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Karamaouna P, Zouraraki C, Economou E, Kafetsios K, Bitsios P, Giakoumaki SG. Cold executive function processes and their hot analogs in schizotypy. J Int Neuropsychol Soc 2024; 30:285-294. [PMID: 37750805 DOI: 10.1017/s1355617723000590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To examine cold (based on logical reasoning) versus hot (having emotional components) executive function processes in groups with high individual schizotypal traits. METHOD Two-hundred and forty-seven participants were administered the Schizotypal Personality Questionnaire and were allocated into schizotypal (cognitive-perceptual, paranoid, negative, disorganized) or control groups according to pre-specified criteria. Participants were also administered a battery of tasks examining working memory, complex selective attention, response inhibition, decision-making and fluid intelligence and their affective counterparts. The outcome measures of each task were reduced to one composite variable thus formulating five cold and five hot cognitive domains. Between-group differences in the cognitive domains were examined with repeated measures analyses of covariance. RESULTS For working memory, the control and the cognitive-perceptual groups outperformed negative schizotypes, while for affective working memory controls outperformed the disorganized group. Controls also scored higher compared with the disorganized group in complex selective attention, while both the control and the cognitive-perceptual groups outperformed negative schizotypes in complex affective selective attention. Negative schizotypes also had striking difficulties in response inhibition, as they scored lower compared with all other groups. Despite the lack of differences in fluid intelligence, controls scored higher compared with all schizotypal groups (except from cognitive-perceptual schizotypes) in emotional intelligence; the latter group reported higher emotional intelligence compared with negative schizotypes. CONCLUSION Results indicate that there is no categorical association between the different schizotypal dimensions with solely cold or hot executive function processes and support impoverished emotional intelligence as a core feature of schizotypy.
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Affiliation(s)
- Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
| | - Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
| | - Elias Economou
- Laboratory of Experimental Psychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
| | | | - Panos Bitsios
- Department of Psychiatry and Behavioural Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
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Arruda Sanchez T, Ramos LR, Araujo F, Schenberg EE, Yonamine M, Lobo I, de Araujo DB, Luna LE. Emotion regulation effects of Ayahuasca in experienced subjects during implicit aversive stimulation: An fMRI study. JOURNAL OF ETHNOPHARMACOLOGY 2024; 320:117430. [PMID: 37979818 DOI: 10.1016/j.jep.2023.117430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 08/15/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ayahuasca is a beverage used in Amazonian traditional medicine and it has been part of the human experience for millennia as well as other different psychoactive plants. Although Ayahuasca has been proposed as potentially therapeutic as an anxiolytic and antidepressant, whilst no studies have been carried out so far investigating their direct effect on brain emotional processing. AIM OF THE STUDY This study aimed to measure the emotional acute effect of Ayahuasca on brain response to implicit aversive stimulation using a face recognition task in functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS Nineteen male experienced Ayahuasca users participated in this study in two fMRI sessions before and after 50 min of the Ayahuasca ingestion. Subjects were presented with pictures of neutral (A) and aversive (B) (fearful or disgusted) faces from the Pictures of Facial Affect Series. Subjects were instructed to identify the gender of the faces (gender discrimination task) while the emotional content was implicit. Subjective mood states were also evaluated before Ayahuasca intake and after the second fMRI session, using a visual analogue mood scale (VAMS). RESULTS During the aversive stimuli, the activity in the bilateral amygdala was attenuated by Ayahuasca (qFDR<0.05). Furthermore, in an exploratory analysis of the effects after intake, Ayahuasca enhances the activation in the insular cortex bilaterally, as well as in the right dorsolateral prefrontal cortex (qFDR<0.05). In the psychometric VAMS scale, subjects reported attenuation of both anxiety and mental sedation (p < 0.01) during acute effects. CONCLUSIONS Together, all reported results including neuroimaging, behavioral data and psychometric self-report suggest that Ayahuasca can promote an emotion regulation mechanism in response to aversive stimuli with corresponding improved cognition including reduced anxiety and mental sedation.
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Affiliation(s)
- Tiago Arruda Sanchez
- Laboratory of Neuroimaging and Psychophysiology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
| | - Lucas Rego Ramos
- Laboratory of Neuroimaging and Psychophysiology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Felipe Araujo
- Laboratory of Neuroimaging and Psychophysiology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Mauricio Yonamine
- Faculdade de Ciências Farmacêuticas, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Isabela Lobo
- Instituto de Biodiversidade e Sustentabilidade (NUPEM), UFRJ, Macaé, RJ, Brazil
| | - Draulio Barros de Araujo
- Brain Institute / Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Luis Eduardo Luna
- Research Centre for the study of psychointegrator plants, Visionary Art and Consciousness - Wasiwaska, Florianópolis, SC, Brazil
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3
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Gournay LR, Ferretti ML, Bilsky S, Vance E, Nguyen AM, Mann E, Williams P, Leen-Feldner EW. The effects of cannabidiol on worry and anxiety among high trait worriers: a double-blind, randomized placebo controlled trial. Psychopharmacology (Berl) 2023; 240:2147-2161. [PMID: 37552290 DOI: 10.1007/s00213-023-06437-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/24/2023] [Indexed: 08/09/2023]
Abstract
RATIONALE Evidence suggests cannabidiol (CBD) displays broad therapeutic potential in the context of anxiety; however, no study has examined the effects of CBD on worry, a defining, cognitive feature of anxiety. Additionally, no study has examined the effects of an acute, single dose of CBD compared to repeated CBD administration. OBJECTIVES Within a sample of 63 individuals with elevated trait worry, the current study aimed to assess the effects of an empirically-derived high dose of CBD (i.e., 300mg) compared to a commercially-derived dose of CBD (i.e., 50mg) versus placebo on worry severity and anxiety symptoms after an acute dose and after a 2-week administration period. RESULTS Results indicated no effect of acute CBD dosing on worry severity or anxiety symptoms. Repeated CBD administration similarly did not impact worry severity; however, 300mg of CBD reduced anxiety symptoms across the 2-week administration period compared to placebo. CONCLUSIONS Taken together, these findings suggest 300mg of oral CBD does not attenuate cognitive symptoms of anxiety (i.e., worry), following both acute and repeated administration. Some evidence for repeated administration of 300mg on physical symptoms of anxiety was obtained. Findings from the current study suggest CBD's modest anxiolytic effects may be specific to the physical aspects of anxious arousal.
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Affiliation(s)
- L Riley Gournay
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA.
| | - Morgan L Ferretti
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
| | | | - Emily Vance
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
| | - Anna Marie Nguyen
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
| | - Eric Mann
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
- Laureate Institute for Brain Research, Tulsa, USA
| | - Parker Williams
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
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Pinggal E, Dockree PM, O'Connell RG, Bellgrove MA, Andrillon T. Pharmacological Manipulations of Physiological Arousal and Sleep-Like Slow Waves Modulate Sustained Attention. J Neurosci 2022; 42:8113-8124. [PMID: 36109167 PMCID: PMC9637000 DOI: 10.1523/jneurosci.0836-22.2022] [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: 04/30/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/21/2022] Open
Abstract
Sustained attention describes our ability to keep a constant focus on a given task. This ability is modulated by our physiological state of arousal. Although lapses of sustained attention have been linked with dysregulations of arousal, the underlying physiological mechanisms remain unclear. An emerging body of work proposes that the intrusion during wakefulness of sleep-like slow waves, a marker of the transition toward sleep, could mechanistically account for attentional lapses. This study aimed to expose, via pharmacological manipulations of the monoamine system, the relationship between the occurrence of sleep-like slow waves and the behavioral consequences of sustained attention failures. In a double-blind, randomized-control trial, 32 healthy human male participants received methylphenidate, atomoxetine, citalopram or placebo during four separate experimental sessions. During each session, electroencephalography (EEG) was used to measure neural activity while participants completed a visual task requiring sustained attention. Methylphenidate, which increases wake-promoting dopamine and noradrenaline across cortical and subcortical areas, improved behavioral performance whereas atomoxetine, which increases dopamine and noradrenaline predominantly over frontal cortices, led to more impulsive responses. Additionally, citalopram, which increases sleep-promoting serotonin, led to more missed trials. Based on EEG recording, citalopram was also associated with an increase in sleep-like slow waves. Importantly, compared with a classical marker of arousal such as α power, only slow waves differentially predicted both misses and faster responses in a region-specific fashion. These results suggest that a decrease in arousal can lead to local sleep intrusions during wakefulness which could be mechanistically linked to impulsivity and sluggishness.SIGNIFICANCE STATEMENT We investigated whether the modulation of attention and arousal could not only share the same neuromodulatory pathways but also rely on similar neuronal mechanisms; for example, the intrusion of sleep-like activity within wakefulness. To do so, we pharmacologically manipulated noradrenaline, dopamine, and serotonin in a four-arm, randomized, placebo-controlled trial and examined the consequences on behavioral and electroencephalography (EEG) indices of attention and arousal. We showed that sleep-like slow waves can predict opposite behavioral signatures: impulsivity and sluggishness. Slow waves may be a candidate mechanism for the occurrence of attentional lapses since the relationship between slow-wave occurrence and performance is region-specific and the consequences of these local sleep intrusions are in line with the cognitive functions carried by the underlying brain regions.
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Affiliation(s)
- Elaine Pinggal
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3168, Australia
| | - Paul M Dockree
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin D02 PN40, Ireland
| | - Redmond G O'Connell
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin D02 PN40, Ireland
| | - Mark A Bellgrove
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3168, Australia
| | - Thomas Andrillon
- School of Philosophical, Historical, and International Studies, Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, Victoria 3168, Australia
- Paris Brain Institute, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale-Centre National de la Recherche Scientifique, Paris 75013, France
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Central nervous system effects of TAK-653, an investigational alpha-amino-3-hydroxy-5-methyl-4-isoxazole receptor (AMPAR) positive allosteric modulator in healthy volunteers. Transl Psychiatry 2022; 12:408. [PMID: 36153330 PMCID: PMC9509332 DOI: 10.1038/s41398-022-02148-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/17/2022] [Accepted: 09/01/2022] [Indexed: 11/24/2022] Open
Abstract
TAK-653 is a novel AMPA receptor positive allosteric modulator in clinical development for the treatment of major depressive disorder (MDD). This study aimed to measure the functional pharmacodynamic central nervous system (CNS) effects of TAK-653. A randomised, double-blind, placebo-controlled, three-way crossover (placebo, TAK-653 0.5 mg and 6 mg) study with 24 healthy volunteers was performed. NeuroCart tests consisting of body sway (BS), saccadic peak velocity (SPV), smooth pursuit eye movements (SP), adaptive tracking (AT), Bowdle and Bond and Lader Visual Analogue Scales (B-VAS and BL-VAS) and Stroop test were performed pre-dose and 3.5 and 4 h post-dose. Data were analysed using a mixed model analysis of covariance with baseline as covariate. It was found that TAK-653 did not affect BS and subjective drug effects as measured by B-VAS and BL-VAS at either dose level. TAK-653 0.5 mg increased SPV (degrees/second) (19.49 [5.98, 32.99], P = 0.02) and affected Stroop difference in reaction time between correct congruent and correct incongruent answers and number of correct responses in incongruent trials (22.0 [4.0, 40.0], P = 0.05 and -0.3 [-0.5, -0.1], P = 0.02, respectively). TAK-653 6 mg improved AT (%) (1.68 [0.51, 2.84], P = 0.02) and increased SPV (degrees/s) (15.40 [1.91, 28.90], P = 0.06) and SP (%) (2.32 [0.37, 4.27], P = 0.05). Based on these findings it can be concluded that TAK-653 demonstrated a psychostimulant-like pharmacodynamic profile on the NeuroCart consistent with previously reported increase of cortical excitability following Transcranial Magnetic Stimulation (TMS) of the human motor cortex.
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6
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Bolsoni LM, Crippa JAS, Hallak JEC, Guimarães FS, Zuardi AW. Effects of cannabidiol on symptoms induced by the recall of traumatic events in patients with posttraumatic stress disorder. Psychopharmacology (Berl) 2022; 239:1499-1507. [PMID: 35029706 DOI: 10.1007/s00213-021-06043-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
Studies with cannabidiol (CBD) suggest that this compound has anxiolytic properties and may mediate the reconsolidation and extinction of aversive memories. The objective of this study was to test whether the administration of CBD 300 mg before the recall of traumatic events attenuated symptoms usually induced by recall in subjects diagnosed with posttraumatic stress disorder (PTSD) and if its potential effects interfere with the reconsolidation of aversive memories. The double-blind trial included 33 participants of both sexes, aged between 18 and 60 years, diagnosed with PTSD according to the SCID-5 and randomly allocated to two groups treated with CBD (n = 17) and placebo (n = 16). In the first experimental section, participants were matched by sex, age, body mass index (BMI), and PTSD symptoms as assessed with the Posttraumatic Stress Disorder Checklist (PCL-5). On the same day, participants prepared the behavior test, recording accounts of their traumas in digital audio for a minute and a half and then imagining the trauma for 30 s. After 7 days, participants received CBD (300 mg) or placebo and performed the behavioral test, listening to the trauma account and imagining themselves in that situation. Before and after the behavioral test, subjective changes in mood and anxiety were recorded (Visual and Analogical Mood Scale - VAMS and STAI-state), along with physiological correlates of anxiety blood pressure (BP), heart rate (HR), and salivary cortisol (SC). Seven days later, participants underwent the same procedures as the previous session, but without the pharmacological intervention, to assess the effect on reconsolidation of traumatic memories. We found that CBD significantly attenuated the increase in the VAMS scale cognitive impairment factor scores, under the CBD's effect, with this effect remaining 1 week after drug administration. No significant differences between the effects of CBD and placebo on anxiety, alertness, and discomfort induced by the recall of the traumatic event during the pharmacological intervention and in the subsequent week, in the absence of it. There were no significant differences between the CBD and placebo groups regarding physiological data (BP, HR, and SC). The attenuation of cognitive impairments during trauma recall under the effect of CBD may have interfered with the reconsolidation of traumatic memories concerning its association with cognitive impairments.
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Affiliation(s)
- Lívia Maria Bolsoni
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - José Alexandre S Crippa
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.,National Institute for Science and Technology in Translational Medicine (INCT - TM), CNPq/FAPESP/CAPES, Ribeirao Preto, Brazil
| | - Jaime Eduardo Cecílio Hallak
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.,National Institute for Science and Technology in Translational Medicine (INCT - TM), CNPq/FAPESP/CAPES, Ribeirao Preto, Brazil
| | - Francisco Silveira Guimarães
- National Institute for Science and Technology in Translational Medicine (INCT - TM), CNPq/FAPESP/CAPES, Ribeirao Preto, Brazil.,Department of Pharmacology, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Antonio Waldo Zuardi
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.,National Institute for Science and Technology in Translational Medicine (INCT - TM), CNPq/FAPESP/CAPES, Ribeirao Preto, Brazil
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7
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Hartley N, McLachlan CS. Aromas Influencing the GABAergic System. Molecules 2022; 27:molecules27082414. [PMID: 35458615 PMCID: PMC9026314 DOI: 10.3390/molecules27082414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 02/07/2023] Open
Abstract
Aromas have a powerful influence in our everyday life and are known to exhibit an array of pharmacological properties, including anxiolytic, anti-stress, relaxing, and sedative effects. Numerous animal and human studies support the use of aromas and their constituents to reduce anxiety-related symptoms and/or behaviours. Although the exact mechanism of how these aromas exert their anxiolytic effects is not fully understood, the GABAergic system is thought to be primarily involved. The fragrance emitted from a number of plant essential oils has shown promise in recent studies in modulating GABAergic neurotransmission, with GABAA receptors being the primary therapeutic target. This review will explore the anxiolytic and sedative properties of aromas found in common beverages, such as coffee, tea, and whisky as well aromas found in food, spices, volatile organic compounds, and popular botanicals and their constituents. In doing so, this review will focus on these aromas and their influence on the GABAergic system and provide greater insight into viable anxiety treatment options.
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Affiliation(s)
- Neville Hartley
- Department of Naturopathy and Western Herbal Medicine, Health Faculty, Fortitude Valley Campus, Torrens University Australia, Brisbane, QLD 4006, Australia
- Correspondence:
| | - Craig S. McLachlan
- Centre for Healthy Futures, Health Faculty, Surry Hills Campus, Torrens University Australia, Sydney, NSW 2010, Australia;
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Bolsoni LM, Crippa JAS, Hallak JEC, Guimarães FS, Zuardi AW. The anxiolytic effect of cannabidiol depends on the nature of the trauma when patients with post-traumatic stress disorder recall their trigger event. BRAZILIAN JOURNAL OF PSYCHIATRY 2022; 44:298-307. [PMID: 35293520 PMCID: PMC9169481 DOI: 10.1590/1516-4446-2021-2317] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/27/2021] [Indexed: 11/24/2022]
Abstract
Objectives: We assessed whether administering cannabidiol (CBD) before recalling the traumatic event that triggered their disorder attenuates anxiety in patients with post-traumatic stress disorder (PTSD). As an exploratory pilot analysis, we also investigated whether this effect depends on the nature of the event (sexual vs. nonsexual trauma). Methods: Thirty-three patients of both sexes with PTSD were recruited and randomized 1:1 into two groups. One group received oral CBD (300 mg), and the other received a placebo before listening to a digital audio playback of their previously recorded report of the trigger event. Subjective and physiological measurements were taken before and after recall. We analyzed the data in two subsamples: trigger events involving sexual and nonsexual trauma. Results: In the nonsexual trauma group, the differences between measurements before and after recall were significantly smaller with CBD than placebo; this held true for anxiety and cognitive impairment. However, in the sexual trauma group, the differences were non-significant for both measurements. Conclusion: A single dose of CBD (300mg) attenuated the increased anxiety and cognitive impairment induced by recalling a traumatic event in patients with PTSD when the event involved nonsexual trauma.
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Affiliation(s)
- Lívia Maria Bolsoni
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - José Alexandre S Crippa
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Jaime Eduardo Cecílio Hallak
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Antonio Waldo Zuardi
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
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Baptista E, André Arriel R, de Castro Carvalho AL, Bispo MMC, Rodrigues AB, Souza H, Mota GR, Marocolo M. Influence of Wearing Blue Lenses on Melatonin Production and
Performance in Volleyball Players. Sports Med Int Open 2022; 6:E1-E8. [PMID: 35211651 PMCID: PMC8860502 DOI: 10.1055/a-1720-6083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/05/2021] [Indexed: 11/29/2022] Open
Abstract
We analyzed the effects of wearing blue lenses on melatonin level, physical and
cognitive performance. Fifteen youth volleyball players
(15.0±1.5 yrs) attended the laboratory on 3 occasions (48-h
interval): on the 1
st
visit they were familiarized with the
procedures of the study, and on 2
nd
and 3
rd
visits they
were submitted to the testing protocol wearing transparent (control) or blue
lens glasses in a counterbalanced crossover design. The protocol consisted of
10 min in “total darkness,” 30 min of light
stimulation (wearing blue or transparent lenses), followed by an attentional
test, and an agility T-test (without wearing the glasses). Samples of saliva (to
determine melatonin concentration) were obtained pre- and post-exposure
(30 min) to artificial light, wearing the lenses. Sleepiness, alertness,
attention, mood, and perceived recovery status and performance variables
(reaction time and T-test) were assessed after lens exposure. Melatonin levels
did not differ within and between groups (blue lenses, pre: 0.79±0.73
and post: 1.19±1.374 pg/dl, p=0.252, effect size
(ES)=0.38; control, pre: 0.97±1.00 and post:
0.67±0.71 pg/dl, p=0.305,
ES=–0.35). Nonetheless, melatonin differences were significantly
correlated with physical sedation for glasses with blue lenses
(r=−0.526; p=0.04). No other variables differed
(p>0.05) between protocols, including T-test performance
(p=0.07; ES=0.41). Blue lenses do not influence melatonin
levels, cognitive/physical performance, and mood status in amateur youth
volleyball players.
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Affiliation(s)
- Eduardo Baptista
- Institute of Biological Sciences, Department of Physiology,
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Rhai André Arriel
- Institute of Biological Sciences, Department of Physiology,
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Ana Luiza de Castro Carvalho
- Institute of Biological Sciences, Department of Physiology,
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Matheus M. C. Bispo
- Institute of Biological Sciences, Department of Physiology,
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Alex Batista Rodrigues
- Institute of Biological Sciences, Department of Physiology,
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Hiago Souza
- Institute of Biological Sciences, Department of Physiology,
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Gustavo R. Mota
- Department of Sport Sciences/Institute of Health Sciences,
Federal University of Triangulo Mineiro, UBERABA, Brazil
| | - Moacir Marocolo
- Institute of Biological Sciences, Department of Physiology,
Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
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10
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Dijkstra FM, Zuiker RGJA, Siebenga PS, Leigh-Pemberton RA, Sun L, Manthis JD, de Kam ML, Lin R, von Moltke LL, Rezendes D, van Gerven JMA. Pharmacological profile of ALKS 7119, an investigational compound evaluated for the treatment of neuropsychiatric disorders, in healthy volunteers. Br J Clin Pharmacol 2022; 88:2909-2925. [PMID: 35014069 PMCID: PMC9302689 DOI: 10.1111/bcp.15229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022] Open
Abstract
AIM ALKS 7119 is a novel compound with in vitro affinity highest for the SERT, and for μ receptor, α1A -adrenoceptor, α1B -adrenoceptor, NMDA receptor and sigma non-opioid intracellular receptor 1. This first-in-human study evaluated safety and PK/PD effects of single ascending doses (SAD) of ALKS 7119 in healthy males and compared effects with neurotransmitter modulators with partially overlapping targets. METHODS In 10 cohorts (n=10 subjects each), PK, safety and PD (NeuroCart tests, measuring neurophysiologic effects [pupillometry, pharmaco-EEG (pEEG)], visuomotor coordination, alertness, [sustained] attention [saccadic peak velocity, adaptive tracking], subjective drug effects [VAS Bowdle and VAS Bond and Lader] and postural stability [body sway]) were evaluated. Neuroendocrine effects (cortisol, prolactin, growth hormone) were measured. Data were analysed over the 12-hour post-dose period using mixed-effects model for repeated measure (MMRM) with baseline as covariate. RESULTS ALKS 7119 demonstrated linear PK and was generally well tolerated. QTcF interval increases of 30-60 ms compared to baseline were observed with ALKS 7119 doses of ≥50 mg without related adverse events. Significant increases in left and right pupil/iris ratio were observed at dose levels ≥50 mg (estimate of difference [95%CI], p-value) (0.04 [0.01; 0.07], P < 0.01) and (0.06 [0.03; 0.09], P = 0.01), respectively. From dose levels ≥50 mg significant increases (% change) of serum cortisol (51.7 [8.4; 112.3], P = 0.02) and prolactin (77.9 [34.2; 135.8], P < 0.01) were observed. CONCLUSION In line with ALKS 7119's in vitro pharmacological profile, the clinical profile observed in this study is most comparable to SERT inhibition.
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Affiliation(s)
- Francis M Dijkstra
- Centre for Human Drug Research (CHDR), Leiden, CL, Leiden, The Netherlands.,Leiden University Medical Center, ZA, Leiden, US
| | - Rob G J A Zuiker
- Centre for Human Drug Research (CHDR), Leiden, CL, Leiden, The Netherlands.,Leiden University Medical Center, ZA, Leiden, US
| | - Pieter S Siebenga
- Centre for Human Drug Research (CHDR), Leiden, CL, Leiden, The Netherlands
| | | | - Lei Sun
- Alkermes, Inc., Waltham, MA, USA
| | | | - Marieke L de Kam
- Centre for Human Drug Research (CHDR), Leiden, CL, Leiden, The Netherlands
| | | | | | | | - Joop M A van Gerven
- Centre for Human Drug Research (CHDR), Leiden, CL, Leiden, The Netherlands.,Leiden University Medical Center, ZA, Leiden, US
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11
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Bakker C, van Esdonk MJ, Stuurman R(FE, Borghans LG, de Kam ML, van Gerven JM, Groeneveld GJ. Biperiden Challenge Model in Healthy Elderly as Proof-of-Pharmacology Tool: A Randomized, Placebo-Controlled Trial. J Clin Pharmacol 2021; 61:1466-1478. [PMID: 34021607 PMCID: PMC8596596 DOI: 10.1002/jcph.1913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/14/2021] [Indexed: 11/08/2022]
Abstract
Selective M1 muscarinic acetylcholine receptor (mAChR) agonists are being developed as symptomatic treatment for neurodegenerative and neuropsychiatric disorders that lead to cognitive dysfunction. Demonstrating cognition-enhancing effects in early-phase clinical development in healthy subjects is difficult. A challenge with the M1 mAChR antagonist biperiden could be used to demonstrate procognitive and pharmacological effects of selective M1 mAChR agonists. The aim of this study was to develop such a model. To this end, 12 healthy elderly subjects participated in a randomized, placebo-controlled, 3-way crossover study investigating tolerability, pharmacokinetic (PK) and pharmacodynamic (PD) effects of 2 and 4 mg biperiden. Repeated PD assessments were performed using neurocognitive tasks and electrophysiological measurements. A population PK-PD model was developed. Four milligrams of biperiden showed significant impairment of sustained attention (-2.1 percentage point in adaptive tracking [95%CI, -3.043 to -1.148], verbal memory (2-3 fewer words recalled [95%CI, -5.9 to -0.2]) and working memory (up to a 50-millisecond increase in the n-back task reaction time [95%CI, 21.854-77.882]) compared with placebo. The PK data were best fitted by a 2-compartment model and showed high interoccasion and intersubject variability. Population PK-PD analysis quantified significant concentration-effect relationships for the n-back reaction time, n-back accuracy, and adaptive tracking. In conclusion, biperiden caused M1 mAChR-related dose- and concentration-dependent temporary declines in cognitive functioning. Therefore a biperiden pharmacological challenge model can be used for proof-of-pharmacology studies and to demonstrate cognition-enhancing effects of new cholinergic compounds that are being developed.
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Affiliation(s)
- Charlotte Bakker
- Centre for Human Drug ResearchLeidenThe Netherlands
- Leiden University Medical CentreLeidenThe Netherlands
| | | | | | | | | | | | - Geert Jan Groeneveld
- Centre for Human Drug ResearchLeidenThe Netherlands
- Leiden University Medical CentreLeidenThe Netherlands
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12
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Epigenetic Mediation of AKT1 rs1130233's Effect on Delta-9-Tetrahydrocannabinol-Induced Medial Temporal Function during Fear Processing. Brain Sci 2021; 11:brainsci11091240. [PMID: 34573260 PMCID: PMC8471665 DOI: 10.3390/brainsci11091240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 12/28/2022] Open
Abstract
High doses of delta-9-tetrahydrocannabinol (THC), the main psychoactive component of cannabis, have been shown to have anxiogenic effects. Additionally, THC effects have been shown to be modulated by genotype, including the single nucleotide polymorphism (SNP) rs1130233 at the protein kinase AKT1 gene, a key component of the dopamine signalling cascade. As such, it is likely that epigenetic methylation around this SNP may affect AKT gene expression, which may in turn impact on the acute effects of THC on brain function. We investigated the genetic (AKT1 rs1130233) and epigenetic modulation of brain function during fear processing in a 2-session, double-blind, cross-over, randomized placebo-controlled THC administration, in 36 healthy males. Fear processing was assessed using an emotion (fear processing) paradigm, under functional magnetic resonance imaging (fMRI). Complete genetic and fMRI data were available for 34 participants. THC caused an increase in anxiety and transient psychotomimetic symptoms and para-hippocampal gyrus/amygdala activation. Number of A alleles at the AKT1 rs1130233 SNP, and percentage methylation at the CpG11-12 site, were independently associated with a greater effect of THC on activation in a network of brain regions including left and right parahippocampal gyri, respectively. AKT1 rs1130233 moderation of the THC effect on left parahippocampal activation persisted after covarying for methylation percentage, and was partially mediated in sections of the left parahippocampal gyrus/hippocampus by methylation percentage. These results may offer an example of how genetic and epigenetic variations influence the psychotomimetic and neurofunctional effects of THC.
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13
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Moulier V, Gaudeau-Bosma C, Thomas F, Isaac C, Thomas M, Durand F, Schenin-King Andrianisaina P, Valabregue R, Laidi C, Benadhira R, Bouaziz N, Januel D. Effect of Intermittent Theta Burst Stimulation on the Neural Processing of Emotional Stimuli in Healthy Volunteers. J Clin Med 2021; 10:jcm10112449. [PMID: 34205840 PMCID: PMC8198492 DOI: 10.3390/jcm10112449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Intermittent theta burst stimulation (iTBS) is a form of repetitive transcranial magnetic stimulation that has shown to be effective in treatment-resistant depression. Through studying the effect of iTBS on healthy subjects, we wished to attain a greater understanding of its impact on the brain. Our objective was to assess whether 10 iTBS sessions altered the neural processing of emotional stimuli, mood and brain anatomy in healthy subjects. METHODS In this double-blind randomized sham-controlled study, 30 subjects received either active iTBS treatment (10 sessions, two sessions a day) or sham treatment over the left dorsolateral prefrontal cortex. Assessments of mood, structural magnetic resonance imaging (MRI) and functional MRI (fMRI) were performed before and after iTBS sessions. During the fMRI, three different categories of stimuli were presented: positive, negative and neutral photographs. RESULTS This study showed that, during the presentation of negative stimuli (compared with neutral stimuli), 10 sessions of iTBS increased activity in the left anterior insula. However, iTBS did not induce any change in mood, regional gray matter volume or cortical thickness. CONCLUSIONS iTBS modifies healthy subjects' brain activity in a key region that processes emotional stimuli. (AFSSAPS: ID-RCB 2010A01032-37).
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Affiliation(s)
- Virginie Moulier
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
- Centre Hospitalier du Rouvray, University Department of Psychiatry, 76301 Sotteville-lès-Rouen, France
- Correspondence: ; Tel.: +33-014-309-3232
| | - Christian Gaudeau-Bosma
- Espace Territoriale d’Accompagnement Psychosociale, CH Les Murets, GHT94, 94120 Fontenay sous Bois, France;
| | - Fanny Thomas
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Clémence Isaac
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Maxence Thomas
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Florence Durand
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Palmyre Schenin-King Andrianisaina
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Romain Valabregue
- Institut du Cerveau et de la Moelle Épinière—ICM, Sorbonne Universités, UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, 75013 Paris, France;
| | - Charles Laidi
- Pôle de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de Médecine de Créteil, DMU IMPACT, Hôpitaux Universitaires Mondor, 94028 Créteil, France;
- Institut National de la Santé et de la Recherche Médicale (INSERM), U955, Institut Mondor de Recherche Biomédicale, Psychiatrie Translationnelle, 94028 Créteil, France
- UNIACT, Psychiatry Team, Neurospin Neuroimaging Platform, CEA Saclay, 91191 Gif-sur-Yvette, France
- Fondation Fondamental, 94028 Créteil, France
| | - René Benadhira
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Noomane Bouaziz
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
| | - Dominique Januel
- Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France; (F.T.); (C.I.); (M.T.); (F.D.); (P.S.-K.A.); (R.B.); (N.B.); (D.J.)
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14
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Crippa JA, Pereira Junior LC, Pereira LC, Zimmermann PM, Brum Junior L, Rechia LM, Dias I, Hallak JE, Campos AC, Guimarães FS, Queiroz RH, Zuardi AW. Effect of two oral formulations of cannabidiol on responses to emotional stimuli in healthy human volunteers: pharmaceutical vehicle matters. BRAZILIAN JOURNAL OF PSYCHIATRY 2021; 44:15-20. [PMID: 34076067 PMCID: PMC8827362 DOI: 10.1590/1516-4446-2020-1684] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/02/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To compare plasma concentrations of cannabidiol (CBD) following oral administration of two formulations of the drug (powder and dissolved in oil), and to evaluate the effects of these distinct formulations on responses to emotional stimuli in healthy human volunteers. METHODS In a randomized, double-blind, placebo-controlled, parallel-group design, 45 healthy male volunteers were randomly assigned to three groups of 15 subjects that received either 150 mg of CBD powder; 150 mg of CBD dissolved in corn oil; or placebo. Blood samples were collected at different times after administration, and a facial emotion recognition task was completed after 150 min. RESULTS There were no significant differences across groups in the subjective and physiological measures, nor in the facial emotion recognition task. However, groups that received the drug showed statistically significant differences in baseline measures of plasma CBD, with a significantly greater difference in favor of the oil formulation. CONCLUSION When administered as a single 150-mg dose, neither formulation of oral CBD altered responses to emotional stimuli in healthy subjects. The oil-based CBD formulation resulted in more rapid achievement of peak plasma level, with an approximate fourfold increase in oral bioavailability.
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Affiliation(s)
- José A Crippa
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.,Instituto Nacional de Ciência e Tecnologia, Medicina Translacional (INCT-TM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Ribeirão Preto, SP, Brazil
| | - Luiz C Pereira Junior
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Lívia C Pereira
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | | | | | - Isabella Dias
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Jaime E Hallak
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.,Instituto Nacional de Ciência e Tecnologia, Medicina Translacional (INCT-TM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Ribeirão Preto, SP, Brazil
| | - Alline C Campos
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.,Departamento de Farmacologia, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - Francisco S Guimarães
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.,Departamento de Farmacologia, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - Regina H Queiroz
- Instituto Nacional de Ciência e Tecnologia, Medicina Translacional (INCT-TM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Ribeirão Preto, SP, Brazil.,Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Antonio W Zuardi
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.,Instituto Nacional de Ciência e Tecnologia, Medicina Translacional (INCT-TM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Ribeirão Preto, SP, Brazil
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15
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Guan Z, Chen XG, Hay J, van Gerven J, Burggraaf J, de Kam M. Stability analysis of clustering of Norris' visual analogue scale: Applying the consensus clustering approach. Medicine (Baltimore) 2021; 100:e25363. [PMID: 33907093 PMCID: PMC8084085 DOI: 10.1097/md.0000000000025363] [Citation(s) in RCA: 1] [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] [Received: 01/14/2020] [Revised: 01/25/2021] [Accepted: 03/11/2021] [Indexed: 11/19/2022] Open
Abstract
ABSTRACT Visual analogue scales are widely used to measure subjective responses. Norris' 16 visual analogue scales (N_VAS) measure subjective feelings of alertness and mood. Up to now, different scientists have clustered items of N_VAS into different ways and Bond and Lader's way has been the most frequently used in clinical research. However, there are concerns about the stability of this clustering over different subject samples and different drug classes. The aim of this study was to test whether Bond and Lader's clustering was stable in terms of subject samples and drug effects. Alternative clustering of N_VAS was tested.Data from studies with 3 types of drugs: cannabinoid receptor agonist (delta-9-tetrahydrocannabinol [THC]), muscarinic antagonist (scopolamine), and benzodiazepines (midazolam and lorazepam), collected between 2005 and 2012, were used for this analysis. Exploratory factor analysis (EFA) was used to test the clustering algorithm of Bond and Lader. Consensus clustering was performed to test the stability of clustering results over samples and over different drug types. Stability analysis was performed using a three-cluster assumption, and then on other alternative assumptions.Heat maps of the consensus matrix (CM) and density plots showed instability of the three-cluster hypothesis and suggested instability over the 3 drug classes. Two- and four-cluster hypothesis were also tested. Heat maps of the CM and density plots suggested that the two-cluster assumption was superior.In summary, the two-cluster assumption leads to a provably stable outcome over samples and the 3 drug types based on the data used.
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Affiliation(s)
- Zheng Guan
- Centre for Human Drug Research
- Leiden University Medical Center, The Netherlands
| | | | | | - Joop van Gerven
- Centre for Human Drug Research
- Leiden University Medical Center, The Netherlands
| | - Jacobus Burggraaf
- Centre for Human Drug Research
- Leiden University Medical Center, The Netherlands
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16
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Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies. Psychopharmacology (Berl) 2021; 238:1911-1922. [PMID: 33745011 PMCID: PMC8233285 DOI: 10.1007/s00213-021-05818-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/03/2021] [Indexed: 12/31/2022]
Abstract
RATIONALE Aggression and irritability are notable psychiatric side effects of anabolic-androgenic steroid (AAS) use. However, no previous study has systematically reviewed and quantitatively synthesized effects reported by experimental studies on this topic. OBJECTIVE We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effect of AAS administration on self-reported and observer-reported aggression. METHODS Twelve RCTs comprising a total of 562 healthy males were identified through systematic searches of MEDLINE, PsycInfo, ISI Web of Science, ProQuest, Google Scholar, and the Cochrane Library. RESULTS After excluding one outlier, AAS administration was associated with an increase in self-reported aggression under a random-effects model, albeit small (Hedges' g = 0.171, 95% CI: 0.029-0.312, k = 11, p = .018), and when restricting the analysis to the effect of acute AAS administration on self-reported aggression under a fixed-effect model (g = 0.291, 95% CI: 0.014-0.524, p = .014). However, the above effects were neither replicated in the analysis of observer-reported aggression nor after restricting the analysis to the effects of the administration of higher (over 500 mg) and long-term (3 days to 14 weeks) doses. CONCLUSIONS The present meta-analysis provides evidence of an increase, although small, in self-reported aggression in healthy males following AAS administration in RCTs. Ecologically rational RCTs are warranted to better explore the effect of AAS administration on aggression in humans.
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17
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Berger B, Brooks S, Zuiker R, Richard M, Muehlan C, Dingemanse J. Pharmacological Interactions between the Dual Orexin Receptor Antagonist Daridorexant and Ethanol in a Double-Blind, Randomized, Placebo-Controlled, Double-Dummy, Four-Way Crossover Phase I Study in Healthy Subjects. CNS Drugs 2020; 34:1253-1266. [PMID: 33205362 DOI: 10.1007/s40263-020-00768-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Daridorexant (ACT-541468) is a potent dual orexin receptor antagonist under development for the treatment of sleep disorders. Concomitant intake of ethanol and hypnotics has been shown to result in additive/supra-additive depression of the central nervous system, resulting in pronounced sedation. OBJECTIVE The aim of this study was to evaluate the pharmacokinetic (PK) and pharmacodynamic (PD) interactions between ethanol and daridorexant. METHOD This was a single-center, double-blind, placebo-controlled, randomized, four-way crossover study conducted in 19 healthy male/female subjects. Subjects received the following four treatments: ethanol with daridorexant, daridorexant alone, ethanol alone, and placebo. Daridorexant 50 mg and the matching placebo were administered as single oral tablets. Ethanol was infused intravenously and clamped at a level of 0.6 g/L for 5 h. The PK of ethanol and daridorexant were assessed and a battery of PD tests performed. RESULTS Concomitant administration of ethanol prolonged the time to reach maximum plasma concentrations (tmax) of daridorexant (median difference 1.25 h). No other relevant PK interactions were observed. Coadministration with ethanol produced a numerically greater impairment on saccadic peak velocity, body sway, visual analog scale (VAS) alertness, VAS alcohol intoxication, smooth pursuit, and adaptive tracking compared with daridorexant alone. All treatments were generally well tolerated without serious adverse events (AEs). The most commonly reported treatment-emergent AEs following coadministration of daridorexant and ethanol included somnolence, headache, fatigue, sudden onset of sleep, and dizziness. CONCLUSIONS Apart from a shift in tmax, no relevant changes in PK parameters were observed following coadministration of daridorexant and ethanol. The coadministration led to reinforced drug actions that were, at most, indicative of infra-additive effects on certain PD markers. Patients will be advised not to consume ethanol with daridorexant. CLINICAL TRIALS REGISTRATION NUMBER NCT03609775 (ClinicalTrials.gov Identifier).
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Affiliation(s)
- Benjamin Berger
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland.
| | - Sander Brooks
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | - Rob Zuiker
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - Muriel Richard
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland
| | - Clemens Muehlan
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland
| | - Jasper Dingemanse
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland
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18
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Abstract
RésuméLes principaux instruments standardisés d’évaluation clinique de la dépression et de l’anxiété comprennent les critères diagnostiques, des échelles d’appréciation et des tests mentaux, principalement des questionnaires. L’utilisation systématique de critères diagnostiques rigoureux se révèle utile pour pouvoir constituer des groupes de Patients suffisamment homogènes pour les recherches cliniques. L'approche polydiagnostique représente, dans cette optique, une voie intéressante de recherche, permettant de ne pas être limité par un système de référence nosographique unique. Les systèmes permettant à ce jour la meilleure homogénéité des groupes de malades sont les critères du DSM III d’un épisode dépressif majeur, les critères de St-Louis de dépression primaire (Feighner, 1972), et les critères de dépression endogène (échelles de Newcastle; Roth, 1983), utilisés conjointement.Certaines échelles de dépression ont fait l’objet de développements récents en Europe comme la MADRS, l’échelle de ralentissement dépressif de Widlocher, l’échelle d évaluation de la dépression de Pichot et l’échelle manie-dépression du système AMDP. Il en est de même pour certains questionnaires ou check-lists comme le questionnaire HAD, la HSCL, les échelles visuelles analogiques de Norris ou la CHESS, check-list d’évaluation des symptômes somatiques. La sensibilité au changement de ces divers instruments en fait leur principal intérêt pratique.
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19
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de Faria SM, de Morais Fabrício D, Tumas V, Castro PC, Ponti MA, Hallak JE, Zuardi AW, Crippa JAS, Chagas MHN. Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson's disease. J Psychopharmacol 2020; 34:189-196. [PMID: 31909680 DOI: 10.1177/0269881119895536] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cannabidiol (CBD) is one of the main components of Cannabis sativa and has anxiolytic properties, but no study has been conducted to evaluate the effects of CBD on anxiety signs and symptoms in patients with Parkinson's disease (PD). This study aimed to evaluate the impacts of acute CBD administration at a dose of 300 mg on anxiety measures and tremors induced by a Simulated Public Speaking Test (SPST) in individuals with PD. METHODS A randomised, double-blinded, placebo-controlled, crossover clinical trial was conducted. A total of 24 individuals with PD were included and underwent two experimental sessions within a 15-day interval. After taking CBD or a placebo, participants underwent the SPST. During the test, the following data were collected: heart rate, systemic blood pressure and tremor frequency and amplitude. In addition, the Visual Analog Mood Scales (VAMS) and Self-Statements during Public Speaking Scale were applied. Statistical analysis was performed by repeated-measures analysis of variance (ANOVA) while considering the drug, SPST phase and interactions between these variables. RESULTS There were statistically significant differences in the VAMS anxiety factor for the drug; CBD attenuated the anxiety experimentally induced by the SPST. Repeated-measures ANOVA showed significant differences in the drug for the variable related to tremor amplitude as recorded by the accelerometer. CONCLUSION Acute CBD administration at a dose of 300 mg decreased anxiety in patients with PD, and there was also decreased tremor amplitude in an anxiogenic situation.
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Affiliation(s)
| | | | - Vitor Tumas
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Paula Costa Castro
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Moacir Antonelli Ponti
- Institute of Mathematical and Computer Sciences, University of São Paulo, São Carlos, Brazil
| | - Jaime Ec Hallak
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antonio W Zuardi
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - José Alexandre S Crippa
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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20
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Carpenter AM, Guy JH, Leach MC. Influence of the Competition Context on Arousal in Agility Dogs. J APPL ANIM WELF SCI 2020; 23:410-423. [PMID: 31899959 DOI: 10.1080/10888705.2019.1711093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
To determine whether participation in dog agility has an impact on canine arousal and welfare, this study aimed firstly to identify the effect of the competition context on arousal changes experienced by dogs, as distinct from purely physical participation in agility, and secondly to assess the handlers' ability to recognize this. Behaviors indicative of changes in arousal were recorded for twenty dogs immediately before completion of both a competition and a training run, whilst the accuracy of handlers' observations of their dogs' behavior was examined via questionnaire. Whilst a moderate number of behaviors presented with greater frequency or duration in competition, the total number of different arousal behaviors performed was higher for dogs in competition (p < 0.01). Context had a relatively modest effect on the level of arousal of agility dogs, with a greater number of behaviors indicating increased arousal in competition. Such increased arousal may adversely influence the success of dog-handler partnerships in competition. In both contexts, handlers observed fewer behaviors than their dogs performed and this finding may have implications for dog welfare.
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Affiliation(s)
- Alison M Carpenter
- School of Natural and Environmental Sciences, Newcastle University , Newcastle, UK
| | - Jonathan H Guy
- School of Natural and Environmental Sciences, Newcastle University , Newcastle, UK
| | - Matthew C Leach
- School of Natural and Environmental Sciences, Newcastle University , Newcastle, UK
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21
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Karamaouna P, Zouraraki C, Giakoumaki SG. Cognitive Functioning and Schizotypy: A Four-Years Study. Front Psychiatry 2020; 11:613015. [PMID: 33488431 PMCID: PMC7820122 DOI: 10.3389/fpsyt.2020.613015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
Although there is ample evidence from cross-sectional studies indicating cognitive deficits in high schizotypal individuals that resemble the cognitive profile of schizophrenia-spectrum patients, there is still lack of evidence by longitudinal/follow-up studies. The present study included assessments of schizotypal traits and a wide range of cognitive functions at two time points (baseline and 4-years assessments) in order to examine (a) their stability over time, (b) the predictive value of baseline schizotypy on cognition at follow-up and (c) differences in cognition between the two time points in high negative schizotypal and control individuals. Only high negative schizotypal individuals were compared with controls due to the limited number of participants falling in the other schizotypal groups at follow-up. Seventy participants (mean age: 36.17; 70% females) were assessed at baseline and follow-up. Schizotypal traits were evaluated with the Schizotypal Personality Questionnaire. We found that schizotypal traits decreased over time, except in a sub-group of participants ("schizotypy congruent") that includes individuals who consistently meet normative criteria of inclusion in either a schizotypal or control group. In these individuals, negative schizotypy and aspects of cognitive-perceptual and disorganized schizotypy remained stable. The stability of cognitive functioning also varied over time: response inhibition, aspects of cued attention switching, set-shifting and phonemic/semantic verbal fluency improved at follow-up. High negative schizotypy at baseline predicted poorer response inhibition and semantic switching at follow-up while high disorganized schizotypy predicted poorer semantic processing and complex processing speed/set-shifting. The between-group analyses revealed that response inhibition, set-shifting and complex processing speed/set-shifting were poorer in negative schizotypals compared with controls at both time points, while maintaining set and semantic switching were poorer only at follow-up. Taken together, the findings show differential stability of the schizotypal traits over time and indicate that different aspects of schizotypy predict a different pattern of neuropsychological task performance during a 4-years time window. These results are of significant use in the formulation of targeted early-intervention strategies for high-risk populations.
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Affiliation(s)
- Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
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22
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Swerdlow NR, Bhakta SG, Talledo J, Benster L, Kotz J, Lavadia M, Light GA. Lessons learned by giving amphetamine to antipsychotic-medicated schizophrenia patients. Neuropsychopharmacology 2019; 44:2277-2284. [PMID: 31445502 PMCID: PMC6897898 DOI: 10.1038/s41386-019-0495-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/29/2019] [Accepted: 08/13/2019] [Indexed: 11/09/2022]
Abstract
Experimental Medicine studies in psychiatric populations test specific, mechanistic hypotheses related to the biology of mental illness, by combining well-characterized neurobiological probes and laboratory-based measures of behavioral performance and neurobiology. However, scientific inquiry through the acute administration of psychoactive drugs to patients with serious mental illness raises important ethical issues. These issues arise in studies in which the psychostimulant, amphetamine, is used as an Experimental Medicine probe in patients with schizophrenia. In this study, we summarize relevant aspects of our experience with acute, laboratory-based challenges of amphetamine in schizophrenia patients. Schizophrenia patients participated in one or more Experimental Medicine studies involving limited doses of amphetamine with clinical monitoring, over a 4-year period. Acute (within hours of ingestion; collective n = 53), subacute (three active doses over 4 weeks; n = 28), and long-term (mean = 17 months after ingestion; n = 19) effects of amphetamine ingestion were assessed. In antipsychotic (AP)-medicated schizophrenia patients, amphetamine was associated with no detrimental subjective, autonomic, or functional changes. Symptoms assessed acutely, subacutely, or long term were either unchanged or diminished. No adverse acute, subacute, or long-term consequences from the Experimental Medicine use of amphetamine in antipsychotic-medicated schizophrenia patients were detected. These findings do not address the safety or effectiveness of the use of amphetamine in unmedicated patients, or as an adjunctive treatment for schizophrenia. Indeed, it is important to distinguish evidence-based risks of symptom exacerbation in an Experimental Medicine setting vs. risks associated with long-term, daily clinical use or even misuse of amphetamine.
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Affiliation(s)
- Neal R. Swerdlow
- Department of Psychiatry, 0804, University of California, San Diego, La Jolla, CA 92093 USA
| | - Savita G. Bhakta
- Department of Psychiatry, 0804, University of California, San Diego, La Jolla, CA 92093 USA
| | - Jo Talledo
- Department of Psychiatry, 0804, University of California, San Diego, La Jolla, CA 92093 USA
| | - Lindsay Benster
- Department of Psychiatry, 0804, University of California, San Diego, La Jolla, CA 92093 USA
| | - Juliana Kotz
- Department of Psychiatry, 0804, University of California, San Diego, La Jolla, CA 92093 USA
| | - Maria Lavadia
- Department of Psychiatry, 0804, University of California, San Diego, La Jolla, CA 92093 USA
| | - Gregory A. Light
- Department of Psychiatry, 0804, University of California, San Diego, La Jolla, CA 92093 USA ,0000 0004 0419 2708grid.410371.0VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA USA
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23
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Huizinga CR, Zuiker RG, de Kam ML, Ziagkos D, Kuipers J, Mejia Y, van Gerven JM, Cohen AF. Evaluation of simulated driving in comparison to laboratory-based tests to assess the pharmacodynamics of alprazolam and alcohol. J Psychopharmacol 2019; 33:791-800. [PMID: 30912701 DOI: 10.1177/0269881119836198] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
RATIONALE Assessment of the effects of medicines on the risks of car driving must be derived from laboratory tests, simulated driving or real on-road driving tests. Relevance of tests is determined by their sensitivity and predictive ability for the probability of accidents or damage. This cannot be determined directly, but methods should be able to at least detect the effects of a positive control in dosage known to be clearly associated with increased risk. OBJECTIVES A driving simulator was evaluated in comparison with a battery of validated tests of CNS performance, the NeuroCart®. Alcohol in a concentration exactly at the legal limit (0.5 g L-1) and well above (1.0 g L-1) as well as alprazolam (1 mg) was used as positive control. METHODS This was a randomised, cross-over study using a double dummy blinded design in 24 healthy study subjects (12 M, 12 F) aged 20-43 years. Alcohol was infused intravenously using a validated clamping protocol to obtain concentrations of 0.5 g L-1 and on another occasion 1.0 g L-1. Alprazolam was given orally. Driving tests and lab tests were done at regular time intervals during a study day. RESULTS Alprazolam and alcohol significantly affected the main parameters of driving in the simulator and affected scores of safe driving and alprazolam increased the odds ratio of a virtual crash. Several laboratory measurements of psychomotor performance were affected by the reference substances as expected and correlated significantly with the driving performance. CONCLUSIONS The driving simulator can detect effects of reference substances at levels that are known to negatively affect driving.
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Affiliation(s)
| | - Rob G Zuiker
- 1 Centre for Human Drug Research, Leiden, The Netherlands
| | | | | | | | - Yuri Mejia
- 1 Centre for Human Drug Research, Leiden, The Netherlands
| | | | - Adam F Cohen
- 1 Centre for Human Drug Research, Leiden, The Netherlands
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24
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Meyhöfer I, Kasparbauer AM, Steffens M, Ettinger U. Effects of nicotine on smooth pursuit eye movements in healthy non-smokers. Psychopharmacology (Berl) 2019; 236:2259-2271. [PMID: 30874860 DOI: 10.1007/s00213-019-05223-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 03/06/2019] [Indexed: 12/12/2022]
Abstract
RATIONALE The non-selective nicotinic acetylcholine receptor (nAChR) agonist nicotine has been argued to improve attention via enhanced filtering of irrelevant stimuli. Here, we tested this hypothesis in the context of smooth pursuit eye movements (SPEMs), an oculomotor function previously shown to improve with nicotine in some but not all studies. OBJECTIVES In order to test whether nicotine improves performance particularly when the inhibition of distracting stimuli is required, SPEM was elicited in conditions with or without peripheral distractors. Additionally, different target frequencies were employed in order to parametrically vary general processing demands on the SPEM system. METHODS Healthy adult non-smokers (N = 18 females, N = 13 males) completed a horizontal sinusoidal SPEM task at different target frequencies (0.2 Hz, 0.4 Hz, 0.6 Hz) in the presence or absence of peripheral distractors in a double-blind, placebo-controlled, cross-over design using a 2 mg nicotine gum. RESULTS Nicotine increased peak pursuit gain relative to placebo (p < .001), but an interaction with distractor condition (p = .001) indicated that this effect was most pronounced in the presence of distractors. Catch-up saccade frequency was reduced by nicotine (p = .01), particularly at higher target frequencies (two-way interaction, p = .04). However, a three-way interaction (p = .006) indicated that the reduction with nicotine was strongest at the highest target frequency (0.6 Hz) only without distractors, whereas in the presence of distractors, it was strongest at 0.4-Hz target frequency. There were no effects of nicotine on subjective state measures. CONCLUSIONS Together, these findings support a role of both distractor inhibition and general processing load in the effects of nicotine on smooth pursuit.
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Affiliation(s)
- Inga Meyhöfer
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany.,Department of Psychiatry and Psychotherapy, Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
| | | | - Maria Steffens
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany.
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Klaassens BL, van Gerven JMA, Klaassen ES, van der Grond J, Rombouts SARB. Cholinergic and serotonergic modulation of resting state functional brain connectivity in Alzheimer's disease. Neuroimage 2019; 199:143-152. [PMID: 31112788 DOI: 10.1016/j.neuroimage.2019.05.044] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 11/19/2022] Open
Abstract
Disruption of cholinergic and serotonergic neurotransmitter systems is associated with cognitive, emotional and behavioural symptoms of Alzheimer's disease (AD). To investigate the responsiveness of these systems in AD we measured the effects of a single-dose of the selective serotonin reuptake inhibitor citalopram and acetylcholinesterase inhibitor galantamine in 12 patients with AD and 12 age-matched controls on functional brain connectivity with resting state functional magnetic resonance imaging. In this randomized, double blind, placebo-controlled crossover study, functional magnetic resonance images were repeatedly obtained before and after dosing, resulting in a dataset of 432 scans. Connectivity maps of ten functional networks were extracted using a dual regression method and drug vs. placebo effects were compared between groups with a multivariate analysis with signals coming from cerebrospinal fluid and white matter as covariates at the subject level, and baseline and heart rate measurements as confound regressors in the higher-level analysis (at p < 0.05, corrected). A galantamine induced difference between groups was observed for the cerebellar network. Connectivity within the cerebellar network and between this network and the thalamus decreased after galantamine vs. placebo in AD patients, but not in controls. For citalopram, voxelwise network connectivity did not show significant group × treatment interaction effects. However, we found default mode network connectivity with the precuneus and posterior cingulate cortex to be increased in AD patients, which could not be detected within the control group. Further, in contrast to the AD patients, control subjects showed a consistent reduction in mean connectivity with all networks after administration of citalopram. Since AD has previously been characterized by reduced connectivity between the default mode network and the precuneus and posterior cingulate cortex, the effects of citalopram on the default mode network suggest a restoring potential of selective serotonin reuptake inhibitors in AD. The results of this study also confirm a change in cerebellar connections in AD, which is possibly related to cholinergic decline.
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Affiliation(s)
- Bernadet L Klaassens
- Leiden University, Institute of Psychology, Leiden, the Netherlands; Leiden University Medical Center, Department of Radiology, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands.
| | | | | | - Jeroen van der Grond
- Leiden University Medical Center, Department of Radiology, Leiden, the Netherlands
| | - Serge A R B Rombouts
- Leiden University, Institute of Psychology, Leiden, the Netherlands; Leiden University Medical Center, Department of Radiology, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands
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26
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Baakman AC, Alvarez-Jimenez R, Loewen G, de Kam ML, Broekhuizen K, Hilt DC, Groeneveld GJ. No synergistic effect of subtherapeutic doses of donepezil and EVP-6124 in healthy elderly subjects in a scopolamine challenge model. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2019; 5:89-98. [PMID: 30984817 PMCID: PMC6446049 DOI: 10.1016/j.trci.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Donepezil is a widely used cholinesterase inhibitor in the management of Alzheimer's disease. Despite large-scaled evidence for its efficacy, elevated peripheral ACh levels often lead to side effects and are dose limiting. The present exploratory study is designed to determine the potentiation of the effects of donepezil by cotreatment with EVP-6124, an alpha-7 nicotinic agonist, to reduce scopolamine-induced cognitive deficits in healthy elderly subjects. Secondary objectives are to explore safety and pharmacokinetic and pharmacodynamics effects of EVP-6124 alone and in combination with donepezil compared to placebo. METHODS A phase I randomized, single-center, placebo-controlled, double-blind, five-way, partial crossover study was performed with donepezil 2.5, 5 mg or placebo combined with EVP-6124 0.3, 1, 2, 4 mg or placebo in three cohorts of healthy elderly subjects in a scopolamine (0.3 mg i.v.) challenge test. Safety, pharmacokinetic, and pharmacodynamics outcomes were assessed. RESULTS A total of 36 subjects completed the study. Donepezil pharmacokinetic parameters were similar with and without EVP-6124. Effective dose combinations were donepezil/EVP-6124(5/2 mg) and donepezil/EVP-6124 (5/0.3 mg) and showed improvements of the delayed recall of the Visual Verbal Learning Test (1.2; CI = 0.1-2.3) and reaction time during the two-back condition of the N-back (-42; CI = -77, -8), respectively. Overall, no marked reversal of scopolamine effects was observed. DISCUSSION This study shows no synergistic effect of subtherapeutic doses of donepezil and EVP-6124 in a scopolamine challenge model in healthy elderly subjects. Dosing of scopolamine and the combination of donepezil and EVP-6124 requires further study.
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Loughnane GM, Brosnan MB, Barnes JJM, Dean A, Nandam SL, O'Connell RG, Bellgrove MA. Catecholamine Modulation of Evidence Accumulation during Perceptual Decision Formation: A Randomized Trial. J Cogn Neurosci 2019; 31:1044-1053. [PMID: 30883291 DOI: 10.1162/jocn_a_01393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Recent behavioral modeling and pupillometry studies suggest that neuromodulatory arousal systems play a role in regulating decision formation but neurophysiological support for these observations is lacking. We employed a randomized, double-blinded, placebo-controlled, crossover design to probe the impact of pharmacological enhancement of catecholamine levels on perceptual decision-making. Catecholamine levels were manipulated using the clinically relevant drugs methylphenidate and atomoxetine, and their effects were compared with those of citalopram and placebo. Participants performed a classic EEG oddball paradigm that elicits the P3b, a centro-parietal potential that has been shown to trace evidence accumulation, under each of the four drug conditions. We found that methylphenidate and atomoxetine administration shortened RTs to the oddball targets. The neural basis of this behavioral effect was an earlier P3b peak latency, driven specifically by an increase in its buildup rate without any change in its time of onset or peak amplitude. This study provides neurophysiological evidence for the catecholaminergic enhancement of a discrete aspect of human decision-making, that is, evidence accumulation. Our results also support theoretical accounts suggesting that catecholamines may enhance cognition via increases in neural gain.
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Affiliation(s)
| | | | | | | | | | | | - Mark A Bellgrove
- Trinity College, University of Dublin.,Monash University.,University of Queensland
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de Rezende MG, Garcia-Leal C, Silva de Sá MF, Cavalli RDC, Del-Ben CM. Withdrawal of plasma estradiol is associated with increased anxiety reported by women in the first 12 hours after delivery. Psychoneuroendocrinology 2019; 101:67-71. [PMID: 30419373 DOI: 10.1016/j.psyneuen.2018.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 11/18/2022]
Abstract
The aim of this study was to verify if the fall of plasma concentrations of steroid hormones in the first 12 h postpartum would be associated with changes in the same period in the emotional state of healthy women. Subjective and hormonal data were collected from 14 women (28.5 ± 7.1 years old) at zero (only hormones), 1, 2, 6 and 12 h after delivery. Subjective measures were taken using the Visual Analogue Mood Scale (VAMS), which consists of four factors (anxiety, sedation, discomfort, and cognitive impairment). Cortisol was measured by radioimmunoassay and estradiol and progesterone by chemiluminescence immunoassay. Women reported a significant increase in anxiety (relative increase: 43.8%±77.6) and discomfort (125.9%±218.5) within the 12 h postpartum. There were also significant decreases in the plasma concentration of estradiol (relative decrease: 96.5%±3.1), progesterone (78.1%±8.7) and cortisol (71.7%±18.0). The relative decrease in estradiol concentrations was significantly correlated with the relative increase in anxiety. No significant associations between progesterone and cortisol concentrations and subjective measures were observed. Changes of estradiol but not of progesterone and cortisol concentrations were associated with changes in the reported emotional state of healthy women in the immediate postpartum period. The role of this association as a predictor of mood disorders in the postpartum period should be explored in further studies.
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Affiliation(s)
- Marcos Gonçalves de Rezende
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
| | - Cybele Garcia-Leal
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcos Felipe Silva de Sá
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Ricardo de Carvalho Cavalli
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Cristina Marta Del-Ben
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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Hohl R, Deslandes AC, Mármora CHC. The Effect of Single-Dose Massage Session on Autonomic Activity, Mood, and Affective Responses in Major Depressive Disorder. J Holist Nurs 2019; 37:312-321. [PMID: 30810079 DOI: 10.1177/0898010119832493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Massage therapy (MT) is a holistic procedure that includes hand pressure (HP), therapeutic communication (TC), and attentive care (AC); together, these procedures could decrease symptoms of depression. Purpose: To study the influence of TC and AC during MT. Methods: Within-subject experimental design with counterbalancing order of treatment. Comparison analysis of the effect of a typical Swedish massage session (SM) with a "sham" massage (ShM; without HP) on the heart rate variability (HRV) mood and affective responses of patients with major depressive disorder (N = 11). During the ShM, clay stones were randomly placed on the body, and the patients were informed about the (sham) therapeutic effect of stones. Findings: A main effect of time showed that after intervention, both SM and ShM increased the HRV (high-frequency power; F[1, 10] = 7.58, p = .02) and reduced scores for anxiety (F[1, 10] = 37.57, p < .001), other feelings (F[1, 10] = 22.64, p = .001), and physical sedation (F[1, 10] = 10.72, p = .008). The SM was associated with more positive affective responses than ShM (qualitative analysis). Conclusions: AC and TC included in MT session improved mood and HRV in the absence of HP. Additional effect on affective responses was observed owing to the HP.
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Costa R, Steinhoff B, Gama H, Ikedo F, Rocha JF, Soares-da-Silva P. Safety, Tolerability and Efficacy of Eslicarbazepine Acetate as Adjunctive Therapy in Patients Aged ≥ 65 Years with Focal Seizures. Drugs Aging 2018; 35:1109-1117. [PMID: 30387043 PMCID: PMC6267536 DOI: 10.1007/s40266-018-0602-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The incidence of epilepsy is high within the first few years of life, stabilizes over the second through fifth decades, and then rises again. Treatment of elderly patients with antiepileptic drugs (AEDs) is complicated by increased sensitivity to drug effects, altered pharmacokinetics and an increased risk for drug interactions due to polytherapy. On the other hand, the safety and efficacy data of AEDs attained during clinical development programmes are relatively limited for this age group. OBJECTIVE The aim of this study was to evaluate the safety, tolerability and efficacy of eslicarbazepine acetate (ESL) as adjunctive therapy in patients aged ≥ 65 years with focal-onset seizures (FOS). METHODS This was an international, multicentre, open-label, non-controlled, single-arm, post-European approval commitment study with flexible doses of ESL between 400 and 1200 mg/day. Seventy-two elderly patients with at least two FOS in the prior 4 weeks, and treated with one or two AEDs, were enrolled. The study consisted of an 8-week baseline, followed by a 26-week treatment period during which the investigator was allowed to up- or down-titrate the ESL dose, and a 4-week follow-up period. Safety and tolerability were assessed as well as mental sedation, cognitive mental state and suicidal ideation. Efficacy was assessed based on patient diaries regarding the absolute and relative changes in seizure frequency, change in intellectual impairment and quality of life. RESULTS Overall, 47 (65.3%) patients experienced 152 treatment-emergent adverse events (TEAEs). The most frequent were dizziness (12.5%), somnolence (9.7%), fatigue, convulsion and hyponatraemia (8.3% each). All patients that experienced hyponatraemia (6/72) recovered without sequelae. Three patients died during the study (due to cardiac failure, glioblastoma multiforme and ischaemic stroke, all considered unrelated to ESL). Overall, 16 (22.2%) patients discontinued prematurely due to TEAEs. The incidences of clinically significant findings were low for vital signs, ECG, physical and neurological examinations. No TEAEs of hypothyroidism were reported; however, 24 (33.3%) patients presented post-baseline shifts from normal to decreased free T4 levels (not clinically significant). ESL decreased standardized seizure frequency from a mean of 4.8 seizures at baseline to 3.6 seizures at endpoint (p > 0.05); and mean number of days with seizures significantly decreased from 4.1 (baseline) to 2.8 at endpoint (p = 0.0408). CONCLUSION ESL taken once daily (400-1200 mg) as adjunctive therapy in patients aged ≥ 65 years was found to be safe, well tolerated and efficacious (EudraCT number: 2009-012587-14).
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Affiliation(s)
- Raquel Costa
- Department of Research and Development, BIAL-Portela & Cª, S.A., À Avenida da Siderurgia Nacional, 4745-457, Coronado (S. Romão e S. Mamede), Portugal
| | | | - Helena Gama
- Department of Research and Development, BIAL-Portela & Cª, S.A., À Avenida da Siderurgia Nacional, 4745-457, Coronado (S. Romão e S. Mamede), Portugal
| | - Fábio Ikedo
- Department of Research and Development, BIAL-Portela & Cª, S.A., À Avenida da Siderurgia Nacional, 4745-457, Coronado (S. Romão e S. Mamede), Portugal
| | - José-Francisco Rocha
- Department of Research and Development, BIAL-Portela & Cª, S.A., À Avenida da Siderurgia Nacional, 4745-457, Coronado (S. Romão e S. Mamede), Portugal
| | - Patrício Soares-da-Silva
- Department of Research and Development, BIAL-Portela & Cª, S.A., À Avenida da Siderurgia Nacional, 4745-457, Coronado (S. Romão e S. Mamede), Portugal.
- Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal.
- MedInUP-Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal.
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Schmitt E, Krack P, Castrioto A, Klinger H, Bichon A, Lhommée E, Pelissier P, Fraix V, Thobois S, Moro E, Martinez-Martin P. The Neuropsychiatric Fluctuations Scale for Parkinson's Disease: A Pilot Study. Mov Disord Clin Pract 2018; 5:265-272. [PMID: 30363450 DOI: 10.1002/mdc3.12607] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/11/2018] [Accepted: 02/02/2018] [Indexed: 12/19/2022] Open
Abstract
Background Non-motor fluctuations represent a main source of disability in Parkinson's disease (PD). Among them, neuropsychiatric fluctuations are the most frequent and are often under-recognized by patients and physicians, partly because specific tools for assessment of neuropsychiatric fluctuations are lacking. Objective To develop a scale for detecting and evaluating the presence and the severity of neuropsychological symptoms during the ON and OFF phases of non-motor fluctuations. Methods Neuropsychiatric symptoms reported by PD patients in the OFF- and the ON-medication conditions were collected using different neuropsychiatric scales (BDI-II, BAI, Young, VAS, etc.). Subsequently, tree phases of a pilot study was performed for cognitive pretesting, identification of ambiguous or redundant items (item reduction), and to obtain preliminary data of acceptability of the new scale. In all the three phases, the scale was applied in both the OFF and ON condition during a levodopa challenge. Results Twenty items were selected for the final version of the neuropsychiatric fluctuation scale (NFS): ten items measured the ON neuropsychological symptoms and ten items the OFF neuropsychological manifestations. Each item rated from 0-3, providing respective subscores from 0 to 30. Conclusions Once validated, our NFS can be used to identify and quantify neuropsychiatric fluctuations during motor fluctuations. The main novelty is that it could be used in acute settings. As such, the NFS can assess the neuropsychiatric state of the patient at the time of examination. The next step will be to validate the NFS to be used in current practice.
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Affiliation(s)
- Emmanuelle Schmitt
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France
| | - Paul Krack
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France.,Department of Clinical Neuroscience, Hôpitaux Universitaires de Genève University of Geneva Switzerland
| | - Anna Castrioto
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France
| | - Helene Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Neurologie C Lyon France.,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Université de Lyon 1 Université de Lyon Lyon France.,CNRS, UMR 5229 Centre de Neurosciences Cognitives Bron France
| | - Amelie Bichon
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France
| | - Eugénie Lhommée
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France
| | - Pierre Pelissier
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France
| | - Valerie Fraix
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France
| | - Stephane Thobois
- Hospices Civils de Lyon, Hôpital Neurologique Neurologie C Lyon France.,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Université de Lyon 1 Université de Lyon Lyon France.,CNRS, UMR 5229 Centre de Neurosciences Cognitives Bron France
| | - Elena Moro
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France.,Grenoble Institut des Neurosciences Grenoble Alpes University France.,Inserm U1216 Grenoble France
| | - Pablo Martinez-Martin
- National Center of Epidemiology Carlos III Institute of Health Madrid Spain.,CIBERNED Carlos III Institute of Health Madrid Spain
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Linares IM, Zuardi AW, Pereira LC, Queiroz RH, Mechoulam R, Guimarães FS, Crippa JA. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. ACTA ACUST UNITED AC 2018; 41:9-14. [PMID: 30328956 PMCID: PMC6781714 DOI: 10.1590/1516-4446-2017-0015] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 01/10/2018] [Indexed: 12/12/2022]
Abstract
Objective: Cannabidiol (CBD), one of the non-psychotomimetic compounds of Cannabis sativa, causes anxiolytic-like effects in animals, with typical bell-shaped dose-response curves. No study, however, has investigated whether increasing doses of this drug would also cause similar curves in humans. The objective of this study was to compare the acute effects of different doses of CBD and placebo in healthy volunteers performing a simulated public speaking test (SPST), a well-tested anxiety-inducing method. Method: A total of 57 healthy male subjects were allocated to receive oral CBD at doses of 150 mg (n=15), 300 mg (n=15), 600 mg (n=12) or placebo (n=15) in a double-blind procedure. During the SPST, subjective ratings on the Visual Analogue Mood Scale (VAMS) and physiological measures (systolic and diastolic blood pressure, heart rate) were obtained at six different time points. Results: Compared to placebo, pretreatment with 300 mg of CBD significantly reduced anxiety during the speech. No significant differences in VAMS scores were observed between groups receiving CBD 150 mg, 600 mg and placebo. Conclusion: Our findings confirm the anxiolytic-like properties of CBD and are consonant with results of animal studies describing bell-shaped dose-response curves. Optimal therapeutic doses of CBD should be rigorously determined so that research findings can be adequately translated into clinical practice.
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Affiliation(s)
- Ila M Linares
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Antonio W Zuardi
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.,Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Luis C Pereira
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Regina H Queiroz
- Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.,Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Raphael Mechoulam
- Institute for Drug Research, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Francisco S Guimarães
- Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.,Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - José A Crippa
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.,Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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Effect of Alternate Nostril Breathing Exercise on Experimentally Induced Anxiety in Healthy Volunteers Using the Simulated Public Speaking Model: A Randomized Controlled Pilot Study. BIOMED RESEARCH INTERNATIONAL 2018; 2017:2450670. [PMID: 29159176 PMCID: PMC5660749 DOI: 10.1155/2017/2450670] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/25/2017] [Accepted: 09/07/2017] [Indexed: 11/20/2022]
Abstract
A randomized controlled pilot study was carried out to determine the effect of a 15-minute practice of ANB exercise on experimentally induced anxiety using the simulated public speaking model in yoga-naïve healthy young adults. Thirty consenting medical students were equally divided into test and control groups. The test group performed alternate nostril breathing exercise for 15 minutes, while the control group sat in a quiet room before participating in the simulated public speaking test (SPST). Visual Analog Mood Scale and Self-Statements during Public Speaking scale were used to measure the mood state at different phases of the SPST. The psychometric scores of both groups were comparable at baseline. Repeated-measures ANOVA showed a significant effect of phase (p < 0.05), but group and gender did not have statistically significant influence on the mean anxiety scores. However, the test group showed a trend towards lower mean scores for the anxiety factor when compared with the control group. Considering the limitations of this pilot study and the trend seen towards lower anxiety in the test group, alternate nostril breathing may have potential anxiolytic effect in acute stressful situations. A study with larger sample size is therefore warranted. This trial is registered with CTRI/2014/03/004460.
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van Amerongen G, Siebenga P, de Kam ML, Hay JL, Groeneveld GJ. Effect profile of paracetamol, Δ9-THC and promethazine using an evoked pain test battery in healthy subjects. Eur J Pain 2018; 22:1331-1342. [PMID: 29635857 DOI: 10.1002/ejp.1222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND A battery of evoked pain tasks (PainCart) was developed to investigate the pharmacodynamic properties of novel analgesics in early-phase clinical research. As part of its clinical validation, compounds with different pharmacological mechanisms of actions are investigated. The aim was to investigate the analgesic effects of classic and nonclassic analgesics compared to a sedating negative control in a randomized placebo-controlled crossover study in 24 healthy volunteers using the PainCart. METHODS The PainCart consisted of pain tasks eliciting electrical, pressure, heat, cold and inflammatory pain. Subjective scales for cognitive functioning and psychotomimetic effects were included. Subjects were administered each of the following oral treatments: paracetamol (1000 mg), Δ9-THC (10 mg), promethazine (50 mg) or matching placebo. Pharmacodynamic measurements were performed at baseline and repeated up to 10 h postdose. RESULTS Paracetamol did not show a significant reduction in pain sensation or subjective cognitive functioning compared to placebo. Promethazine induced a statistically significant reduction in PTT for cold pressor and pressure stimulation. Furthermore, reduced subjective alertness was observed. Δ9-THC showed a statistically significant decrease in PTT for electrical and pressure stimulation. Δ9-THC also demonstrated subjective effects, including changes in alertness and calmness, as well as feeling high and psychotomimetic effects. CONCLUSIONS This study found a decreased pain tolerance due to Δ9-THC and promethazine, or lack thereof, using an evoked pain task battery. Pain thresholds following paracetamol administration remained unchanged, which may be due to insufficient statistical power. We showed that pain thresholds determined using this pain test battery are not driven by sedation. SIGNIFICANCE The multimodal battery of evoked pain tasks utilized in this study may play an important role in early-phase clinical drug development. This battery of pain tasks is not sensitive to the effects of sedation alone, and thus suitable to investigate the analgesic potential of novel analgesic compounds.
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Affiliation(s)
- G van Amerongen
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - P Siebenga
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - M L de Kam
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - J L Hay
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - G J Groeneveld
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
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Linares IMP, Guimaraes FS, Eckeli A, Crippa ACS, Zuardi AW, Souza JDS, Hallak JE, Crippa JAS. No Acute Effects of Cannabidiol on the Sleep-Wake Cycle of Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study. Front Pharmacol 2018; 9:315. [PMID: 29674967 PMCID: PMC5895650 DOI: 10.3389/fphar.2018.00315] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 03/19/2018] [Indexed: 12/17/2022] Open
Abstract
Cannabidiol (CBD) is a component of Cannabis sativa that has a broad spectrum of potential therapeutic effects in neuropsychiatric and other disorders. However, few studies have investigated the possible interference of CBD on the sleep-wake cycle. The aim of the present study was to evaluate the effect of a clinically anxiolytic dose of CBD on the sleep-wake cycle of healthy subjects in a crossover, double-blind design. Twenty-seven healthy volunteers that fulfilled the eligibility criteria were selected and allocated to receive either CBD (300 mg) or placebo in the first night in a double-blind randomized design (one volunteer withdrew from the study). In the second night, the same procedure was performed using the substance that had not been administered in the previous occasion. CBD or placebo were administered 30 min before the start of polysomnography recordings that lasted 8 h. Cognitive and subjective measures were performed immediately after polysomnography to assess possible residual effects of CBD. The drug did not induce any significant effect (p > 0.05). Different from anxiolytic and antidepressant drugs such as benzodiazepines and selective serotonin reuptake inhibitors, acute administration of an anxiolytic dose of CBD does not seem to interfere with the sleep cycle of healthy volunteers. The present findings support the proposal that CBD do not alter normal sleep architecture. Future studies should address the effects of CBD on the sleep-wake cycle of patient populations as well as in clinical trials with larger samples and chronic use of different doses of CBD. Such studies are desirable and opportune.
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Affiliation(s)
- Ila M. P. Linares
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Francisco S. Guimaraes
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Alan Eckeli
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Ana C. S. Crippa
- Department of Pediatrics, Neuropediatrics, Federal University of Paraná, Curitiba, Brazil
| | - Antonio W. Zuardi
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Jose D. S. Souza
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Jaime E. Hallak
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - José A. S. Crippa
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
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Leijenaar JF, Groeneveld GJ, van der Flier WM, Scheltens P, Klaassen ES, Weinstein HC, Biessels GJ, Barkhof F, Prins ND. Symptomatic Treatment of Vascular Cognitive Impairment (STREAM-VCI): Protocol for a Cross-Over Trial. JMIR Res Protoc 2018; 7:e80. [PMID: 29559423 PMCID: PMC5883073 DOI: 10.2196/resprot.9192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/24/2017] [Accepted: 12/24/2017] [Indexed: 01/16/2023] Open
Abstract
Background People with vascular cognitive impairment (VCI) constitute a clinically heterogeneous group, but previous symptomatic drug trials in VCI did not take this clinical heterogeneity into account. Executive dysfunction and memory impairment are the cognitive domains that are most frequently impaired in VCI, and these impairments are likely to reflect vascular damage to specific neurotransmitter systems, which opens the possibility for targeted symptomatic treatment directed at specific neurotransmitters. Objective Here we describe the design of the “Symptomatic Treatment of Vascular Cognitive Impairment” (STREAM-VCI) trial. In this proof-of-concept study, we investigate whether people with VCI with executive dysfunction due to vascular damage to the monoaminergic neurotransmitter system differentially respond to a monoaminergic challenge, whereas people with VCI with memory dysfunction associated with vascular damage to the cholinergic system will in turn respond to a cholinergic challenge. Methods The STREAM-VCI is a single center, double blind, three-way cross-over trial among 30 people with VCI, in which subjects received a single dose of galantamine, methylphenidate, or placebo on separate occasions. The most important inclusion criteria were a diagnosis of VCI with a Mini-Mental State Examination score of ≥16 and a Clinical Dementia Rating of 0.5-1.0. For each person, the challenges consisted of a single 16 mg dose of galantamine, 10 mg of methylphenidate, and placebo, in random order on three separate visits. Change in performance in executive functioning and memory was assessed directly after the challenge using standardized neuropsychological tests. We will correlate a positive response to the cholinergic and monoaminergic treatment with differences in structural and functional connectivity at baseline using structural magnetic resonance imaging (MRI), diffusion tension MRI, and resting-state functional MRI. Results The protocol of this study is approved by the Medical Ethics Committee of VU University Medical Center and the competent authority. The first participant was enrolled in April 2014. In September 2017, enrolment for the study was completed. We expect to publish the results in 2018. Conclusions STREAM-VCI is the first study to investigate the association of a response to a cholinergic and monoaminergic treatment with structural and functional connectivity of the monoaminergic and/or cholinergic systems on MRI. We aim to predict on an individual basis which individuals show a positive response to a cholinergic and/or monoaminergic challenge in people with VCI. This may be instrumental in moving in the direction of individually-tailored pharmacological interventions based on MRI measures in people with VCI. Trial Registration ClinicalTrials.gov NCT02098824; https://clinicaltrials.gov/ct2/show/NCT02098824 (Archived by WebCite at http://www.webcitation.org/6xhO7Ya1q)
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Affiliation(s)
- Jolien Fleur Leijenaar
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Geert Jan Groeneveld
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands.,Centre for Human Drug Research, Leiden, Netherlands
| | - Wiesje Maria van der Flier
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands.,Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | | | | | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands.,Institutes of Neurology and Healthcare Engineering, University College London, London, United Kingdom
| | - Niels Daniël Prins
- Alzheimer Center & Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands.,Brain Research Center, Amsterdam, Netherlands
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Swerdlow NR, Bhakta SG, Talledo JA, Franz DM, Hughes EL, Rana BK, Light GA. Effects of Amphetamine on Sensorimotor Gating and Neurocognition in Antipsychotic-Medicated Schizophrenia Patients. Neuropsychopharmacology 2018; 43:708-717. [PMID: 29154367 PMCID: PMC5809803 DOI: 10.1038/npp.2017.285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/18/2017] [Accepted: 11/08/2017] [Indexed: 01/01/2023]
Abstract
Prepulse inhibition (PPI) of startle is being explored both as an indicator of target engagement for, and a biomarker predicting the sensitivity to, procognitive effects of drugs. We now report the effects of the pro-attentional drug, d-amphetamine, on PPI and neurocognition in antipsychotic-medicated schizophrenia patients and healthy subjects (HS) who were also tested in a targeted cognitive training (TCT) module. 44 HS and 38 schizophrenia patients completed a double-blind, placebo-controlled crossover study of the effects of a single dose of amphetamine (10 mg po) on PPI and MATRICS Consensus Cognitive Battery (MCCB) performance; TCT results were previously reported from 60 of these subjects. Moderators predicting AMPH sensitivity were assessed, including the rs4680 single-nucleotide polymorphism for catechol-O-methyltransferase (COMT). After placebo, patients exhibited PPI deficits with 60 ms prepulse intervals; these deficits were 'rescued' by amphetamine. The magnitude of amphetamine-enhanced PPI was greater in patients than in HS (p<0.032), and was associated with positive symptoms (p<0.007), antipsychotic load (p<0.015), hedonic effects of AMPH (p<0.003), and with the presence of at least one methionine allele in rs4680 (p<0.008). No significant effects of amphetamine on MCCB performance were detected in either group, though pro-attentional effects of amphetamine in patients were associated with greater amphetamine-enhanced TCT learning. Amphetamine acutely 'normalized' PPI in antipsychotic-medicated schizophrenia patients; no concurrent acute neurocognitive changes were detected by the MCCB. Findings suggest that in the context of appropriate antipsychotic medication, a low dose of amphetamine enhances brain processes associated with higher function in schizophrenia patients, without accompanying changes in MCCB performance.
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Affiliation(s)
- Neal R Swerdlow
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA,Department of Psychiatry, UCSD School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093-0804, USA, Tel: +619-543-6270, Fax: +619-543-2493, E-mail:
| | - Savita G Bhakta
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
| | - Jo A Talledo
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
| | - Daniel M Franz
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
| | - Erica L Hughes
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
| | - Brinda K Rana
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
| | - Gregory A Light
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
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Serotonergic and cholinergic modulation of functional brain connectivity: A comparison between young and older adults. Neuroimage 2017; 169:312-322. [PMID: 29258890 DOI: 10.1016/j.neuroimage.2017.12.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/08/2017] [Accepted: 12/13/2017] [Indexed: 12/16/2022] Open
Abstract
Aging is accompanied by changes in neurotransmission. To advance our understanding of how aging modifies specific neural circuitries, we examined serotonergic and cholinergic stimulation with resting state functional magnetic resonance imaging (RS-fMRI) in young and older adults. The instant response to the selective serotonin reuptake inhibitor citalopram (30 mg) and the acetylcholinesterase inhibitor galantamine (8 mg) was measured in 12 young and 17 older volunteers during a randomized, double blind, placebo-controlled, crossover study. A powerful dataset consisting of 522 RS-fMRI scans was obtained by acquiring multiple scans per subject before and after drug administration. Group × treatment interaction effects on voxelwise connectivity with ten functional networks were investigated (p < .05, FWE-corrected) using a non-parametric multivariate analysis technique with cerebrospinal fluid, white matter, heart rate and baseline measurements as covariates. Both groups showed a decrease in sensorimotor network connectivity after citalopram administration. The comparable findings after citalopram intake are possibly due to relatively similar serotonergic systems in the young and older subjects. Galantamine altered connectivity between the occipital visual network and regions that are implicated in learning and memory in the young subjects. The lack of a cholinergic response in the elderly might relate to the well-known association between cognitive and cholinergic deterioration at older age.
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Chaves Neto G, Braga JEF, Alves MF, de Morais Pordeus LC, dos Santos SG, Scotti MT, Almeida RN, Diniz MDFFM. Anxiolytic Effect of Citrus aurantium L. in Crack Users. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2017; 2017:7217619. [PMID: 29234424 PMCID: PMC5664288 DOI: 10.1155/2017/7217619] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/07/2017] [Indexed: 11/21/2022]
Abstract
The objective of this study was to investigate the anxiolytic effects of the essential oil (EO) of Citrus aurantium L. in patients experiencing crack withdrawal. This was developed with internal users in therapeutic communities in Paraíba, Brazil. The test population consisted of 51 volunteers, subdivided into three groups. To elicit anxiety, the Simulated Public Speaking (SPS) method was used. Physiological measures were assessed at specific phases during the experiment using appropriate equipment. Psychological measures of anxiety were assessed using the Trait-State Anxiety Inventory (IDATE) and the Analog Smoke Scale (HAS). EO was administered by nebulization. The experiment was developed in individual sessions and consolidated to four phases. The results demonstrated that the test subjects in the groups that were given the EO maintained controlled anxiety levels during SPS, when compared to the Control Group (no treatment). Subjects who used the EO also maintained levels of "discomfort" and "cognitive impairment" during SPS. It was concluded that individuals who are experiencing internal crack cocaine withdrawal present high anxiety traits and that nebulization of the EO of Citrus aurantium L. provided an acute anxiolytic effect in crack cocaine users exposed to SPS.
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Affiliation(s)
- Gabriel Chaves Neto
- Postgraduate Program in Neuroscience Cognitive and Behavior, Federal University of Paraíba, João Pessoa, PB, Brazil
| | | | - Mateus Feitosa Alves
- Postgraduate Program in Natural and Synthetic Bioactive Products, Federal University of Paraíba, João Pessoa, PB, Brazil
| | | | | | - Marcus Tullius Scotti
- Postgraduate Program in Natural and Synthetic Bioactive Products, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Reinaldo N. Almeida
- Postgraduate Program in Neuroscience Cognitive and Behavior, Federal University of Paraíba, João Pessoa, PB, Brazil
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Baakman AC, Alvarez‐Jimenez R, Rissmann R, Klaassen ES, Stevens J, Goulooze SC, den Burger JCG, Swart EL, van Gerven JMA, Groeneveld GJ. An anti-nicotinic cognitive challenge model using mecamylamine in comparison with the anti-muscarinic cognitive challenge using scopolamine. Br J Clin Pharmacol 2017; 83:1676-1687. [PMID: 28217868 PMCID: PMC5510063 DOI: 10.1111/bcp.13268] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 01/06/2023] Open
Abstract
AIMS The muscarinic acetylcholine receptor antagonist scopolamine is often used for proof-of-pharmacology studies with pro-cognitive compounds. From a pharmacological point of view, it would seem more rational to use a nicotinic rather than a muscarinic anticholinergic challenge to prove pharmacology of a nicotinic acetylcholine receptor agonist. This study aims to characterize a nicotinic anticholinergic challenge model using mecamylamine and to compare it to the scopolamine model. METHODS In this double-blind, placebo-controlled, four-way cross-over trial, 12 healthy male subjects received oral mecamylamine 10 and 20 mg, intravenous scopolamine 0.5 mg and placebo. Pharmacokinetics were analysed using non-compartmental analysis. Pharmacodynamic effects were measured with a multidimensional test battery that includes neurophysiological, subjective, (visuo)motor and cognitive measurements. RESULTS All treatments were safe and well tolerated. Mecamylamine had a tmax of 2.5 h and a Cmax of 64.5 ng ml-1 for the 20 mg dose. Mecamylamine had a dose-dependent effect decreasing the adaptive tracking performance and VAS alertness, and increasing the finger tapping and visual verbal learning task performance time and errors. Scopolamine significantly affected almost all pharmacodynamic tests. CONCLUSION This study demonstrated that mecamylamine causes nicotinic receptor specific temporary decline in cognitive functioning. Compared with the scopolamine model, pharmacodynamic effects were less pronounced at the dose levels tested; however, mecamylamine caused less sedation. The cognitive effects of scopolamine might at least partly be caused by sedation. Whether the mecamylamine model can be used for proof-of-pharmacology of nicotinic acetylcholine receptor agonists remains to be established.
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Affiliation(s)
| | | | | | | | | | | | - Jeroen C. G. den Burger
- Department of Clinical Pharmacology and PharmacyVU University Medical CenterAmsterdamThe Netherlands
| | - Eleonora L. Swart
- Department of Clinical Pharmacology and PharmacyVU University Medical CenterAmsterdamThe Netherlands
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Chagas MHN, Oliveira THGF, Linares IMP, Balarini FB, Chagas NMS, Tumas V, Crippa JAS. Can anxiety increase tremors in patients with Parkinson’s disease? An experimental model. ARCH CLIN PSYCHIAT 2017. [DOI: 10.1590/0101-60830000000126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Kruithof AC, Watanabe S, Peeters PA, de Kam ML, Zuiker RG, Stevens J, van Gerven JM, Stockis A. Pharmacological interactions between brivaracetam and ethanol in healthy males. J Psychopharmacol 2017; 31:915-926. [PMID: 27649776 DOI: 10.1177/0269881116665326] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This double-blind, randomized, three-way crossover study explored the potential pharmacokinetic and pharmacodynamic interactions between ethanol and brivaracetam in 18 healthy males, as required for the development of CNS-active drugs. Subjects received (A) ethanol+brivaracetam, (B) ethanol placebo+brivaracetam and (C) ethanol+brivaracetam placebo. Ethanol was infused as a 5.5-hour intravenous clamp with the first 0.5-hour as loading phase to a target level of 0.6 g/L, and brivaracetam was orally administered as a single 200 mg dose. No relevant pharmacokinetic interactions were observed. Co-administration of brivaracetam and ethanol resulted in decreased saccadic peak velocity, smooth pursuit, adaptive tracking and VAS alertness, and increased body sway, saccadic reaction time and VAS score for ethanol effect compared with brivaracetam alone or ethanol alone. Additionally, the immediate word recall scores were generally lower when brivaracetam was co-administered with ethanol, whereas the delayed word test did not show clear additional effects. A post-hoc exploratory analysis for supra-additivity suggested that most pharmacodynamic effects were likely to be additive in nature, except for adaptive tracking, which appeared to be slightly supra-additive. In conclusion, brivaracetam increased ethanol effects on psychomotor function, attention and memory in healthy males. Intake of brivaracetam with alcohol is not recommended.
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Affiliation(s)
| | | | | | | | - Rob Gja Zuiker
- 1 Centre for Human Drug Research, Leiden, the Netherlands
| | - Jasper Stevens
- 1 Centre for Human Drug Research, Leiden, the Netherlands
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43
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Effects of nicotine on response inhibition and interference control. Psychopharmacology (Berl) 2017; 234:1093-1111. [PMID: 28150023 DOI: 10.1007/s00213-017-4542-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 01/23/2017] [Indexed: 02/07/2023]
Abstract
Nicotine is a cholinergic agonist with known pro-cognitive effects in the domains of alerting and orienting attention. However, its effects on attentional top-down functions such as response inhibition and interference control are less well characterised. Here, we investigated the effects of 7 mg transdermal nicotine on performance on a battery of response inhibition and interference control tasks. A sample of N = 44 healthy adult non-smokers performed antisaccade, stop signal, Stroop, go/no-go, flanker, shape matching and Simon tasks, as well as the attentional network test (ANT) and a continuous performance task (CPT). Nicotine was administered in a within-subjects, double-blind, placebo-controlled design, with order of drug administration counterbalanced. Relative to placebo, nicotine led to significantly shorter reaction times on a prosaccade task and on CPT hits but did not significantly improve inhibitory or interference control performance on any task. Instead, nicotine had a negative influence in increasing the interference effect on the Simon task. Nicotine did not alter inter-individual associations between reaction times on congruent trials and error rates on incongruent trials on any task. Finally, there were effects involving order of drug administration, suggesting practice effects but also beneficial nicotine effects when the compound was administered first. Overall, our findings support previous studies showing positive effects of nicotine on basic attentional functions but do not provide direct evidence for an improvement of top-down cognitive control through acute administration of nicotine at this dose in healthy non-smokers.
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Chen X, Broeyer F, de Kam M, Baas J, Cohen A, van Gerven J. Pharmacodynamic response profiles of anxiolytic and sedative drugs. Br J Clin Pharmacol 2017; 83:1028-1038. [PMID: 27922194 DOI: 10.1111/bcp.13204] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 02/04/2023] Open
Abstract
AIM Centrally-acting acutely anxiolytic drugs, such as benzodiazepines, barbiturates and gabapentinoids, affect various central nervous system (CNS) functions, which reflects not only their anxiolytic effects but also neuropsychological side-effects. To validate the pharmacodynamic biomarkers for GABA-ergic anxiolytics, this study determined the pharmacodynamics of two anxiolytics and a nonanxiolytic control, and linked them to their anxiolytic and sedative effects, during an anxiety-challenge study day. METHODS Twenty healthy volunteers were randomized in this placebo-controlled, double-blind, four-way cross-over study with single-dose alprazolam (1 mg), diphenhydramine (50 mg), pregabalin (200 mg) or placebo. The Neurocart was used between repeated fear-potentiated startle assessments. Thus, the potential influence of anxiety on CNS pharmacodynamic markers could be examined. RESULTS Compared to placebo, VAScalmness increased with alprazolam (2.0 mm) and pregabalin (2.5 mm) but not with diphenhydramine. Saccadic peak velocity (SPV) declined after alprazolam (-57 ° s-1 ) and pregabalin (-28 ° s-1 ), more than with diphenhydramine (-14 ° s-1 ); so did smooth pursuit. The average responses of SPV and smooth pursuit were significantly correlated with the drug-induced increases in VAScalmness . The SPV-relative responses of VASalertness , body-sway and adaptive-tracking also differed among alprazolam, pregabalin and diphenhydramine. CONCLUSIONS Compared with the antihistaminergic sedative diphenhydramine, alprazolam and pregabalin caused larger SPV reduction, which was correlated with simultaneous improvement of subjective calmness, during a study day in which anxiety was stimulated repeatedly. The different effect profiles of the three drugs are in line with their pharmacological distinctions. These findings corroborate the profiling of CNS effects to demonstrate pharmacological selectivity, and further support SPV as biomarker for anxiolysis involving GABA-ergic neurons. The study also supports the use of prolonged mild threat to demonstrate anxiolytic effects in healthy volunteers.
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Affiliation(s)
- Xia Chen
- Phase I Unit, Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Beijing, 100032, China.,Centre for Human Drug Research, Leiden, The Netherlands
| | | | | | - Joke Baas
- Department of Experimental Psychology, Faculty of Social Sciences, Utrecht University, The Netherlands
| | - Adam Cohen
- Centre for Human Drug Research, Leiden, The Netherlands
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Cueva C, Roberts RE, Spencer TJ, Rani N, Tempest M, Tobler PN, Herbert J, Rustichini A. Testosterone administration does not affect men's rejections of low ultimatum game offers or aggressive mood. Horm Behav 2017; 87:1-7. [PMID: 27712924 DOI: 10.1016/j.yhbeh.2016.09.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 09/23/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
Abstract
Correlative evidence suggests that testosterone promotes dominance and aggression. However, causal evidence is scarce and offers mixed results. To investigate this relationship, we administered testosterone for 48h to 41 healthy young adult men in a within-subjects, double-blind placebo-controlled balanced crossover design. Subjects played the role of responders in an ultimatum game, where rejecting a low offer is costly, but serves to destroy the proposer's profit. Such action can hence be interpreted as non-physical aggression in response to social provocation. In addition, subjects completed a self-assessed mood questionnaire. As expected, self-reported aggressiveness was a key predictor of ultimatum game rejections. However, while testosterone affected subjective ratings of feeling energetic and interested, our evidence strongly suggests that testosterone had no effect on ultimatum game rejections or on aggressive mood. Our findings illustrate the importance of using causal interventions to assess correlative evidence.
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Affiliation(s)
- Carlos Cueva
- Departamento de Fundamentos del Análisis Económico, Universidad de Alicante, Spain.
| | - R Edward Roberts
- Division of Brain Sciences, Department of Medicine, Imperial College London, UK
| | - Tom J Spencer
- Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn Hospital, Cambridge, UK
| | - Nisha Rani
- Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn Hospital, Cambridge, UK
| | | | - Philippe N Tobler
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Switzerland
| | - Joe Herbert
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Aldo Rustichini
- Department of Economics, University of Minnesota, USA; Department of Physiology, Development and Neuroscience, University of Cambridge, UK.
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Schrier L, Zuiker R, Merkus FWHM, Klaassen ES, Guan Z, Tuk B, van Gerven JMA, van der Geest R, Groeneveld GJ. Pharmacokinetics and pharmacodynamics of a new highly concentrated intranasal midazolam formulation for conscious sedation. Br J Clin Pharmacol 2016; 83:721-731. [PMID: 27780297 DOI: 10.1111/bcp.13163] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 09/14/2016] [Accepted: 10/02/2016] [Indexed: 02/03/2023] Open
Abstract
AIM To evaluate the pharmacokinetics, pharmacodynamics, nasal tolerance and effects on sedation of a highly concentrated aqueous intranasal midazolam formulation (Nazolam) and to compare these to intravenous midazolam. METHODS In this four-way crossover, double-blind, double-dummy, randomized, placebo-controlled study, 16 subjects received 2.5 mg Nazolam, 5.0 mg Nazolam, 2.5 mg intravenous midazolam or placebo on different occasions. Pharmacokinetics of midazolam and α-hydroxy-midazolam were characterized and related to outcome variables for sedation (saccadic peak velocity, the Bond and Lader visual analogue scale for sedation, the simple reaction time task and the observer's assessment of alertness/sedation). Nasal tolerance was evaluated through subject reporting, and ear, nose and throat examination. RESULTS Nazolam bioavailability was 75%. Maximal plasma concentrations of 31 ng ml-1 (CV, 42.3%) were reached after 11 min (2.5 mg Nazolam), and of 66 ng ml-1 (coefficient of variability, 31.5%) after 14 min (5.0 mg Nazolam). Nazolam displayed a significant effect on OAA/S scores. Sedation onset (based on SPV change) occurred 1 ± 0.7 min after administration of 2.5 mg intravenous midazolam, 7 ± 4.4 min after 2.5 mg Nazolam, and 4 ± 1.8 min after 5 mg Nazolam. Sedation duration was 118 ± 95.6 min for 2.5 mg intravenous midazolam, 76 ± 80.4 min for 2.5 mg Nazolam, and 145 ± 104.9 min for 5.0 mg Nazolam. Nazolam did not lead to nasal mucosa damage. CONCLUSIONS This study demonstrates the nasal tolerance, safety and efficacy of Nazolam. When considering the preparation time needed for obtaining venous access, conscious sedation can be achieved in the same time span as needed for intravenous midazolam. Nazolam may offer important advantages in conscious sedation.
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Affiliation(s)
- Lenneke Schrier
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - Rob Zuiker
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | | | | | - Zheng Guan
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - Bert Tuk
- TCIM B.V., Willemstad, The Netherlands
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Shuhama R, Rondinoni C, de Araujo DB, de Freitas Caetano G, dos Santos AC, Graeff FG, Del-Ben CM. Behavioral and neuroimaging responses induced by mental imagery of threatening scenarios. Behav Brain Res 2016; 313:358-369. [DOI: 10.1016/j.bbr.2016.06.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/26/2016] [Accepted: 06/29/2016] [Indexed: 02/07/2023]
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Klaassens BL, Rombouts SARB, Winkler AM, van Gorsel HC, van der Grond J, van Gerven JMA. Time related effects on functional brain connectivity after serotonergic and cholinergic neuromodulation. Hum Brain Mapp 2016; 38:308-325. [PMID: 27622387 PMCID: PMC5215384 DOI: 10.1002/hbm.23362] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/22/2016] [Accepted: 08/22/2016] [Indexed: 01/12/2023] Open
Abstract
Psychopharmacological research, if properly designed, may offer insight into both timing and area of effect, increasing our understanding of the brain's neurotransmitter systems. For that purpose, the acute influence of the selective serotonin reuptake inhibitor citalopram (30 mg) and the acetylcholinesterase inhibitor galantamine (8 mg) was repeatedly measured in 12 healthy young volunteers with resting state functional magnetic resonance imaging (RS‐fMRI). Eighteen RS‐fMRI scans were acquired per subject during this randomized, double blind, placebo‐controlled, crossover study. Within‐group comparisons of voxelwise functional connectivity with 10 functional networks were examined (P < 0.05, FWE‐corrected) using a non‐parametric multivariate approach with cerebrospinal fluid, white matter, heart rate, and baseline measurements as covariates. Although both compounds did not change cognitive performance on several tests, significant effects were found on connectivity with multiple resting state networks. Serotonergic stimulation primarily reduced connectivity with the sensorimotor network and structures that are related to self‐referential mechanisms, whereas galantamine affected networks and regions that are more involved in learning, memory, and visual perception and processing. These results are consistent with the serotonergic and cholinergic trajectories and their functional relevance. In addition, this study demonstrates the power of using repeated measures after drug administration, which offers the chance to explore both combined and time specific effects. Hum Brain Mapp 38:308–325, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Bernadet L Klaassens
- Leiden University, Institute of Psychology, Leiden, the Netherlands.,Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands.,Centre for Human Drug Research, Leiden, the Netherlands
| | - Serge A R B Rombouts
- Leiden University, Institute of Psychology, Leiden, the Netherlands.,Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Anderson M Winkler
- Oxford Centre for Functional MRI of the Brain, Oxford University, Oxford, United Kingdom
| | - Helene C van Gorsel
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands.,Centre for Human Drug Research, Leiden, the Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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50
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Affiliation(s)
- Jane Leserman
- Department of Psychiatry and Medicine University of North Carolina Medical School Chapel Hill, North Carolina
| | - Gary Koch
- Department of Biostatistics University of North Carolina Chapel Hill, North Carolina
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