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Dixon T, Cadenhead KS. Cannabidiol versus placebo as adjunctive treatment in early psychosis: study protocol for randomized controlled trial. Trials 2023; 24:775. [PMID: 38037108 PMCID: PMC10691114 DOI: 10.1186/s13063-023-07789-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Psychotic disorders are a leading cause of disability in young adults. Antipsychotics have been the primary intervention for psychosis for over 60 years, and yet, we have made little progress in treating negative symptoms, neurocognition, and functional disability. There is growing evidence that cannabidiol (CBD) is effective in treating positive psychotic symptoms, possibly also negative and neurocognitive symptoms, and moreover is well tolerated compared to other psychotropic medications. Anecdotally, patients participating in the Cognitive Assessment and Risk Evaluation (CARE) Early Psychosis Treatment Program at the University of California, San Diego, are self-administering CBD and report subjective improvement in stress, anxiety, and ability to cope with symptoms. The overarching aim of the trial is to explore the effectiveness of CBD augmentation on symptoms and neurocognition in early psychosis while also exploring the mechanism of action of CBD and predictors of response to treatment. The mechanism by which cannabidiol has a therapeutic effect on psychosis is poorly understood. Recent evidence has suggested that CBD may reduce stress and pro-inflammatory biomarker levels. Endocannabinoids also have powerful roles in eating behavior, reward, and mood, indicating these neurotransmitters may play a role in reducing hyperphagia and metabolic abnormalities that are present early in the course of psychotic illness and exacerbated by antipsychotic medication. The neurophysiological effects of CBD have been studied in animal models of psychosis that show improvements in information processing in response to CBD, but there are no studies in individuals with early psychosis. METHOD A total of 120 individuals in the early stages of psychosis will be randomized to 1000 mg of CBD versus placebo as an adjunct to existing treatment in a 8-week, double-blind superiority randomized control trial. The primary outcome measures are symptoms and neurocognition. DISCUSSION We hypothesized that CBD will improve symptoms and neurocognition as well as secondary outcome measures of neurohormones, inflammation, eating behaviors, and information processing. Importantly, predictors, moderators, and mediators of the CBD effects will be examined. A better understanding of which individuals are likely to respond to CBD can inform treatment planning and personalize treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04411225. Registered on June 2, 2020.
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Affiliation(s)
- T Dixon
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0810, La Jolla, CA, 92093-0810, USA
| | - K S Cadenhead
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0810, La Jolla, CA, 92093-0810, USA.
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Inubushi T, Ito M, Mori Y, Futatsubashi M, Sato K, Ito S, Yokokura M, Shinke T, Kameno Y, Kakimoto A, Kanno T, Okada H, Ouchi Y, Yoshikawa E. Neural correlates of head restraint: Unsolicited neuronal activation and dopamine release. Neuroimage 2020; 224:117434. [PMID: 33039616 DOI: 10.1016/j.neuroimage.2020.117434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/01/2020] [Accepted: 10/03/2020] [Indexed: 11/29/2022] Open
Abstract
To minimize motion-related distortion of reconstructed images, conventional positron emission tomography (PET) measurements of the brain inevitably require a firm and tight head restraint. While such a restraint is now a routine procedure in brain imaging, the physiological and psychological consequences resulting from the restraint have not been elucidated. To address this problem, we developed a restraint-free brain PET system and conducted PET scans under both restrained and non-restrained conditions. We examined whether head restraint during PET scans could alter brain activities such as regional cerebral blood flow (rCBF) and dopamine release along with psychological stress related to head restraint. Under both conditions, 20 healthy male participants underwent [15O]H2O and [11C]Raclopride PET scans during working memory tasks with the same PET system. Before, during, and after each PET scan, we measured physiological and psychological stress responses, including the State-Trait Anxiety Inventory (STAI) scores. Analysis of the [15O]H2O-PET data revealed higher rCBF in regions such as the parahippocampus in the restrained condition. We found the binding potential (BPND) of [11C]Raclopride in the putamen was significantly reduced in the restrained condition, which reflects an increase in dopamine release. Moreover, the restraint-induced change in BPND was correlated with a shift in the state anxiety score of the STAI, indicating that less anxiety accompanied smaller dopamine release. These results suggest that the stress from head restraint could cause unsolicited responses in brain physiology and emotional states. The restraint-free imaging system may thus be a key enabling technology for the natural depiction of the mind.
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Affiliation(s)
- Tomoo Inubushi
- Central Research Laboratory, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan
| | - Masanori Ito
- Global Strategic Challenge Center, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan
| | - Yutaro Mori
- Department of Biofunctional Imaging, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu, Shizuoka 431-3192, Japan
| | - Masami Futatsubashi
- Global Strategic Challenge Center, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan
| | - Kengo Sato
- Central Research Laboratory, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan
| | - Shigeru Ito
- Global Strategic Challenge Center, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan
| | - Masamichi Yokokura
- Department of Psychiatry, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan
| | - Tomomi Shinke
- Global Strategic Challenge Center, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan
| | - Yosuke Kameno
- Department of Psychiatry, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan
| | - Akihiro Kakimoto
- Department of Biofunctional Imaging, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu, Shizuoka 431-3192, Japan; Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Shizuoka 434-0041, Japan
| | - Toshihiko Kanno
- Department of Radiological Sciences, Morinomiya University of Medical Sciences, Osaka 559-8611, Japan
| | - Hiroyuki Okada
- Global Strategic Challenge Center, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan; Department of Radiological Sciences, Morinomiya University of Medical Sciences, Osaka 559-8611, Japan
| | - Yasuomi Ouchi
- Department of Biofunctional Imaging, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu, Shizuoka 431-3192, Japan; Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Shizuoka 434-0041, Japan.
| | - Etsuji Yoshikawa
- Central Research Laboratory, Hamamatsu Photonics KK, Shizuoka 434-8601, Japan; Department of Biofunctional Imaging, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu, Shizuoka 431-3192, Japan
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Colom M, Vidal B, Zimmer L. Is There a Role for GPCR Agonist Radiotracers in PET Neuroimaging? Front Mol Neurosci 2019; 12:255. [PMID: 31680859 PMCID: PMC6813225 DOI: 10.3389/fnmol.2019.00255] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/02/2019] [Indexed: 12/30/2022] Open
Abstract
Positron emission tomography (PET) is a molecular imaging modality that enables in vivo exploration of metabolic processes and especially the pharmacology of neuroreceptors. G protein-coupled receptors (GPCRs) play an important role in numerous pathophysiologic disorders of the central nervous system. Thus, they are targets of choice in PET imaging to bring proof concept of change in density in pathological conditions or in pharmacological challenge. At present, most radiotracers are antagonist ligands. In vitro data suggest that properties differ between GPCR agonists and antagonists: antagonists bind to receptors with a single affinity, whereas agonists are characterized by two different affinities: high affinity for receptors that undergo functional coupling to G-proteins, and low affinity for those that are not coupled. In this context, agonist radiotracers may be useful tools to give functional images of GPCRs in the brain, with high sensitivity to neurotransmitter release. Here, we review all existing PET radiotracers used from animals to humans and their role for understanding the ligand-receptor paradigm of GPCR in comparison with corresponding antagonist radiotracers.
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Affiliation(s)
- Matthieu Colom
- Lyon Neuroscience Research Center, INSERM, CNRS, Université de Lyon, Lyon, France.,CERMEP, Hospices Civils de Lyon, Bron, France
| | - Benjamin Vidal
- Lyon Neuroscience Research Center, INSERM, CNRS, Université de Lyon, Lyon, France
| | - Luc Zimmer
- Lyon Neuroscience Research Center, INSERM, CNRS, Université de Lyon, Lyon, France.,CERMEP, Hospices Civils de Lyon, Bron, France.,Institut National des Sciences et Techniques Nucléaires, CEA Saclay, Gif-sur-Yvette, France
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4
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Sebold M, Spitta G, Gleich T, Dembler-Stamm T, Butler O, Zacharias K, Aydin S, Garbusow M, Rapp M, Schubert F, Buchert R, Gallinat J, Heinz A. Stressful life events are associated with striatal dopamine receptor availability in alcohol dependence. J Neural Transm (Vienna) 2019; 126:1127-1134. [DOI: 10.1007/s00702-019-01985-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 02/06/2019] [Indexed: 11/30/2022]
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A meta-analytical evaluation of the dual-hormone hypothesis: Does cortisol moderate the relationship between testosterone and status, dominance, risk taking, aggression, and psychopathy? Neurosci Biobehav Rev 2019; 96:250-271. [DOI: 10.1016/j.neubiorev.2018.12.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 12/28/2022]
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Shalgunov V, van Waarde A, Booij J, Michel MC, Dierckx RAJO, Elsinga PH. Hunting for the high-affinity state of G-protein-coupled receptors with agonist tracers: Theoretical and practical considerations for positron emission tomography imaging. Med Res Rev 2018; 39:1014-1052. [PMID: 30450619 PMCID: PMC6587759 DOI: 10.1002/med.21552] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/02/2018] [Accepted: 10/19/2018] [Indexed: 12/15/2022]
Abstract
The concept of the high‐affinity state postulates that a certain subset of G‐protein‐coupled receptors is primarily responsible for receptor signaling in the living brain. Assessing the abundance of this subset is thus potentially highly relevant for studies concerning the responses of neurotransmission to pharmacological or physiological stimuli and the dysregulation of neurotransmission in neurological or psychiatric disorders. The high‐affinity state is preferentially recognized by agonists in vitro. For this reason, agonist tracers have been developed as tools for the noninvasive imaging of the high‐affinity state with positron emission tomography (PET). This review provides an overview of agonist tracers that have been developed for PET imaging of the brain, and the experimental paradigms that have been developed for the estimation of the relative abundance of receptors configured in the high‐affinity state. Agonist tracers appear to be more sensitive to endogenous neurotransmitter challenge than antagonists, as was originally expected. However, other expectations regarding agonist tracers have not been fulfilled. Potential reasons for difficulties in detecting the high‐affinity state in vivo are discussed.
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Affiliation(s)
- Vladimir Shalgunov
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Aren van Waarde
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Martin C Michel
- Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany
| | - Rudi A J O Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Nuclear Medicine, Ghent University, University Hospital, Ghent, Belgium
| | - Philip H Elsinga
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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7
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Yokoyama C, Onoe H. Positron emission tomography imaging of the social brain of common marmosets. Neurosci Res 2015; 93:82-90. [DOI: 10.1016/j.neures.2014.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 12/08/2014] [Accepted: 12/11/2014] [Indexed: 01/07/2023]
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8
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Naganawa M, Zheng MQ, Henry S, Nabulsi N, Lin SF, Ropchan J, Labaree D, Najafzadeh S, Kapinos M, Tauscher J, Neumeister A, Carson RE, Huang Y. Test-retest reproducibility of binding parameters in humans with 11C-LY2795050, an antagonist PET radiotracer for the κ opioid receptor. J Nucl Med 2015; 56:243-8. [PMID: 25593119 DOI: 10.2967/jnumed.114.147975] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED (11)C-LY2795050 is a new antagonist PET radioligand for the κ opioid receptor (KOR). In this study, we assessed the reproducibility of the binding parameters of (11)C-LY2795050 in healthy human subjects. METHODS Sixteen healthy subjects (11 men and 5 women) underwent 2 separate 90-min PET scans with arterial input function and plasma free fraction (fP) measurements. The 2-tissue-compartment model and multilinear analysis-1 were applied to calculate 5 outcome measures in 14 brain regions: distribution volume (VT), VT normalized by fP (VT/fP), and 3 binding potentials (nondisplaceable binding potential, binding potential relative to total plasma concentration, and binding potential relative to free plasma concentration: BPND, BPP, BPF, respectively). Since KOR is distributed ubiquitously throughout the brain, there are no suitable reference regions. We used a fixed fraction of individual cerebellar VT value (VT,CER) as the nondisplaceable VT (VND) (VND = VT,CER/1.17). The relative and absolute test-retest variability and intraclass correlation coefficient were evaluated for the outcome measures of (11)C-LY2795050. RESULTS The test-retest variability of (11)C-LY2795050 for VT was no more than 10% in any region and was 12% in the amygdala. For binding potential (BPND and BPP), the test-retest variability was good in regions of moderate and high KOR density (BPND > 0.4) and poor in regions of low density. Correction by fP (VT/fP or BPF) did not improve the test-retest performance. CONCLUSION Our results suggest that quantification of (11)C-LY2795050 imaging is reproducible and reliable in regions with moderate and high KOR density. Therefore, we conclude that this first antagonist radiotracer is highly useful for PET studies of KOR.
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Affiliation(s)
- Mika Naganawa
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Ming-Qiang Zheng
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Shannan Henry
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Nabeel Nabulsi
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Shu-Fei Lin
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Jim Ropchan
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - David Labaree
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Soheila Najafzadeh
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Michael Kapinos
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | | | - Alexander Neumeister
- Department of Psychiatry and Radiology, New York University School of Medicine, New York, New York
| | - Richard E Carson
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Yiyun Huang
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
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9
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Wu X, Cai H, Ge R, Li L, Jia Z. Recent progress of imaging agents for Parkinson's disease. Curr Neuropharmacol 2014; 12:551-63. [PMID: 25977680 PMCID: PMC4428027 DOI: 10.2174/1570159x13666141204221238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/22/2014] [Accepted: 12/02/2014] [Indexed: 02/05/2023] Open
Abstract
Parkinson's disease (PD) is a common progressive, neurodegenerative brain disease that is promoted by mitochondrial dysfunction, oxidative stress, protein aggregation and proteasome dysfunction in the brain. Compared with computer tomography (CT) or magnetic resonance imaging (MRI), non-invasive nuclear radiopharmaceuticals have great significance for the early diagnosis of PD due to their high sensitivity and specificity in atypical and preclinical cases. Based on the development of coordination chemistry and chelator design, radionuclides may be delivered to lesions by attaching to PD-related transporters and receptors, such as dopamine, serotonin, and others. In this review, we comprehensively detailed the current achievements in radionuclide imaging in Parkinson's disease.
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Affiliation(s)
- Xiaoai Wu
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Huawei Cai
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Ran Ge
- Department of Nuclear Medicine, Fujian Medical University Union Hospital, Fuzhou, P.R. China
| | - Lin Li
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, P.R. China
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10
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High-anxiety rats are less sensitive to the rewarding affects of amphetamine on 50kHz USV. Behav Brain Res 2014; 275:234-42. [PMID: 25234225 DOI: 10.1016/j.bbr.2014.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/03/2014] [Accepted: 09/07/2014] [Indexed: 11/21/2022]
Abstract
This study assessed behaviour, as measured by 50kHz calls related to positive affect, in rats with different fear conditioned response strengths: low-anxiety rats (LR) and high-anxiety rats (HR), after amphetamine injection in a two-injection protocol (TIPS). The results showed that the first dose of amphetamine evoked similar behavioural effects in frequency-modulated (FM) 50kHz calls in the LR and HR groups. The second injection of amphetamine resulted in stronger FM 50kHz calls in LR compared with HR rats. The biochemical data ('ex vivo' analysis) showed that the LR rats had increased basal levels of dopamine in the amygdala, and increased homovanilic acid (HVA), dopamine's main metabolite, in the amygdala and prefrontal cortex compared with HR rats. The 'in vivo' analysis (microdialysis study) showed that the LR rats had increased HVA concentrations in the basolateral amygdala in response to an aversively conditioned context. Research has suggested that differences in dopaminergic system activity in the amygdala and prefrontal cortex may be one of the biological factors that underlie individual differences in response to fear stimuli, which may also affect the rewarding effects of amphetamine.
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11
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Oswald LM, Wand GS, Kuwabara H, Wong DF, Zhu S, Brasic JR. History of childhood adversity is positively associated with ventral striatal dopamine responses to amphetamine. Psychopharmacology (Berl) 2014; 231:2417-33. [PMID: 24448898 PMCID: PMC4040334 DOI: 10.1007/s00213-013-3407-z] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 12/11/2013] [Indexed: 12/17/2022]
Abstract
RATIONALE Childhood exposure to severe or chronic trauma is an important risk factor for the later development of adult mental health problems, such as substance abuse. Even in nonclinical samples of healthy adults, persons with a history of significant childhood adversity seem to experience greater psychological distress than those without this history. Evidence from rodent studies suggests that early life stress may impair dopamine function in ways that increase risks for drug abuse. However, the degree to which these findings translate to other species remains unclear. OBJECTIVES This study was conducted to examine associations between childhood adversity and dopamine and subjective responses to amphetamine in humans. METHODS Following intake assessment, 28 healthy male and female adults, aged 18-29 years, underwent two consecutive 90-min positron emission tomography studies with high specific activity [(11)C]raclopride. The first scan was preceded by intravenous saline; the second by amphetamine (AMPH 0.3 mg/kg). RESULTS Consistent with prior literature, findings showed positive associations between childhood trauma and current levels of perceived stress. Moreover, greater number of traumatic events and higher levels of perceived stress were each associated with higher ventral striatal dopamine responses to AMPH. Findings of mediation analyses further showed that a portion of the relationship between childhood trauma and dopamine release may be mediated by perceived stress. CONCLUSIONS Overall, results are consistent with preclinical findings suggesting that early trauma may lead to enhanced sensitivity to psychostimulants and that this mechanism may underlie increased vulnerability for drug abuse.
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Affiliation(s)
- Lynn M. Oswald
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA,Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Gary S. Wand
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Hiroto Kuwabara
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Dean F. Wong
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA,Department of Environmental Health Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Shijun Zhu
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA
| | - James R. Brasic
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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12
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Oei NYL, Both S, van Heemst D, van der Grond J. Acute stress-induced cortisol elevations mediate reward system activity during subconscious processing of sexual stimuli. Psychoneuroendocrinology 2014; 39:111-120. [PMID: 24275010 DOI: 10.1016/j.psyneuen.2013.10.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/08/2013] [Accepted: 10/08/2013] [Indexed: 12/19/2022]
Abstract
Stress is thought to alter motivational processes by increasing dopamine (DA) secretion in the brain's "reward system", and its key region, the nucleus accumbens (NAcc). However, stress studies using functional magnetic resonance imaging (fMRI), mainly found evidence for stress-induced decreases in NAcc responsiveness toward reward cues. Results from both animal and human PET studies indicate that the stress hormone cortisol may be crucial in the interaction between stress and dopaminergic actions. In the present study we therefore investigated whether cortisol mediated the effect of stress on DA-related responses to -subliminal-presentation of reward cues using the Trier Social Stress Test (TSST), which is known to reliably enhance cortisol levels. Young healthy males (n = 37) were randomly assigned to the TSST or control condition. After stress induction, brain activation was assessed using fMRI during a backward-masking paradigm in which potentially rewarding (sexual), emotionally negative and neutral stimuli were presented subliminally, masked by pictures of inanimate objects. A region of interest analysis showed that stress decreased activation in the NAcc in response to masked sexual cues (voxel-corrected, p<05). Furthermore, with mediation analysis it was found that high cortisol levels were related to stronger NAcc activation, showing that cortisol acted as a suppressor variable in the negative relation between stress and NAcc activation. The present findings indicate that cortisol is crucially involved in the relation between stress and the responsiveness of the reward system. Although generally stress decreases activation in the NAcc in response to rewarding stimuli, high stress-induced cortisol levels suppress this relation, and are associated with stronger NAcc activation. Individuals with a high cortisol response to stress might on one hand be protected against reductions in reward sensitivity, which has been linked to anhedonia and depression, but they may ultimately be more vulnerable to increased reward sensitivity, and addictions. Future studies investigating effects of stress on reward sensitivity should take into account the severity of the stressor and the individual cortisol response to stress.
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Affiliation(s)
- Nicole Y L Oei
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
| | - Stephanie Both
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands; Department of Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Diana van Heemst
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Netherlands Consortium of Healthy Ageing, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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13
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Cortisol levels and risk for psychosis: initial findings from the North American prodrome longitudinal study. Biol Psychiatry 2013; 74:410-7. [PMID: 23562006 PMCID: PMC3707958 DOI: 10.1016/j.biopsych.2013.02.016] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/31/2013] [Accepted: 02/03/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Studies of biomarkers of hypothalamic-pituitary-adrenal activity indicate that psychotic disorders are associated with elevated cortisol. This study examined cortisol levels in healthy control subjects and individuals who met clinical high-risk (CHR) criteria for psychosis. It was hypothesized that cortisol levels would be 1) elevated in the CHR group relative to control subjects, 2) positively correlated with symptom severity, and 3) most elevated in CHR patients who transition to psychotic level severity. METHODS Baseline assessments were conducted at eight centers in the North American Prodrome Longitudinal Study. The present CHR sample included 256 individuals meeting the Scale for Prodromal Symptoms criteria and 141 control subjects, all of whom underwent baseline assessment and measurement of salivary cortisol. RESULTS Consistent with previous reports, there was an effect of age on cortisol, with increases through the adolescent/early adult years. Analysis of covariance showed a main effect of diagnostic group, with the CHR group showing higher cortisol. There were modest, positive correlations of cortisol with baseline symptom severity, and analysis of covariance revealed higher baseline cortisol in those who transitioned to psychotic level symptoms when compared with healthy control subjects and CHR subjects who remitted. CONCLUSIONS The present findings add to accumulating evidence of heightened cortisol secretion in CHR individuals. The findings also indicate nonspecific associations between cortisol levels and symptom severity, as well as symptom progression. The role of hypothalamic-pituitary-adrenal activity in prediction of conversion to psychosis and its relation with other biomarkers of risk should receive attention in future research.
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Mueller SC, Daniele T, MacIntyre J, Korelitz K, Carlisi C, Hardin MG, VanRyzin C, Merke DP, Ernst M. Incentive processing in Congenital Adrenal Hyperplasia (CAH): a reward-based antisaccade study. Psychoneuroendocrinology 2013; 38:716-21. [PMID: 22917623 PMCID: PMC3522784 DOI: 10.1016/j.psyneuen.2012.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 08/01/2012] [Accepted: 08/02/2012] [Indexed: 12/27/2022]
Abstract
Little is known about how steroid hormones contribute to the beneficial effect of incentives on cognitive control during adolescent development. In this study, 27 adolescents with Congenital Adrenal Hyperplasia (CAH, mean age 15.6 years, 12 female), a disorder of cortisol deficiency and androgen excess, and 36 healthy participants (mean age 16.3 years, 18 female) completed a reward-based antisaccade task. In this mixed-saccade task, participants performed eye movements towards (prosaccades) or away (antisaccades) from a peripherally occuring stimulus. On incentive trials, monetary reward was provided for correct performance, while no such reward was provided on no-incentive trials. Consistent with the hypothesis, the results showed that healthy, but not CAH adolescents, significantly improved their inhibitory control (antisaccade accuracy) during incentive trials relative to no-incentive trials. These findings were not driven by severity of CAH (salt wasters vs. simple virilizers), individual hormone levels, sex, age-at-diagnosis, or medication type (dexamethasone vs. hydrocortisone). In addition, no significant differences between groups were found on orienting responses (prosaccades). Additional analyses revealed an impact of glucocorticoid (GC) dosage, such that higher GC dose predicted better antisaccade performance. However, this effect did not impact incentive processing. The data are discussed within the context of steroid hormone mediated effects on cognitive control and reward processing.
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Affiliation(s)
- Sven C. Mueller
- Section of Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892, USA,Department of Experimental Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium,Corresponding author: Sven Mueller Dept. of Experimental Clinical and Health Psychology Ghent University Henri Dunantlaan 2 9000 Ghent, Belgium Tel: +32 - 9 - 2648622 Fax: +32 - 9- 2646489
| | - Teresa Daniele
- Section of Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Jessica MacIntyre
- Section of Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Katherine Korelitz
- Section of Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Christina Carlisi
- Section of Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Michael G. Hardin
- Section of Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | | | - Deborah P. Merke
- NIH Clinical Center, Bethesda, MD, 20892, USA,Program in Developmental Endocrinology and Genetics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Monique Ernst
- Section of Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892, USA
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Zimmer L, Luxen A. PET radiotracers for molecular imaging in the brain: Past, present and future. Neuroimage 2012; 61:363-70. [DOI: 10.1016/j.neuroimage.2011.12.037] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 12/15/2011] [Indexed: 12/22/2022] Open
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