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Gos A, Steiner J, Trübner K, Mawrin C, Kaliszan M, Gos T. Impairment of the GABAergic system in the anterior insular cortex of heroin-addicted males. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01848-2. [PMID: 38980335 DOI: 10.1007/s00406-024-01848-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/17/2024] [Indexed: 07/10/2024]
Abstract
Opioid addiction is a global problem, causing the greatest health burden among drug use disorders, with opioid overdose deaths topping the statistics of fatal overdoses. The multifunctional anterior insular cortex (AIC) is involved in inhibitory control, which is severely impaired in opioid addiction. GABAergic interneurons shape the output of the AIC, where abnormalities have been reported in individuals addicted to opioids. In these neurons, glutamate decarboxylase (GAD) with its isoforms GAD 65 and 67 is a key enzyme in the synthesis of GABA, and research data point to a dysregulation of GABAergic activity in the AIC in opioid addiction. Our study, which was performed on paraffin-embedded brains from the Magdeburg Brain Bank, aimed to investigate abnormalities in the GABAergic function of the AIC in opioid addiction by densitometric evaluation of GAD 65/67-immunostained neuropil. The study showed bilaterally increased neuropil density in layers III and V in 13 male heroin-addicted males compared to 12 healthy controls, with significant U-test P values for layer V bilaterally. Analysis of confounding variables showed that age, brain volume and duration of formalin fixation did not confound the results. Our findings suggest a dysregulation of GABAergic activity in the AIC in opioid addiction, which is consistent with experimental data from animal models and human neuroimaging studies.
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Affiliation(s)
- Anna Gos
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital, Zurich, Switzerland
- Department of Psychiatry, Otto von Guericke University, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry, Otto von Guericke University, Magdeburg, Germany
| | - Kurt Trübner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Christian Mawrin
- Department of Neuropathology, Otto von Guericke University, Magdeburg, Germany
| | - Michał Kaliszan
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland
| | - Tomasz Gos
- Department of Psychiatry, Otto von Guericke University, Magdeburg, Germany.
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland.
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Gos A, Steiner J, Trübner K, Ungewickell J, Mawrin C, Karnecki K, Kaliszan M, Gos T. Inverse pattern of GABAergic system impairment in the external versus internal globus pallidus in male heroin addicts. Eur Arch Psychiatry Clin Neurosci 2024; 274:445-452. [PMID: 37507486 PMCID: PMC10914887 DOI: 10.1007/s00406-023-01656-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
Opioid addiction is a global problem that has been exacerbated in the USA and Europe by the COVID-19 pandemic. The globus pallidus (GP) plays a prominent neurobiological role in the regulation of behaviour as an output station of the striato-pallidal system. GABAergic large projection neurons are the main neuronal type in the external (EGP) and internal (IGP) parts of the GP, where addiction-specific molecular and functional abnormalities occur. In these neurons, glutamate decarboxylase (GAD) with isoforms GAD 65 and 67 is a key enzyme in GABA synthesis, and experimental studies suggest GAD dysregulation in the GP of heroin addicts. Our study, which was performed on paraffin-embedded brains from the Magdeburg Brain Bank, aimed to investigate abnormalities in the GABAergic function of large GP neurons by densitometric evaluation of their GAD 65/67-immunostained thick dendrites. The study revealed a bilaterally decreased fibres density in the EGP paralleled by the increase in the IGP in 11 male heroin addicts versus 11 healthy controls (significant U-test P values). The analysis of confounding variables found no interference of age, brain volume, and duration of formalin fixation with the results. Our findings suggest a dysregulation of GABAergic activity in the GP of heroin addicts, which is consistent with experimental data from animal models and plays potentially a role in the disturbed function of basal ganglia circuit in opioid addiction.
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Affiliation(s)
- Anna Gos
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany
| | - Kurt Trübner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jonas Ungewickell
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany
| | - Christian Mawrin
- Department of Neuropathology, Otto Von Guericke University, Magdeburg, Germany
| | - Karol Karnecki
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland
| | - Michał Kaliszan
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland
| | - Tomasz Gos
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany.
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland.
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Müller UJ, Schmalenbach LJ, Dobrowolny H, Guest PC, Schlaaff K, Mawrin C, Truebner K, Bogerts B, Gos T, Bernstein HG, Steiner J. Reduced anterior insular cortex volume in male heroin addicts: a postmortem study. Eur Arch Psychiatry Clin Neurosci 2023; 273:1233-1241. [PMID: 36719479 PMCID: PMC9888352 DOI: 10.1007/s00406-023-01553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/09/2023] [Indexed: 02/01/2023]
Abstract
We and others have observed reduced volumes of brain regions, including the nucleus accumbens, globus pallidus, hypothalamus, and habenula in opioid addiction. Notably, the insular cortex has been under increasing study in addiction, and a smaller anterior insula has been found in alcohol-addicted cases. Here, we have investigated whether similar effects occur in heroin addicts compared to healthy controls. Volumes of the anterior and posterior insula in heroin addicts (n = 14) and controls (n = 13) were assessed by morphometry of Nissl-myelin-stained serial whole-brain coronal sections. The mean relative volume of the anterior insular cortex was smaller than in non-addicted controls (3010 ± 614 *10-6 versus 3970 ± 1306 *10-6; p = 0.021). However, no significant differences in neuronal cell counts were observed. Therefore, the observed volume reduction appears to be a consequence of damaged connecting structures such as neuropil and glial cells. The findings were not confounded by age or duration of autolysis. Our results provide further evidence of structural deficits in key hubs of the addiction circuitry in heroin-dependent individuals and warrant further research in this area.
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Affiliation(s)
- Ulf J Müller
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany
| | - Lucas J Schmalenbach
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Henrik Dobrowolny
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Paul C Guest
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Konstantin Schlaaff
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- German Center for Mental Health (DZP), Center for Intervention and Research On Adaptive and Maladaptive Brain Circuits Underlying, Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Christian Mawrin
- Department of Neuropathology, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Kurt Truebner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Bernhard Bogerts
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Salus Institute, Magdeburg, Germany
| | - Tomasz Gos
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Hans-Gert Bernstein
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany.
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany.
- Center for Behavioral Brain Sciences, Magdeburg, Germany.
- German Center for Mental Health (DZP), Center for Intervention and Research On Adaptive and Maladaptive Brain Circuits Underlying, Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany.
- Center for Health Und Medical Prevention (CHaMP), Magdeburg, Germany.
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Hauser KF, Ohene-Nyako M, Knapp PE. Accelerated brain aging with opioid misuse and HIV: New insights on the role of glially derived pro-inflammation mediators and neuronal chloride homeostasis. Curr Opin Neurobiol 2023; 78:102653. [PMID: 36584655 PMCID: PMC9933139 DOI: 10.1016/j.conb.2022.102653] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/26/2022] [Accepted: 11/10/2022] [Indexed: 12/29/2022]
Abstract
Opioid use disorder (OUD) has become a national crisis and contributes to the spread of human immunodeficiency virus (HIV) infection. Emerging evidence and advances in experimental models, methodology, and our understanding of disease processes at the molecular and cellular levels reveal that opioids per se can directly exacerbate the pathophysiology of neuroHIV. Despite substantial inroads, the impact of OUD on the severity, development, and prognosis of neuroHIV and HIV-associated neurocognitive disorders is not fully understood. In this review, we explore current evidence that OUD and neuroHIV interact to accelerate cognitive deficits and enhance the neurodegenerative changes typically seen with aging, through their effects on neuroinflammation. We suggest new thoughts on the processes that may underlie accelerated brain aging, including dysregulation of neuronal inhibition, and highlight findings suggesting that opioids, through actions at the μ-opioid receptor, interact with HIV in the central nervous system to promote unique structural and functional comorbid deficits not seen in either OUD or neuroHIV alone.
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Affiliation(s)
- Kurt F Hauser
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA; Department of Anatomy and Neurobiology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0709, USA; Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 203 East Cary Street, Richmond, Virginia 23298-0059, USA
| | - Michael Ohene-Nyako
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA
| | - Pamela E Knapp
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA; Department of Anatomy and Neurobiology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0709, USA; Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 203 East Cary Street, Richmond, Virginia 23298-0059, USA.
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Winstanley EL, Mahoney JJ, Castillo F, Comer SD. Neurocognitive impairments and brain abnormalities resulting from opioid-related overdoses: A systematic review. Drug Alcohol Depend 2021; 226:108838. [PMID: 34271512 PMCID: PMC8889511 DOI: 10.1016/j.drugalcdep.2021.108838] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Non-fatal opioid-related overdoses have increased significantly over the past two decades and there have been increasing reports of brain injuries and/or neurocognitive impairments following overdose events. Limited preclinical research suggests that opioid overdoses may cause brain injury; however, little is known about such injuries in humans. The purpose this systematic review is to summarize existing studies on neurocognitive impairments and/or brain abnormalities associated with an opioid-related overdose in humans. METHODS PubMed, Web of Science, Ovid MEDLINE and PsyINFO were searched, without year restrictions, and identified 3099 articles. An additional 24 articles were identified by reviewing references. Articles were included if they were published in English, reported study findings in humans, included individuals 18 years of age or older, and reported an objective measure of neurocognitive impairments and/or brain abnormalities resulting from an opioid-related overdose. Six domains of bias (selection, performance, attrition, detection (two dimensions) and reporting were evaluated and themes were summarized. RESULTS Seventy-nine journal articles, published between 1973-2020, were included in the review. More than half of the articles were case reports (n = 44) and there were 11 cohort studies, 18 case series, and 6 case-control studies. All of the studies were categorized as at-risk of bias, few controlled for confounding factors, and methodological differences made direct comparisons difficult. Less than half of the studies reported toxicology results confirming an opioid-related overdose; 64.6 % reported brain MRI results and 27.8 % reported results of neuropsychological testing. Only two studies had within subject comparative data to document changes in the brain possibly associated with an overdose. Despite these limitations, existing publications suggest that brain injuries and neurocognitive impairments are associated with opioid overdose. Additional research is needed to establish the incidence of overdose-related brain injuries and the potential impact on functioning, as well as engagement in treatment of substance use disorders. CONCLUSIONS Respiratory depression is a defining characteristic of opioid overdose and prolonged cerebral hypoxia may cause brain injuries and/or neurocognitive impairments. The onset, characteristics, and duration of such injuries is variable and additional research is needed to understand their clinical implications.
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Affiliation(s)
- Erin L. Winstanley
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA,Department of Neuroscience, West Virginia University, Morgantown, WV, USA,Corresponding author at: West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV 26505, USA. (E.L. Winstanley)
| | - James J. Mahoney
- Department of Behavioral Medicine and Psychiatry, School of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA,Department of Neuroscience, West Virginia University, Morgantown, WV, USA
| | - Felipe Castillo
- Columbia University, Department of Psychiatry and New York State Psychiatric Institute, New York, NY, USA
| | - Sandra D. Comer
- Columbia University, Department of Psychiatry and New York State Psychiatric Institute, New York, NY, USA
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Müller UJ, Ahrens M, Vasilevska V, Dobrowolny H, Schiltz K, Schlaaff K, Mawrin C, Frodl T, Bogerts B, Gos T, Truebner K, Bernstein HG, Steiner J. Reduced habenular volumes and neuron numbers in male heroin addicts: a post-mortem study. Eur Arch Psychiatry Clin Neurosci 2021; 271:835-845. [PMID: 33001272 DOI: 10.1007/s00406-020-01195-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/17/2020] [Indexed: 11/24/2022]
Abstract
The Habenula is increasingly being investigated in addiction. Reduced volumes of other relevant brain regions in addiction, such as nucleus accumbens, globus pallidus and hypothalamus have been reported. Reduced volumes of the habenula as well as reduced neuronal cell count in the habenula have also been reported in mood disorders and an overlap between mood disorders and addiction is clinically widely recognized. Thus, our aim was to investigate possible volume and neuronal cell count differences in heroin addicts compared to healthy controls. Volumes of the medial (MHB) and lateral habenula (LHB) in heroin addicts (n = 12) and healthy controls (n = 12) were assessed by morphometry of 20 µm serial whole brain sections. Total brain volume was larger in the heroin group (mean 1466.6 ± 58.5 cm3 vs. mean 1331.5 ± 98.8 cm3), possibly because the heroin group was about 15 years younger (p = 0.001). Despite larger mean whole brain volume, the mean relative volume of the MHB was smaller than in healthy non-addicted controls (6.94 ± 2.38 × 10-6 vs.10.64 ± 3.22 × 10-6; p = 0.004). A similar finding was observed regarding relative volumes of the LHB (46.62 ± 10.90 × 10-6 vs. 63.05 ± 16.42 × 10-6 p = 0.009). In parallel, neuronal cell numbers were reduced in the MHB of heroin-addicted subjects (395,966 ± 184,178 vs. 644,149 ± 131,140; p < 0.001). These findings were not significantly confounded by age and duration of autolysis. Our results provide further evidence for brain-structural deficits in heroin addiction.
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Affiliation(s)
- Ulf J Müller
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany.
- Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany.
| | - Moritz Ahrens
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Veronika Vasilevska
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Henrik Dobrowolny
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Kolja Schiltz
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Konstantin Schlaaff
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Christian Mawrin
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Department of Neuropathology, University of Magdeburg, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Bernhard Bogerts
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Salus Institute, Magdeburg, Germany
| | - Tomasz Gos
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Kurt Truebner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Hans-Gert Bernstein
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany.
- Center for Behavioral Brain Sciences, Magdeburg, Germany.
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Hegedüs P, Heckenast J, Hangya B. Differential recruitment of ventral pallidal e-types by behaviorally salient stimuli during Pavlovian conditioning. iScience 2021; 24:102377. [PMID: 33912818 PMCID: PMC8066429 DOI: 10.1016/j.isci.2021.102377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/22/2021] [Accepted: 03/26/2021] [Indexed: 10/25/2022] Open
Abstract
The ventral pallidum (VP) is interfacing striatopallidal and limbic circuits, conveying information about salience and valence crucial to adjusting behavior. However, how VP neuron populations with distinct electrophysiological properties (e-types) represent these variables is not fully understood. Therefore, we trained mice on probabilistic Pavlovian conditioning while recording the activity of VP neurons. Many VP neurons responded to punishment (54%), reward (48%), and outcome-predicting auditory stimuli (32%), increasingly differentiating distinct outcome probabilities through learning. We identified e-types based on the presence of bursts or fast rhythmic discharges and found that non-bursting, non-rhythmic neurons were the most sensitive to reward and punishment. Some neurons exhibited distinct responses of their bursts and single spikes, suggesting a multiplexed coding scheme in the VP. Finally, we demonstrate synchronously firing neuron assemblies, particularly responsive to reinforcing stimuli. These results suggest that electrophysiologically defined e-types of the VP differentially participate in transmitting reinforcement signals during learning.
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Affiliation(s)
- Panna Hegedüs
- Lendület Laboratory of Systems Neuroscience, Institute of Experimental Medicine, Budapest 1083, Hungary
- János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest 1085, Hungary
| | - Julia Heckenast
- Lendület Laboratory of Systems Neuroscience, Institute of Experimental Medicine, Budapest 1083, Hungary
| | - Balázs Hangya
- Lendület Laboratory of Systems Neuroscience, Institute of Experimental Medicine, Budapest 1083, Hungary
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Blackwood CA, Cadet JL. The molecular neurobiology and neuropathology of opioid use disorder. CURRENT RESEARCH IN NEUROBIOLOGY 2021; 2. [PMID: 35548327 PMCID: PMC9090195 DOI: 10.1016/j.crneur.2021.100023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The number of people diagnosed with opioid use disorder has skyrocketed as a consequence of the opioid epidemic and the increased prescribing of opioid drugs for chronic pain relief. Opioid use disorder is characterized by loss of control of drug taking, continued drug use in the presence of adverse consequences, and repeated relapses to drug taking even after long periods of abstinence. Patients who suffer from opioid use disorder often present with cognitive deficits that are potentially secondary to structural brain abnormalities that vary according to the chemical composition of the abused opioid. This review details the neurobiological effects of oxycodone, morphine, heroin, methadone, and fentanyl on brain neurocircuitries by presenting the acute and chronic effects of these drugs on the human brain. In addition, we review results of neuroimaging in opioid use disorder patients and/or histological studies from brains of patients who had expired after acute intoxication following long-term use of these drugs. Moreover, we include relevant discussions of the neurobiological mechanisms involved in promoting abnormalities in the brains of opioid-exposed patients. Finally, we discuss how novel strategies could be used to provide pharmacological treatment against opioid use disorder. Brain abnormalities caused by opioid intoxication. Intoxication of opioids leads to defects in brain neurocircuitries. Insight into the molecular mechanisms associated with craving in heroin addicts.
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Affiliation(s)
| | - Jean Lud Cadet
- Corresponding author.Molecular Neuropsychiatry Research Branch NIH/NIDA Intramural Research Program 251 Bayview Boulevard Baltimore, MD, USA
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Fitting S, McRae M, Hauser KF. Opioid and neuroHIV Comorbidity - Current and Future Perspectives. J Neuroimmune Pharmacol 2020; 15:584-627. [PMID: 32876803 PMCID: PMC7463108 DOI: 10.1007/s11481-020-09941-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/02/2020] [Indexed: 12/14/2022]
Abstract
With the current national opioid crisis, it is critical to examine the mechanisms underlying pathophysiologic interactions between human immunodeficiency virus (HIV) and opioids in the central nervous system (CNS). Recent advances in experimental models, methodology, and our understanding of disease processes at the molecular and cellular levels reveal opioid-HIV interactions with increasing clarity. However, despite the substantial new insight, the unique impact of opioids on the severity, progression, and prognosis of neuroHIV and HIV-associated neurocognitive disorders (HAND) are not fully understood. In this review, we explore, in detail, what is currently known about mechanisms underlying opioid interactions with HIV, with emphasis on individual HIV-1-expressed gene products at the molecular, cellular and systems levels. Furthermore, we review preclinical and clinical studies with a focus on key considerations when addressing questions of whether opioid-HIV interactive pathogenesis results in unique structural or functional deficits not seen with either disease alone. These considerations include, understanding the combined consequences of HIV-1 genetic variants, host variants, and μ-opioid receptor (MOR) and HIV chemokine co-receptor interactions on the comorbidity. Lastly, we present topics that need to be considered in the future to better understand the unique contributions of opioids to the pathophysiology of neuroHIV. Graphical Abstract Blood-brain barrier and the neurovascular unit. With HIV and opiate co-exposure (represented below the dotted line), there is breakdown of tight junction proteins and increased leakage of paracellular compounds into the brain. Despite this, opiate exposure selectively increases the expression of some efflux transporters, thereby restricting brain penetration of specific drugs.
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Affiliation(s)
- Sylvia Fitting
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-3270, USA
| | - MaryPeace McRae
- Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Kurt F Hauser
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, 1217 East Marshall Street, Richmond, VA, 23298-0613, USA.
- Department of Anatomy and Neurobiology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0709, USA.
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 203 East Cary Street, Richmond, VA, 23298-0059, USA.
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10
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Prasad AA, McNally GP. The ventral pallidum and relapse in alcohol seeking. Br J Pharmacol 2020; 177:3855-3864. [PMID: 32557550 DOI: 10.1111/bph.15160] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022] Open
Abstract
Alcohol-use disorders are chronically relapsing conditions characterized by cycles of use, abstinence and relapse. The ventral pallidum (VP) is a key node in the neural circuits controlling relapse to alcohol seeking and a key target of pharmacotherapies for relapse prevention. There has been a significant increase in our understanding of the molecular, anatomical, pharmacological and functional properties of the ventral pallidum, laying foundations for a new understanding of its role in relapse to alcohol seeking and motivation. Here we review these advances, placing special emphasis on how advances in understanding in the cellular and circuit architectures of ventral pallidum contributes to the relapse to alcohol seeking. We show how this knowledge improves mechanistic understanding of current relapse prevention pharmacotherapies, how it may be used to tailor these against different forms of relapse and how it may help provide insights into the mental health problems frequently co-morbid with alcohol-use disorders.
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