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Craven AR, Dwyer G, Ersland L, Kazimierczak K, Noeske R, Sandøy LB, Johnsen E, Hugdahl K. GABA, glutamatergic dynamics and BOLD contrast assessed concurrently using functional MRS during a cognitive task. NMR IN BIOMEDICINE 2024; 37:e5065. [PMID: 37897259 DOI: 10.1002/nbm.5065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/30/2023]
Abstract
A recurring issue in functional neuroimaging is how to link task-driven haemodynamic blood oxygen level dependent functional MRI (BOLD-fMRI) responses to underlying neurochemistry at the synaptic level. Glutamate and γ-aminobutyric acid (GABA), the major excitatory and inhibitory neurotransmitters respectively, are typically measured with MRS sequences separately from fMRI, in the absence of a task. The present study aims to resolve this disconnect, developing acquisition and processing techniques to simultaneously assess GABA, glutamate and glutamine (Glx) and BOLD in relation to a cognitive task, at 3 T. Healthy subjects (N = 81) performed a cognitive task (Eriksen flanker), which was presented visually in a task-OFF, task-ON block design, with individual event onset timing jittered with respect to the MRS readout. fMRS data were acquired from the medial anterior cingulate cortex during task performance, using an adapted MEGA-PRESS implementation incorporating unsuppressed water-reference signals at a regular interval. These allowed for continuous assessment of BOLD activation, through T2 *-related changes in water linewidth. BOLD-fMRI data were additionally acquired. A novel linear model was used to extract modelled metabolite spectra associated with discrete functional stimuli, building on well established processing and quantification tools. Behavioural outcomes from the flanker task, and activation patterns from the BOLD-fMRI sequence, were as expected from the literature. BOLD response assessed through fMRS showed a significant correlation with fMRI, specific to the fMRS-targeted region of interest; fMRS-assessed BOLD additionally correlated with lengthening of response time in the incongruent flanker condition. While no significant task-related changes were observed for GABA+, a significant increase in measured Glx levels (~8.8%) was found between task-OFF and task-ON periods. These findings verify the efficacy of our protocol and analysis pipelines for the simultaneous assessment of metabolite dynamics and BOLD. As well as establishing a robust basis for further work using these techniques, we also identify a number of clear directions for further refinement in future studies.
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Affiliation(s)
- Alexander R Craven
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
- NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Gerard Dwyer
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Lars Ersland
- Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
- NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway
| | | | | | - Lydia Brunvoll Sandøy
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Department of Physics and Technology, University of Bergen, Bergen, Norway
| | - Erik Johnsen
- NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
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Heinzel A, Mauler J, Herzog H, Boers F, Mottaghy FM, Langen KJ, Scheins J, Lerche C, Neumaier B, Northoff G, Shah NJ. GABA A receptor availability relates to emotion-induced BOLD responses in the medial prefrontal cortex: simultaneous fMRI/PET with [ 11C]flumazenil. Front Neurosci 2023; 17:1027697. [PMID: 37766785 PMCID: PMC10520870 DOI: 10.3389/fnins.2023.1027697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction The fMRI BOLD response to emotional stimuli highlighting the role of the medial prefrontal cortex (MPFC) has been thoroughly investigated. Recently, the relationship between emotion processing and GABA levels has been studied using MPFC proton magnetic resonance spectroscopy (1H-MRS). However, the role of GABAA receptors in the MPFC during emotion processing remains unexplored. Methods Using [11C]flumazenil PET, we investigated the relationship between the binding potential of GABAA receptors and emotion processing as measured using simultaneous fMRI BOLD. We hypothesized a correlation between the percent signal change in the BOLD signal and the binding potential of GABAA receptors in the MPFC. In a combined simultaneous fMRI and [11C]flumazenil-PET study, we analyzed the data from 15 healthy subjects using visual emotional stimuli. Our task comprised two types of emotional processing: passive viewing and appraisal. Following the administration of a bolus plus infusion protocol, PET and fMRI data were simultaneously acquired in a hybrid 3 T MR-BrainPET. Results We found a differential correlation of BOLD percent signal change with [11C]flumazenil binding potential in the MPFC. Specifically, [11C]flumazenil binding potential in the ventromedial prefrontal cortex (vMPFC) correlated with passive viewing of emotionally valenced pictures. In contrast, the [11C]flumazenil binding potential and the BOLD signal induced by picture appraisal did show a correlation in the paracingulate gyrus. Conclusion Our data deliver first evidence for a relationship between MPFC GABAA receptors and emotion processing in the same region. Moreover, we observed that GABAA receptors appear to play different roles in emotion processing in the vMPFC (passive viewing) and paracingulate gyrus (appraisal).
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Affiliation(s)
- Alexander Heinzel
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
- Department of Nuclear Medicine, Medical Faculty RWTH Aachen, Aachen, Germany
- Department of Nuclear medicine, University Hospital Halle, Halle (Saale), Germany
| | - Jörg Mauler
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
| | - Hans Herzog
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
| | - Frank Boers
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
| | - Felix M. Mottaghy
- Department of Nuclear Medicine, Medical Faculty RWTH Aachen, Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
- Department of Nuclear Medicine, Medical Faculty RWTH Aachen, Aachen, Germany
| | - Jürgen Scheins
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
| | - Christoph Lerche
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
| | - Bernd Neumaier
- Institute of Neuroscience and Medicine – 5, Forschungszentrum Jülich, Jülich, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, Institute of Mental Health, Royal Ottawa Mental Health Centre and University of Ottawa, Ottawa, ON, Canada
| | - N. Jon Shah
- Institute of Neuroscience and Medicine – 4, Forschungszentrum Jülich, Jülich, Germany
- Institute of Neuroscience and Medicine – 11, Forschungszentrum Jülich, Jülich, Germany
- JARA – BRAIN – Translational Medicine, Aachen, Germany
- Department of Neurology, RWTH Aachen University, Aachen, Germany
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3
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Cao L, Feng R, Gao Y, Bao W, Zhou Z, Liang K, Hu X, Li H, Zhang L, Li Y, Zhuo L, Huang G, Huang X. Suprachiasmatic nucleus functional connectivity related to insomnia symptoms in adolescents with major depressive disorder. Front Psychiatry 2023; 14:1154095. [PMID: 37260759 PMCID: PMC10228684 DOI: 10.3389/fpsyt.2023.1154095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
Background Insomnia is a commonly seen symptom in adolescents with major depressive disorder (MDD). The suprachiasmatic nucleus (SCN), which is the circadian rhythm regulation center, plays a crucial role in the regulation of sleep-wake circulation. Nevertheless, how SCN function contributes to the exact neural mechanisms underlying the associations between insomnia and depressive symptoms has not been explored in adolescents. In the current study, we aimed to explore the relationship between SCN functional connectivity (FC) and insomnia symptoms in adolescents with MDD using a seed-based FC method. Methods In the current study, we recruited sixty-eight first-episode drug-naïve adolescents with MDD and classified them into high insomnia (MDD-HI) and low insomnia (MDD-LI) groups according to the sleep disturbance subscale of the Hamilton Depression Rating Scale (HAMD-S). Forty-three age/gender-matched healthy controls (HCs) were also recruited. SCN FC maps were generally for all subjects and compared among three groups using one-way ANOVA with age, gender and adjusted HAMD score as covariates. We used partial correlations to explore associations between altered FC and clinical symptoms, including sleep quality scores. Results Adolescents with MDD showed worse sleep quality, which positively correlated with the severity of depression. Compared to MDD-LI and HCs, MDD-HI adolescents demonstrated significantly decreased FC between the right SCN and bilateral precuneus, and there was no significant difference between the MDD-LI and HC groups. The HAMD-S scores were negatively correlated with bilateral SCN-precuneus connectivity, and the retardation factor score of HAMD was negatively correlated with right SCN-precuneus connectivity. Conclusion The altered FC between the SCN and precuneus may underline the neural mechanism of sleep-related symptoms in depressive adolescents and provide potential targets for personalized treatment strategies.
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Affiliation(s)
- Lingling Cao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Ruohan Feng
- Department of Radiology, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yingxue Gao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Weijie Bao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Zilin Zhou
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Kaili Liang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xinyue Hu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Hailong Li
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Lianqing Zhang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Yang Li
- Department of Psychiatry, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Lihua Zhuo
- Department of Radiology, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Guoping Huang
- Department of Psychiatry, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Xiaoqi Huang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
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Wang X, Wang T, Fan X, Zhang Z, Wang Y, Li Z. A Molecular Toolbox of Positron Emission Tomography Tracers for General Anesthesia Mechanism Research. J Med Chem 2023; 66:6463-6497. [PMID: 37145921 DOI: 10.1021/acs.jmedchem.2c01965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
With appropriate radiotracers, positron emission tomography (PET) allows direct or indirect monitoring of the spatial and temporal distribution of anesthetics, neurotransmitters, and biomarkers, making it an indispensable tool for studying the general anesthesia mechanism. In this Perspective, PET tracers that have been recruited in general anesthesia research are introduced in the following order: 1) 11C/18F-labeled anesthetics, i.e., PET tracers made from inhaled and intravenous anesthetics; 2) PET tracers targeting anesthesia-related receptors, e.g., neurotransmitters and voltage-gated ion channels; and 3) PET tracers for studying anesthesia-related neurophysiological effects and neurotoxicity. The radiosynthesis, pharmacodynamics, and pharmacokinetics of the above PET tracers are mainly discussed to provide a practical molecular toolbox for radiochemists, anesthesiologists, and those who are interested in general anesthesia.
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Affiliation(s)
- Xiaoxiao Wang
- Center for Molecular Imaging and Translational Medicine, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian 361102, China
| | - Tao Wang
- Center for Molecular Imaging and Translational Medicine, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian 361102, China
| | - Xiaowei Fan
- Center for Molecular Imaging and Translational Medicine, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian 361102, China
| | - Zhao Zhang
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yingwei Wang
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zijing Li
- Center for Molecular Imaging and Translational Medicine, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, Fujian 361102, China
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5
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Koush Y, Rothman DL, Behar KL, de Graaf RA, Hyder F. Human brain functional MRS reveals interplay of metabolites implicated in neurotransmission and neuroenergetics. J Cereb Blood Flow Metab 2022; 42:911-934. [PMID: 35078383 PMCID: PMC9125492 DOI: 10.1177/0271678x221076570] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/26/2021] [Accepted: 01/05/2022] [Indexed: 01/28/2023]
Abstract
While functional MRI (fMRI) localizes brain activation and deactivation, functional MRS (fMRS) provides insights into the underlying metabolic conditions. There is much interest in measuring task-induced and resting levels of metabolites implicated in neuroenergetics (e.g., lactate, glucose, or β-hydroxybutyrate (BHB)) and neurotransmission (e.g., γ-aminobutyric acid (GABA) or pooled glutamate and glutamine (Glx)). Ultra-high magnetic field (e.g., 7T) has boosted the fMRS quantification precision, reliability, and stability of spectroscopic observations using short echo-time (TE) 1H-MRS techniques. While short TE 1H-MRS lacks sensitivity and specificity for fMRS at lower magnetic fields (e.g., 3T or 4T), most of these metabolites can also be detected by J-difference editing (JDE) 1H-MRS with longer TE to filter overlapping resonances. The 1H-MRS studies show that JDE can detect GABA, Glx, lactate, and BHB at 3T, 4T and 7T. Most recently, it has also been demonstrated that JDE 1H-MRS is capable of reliable detection of metabolic changes in different brain areas at various magnetic fields. Combining fMRS measurements with fMRI is important for understanding normal brain function, but also clinically relevant for mechanisms and/or biomarkers of neurological and neuropsychiatric disorders. We provide an up-to-date overview of fMRS research in the last three decades, both in terms of applications and technological advances. Overall the emerging fMRS techniques can be expected to contribute substantially to our understanding of metabolism for brain function and dysfunction.
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Affiliation(s)
- Yury Koush
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Douglas L Rothman
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Kevin L Behar
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Robin A de Graaf
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Fahmeed Hyder
- Magnetic Resonance Research Center, Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
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6
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Kumar P, Nagaraj C, Joshi R, Goud NS, Kumar D, Korann V, Mangalore S, Rao NP. Radiosynthesis of [18F]flumazenil for imaging benzodiazepine receptors and its evaluation in human volunteers using simultaneous PET-MRI. J Radioanal Nucl Chem 2021. [DOI: 10.1007/s10967-021-07859-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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7
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Out-of-step: brain-heart desynchronization in anxiety disorders. Mol Psychiatry 2021; 26:1726-1737. [PMID: 33504952 DOI: 10.1038/s41380-021-01029-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/30/2020] [Accepted: 01/12/2021] [Indexed: 12/11/2022]
Abstract
Imaging studies in anxiety disorders (AD) show abnormal functional connectivity primarily in the salience network (SN), somatomotor network (SMN), and default mode network (DMN). However, it is not clear how precisely these network changes occur including their relation to psychopathological symptoms. Here, we show that the functional networks affected in AD overlap with cortical regions that receive visceral inputs (the so-called central/visceral autonomic network). Focusing on cardiac afferents, we suggest that network changes in AD may be due to reduced phase synchronization between ongoing neural and cardiac activity. This neuro-cardiac desynchronization occurs due to the abnormal phase resetting of neural activity at the onset of each heartbeat, as measured by a lower intertrial coherence and heartbeat-evoked potential. Biochemically, cardiac afferents reach subcortical serotonergic raphe nuclei and noradrenergic locus coeruleus (among others) which, in turn, are known to reciprocally modulate the DMN and SMN/SN on the cortical level. Consistent with the network changes in AD, decreases in serotonergic and noradrenergic activity are known to increase connectivity in both SMN and SN while, at the same time, they decrease DMN connectivity. SMN and SN increases, in turn, lead to increased emotional arousal/anxiety and bodily awareness whereas decreased DMN connectivity leads to an unstable sense-of-self in AD. Finally, we integrate our proposal with interoceptive predictive processing models suggesting neuro-cardiac desynchronization as a mechanism for "noisy" bottom-up information leading to a persistently uncertain bodily state in top-down models. In sum, integrating theories on active interference and hyperarousal, we propose a precise neuro-cardiac and biochemically -driven mechanisms for key psychopathological symptoms of AD.
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8
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Abstract
An imbalance between excitatory and inhibitory neurotransmission has been linked to fibromyalgia (FM). Magnetic resonance spectroscopy has shown increased levels of glutamate in the insula and posterior cingulate cortex in FM as well as reduced insular levels of gamma-aminobutyric acid (GABA). Both of these changes have been associated with increased pain sensitivity. However, it is not clear whether excitatory and/or inhibitory neurotransmission is altered across the brain. Therefore, the aim of this study was to quantify GABAA receptor concentration on the whole brain level in FM to investigate a potential dysregulation of the GABAergic system. Fifty-one postmenopausal women (26 FM, 25 matched controls) underwent assessments of pain sensitivity, attention and memory, psychological status and function, as well as positron emission tomography imaging using a tracer for GABAA receptors, [F]flumazenil. Patients showed increased pain sensitivity, impaired immediate memory, and increased cortical GABAA receptor concentration in the attention and default-mode networks. No decrease of GABAA receptor concentration was observed. Across the 2 groups, GABAA receptor concentration correlated positively with functional scores and current pain in areas overlapping with regions of increased GABAA receptor concentration. This study shows increased GABAA receptor concentration in FM, associated with pain symptoms and impaired function. The changes were widespread and not restricted to pain-processing regions. These findings suggest that the GABAergic system is altered, possibly indicating an imbalance between excitatory and inhibitory neurotransmission. Future studies should try to understand the nature of the dysregulation of the GABAergic system in FM and in other pain syndromes.
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Cui H, Zhang B, Li W, Li H, Pang J, Hu Q, Zhang L, Tang Y, Yang Z, Wang J, Li C, Northoff G. Insula shows abnormal task-evoked and resting-state activity in first-episode drug-naïve generalized anxiety disorder. Depress Anxiety 2020; 37:632-644. [PMID: 32196828 DOI: 10.1002/da.23009] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 02/27/2020] [Accepted: 03/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Interoception is associated with neural activity in the insula of healthy humans. On the basis of the somatic symptoms in generalized anxiety disorder (GAD), especially abnormal heartbeat perception, we hypothesized that abnormal activity in the insula was associated with interoceptive awareness in patients with GAD. METHODS We investigated the psychological correlates of interoceptive awareness in a sample of 34 patients with first-onset, drug-naïve GAD and 30 healthy controls (HCs). Furthermore, we compared blood oxygenation level-dependent responses between the two groups during a heartbeat perception task to assess task-evoked activity and its relationship with psychological measures. We also examined between-group differences in insular subregions resting-state functional connectivity (rsFC), and its relationship with anxiety severity. RESULTS Patients with GAD had significantly higher body perception scores than HCs. They also exhibited greater task-evoked activity in the left anterior insula, left posterior insula, and right anterior insula during interoceptive awareness than HCs. Left anterior insula activity was positively correlated with body awareness in patients with GAD, and rsFC between the left anterior insula and left medial prefrontal gyrus was negatively correlated with somatic anxiety severity. CONCLUSIONS Investigating a sample of first-episode, drug-naïve patients, our study demonstrated abnormal interoceptive awareness in patients with GAD and that this was related to abnormal anterior insular activity during both rest and task. These results shed new light on the psychological and neural substrates of somatic symptoms in GAD, and they may serve to establish abnormal interoceptive awareness as a neural and psychological marker of GAD.
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Affiliation(s)
- Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaoyan Pang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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10
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Kühnel A, Widmann A, Colic L, Herrmann L, Demenescu LR, Leutritz AL, Li M, Grimm S, Nolte T, Fonagy P, Walter M. Impaired cognitive self-awareness mediates the association between alexithymia and excitation/inhibition balance in the pgACC. Psychol Med 2020; 50:1727-1735. [PMID: 31328716 DOI: 10.1017/s0033291719001806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous research showed that automatic emotion regulation is associated with activation of subcortical areas and subsequent feedforward processes to cortical areas. In contrast, cognitive awareness of emotions is mediated by negative feedback from cortical to subcortical areas. Pregenual anterior cingulate cortex (pgACC) is essential in the modulation of both affect and alexithymia. We considered the interplay between these two mechanisms in the pgACC and their relationship with alexithymia. METHOD In 68 healthy participants (30 women, age = 26.15 ± 4.22) we tested associations of emotion processing and alexithymia with excitation/inhibition (E/I) balance represented as glutamate (Glu)/GABA in the pgACC measured via magnetic resonance spectroscopy in 7 T. RESULTS Alexithymia was positively correlated with the Glu/GABA ratio (N = 41, p = 0.0393). Further, cognitive self-awareness showed an association with Glu/GABA (N = 52, p = 0.003), which was driven by a correlation with GABA. In contrast, emotion regulation was only correlated with glutamate levels in the pgACC (N = 49, p = 0.008). CONCLUSION Our results corroborate the importance of the pgACC as a mediating region of alexithymia, reflected in an altered E/I balance. Furthermore, we could specify that this altered balance is linked to a GABA-related modulation of cognitive self-awareness of emotions.
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Affiliation(s)
- A Kühnel
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - A Widmann
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Experimental and Molecular Psychiatry, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - L Colic
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry, Mood Disorders Research Program, Yale School of Medicine, New Haven, CT, USA
| | - L Herrmann
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - L R Demenescu
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
| | - A L Leutritz
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
| | - M Li
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, OVGU Magdeburg, Magdeburg, Germany
| | - S Grimm
- Department of Psychiatry, Charité, CBF, Berlin, Germany
- MSB Medical School Berlin, Calandrellistraße 1-9, 12247Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8032Zurich, Switzerland
| | - T Nolte
- The Anna Freud National Centre for Children and Families, London, UK
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - P Fonagy
- The Anna Freud National Centre for Children and Families, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - M Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
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11
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Chen X, Fan X, Hu Y, Zuo C, Whitfield-Gabrieli S, Holt D, Gong Q, Yang Y, Pizzagalli DA, Du F, Ongur D. Regional GABA Concentrations Modulate Inter-network Resting-state Functional Connectivity. Cereb Cortex 2020; 29:1607-1618. [PMID: 29608677 DOI: 10.1093/cercor/bhy059] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/30/2018] [Indexed: 02/05/2023] Open
Abstract
Coordinated activity within and differential activity between large-scale neuronal networks such as the default mode network (DMN) and the control network (CN) is a critical feature of brain organization. The CN usually exhibits activations in response to cognitive tasks while the DMN shows deactivations; in addition, activity between the two networks is anti-correlated at rest. To address this issue, we used functional MRI to measure whole-brain BOLD signal during resting-state and task-evoked conditions, and MR spectroscopy (MRS) to quantify GABA and glutamate concentrations, in nodes within the DMN and CN (MPFC and DLPFC, respectively) in 19 healthy individuals at 3 Tesla. We found that GABA concentrations in the MPFC were significantly associated with DMN deactivation during a working memory task and with anti-correlation between DMN and CN at rest and during task performance, while GABA concentrations in the DLPFC weakly modulated DMN-CN anti-correlation in the opposite direction. Highlighting specificity, glutamate played a less significant role related to brain activity. These findings indicate that GABA in the MPFC is potentially involved in orchestrating between-network brain activity at rest and during task performance.
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Affiliation(s)
- Xi Chen
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA.,Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Xiaoying Fan
- Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Yuzheng Hu
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Programs, National Institute of Health, Baltimore, MD, USA
| | - Chun Zuo
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Susan Whitfield-Gabrieli
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Daphne Holt
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Programs, National Institute of Health, Baltimore, MD, USA
| | - Diego A Pizzagalli
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA.,Center For Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Fei Du
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA.,Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Dost Ongur
- Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA
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12
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Northoff G. Anxiety Disorders and the Brain's Resting State Networks: From Altered Spatiotemporal Synchronization to Psychopathological Symptoms. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:71-90. [PMID: 32002923 DOI: 10.1007/978-981-32-9705-0_5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Anxiety disorders include a variety of different disorders including panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and phobias. We here focus our review on GAD, SAD, and PD and put a specific emphasis on resting state networks and the coupling between the brain and the heart as all anxiety disorders exhibit abnormal perception of their own heartbeat in some way or the other. Resting state functional connectivity (rsFC) studies demonstrate abnormalities in default-mode network (DMN) in all anxiety disorders, e.g., mostly decreases in rsFC of DMN. In contrast, resting state fMRI shows increased rsFC in salience network (SN) (SAD, GAD) and/or somato-motor/sensory network (SMN) (PD). Since rsFC is coherence- or phase-based operating in the infraslow frequency domain (0.01-0.1 Hz), these data suggest spatiotemporal hypo- or hyper-synchronization in DMN and SMN/SN, respectively. These abnormalities in the neural network's spatiotemporal synchronization may, in turn, impact phase-based temporal synchronization of neural and cardiac activities resulting in decreased (DMN) or increased (SMN/SN) neuro-cardiac coupling in anxiety disorders. That, in turn, may be related to the various psychopathological symptoms like unstable sense of self (as based on unstable DMN showing spatiotemporal hypo-synchronization), increased emotions and specifically anxiety (as related to increased SN showing spatiotemporal hyper-synchronization), and increased bodily awareness (mediated by increased SMN with spatiotemporal hyper-synchronization) in anxiety disorders. Taken together, we here suggest altered spatiotemporal synchronization of neural and cardiac activity within the brain's resting state to underlie various psychopathological symptoms in anxiety disorders. Such spatiotemporal basis of psychopathological symptoms is well compatible with the recently suggested "Spatiotemporal Psychopathology."
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Affiliation(s)
- Georg Northoff
- EJLB-Michael Smith Chair for Neuroscience and Mental Health, Royal Ottawa Healthcare Group, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
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13
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Horder J, Andersson M, Mendez MA, Singh N, Tangen Ä, Lundberg J, Gee A, Halldin C, Veronese M, Bölte S, Farde L, Sementa T, Cash D, Higgins K, Spain D, Turkheimer F, Mick I, Selvaraj S, Nutt DJ, Lingford-Hughes A, Howes OD, Murphy DG, Borg J. GABA A receptor availability is not altered in adults with autism spectrum disorder or in mouse models. Sci Transl Med 2019; 10:10/461/eaam8434. [PMID: 30282698 DOI: 10.1126/scitranslmed.aam8434] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 08/15/2017] [Accepted: 12/15/2017] [Indexed: 01/16/2023]
Abstract
Preliminary studies have suggested that γ-aminobutyric acid type A (GABAA) receptors, and potentially the GABAA α5 subtype, are deficient in autism spectrum disorder (ASD). However, prior studies have been confounded by the effects of medications, and these studies did not compare findings across different species. We measured both total GABAA and GABAA α5 receptor availability in two positron emission tomography imaging studies. We used the tracer [11C]flumazenil in 15 adults with ASD and in 15 control individuals without ASD and the tracer [11C]Ro15-4513 in 12 adults with ASD and in 16 control individuals without ASD. All participants were free of medications. We also performed autoradiography, using the same tracers, in three mouse models of ASD: the Cntnap2 knockout mouse, the Shank3 knockout mouse, and mice carrying a 16p11.2 deletion. We found no differences in GABAA receptor or GABAA α5 subunit availability in any brain region of adults with ASD compared to those without ASD. There were no differences in GABAA receptor or GABAA α5 subunit availability in any of the three mouse models. However, adults with ASD did display altered performance on a GABA-sensitive perceptual task. Our data suggest that GABAA receptor availability may be normal in adults with ASD, although GABA signaling may be functionally impaired.
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Affiliation(s)
- Jamie Horder
- Department of Forensic and Neurodevelopmental Sciences and Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Max Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
| | - Maria A Mendez
- Department of Forensic and Neurodevelopmental Sciences and Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nisha Singh
- Department of Neuroimaging, Institute of Psychiatry Psychology, and Neuroscience, King's College London, London, UK.,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Ämma Tangen
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
| | - Johan Lundberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
| | - Antony Gee
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Christer Halldin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry Psychology, and Neuroscience, King's College London, London, UK
| | - Sven Bölte
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Lars Farde
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden.,Personalised Healthcare and Biomarkers, AstraZeneca, PET Science Centre, Karolinska Institutet, Stockholm, Sweden
| | - Teresa Sementa
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Diana Cash
- Department of Neuroimaging, Institute of Psychiatry Psychology, and Neuroscience, King's College London, London, UK
| | - Karen Higgins
- Department of Neuroimaging, Institute of Psychiatry Psychology, and Neuroscience, King's College London, London, UK
| | - Debbie Spain
- Department of Forensic and Neurodevelopmental Sciences and Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federico Turkheimer
- Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
| | - Inge Mick
- Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
| | - Sudhakar Selvaraj
- Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
| | - David J Nutt
- Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
| | - Anne Lingford-Hughes
- Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences and Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Jacqueline Borg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden.,Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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14
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Reuveni I, Nugent AC, Gill J, Vythilingam M, Carlson PJ, Lerner A, Neumeister A, Charney DS, Drevets WC, Bonne O. Altered cerebral benzodiazepine receptor binding in post-traumatic stress disorder. Transl Psychiatry 2018; 8:206. [PMID: 30287828 PMCID: PMC6172250 DOI: 10.1038/s41398-018-0257-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 07/19/2018] [Accepted: 08/17/2018] [Indexed: 12/27/2022] Open
Abstract
Agonists of the γ-aminobutyric acid (GABA) type A benzodiazepine (BZD) receptor exert anxiolytic effects in anxiety disorders, raising the possibility that altered GABA-ergic function may play a role in the pathophysiology of anxiety disorders, such as post-traumatic stress disorder (PTSD). However, few neuroimaging studies have assessed the function or binding potential of the central GABAA BZD receptor system in PTSD. Therefore, our aim was to compare the BZD receptor binding potential between PTSD patients and healthy controls. Twelve medication-free participants with a current diagnosis of PTSD and 15 matched healthy controls underwent positron emission tomography (PET) imaging using [11C] flumazenil. Structural magnetic resonance imaging (MRI) scans were obtained and co-registered to the PET images to permit co-location of neuroanatomical structures in the lower resolution PET image data. Compared to healthy controls, PTSD patients exhibited increased BZD binding in the caudal anterior cingulate cortex and precuneus (p's < 0.05). Severity of PTSD symptoms positively correlated with BZD binding in the left mid- and anterior insular cortices. This study extends previous findings by suggesting that central BZD receptor system involvement in PTSD includes portions of the default mode and salience networks, along with insular regions that support interoception and autonomic arousal.
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Affiliation(s)
- Inbal Reuveni
- 0000 0001 2221 2926grid.17788.31Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Allison C. Nugent
- 0000 0004 0464 0574grid.416868.5Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Jessica Gill
- 0000 0001 2297 5165grid.94365.3dCenter for Neuroscience and Regenerative Medicine (CNRM), National Institutes of Health, Bethesda, MD USA
| | - Meena Vythilingam
- Deployment Health Clinical Center, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Silver Spring, MD USA
| | - Paul J. Carlson
- 0000 0001 2193 0096grid.223827.eDepartment of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Alicja Lerner
- 0000 0001 2243 3366grid.417587.8Controlled Substance Staff, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Alexander Neumeister
- 0000 0001 2182 2255grid.28046.38Institute of Mental Health Research (IMHR), University of Ottawa, Ottawa, ON Canada
| | - Dennis S. Charney
- 0000 0001 0670 2351grid.59734.3cMood and Anxiety Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Wayne C. Drevets
- grid.417429.dJanssen Research and Development, LLC of Johnson & Johnson Inc., Titusville, NJ USA
| | - Omer Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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15
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Sun R, Wang G, Gao X, Wang S. Flumazenil reduces respiratory complications during anesthesia emergence in children with preoperative upper respiratory tract infections. Medicine (Baltimore) 2018; 97:e0516. [PMID: 29703020 PMCID: PMC5944528 DOI: 10.1097/md.0000000000010516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Despite its benignity, upper respiratory infections (URIs) 1 increase the risk of postoperative respiratory complications during the perioperative and postoperative periods. Flumazenil could improve the symptoms of respiratory obstruction.To evaluate the effect of flumazenil on the occurrence of respiratory complications during anesthesia emergence of children with preoperative URI.This was a prospective study of 164 consecutive pediatric patients who underwent strabismus surgery under general anesthesia at the Tianjin Eye Hospital between August 2016 and April 2017. The patients were grouped as: normal airway (N), recent mild URI (I), normal airway and flumazenil (NF), and recent mild URI and flumazenil (group IF) (n = 41/group). An initial dose of flumazenil (0.1 mg) was administrated intravenously to groups IF and NF. The intraoperative and postoperative respiratory complications were recorded by one anesthesiologist unaware of the grouping.All patients underwent surgery uneventfully. The incidence of postoperative respiratory complications in post-anesthesia care unit (PACU) was higher in group I compared with the other 3 groups (IF: 17%; I: 41%; NF: 5%; N: 10%; P = .0147). During the PACU period, significant differences among groups were seen for cough (IF: 15%; I: 20%; NF: 2%; N: 0%; P = .004), secretion (IF: 17%; I: 29%; NF: 5%; N: 7%; P = .007), low oxygen saturation (IF: 12%; I: 32%; NF: 2%; N: 7%; P = .001), and glossocoma (IF: 15%; I: 34%; NF: 10%; N: 32%; P = .015).Respiratory complications during anesthesia emergence were higher in patients with recent preoperative URI compared to patients with healthy airways. Postoperative flumazenil could reduce the incidence of glossocoma.
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Affiliation(s)
- Ruiqiang Sun
- Cinical College of Ophthalmology, Tianjin Medical University
| | - Guolin Wang
- General Hospital of Tianjin Medical University, Tianjin, China
| | - Xuesong Gao
- Cinical College of Ophthalmology, Tianjin Medical University
| | - Shuzhen Wang
- Cinical College of Ophthalmology, Tianjin Medical University
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16
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Kassenbrock A, Vasdev N, Liang SH. Selected PET Radioligands for Ion Channel Linked Neuroreceptor Imaging: Focus on GABA, NMDA and nACh Receptors. Curr Top Med Chem 2017; 16:1830-42. [PMID: 26975506 DOI: 10.2174/1568026616666160315142457] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/01/2015] [Accepted: 08/03/2015] [Indexed: 12/11/2022]
Abstract
Positron emission tomography (PET) neuroimaging of ion channel linked receptors is a developing area of preclinical and clinical research. The present review focuses on recent advances with radiochemistry, preclinical and clinical PET imaging studies of three receptors that are actively pursued in neuropsychiatric drug discovery: namely the γ-aminobutyric acid-benzodiazapine (GABA) receptor, nicotinic acetylcholine receptor (nAChR), and N-methyl-D-aspartate (NMDA) receptor. Recent efforts to develop new PET radioligands for these targets with improved brain uptake, selectivity, stability and pharmacokinetics are highlighted.
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Affiliation(s)
| | | | - Steven H Liang
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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17
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Burhan AM, Marlatt NM, Palaniyappan L, Anazodo UC, Prato FS. Role of Hybrid Brain Imaging in Neuropsychiatric Disorders. Diagnostics (Basel) 2015; 5:577-614. [PMID: 26854172 PMCID: PMC4728476 DOI: 10.3390/diagnostics5040577] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/21/2015] [Accepted: 11/26/2015] [Indexed: 01/09/2023] Open
Abstract
This is a focused review of imaging literature to scope the utility of hybrid brain imaging in neuropsychiatric disorders. The review focuses on brain imaging modalities that utilize hybrid (fusion) techniques to characterize abnormal brain molecular signals in combination with structural and functional changes that have been observed in neuropsychiatric disorders. An overview of clinical hybrid brain imaging technologies for human use is followed by a selective review of the literature that conceptualizes the use of these technologies in understanding basic mechanisms of major neuropsychiatric disorders and their therapeutics. Neuronal network abnormalities are highlighted throughout this review to scope the utility of hybrid imaging as a potential biomarker for each disorder.
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Affiliation(s)
- Amer M Burhan
- St. Joseph's Health Care London, Parkwood Institute, 550 Wellington Road, London, ON N6C 0A7, Canada.
- Department of Psychiatry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6C 2R6, Canada.
| | - Nicole M Marlatt
- St. Joseph's Health Care London, Parkwood Institute, 550 Wellington Road, London, ON N6C 0A7, Canada.
| | - Lena Palaniyappan
- Department of Psychiatry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6C 2R6, Canada.
| | | | - Frank S Prato
- Lawson Health Research Institute, London, ON N6C 2R5, Canada.
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18
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Bai Y, Nakao T, Xu J, Qin P, Chaves P, Heinzel A, Duncan N, Lane T, Yen NS, Tsai SY, Northoff G. Resting state glutamate predicts elevated pre-stimulus alpha during self-relatedness: A combined EEG-MRS study on “rest-self overlap”. Soc Neurosci 2015. [DOI: 10.1080/17470919.2015.1072582] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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19
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Hayes DJ. GABAergic circuits underpin valuative processing. Front Syst Neurosci 2015; 9:76. [PMID: 26029062 PMCID: PMC4428122 DOI: 10.3389/fnsys.2015.00076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 04/26/2015] [Indexed: 11/21/2022] Open
Affiliation(s)
- Dave J Hayes
- Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, Toronto Western Hospital, University Health Network Toronto, ON, Canada
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20
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Wiebking C, de Greck M, Duncan NW, Tempelmann C, Bajbouj M, Northoff G. Interoception in insula subregions as a possible state marker for depression-an exploratory fMRI study investigating healthy, depressed and remitted participants. Front Behav Neurosci 2015; 9:82. [PMID: 25914633 PMCID: PMC4392695 DOI: 10.3389/fnbeh.2015.00082] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/17/2015] [Indexed: 12/16/2022] Open
Abstract
Background: Interoceptive awareness (iA), the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored. Methods: A well-established fMRI paradigm for studying (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups. Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences. Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst non-psychiatric participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
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Affiliation(s)
- Christine Wiebking
- Cluster of Excellence in Cognitive Sciences, Department of Sociology of Physical Activity and Health, University of Potsdam Potsdam, Germany ; Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, University of Ottawa Ottawa, ON, Canada
| | - Moritz de Greck
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine Mainz Mainz, Germany
| | - Niall W Duncan
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, University of Ottawa Ottawa, ON, Canada ; Centre for Cognition and Brain Disorders, Hangzhou Normal University Hangzhou, China ; Graduate Institute of Humanities in Medicine, Taipei Medical University Taipei, Taiwan ; Brain and Consciousness Research Center, Taipei Medical University-Shuang Ho Hospital New Taipei City, Taiwan
| | - Claus Tempelmann
- Department of Neurology, Otto-von-Guericke University Magdeburg Magdeburg, Germany
| | - Malek Bajbouj
- Cluster of Excellence "Languages of Emotion" and Dahlem Institute for Neuroimaging of Emotion, Freie Universität Berlin Berlin, Germany ; Department of Psychiatry, Charité-Universitätsmedizin, Campus Benjamin Franklin Berlin, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, University of Ottawa Ottawa, ON, Canada ; Centre for Cognition and Brain Disorders, Hangzhou Normal University Hangzhou, China ; Graduate Institute of Humanities in Medicine, Taipei Medical University Taipei, Taiwan ; Brain and Consciousness Research Center, Taipei Medical University-Shuang Ho Hospital New Taipei City, Taiwan ; Department of Psychology, National Chengchi University Taipei, Taiwan
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21
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Affiliation(s)
- Georg Northoff
- University of Ottawa Institute of Mental Health Research, Ottawa, Canada; Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China; Center for Brain and Consciousness and College for Humanities and Medicine, Taipeh Medical UniversityTaipeh, Taiwan
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22
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Pettingill P, Kramer HB, Coebergh JA, Pettingill R, Maxwell S, Nibber A, Malaspina A, Jacob A, Irani SR, Buckley C, Beeson D, Lang B, Waters P, Vincent A. Antibodies to GABAA receptor α1 and γ2 subunits: clinical and serologic characterization. Neurology 2015; 84:1233-41. [PMID: 25636713 PMCID: PMC4366091 DOI: 10.1212/wnl.0000000000001326] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective: To search for antibodies against neuronal cell surface proteins. Methods: Using immunoprecipitation from neuronal cultures and tandem mass spectrometry, we identified antibodies against the α1 subunit of the γ-aminobutyric acid A receptor (GABAAR) in a patient whose immunoglobulin G (IgG) antibodies bound to hippocampal neurons. We searched 2,548 sera for antibodies binding to GABAAR α, β, and γ subunits on live HEK293 cells and identified the class, subclass, and GABAAR subunit specificities of the positive samples. Results: GABAAR-Abs were identified in 40 of 2,046 (2%) referred sera previously found negative for neuronal antibodies, in 5/502 (1%) previously positive for other neuronal surface antibodies, but not in 92 healthy individuals. The antibodies in 40% bound to either the α1 (9/45, 20%) or the γ2 subunits (9/45, 20%) and were of IgG1 (94%) or IgG3 (6%) subclass. The remaining 60% had lower antibody titers (p = 0.0005), which were mainly immunoglobulin M (IgM) (p = 0.0025), and showed no defined subunit specificity. Incubation of primary hippocampal neurons with GABAAR IgG1 sera reduced surface GABAAR membrane expression. The clinical features of 15 patients (GABAAR α1 n = 6, γ2 n = 5, undefined n = 4) included seizures (47%), memory impairment (47%), hallucinations (33%), or anxiety (20%). Most patients had not been given immunotherapies, but one with new-onset treatment-resistant catatonia made substantial improvement after plasma exchange. Conclusions: The GABAAR α1 and γ2 are new targets for antibodies in autoimmune neurologic disease. The full spectrum of clinical features, treatment responses, correlation with antibody specificity, and in particular the role of the IgM antibodies will need to be assessed in future studies.
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Affiliation(s)
- Philippa Pettingill
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Holger B Kramer
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Jan Adriaan Coebergh
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Rosie Pettingill
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Susan Maxwell
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Anjan Nibber
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Andrea Malaspina
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Anu Jacob
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Sarosh R Irani
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Camilla Buckley
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - David Beeson
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Bethan Lang
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Patrick Waters
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK
| | - Angela Vincent
- From the Nuffield Department of Clinical Neurosciences (P.P., R.P., S.M., A.N., S.R.I., C.B., D.B., B.L., P.W., A.V.) and the Department of Physiology, Anatomy and Genetics (H.B.K.), University of Oxford; St George's Healthcare NHS Trust (J.A.C.), Tooting, London; the Centre for Neuroscience & Trauma, Blizard Institute (A.M.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and The Walton Centre Foundation Trust (A.J.), Liverpool, UK.
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23
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Lipsman N, Nakao T, Kanayama N, Krauss JK, Anderson A, Giacobbe P, Hamani C, Hutchison WD, Dostrovsky JO, Womelsdorf T, Lozano AM, Northoff G. Neural overlap between resting state and self-relevant activity in human subcallosal cingulate cortex – Single unit recording in an intracranial study. Cortex 2014; 60:139-44. [DOI: 10.1016/j.cortex.2014.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 12/04/2013] [Accepted: 09/11/2014] [Indexed: 11/30/2022]
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24
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Ebisch SJH, Mantini D, Northoff G, Salone A, De Berardis D, Ferri F, Ferro FM, Di Giannantonio M, Romani GL, Gallese V. Altered brain long-range functional interactions underlying the link between aberrant self-experience and self-other relationship in first-episode schizophrenia. Schizophr Bull 2014; 40:1072-82. [PMID: 24191160 PMCID: PMC4133668 DOI: 10.1093/schbul/sbt153] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Self-experience anomalies are elementary features of schizophrenic pathology. Such deficits can have a profound impact on self-other relationship, but how they are related through aberrant brain function remains poorly understood. In this functional magnetic resonance imaging (fMRI) study, we provide new evidence for a cortical link between aberrant self-experience and social cognition in first-episode schizophrenia (FES). As identified in previous studies, ventral premotor cortex (vPMC) and posterior insula (pIC) are candidate brain regions underlying disturbances in both self-experience and self-other relationship due to their processing of predominantly externally guided (vPMC; goal-oriented behavior) and internally guided (pIC; interoception) stimuli. Results from functional interaction analysis in a sample of 24 FES patients and 22 healthy controls show aberrant functional interactions (background/intrinsic connectivity) of right vPMC and bilateral pIC with posterior cingulate cortex (PCC), a midline region that has been shown central in mediating self-experience. More specifically, our results show increased functional coupling between vPMC and PCC, which positively correlated with basic symptoms (subjective self-experience disturbances). pIC showed reduced functional coupling with PCC and postcentral gyrus and increased functional interactions with anterior insula. Taken together, our results suggest an imbalance in the processing between internally and externally guided information and its abnormal integration with self-referential processing as mediated by PCC. Due to our correlation findings, we suggest this imbalance to be closely related to basic symptoms in FES and thus anomalous self-experience. The findings further disentangle the cortical basis of how self-experience anomalies may pervade the social domain.
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Affiliation(s)
- Sjoerd J H Ebisch
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Institute of Advanced Biomedical Technologies, G. d'Annunzio Foundation, Chieti, Italy;
| | - Dante Mantini
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Anatolia Salone
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Institute of Psychiatry, G. d'Annunzio University, Chieti, Italy
| | - Domenico De Berardis
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment and Hospital "G. Mazzini," ASL 4, Teramo, Italy
| | - Francesca Ferri
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Filippo M Ferro
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Institute of Psychiatry, G. d'Annunzio University, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Institute of Psychiatry, G. d'Annunzio University, Chieti, Italy
| | - Gian L Romani
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Institute of Advanced Biomedical Technologies, G. d'Annunzio Foundation, Chieti, Italy
| | - Vittorio Gallese
- Department of Neuroscience, Section of Physiology, Parma University, Parma, Italy; Italian Institute of Technology, Brain Center for Social and Motor Cognition, Parma, Italy
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25
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Associations of regional GABA and glutamate with intrinsic and extrinsic neural activity in humans—a review of multimodal imaging studies. Neurosci Biobehav Rev 2014; 47:36-52. [PMID: 25066091 DOI: 10.1016/j.neubiorev.2014.07.016] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 06/30/2014] [Accepted: 07/17/2014] [Indexed: 01/04/2023]
Abstract
The integration of multiple imaging modalities is becoming an increasingly well used research strategy for studying the human brain. The neurotransmitters glutamate and GABA particularly lend themselves towards such studies. This is because these transmitters are ubiquitous throughout the cortex, where they are the key constituents of the inhibition/excitation balance, and because they can be easily measured in vivo through magnetic resonance spectroscopy, as well as with select positron emission tomography approaches. How these transmitters underly functional responses measured with techniques such as fMRI and EEG remains unclear though, and was the target of this review. Consistently shown in the literature was a negative correlation between GABA concentrations and stimulus-induced activity within the measured region. Also consistently found was a positive correlation between glutamate concentrations and inter-regional activity relationships, both during tasks and rest. These findings are outlined along with results from populations with mental disorders to give an overview of what brain imaging has suggested to date about the biochemical underpinnings of functional activity in health and disease. We conclude that the combination of functional and biochemical imaging in humans is an increasingly informative approach that does however require a number of key methodological and interpretive issues be addressed before can meet its potential.
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26
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Hayes DJ, Duncan NW, Wiebking C, Pietruska K, Qin P, Lang S, Gagnon J, BIng PG, Verhaeghe J, Kostikov AP, Schirrmacher R, Reader AJ, Doyon J, Rainville P, Northoff G. GABAA receptors predict aversion-related brain responses: an fMRI-PET investigation in healthy humans. Neuropsychopharmacology 2013; 38:1438-50. [PMID: 23389691 PMCID: PMC3682137 DOI: 10.1038/npp.2013.40] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The perception of aversive stimuli is essential for human survival and depends largely on environmental context. Although aversive brain processing has been shown to involve the sensorimotor cortex, the neural and biochemical mechanisms underlying the interaction between two independent aversive cues are unclear. Based on previous work indicating ventromedial prefrontal cortex (vmPFC) involvement in the mediation of context-dependent emotional effects, we hypothesized a central role for the vmPFC in modulating sensorimotor cortex activity using a GABAergic mechanism during an aversive-aversive stimulus interaction. This approach revealed differential activations within the aversion-related network (eg, sensorimotor cortex, midcingulate, and insula) for the aversive-aversive, when compared with the aversive-neutral, interaction. Individual differences in sensorimotor cortex signal changes during the aversive-aversive interaction were predicted by GABAA receptors in both vmPFC and sensorimotor cortex. Together, these results demonstrate the central role of GABA in mediating context-dependent effects in aversion-related processing.
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Affiliation(s)
- Dave J Hayes
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, Royal Ottawa Health Care Group, University of Ottawa, Ottawa, ON, Canada.
| | - Niall W Duncan
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, Royal Ottawa Health Care Group, University of Ottawa, Ottawa, ON, Canada,Department of Biology, University of Carleton, Ottawa, ON, Canada
| | - Christine Wiebking
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, Royal Ottawa Health Care Group, University of Ottawa, Ottawa, ON, Canada,Department of Biology, Freie Universität, Berlin, Germany
| | - Karin Pietruska
- Faculté de médecine dentaire, Université de Montréal, Pavillon Paul G. Desmarais, Montréal, QC, Canada
| | - Pengmin Qin
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, Royal Ottawa Health Care Group, University of Ottawa, Ottawa, ON, Canada
| | - Stefan Lang
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, Royal Ottawa Health Care Group, University of Ottawa, Ottawa, ON, Canada
| | - Jean Gagnon
- Centre de réadaptation Lucie-Bruneau, Université de Montréal, Montréal, QC, Canada
| | - Paul Gravel BIng
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, Montréal, QC, Canada
| | - Jeroen Verhaeghe
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, Montréal, QC, Canada
| | - Alexey P Kostikov
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, Montréal, QC, Canada
| | - Ralf Schirrmacher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, Montréal, QC, Canada
| | - Andrew J Reader
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, Montréal, QC, Canada
| | - Julien Doyon
- Functional Neuroimaging Unit, Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Pierre Rainville
- Faculté de médecine dentaire, Université de Montréal, Pavillon Paul G. Desmarais, Montréal, QC, Canada,Functional Neuroimaging Unit, Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, Royal Ottawa Health Care Group, University of Ottawa, Ottawa, ON, Canada
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27
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Wiebking C, Duncan NW, Tiret B, Hayes DJ, Marjaǹska M, Doyon J, Bajbouj M, Northoff G. GABA in the insula - a predictor of the neural response to interoceptive awareness. Neuroimage 2013; 86:10-8. [PMID: 23618604 DOI: 10.1016/j.neuroimage.2013.04.042] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 03/17/2013] [Accepted: 04/12/2013] [Indexed: 12/18/2022] Open
Abstract
The insula has been identified as a key region involved in interoceptive awareness. Whilst imaging studies have investigated the neural activation patterns in this region involved in intero- and exteroceptive awareness, the underlying biochemical mechanisms still remain unclear. In order to investigate these, a well-established fMRI task targeting interoceptive awareness (heartbeat counting) and exteroceptive awareness (tone counting) was combined with magnetic resonance spectroscopy (MRS). Controlling for physiological noise, neural activity in the insula during intero- and exteroceptive awareness was confirmed in an independent data sample using the same fMRI design. Focussing on MRS values from the left insula and combining them with neural activity during intero- and exteroceptive awareness in the same healthy individuals, we demonstrated that GABA concentration in a region highly involved in interoceptive processing is correlated with neural responses to interoceptive stimuli, as opposed to exteroceptive stimuli. In addition, both GABA and interoceptive signal changes in the insula predicted the degree of depressed affect, as measured by the Beck Hopelessness Scale. On the one hand, the association between GABA concentration and neural activity during interoceptive awareness provides novel insight into the biochemical underpinnings of insula function and interoception. On the other, through the additional association of both GABA and neural activity during interoception with depressed affect, these data also bear potentially important implications for psychiatric disorders like depression and anxiety, where GABAergic deficits, altered insula function and abnormal affect coincide.
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Affiliation(s)
- Christine Wiebking
- Department of Biology, Freie Universität Berlin, Germany; Institute of Mental Health Research, Ottawa, Canada.
| | | | - Brice Tiret
- Functional Neuroimaging Unit and Department of Psychology, University of Montréal, Canada
| | - Dave J Hayes
- Institute of Mental Health Research, Ottawa, Canada
| | - Małgorzata Marjaǹska
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Julien Doyon
- Functional Neuroimaging Unit and Department of Psychology, University of Montréal, Canada
| | - Malek Bajbouj
- Cluster of Excellence "Languages of Emotion" and Dahlem Institute for Neuroimaging of Emotion (D.I.N.E.), Freie Universität Berlin, Germany
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28
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Chronic opioid therapy and opioid tolerance: a new hypothesis. PAIN RESEARCH AND TREATMENT 2013; 2013:407504. [PMID: 23401765 PMCID: PMC3557641 DOI: 10.1155/2013/407504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 12/23/2012] [Accepted: 12/27/2012] [Indexed: 11/17/2022]
Abstract
Opioids are efficacious and cost-effective analgesics, but tolerance limits their effectiveness. This paper does not present any new clinical or experimental data but demonstrates that there exist ascending sensory pathways that contain few opioid receptors. These pathways are located by brain PET scans and spinal cord autoradiography. These nonopioid ascending pathways include portions of the ventral spinal thalamic tract originating in Rexed layers VI-VIII, thalamocortical fibers that project to the primary somatosensory cortex (S1), and possibly a midline dorsal column visceral pathway. One hypothesis is that opioid tolerance and opioid-induced hyperalgesia may be caused by homeostatic upregulation during opioid exposure of nonopioid-dependent ascending pain pathways. Upregulation of sensory pathways is not a new concept and has been demonstrated in individuals impaired with deafness or blindness. A second hypothesis is that adjuvant nonopioid therapies may inhibit ascending nonopioid-dependent pathways and support the clinical observations that monotherapy with opioids usually fails. The uniqueness of opioid tolerance compared to tolerance associated with other central nervous system medications and lack of tolerance from excess hormone production is discussed. Experimental work that could prove or disprove the concepts as well as flaws in the concepts is discussed.
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29
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Qin P, Duncan NW, Wiebking C, Gravel P, Lyttelton O, Hayes DJ, Verhaeghe J, Kostikov A, Schirrmacher R, Reader AJ, Northoff G. GABA(A) receptors in visual and auditory cortex and neural activity changes during basic visual stimulation. Front Hum Neurosci 2012; 6:337. [PMID: 23293594 PMCID: PMC3533380 DOI: 10.3389/fnhum.2012.00337] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 12/07/2012] [Indexed: 11/13/2022] Open
Abstract
Recent imaging studies have demonstrated that levels of resting γ-aminobutyric acid (GABA) in the visual cortex predict the degree of stimulus-induced activity in the same region. These studies have used the presentation of discrete visual stimulus; the change from closed eyes to open also represents a simple visual stimulus, however, and has been shown to induce changes in local brain activity and in functional connectivity between regions. We thus aimed to investigate the role of the GABA system, specifically GABA(A) receptors, in the changes in brain activity between the eyes closed (EC) and eyes open (EO) state in order to provide detail at the receptor level to complement previous studies of GABA concentrations. We conducted an fMRI study involving two different modes of the change from EC to EO: an EO and EC block design, allowing the modeling of the haemodynamic response, followed by longer periods of EC and EO to allow the measuring of functional connectivity. The same subjects also underwent [(18)F]Flumazenil PET to measure GABA(A) receptor binding potentials. It was demonstrated that the local-to-global ratio of GABA(A) receptor binding potential in the visual cortex predicted the degree of changes in neural activity from EC to EO. This same relationship was also shown in the auditory cortex. Furthermore, the local-to-global ratio of GABA(A) receptor binding potential in the visual cortex also predicted the change in functional connectivity between the visual and auditory cortex from EC to EO. These findings contribute to our understanding of the role of GABA(A) receptors in stimulus-induced neural activity in local regions and in inter-regional functional connectivity.
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Affiliation(s)
- Pengmin Qin
- Mind, Brain Imaging and Neuroethics, University of Ottawa Institute of Mental Health Research Ottawa, ON, Canada
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