question, we asked whether chronic treatment with clozapine can induce obsessive compulsive disorder (OCD)-like behavior in mice. We injected mice with long-term continuous release pellets embedded with clozapine four times at 60-day intervals and then monitored the mice for signs of OCD-like behavior up to 40 wk. of age. We found clozapine increases grooming behavior as early as 30 wk. of age. We also investigated the effect clozapine on grooming behavior in Sapap3 knockout (KO) mice, which are a well-known animal model of OCD. In Sapap3 heterozygous KO mice, clozapine increases grooming behavior much earlier than in wild-type mice, suggesting a clozapine-OCD gene interaction. Fluoxetine, which is often used in the treatment of OCS and OCD, reduced the grooming behavior induced by clozapine. These data demonstrate that chronic clozapine treatment can generate OCD-like behavior in mice and support the hypothesis that clozapine produces de novo OCS regardless of schizophrenia status.
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Affiliation(s)
- Shinwon Kang
- Department of Pharmacology, BK21 PLUS Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Hyun Jong Noh
- Department of Pharmacology, BK21 PLUS Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | | | - Yong-Seok Kim
- Korea Brain Research Institute, Daegu, 41068, South Korea.,Department of Brain and Cognitive Sciences, DGIST, Daegu, 42988, South Korea
| | - Hogun Lew
- Department of Pharmacology, BK21 PLUS Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Jisoo Lim
- Department of Pharmacology, BK21 PLUS Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Se Joo Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Kyung Sue Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, 06351, South Korea
| | - Jong-Cheol Rah
- Korea Brain Research Institute, Daegu, 41068, South Korea. .,Department of Brain and Cognitive Sciences, DGIST, Daegu, 42988, South Korea.
| | - Chul Hoon Kim
- Department of Pharmacology, BK21 PLUS Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea. .,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea.
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48
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Geramita MA, Yttri EA, Ahmari SE. The two‐step task, avoidance, and OCD. J Neurosci Res 2020; 98:1007-1019. [DOI: 10.1002/jnr.24594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 01/02/2020] [Accepted: 01/30/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Matthew A. Geramita
- Department of Psychiatry University of Pittsburgh Pittsburgh PA USA
- Department of Biological Sciences Carnegie Mellon University Pittsburgh PA USA
- Center for Neural Basis of Cognition University of Pittsburgh Pittsburgh PA USA
| | - Eric A. Yttri
- Department of Biological Sciences Carnegie Mellon University Pittsburgh PA USA
- Center for Neural Basis of Cognition University of Pittsburgh Pittsburgh PA USA
| | - Susanne E. Ahmari
- Department of Psychiatry University of Pittsburgh Pittsburgh PA USA
- Center for Neural Basis of Cognition University of Pittsburgh Pittsburgh PA USA
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Khoo SYS, Correia V, Uhrig A. Nesting material enrichment reduces severity of overgrooming-related self-injury in individually housed rats. Lab Anim 2020; 54:546-558. [PMID: 31924130 DOI: 10.1177/0023677219894356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individual or singly-housing laboratory rats is common in many animal facilities, but has an adverse impact on the welfare of this social species. It has previously been shown that a small proportion of individually housed mice (∼5%) engage in pathological overgrooming behaviour, but this has not been assessed in rats. We performed an observational study to determine the prevalence of overgrooming-related self-injury and whether providing nesting material enrichment throughout an animal's life would affect the prevalence or severity of overgrooming-related self-injury. Due to protocol differences between projects in our behavioural neuroscience lab, unenriched rats received a nylabone and a shelter (n = 167), while baseline-enriched rats received a nylabone, shelter and shredded paper nesting material throughout experiments (n = 238). Unenriched rats received nesting material enrichment after the onset of overgrooming-related self-injury. Over 18 months, rats were monitored by their experimenters on a daily basis (5-7 days/week over 2-3 months/project) and any cases of overgrooming-related self-injury were recorded. Replicating the findings of previous studies in mice, we observed 20 cases of overgrooming-related self-injury (∼5%) with no difference in prevalence between rats on the basis of supplier, cage position, experimental procedure (behavioural only or involving surgical procedures), reinforcer (ethanol or sugar) or level of baseline-enrichment. While there was no difference in onset severity between rats that were unenriched at baseline and baseline-enriched rats, baseline-enriched rats had lower self-injury severity scores at one-, two- and four-week follow-ups. These results suggest that nesting material enrichment provided throughout an animal's life may reduce overgrooming-related self-injury.
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Affiliation(s)
- Shaun Y-S Khoo
- Center for Studies in Behavioral Neurobiology, Department of Psychology, 5618Concordia University, Montreal, Canada
| | - Vanessa Correia
- Center for Studies in Behavioral Neurobiology, Department of Psychology, 5618Concordia University, Montreal, Canada
| | - Alexandra Uhrig
- Center for Studies in Behavioral Neurobiology, Department of Psychology, 5618Concordia University, Montreal, Canada
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Obsessive-Compulsive Disorder: Lesions. Stereotact Funct Neurosurg 2020. [DOI: 10.1007/978-3-030-34906-6_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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