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Laubacher C, Imhoff-Smith TP, Klaus DR, Frye CJ, Esnault S, Busse WW, Rosenkranz MA. Salience network resting state functional connectivity during airway inflammation in asthma: A feature of mental health resilience? Brain Behav Immun 2024; 122:9-17. [PMID: 39097203 DOI: 10.1016/j.bbi.2024.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/07/2024] [Accepted: 07/28/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Inflammation is an established contributor to the pathophysiology of depression and the prevalence of depression in those with chronic inflammatory disease is two- to four-fold higher than the general population. Yet little is known about the neurobiological changes that confer depression or resilience to depression, that occur when episodes of heightened inflammation are frequent or span many years. METHODS We used an innovative combination of longitudinal resting state functional magnetic resonance imaging coupled to segmental bronchial provocation with allergen (SBP-Ag) to assess changes in resting state functional connectivity (rsFC) of the salience network (SN) caused by an acute inflammatory exacerbation in twenty-six adults (15 female) with asthma and varying levels of depressive symptoms. Eosinophils measured in bronchoalveolar lavage fluid and blood provided an index of allergic inflammation and the Beck Depression Inventory provided an index of depressive symptoms. RESULTS We found that in those with the highest symptoms of depression at baseline, SN rsFC declined most from pre- to post-SBP-Ag in the context of a robust eosinophilic response to challenge, but in those with low depressive symptoms SN rsFC was maintained or increased, even in those with the most pronounced SBP-Ag response. CONCLUSIONS Thus, the maintenance of SN rsFC during inflammation may be a biomarker of resilience to depression, perhaps via more effective orchestration of large-scale brain network dynamics by the SN. These findings advance our understanding of the functional role of the SN during inflammation and inform treatment recommendations for those with comorbid inflammatory disease and depression.
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Affiliation(s)
- Claire Laubacher
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave, Madison, WI 53703, USA
| | - Theodore P Imhoff-Smith
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Danika R Klaus
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Corrina J Frye
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI 53705, USA
| | - Stephane Esnault
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, 600 Highland Ave, Madison, WI 53792, USA; University of Lille, INSERM, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - William W Busse
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Melissa A Rosenkranz
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave, Madison, WI 53703, USA; Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA.
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Liu X, Zhang C, Li H. Neuroinflammation in the medullary visceral zone exert a powerful impaction on the systemic inflammation in sepsis through cholinergic anti-inflammatory pathway. Sci Rep 2024; 14:16921. [PMID: 39043772 PMCID: PMC11266613 DOI: 10.1038/s41598-024-67531-7] [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: 01/10/2024] [Accepted: 07/12/2024] [Indexed: 07/25/2024] Open
Abstract
To investigate whether sepsis-induced neuroinflammation of medulla visceral zone (MVZ) predominates the systemic inflammation through cholinergic anti-inflammatory pathway (CAP), and to explore the effect of central anti-inflammation on systemic inflammation. 112 adult Sprague-Dawley male rats were randomly divided into sepsis experimental group (n = 56) and neuroinflammation experimental group (n = 56). The two experimental groups were individually randomly divided into control group (n = 8), model group (n = 16), central anti-inflammatory group (n = 16) and vagus transection group (n = 16). Rats in two control groups were administered with saline at the dose of 6 mL/kg intraperitoneally or with 25 μL artificial cerebrospinal fluid injected into forth ventricle once a day for 3 days. Rats in two model groups were administered with Lipopolysaccharide (LPS) at the dose of 6 mg/kg intraperitoneally or with 25 μg/25 μL LPS injected into forth ventricle once a day for 3 days. Rats in two central anti-inflammatory groups were fed with 10 mg/mL minocycline sucrose solution as the only water source for 4 days prior to be treated as the model groups of their own, and feeding style was continued until the end of the experiment. Rats in the two vagus transection groups were undergone right vagotomy and 7 days of adaptive feeding prior to be treated as the same as those in the central anti-inflammatory group of their own. The Murine Sepsis Score (MSS), mortality rate and heat rate variability (HRV) were recorded during the last 3 days of intervention. Then the rats were sacrificed and blood samples were collected for ELISA analysis to detect the serum level of inflammatory cytokines such as TNF-α, IL-6, and IL-10. The expression of TNF-α and IL-6 in medulla oblongata were analyzed by Western blot. The correlation and regression analysis among the expression levels of cytokines in medulla oblongata, HRV indexes and serum inflammatory cytokines were performed. The mortality rate and MSS of the sepsis model group and the MVZ's neuroinflammation model group were significantly higher than those of their own control group, and the central anti-inflammation reduced the mortality rate and MSS scores of the two model groups, while the right vagotomy abolished the effect of central anti-inflammatory. In the sepsis model group and the MVZ's neuroinflammation model group, the levels of TNF-α, IL-6, and other cytokines in serum and MVZ were significantly increased, and HRV indexes (SDNN, RMSSD, LF, HF, LF/HF) were significantly decreased (P = 0.000). Central anti-inflammatory treatment reversed the above changes. However, right vagotomy abolished the central anti-inflammatory effect. Correlation and regression analysis showed that there was a significant linear correlation among the expression of inflammatory factors in MVZ, the indexes of HRV and the levels of serum cytokines. Our study shows that sepsis-induced MVZ's neuroinflammation exert a powerful influence on the systemic inflammation through CAP in sepsis. Central anti-inflammation effectively improves systemic inflammation through inhibiting MVZ's neuroinflammation in sepsis. The time domain and frequency domain indexes of HRV can reflect the regulatory effect of CAP and the degree of inflammation of MVZ, which may be potentially used to monitor the condition and treatment effectiveness of sepsis patients.
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Affiliation(s)
- Xian Liu
- Department of Geriatric Medicine of the First People's Hospital of Guiyang of Guizhou Province, Guiyang, 550002, China
| | - Cheng Zhang
- Emergency Department of the First People's Hospital of Guiyang of Guizhou Province, Guiyang, 550002, China
| | - Hongbing Li
- Emergency Department of the First People's Hospital of Guiyang of Guizhou Province, Guiyang, 550002, China.
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Schrock JM. Accelerated aging in people living with HIV: The neuroimmune feedback model. Brain Behav Immun Health 2024; 36:100737. [PMID: 38356933 PMCID: PMC10864877 DOI: 10.1016/j.bbih.2024.100737] [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: 08/18/2023] [Revised: 01/02/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024] Open
Abstract
People living with HIV (PLWH) experience earlier onset of aging-related comorbidities compared to their counterparts without HIV. This paper lays out a theoretical model to explain why PLWH experience accelerated aging. Briefly, the model is structured as follows. PLWH experience disproportionately heavy burdens of psychosocial stress across the life course. This psychosocial stress increases risks for depressive symptoms and problematic substance use. Depressive symptoms and problematic substance use interfere with long-term adherence to antiretroviral therapy (ART). Lower ART adherence, in turn, exacerbates the elevated systemic inflammation stemming from HIV infection. This inflammation increases risks for aging-related comorbidities. Systemic inflammation also reduces connectivity in the brain's central executive network (CEN), a large-scale brain network that is critical for coping with stressful circumstances. This reduced capacity for coping with stress leads to further increases in depressive symptoms and problematic substance use. Together, these changes form a neuroimmune feedback loop that amplifies the impact of psychosocial stress on aging-related comorbidities. In this paper, I review the existing evidence relevant to this model and highlight directions for future research.
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Affiliation(s)
- Joshua M. Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, United states
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Dill-McFarland KA, Altman MC, Esnault S, Jarjour NN, Busse WW, Rosenkranz MA. Molecular pathways underlying lung-brain axis signaling in asthma: Relevance for psychopathology and neuroinflammation. J Allergy Clin Immunol 2024; 153:111-121. [PMID: 37730134 PMCID: PMC10841090 DOI: 10.1016/j.jaci.2023.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Accumulating evidence indicates that asthma has systemic effects and affects brain function. Although airway inflammation is proposed to initiate afferent communications with the brain, the signaling pathways have not been established. OBJECTIVE We sought to identify the cellular and molecular pathways involved in afferent lung-brain communication during airway inflammation in asthma. METHODS In 23 adults with mild asthma, segmental bronchial provocation with allergen (SBP-Ag) was used to provoke airway inflammation and retrieve bronchoalveolar lavage fluid for targeted protein analysis and RNA sequencing to determine gene expression profiles. Neural responses to emotional cues in nodes of the salience network were assessed with functional magnetic resonance imaging at baseline and 48 hours after SBP-Ag. RESULTS Cell deconvolution and gene coexpression network analysis identified 11 cell-associated gene modules that changed in response to SBP-Ag. SBP-Ag increased bronchoalveolar lavage eosinophils and expression of an eosinophil-associated module enriched for genes related to TH17-type inflammation (eg, IL17A), as well as cell proliferation in lung and brain (eg, NOTCH1, VEGFA, and LIF). Increased expression of genes in this module, as well as several TH17-type inflammation-related proteins, was associated with an increase from baseline in salience network reactivity. CONCLUSIONS Our results identify a specific inflammatory pathway linking asthma-related airway inflammation and emotion-related neural function. Systemically, TH17-type inflammation has been implicated in both depression and neuroinflammation, with impacts on long-term brain health. Thus, our data emphasize that inflammation in the lung in asthma may have profound effects outside of the lung that may be targetable with novel therapeutic approaches.
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Affiliation(s)
| | - Matthew C Altman
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, Wash; Systems Immunology Program, Benaroya Research Institute, Seattle, Wash
| | - Stephane Esnault
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin-Madison, Madison, Wis
| | - Nizar N Jarjour
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin-Madison, Madison, Wis
| | - William W Busse
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin-Madison, Madison, Wis
| | - Melissa A Rosenkranz
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wis; Department of Psychiatry, University of Wisconsin-Madison, Madison, Wis.
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Martucci KT, Karshikoff B, Mackey SC. Links between brain neuroimaging and blood inflammatory markers in urological chronic pelvic pain syndrome. Physiol Behav 2023; 271:114358. [PMID: 37769862 PMCID: PMC10599305 DOI: 10.1016/j.physbeh.2023.114358] [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: 06/27/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
Urological chronic pelvic pain syndrome (UCPPS) is a debilitating painful condition with unclear etiology. Prior researchers have indicated that compared to healthy controls, patients with UCPPS demonstrated altered brain activity. Researchers have also shown that in UCPPS, several blood inflammatory markers relate to clinical variables of pain, fatigue, and pain widespreadness. However, how altered brain function in patients with UCPPS relates to blood inflammation remains unknown. To extend and connect prior findings of altered brain function and inflammatory factors in UCPPS, we conducted a secondary analysis of data from a cohort of UCPPS patients (N = 29) and healthy controls (N = 31) who provided both neuroimaging and blood data (National Institute of Health MAPP Research Network publicly available dataset). In our present study, we aimed to evaluate relationships between a priori-defined brain neuroimaging markers and inflammatory factors of interest and their relationships to pain-psychological variables. We hypothesized that two brain alterations of interest (i.e., PCC - left hippocampus functional connectivity and PCC - bilateral amygdala functional connectivity) would be correlated with four cytokine markers of interest: interleukin (IL) - 6, tumor necrosis factor-alpha (TNF-a), IL-8, and granulocyte-macrophage colony-stimulating factor (GM-CSF). In the UCPPS cohort, we identified a significant PCC - left hippocampus functional connectivity relationship with IL-6 (p = 0.0044). Additionally, in the UCPPS cohort, we identified a PCC - amygdala functional connectivity relationship with GM-CSF which did not meet our model's threshold for statistical significance (p = 0.0665). While these data are preliminary and cross-sectional, our findings suggest connections between brain function and levels of low-grade systemic inflammation in UCPPS. Thus, while further study is needed, our data indicate the potential for advancing the understanding of how brain functional circuits may relate to clinical symptoms and systemic inflammation.
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Affiliation(s)
- Katherine T Martucci
- Human Affect and Pain Neuroscience Laboratory, Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
| | - Bianka Karshikoff
- UiS Biopsychology Research Group, Department of Social Studies, Stavanger University, Stavanger, Norway; Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Sean C Mackey
- Stanford Neuroscience and Pain Laboratory, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA
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Lizano P, Kiely C, Mijalkov M, Meda SA, Keedy SK, Hoang D, Zeng V, Lutz O, Pereira JB, Ivleva EI, Volpe G, Xu Y, Lee AM, Rubin LH, Kristian Hill S, Clementz BA, Tamminga CA, Pearlson GD, Sweeney JA, Gershon ES, Keshavan MS, Bishop JR. Peripheral inflammatory subgroup differences in anterior Default Mode network and multiplex functional network topology are associated with cognition in psychosis. Brain Behav Immun 2023; 114:3-15. [PMID: 37506949 PMCID: PMC10592140 DOI: 10.1016/j.bbi.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/17/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION High-inflammation subgroups of patients with psychosis demonstrate cognitive deficits and neuroanatomical alterations. Systemic inflammation assessed using IL-6 and C-reactive protein may alter functional connectivity within and between resting-state networks, but the cognitive and clinical implications of these alterations remain unknown. We aim to determine the relationships of elevated peripheral inflammation subgroups with resting-state functional networks and cognition in psychosis spectrum disorders. METHODS Serum and resting-state fMRI were collected from psychosis probands (schizophrenia, schizoaffective, psychotic bipolar disorder) and healthy controls (HC) from the B-SNIP1 (Chicago site) study who were stratified into inflammatory subgroups based on factor and cluster analyses of 13 cytokines (HC Low n = 32, Proband Low n = 65, Proband High n = 29). Nine resting-state networks derived from independent component analysis were used to assess functional and multilayer connectivity. Inter-network connectivity was measured using Fisher z-transformation of correlation coefficients. Network organization was assessed by investigating networks of positive and negative connections separately, as well as investigating multilayer networks using both positive and negative connections. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia. Linear regressions, Spearman correlations, permutations tests and multiple comparison corrections were used for analyses in R. RESULTS Anterior default mode network (DMNa) connectivity was significantly reduced in the Proband High compared to Proband Low (Cohen's d = -0.74, p = 0.002) and HC Low (d = -0.85, p = 0.0008) groups. Inter-network connectivity between the DMNa and the right-frontoparietal networks was lower in Proband High compared to Proband Low (d = -0.66, p = 0.004) group. Compared to Proband Low, the Proband High group had lower negative (d = 0.54, p = 0.021) and positive network (d = 0.49, p = 0.042) clustering coefficient, and lower multiplex network participation coefficient (d = -0.57, p = 0.014). Network findings in high inflammation subgroups correlate with worse verbal fluency, verbal memory, symbol coding, and overall cognition. CONCLUSION These results expand on our understanding of the potential effects of peripheral inflammatory signatures and/or subgroups on network dysfunction in psychosis and how they relate to worse cognitive performance. Additionally, the novel multiplex approach taken in this study demonstrated how inflammation may disrupt the brain's ability to maintain healthy co-activation patterns between the resting-state networks while inhibiting certain connections between them.
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Affiliation(s)
- Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Chelsea Kiely
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mite Mijalkov
- Neuro Division, Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Shashwath A Meda
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neurosciences, University of Chicago, Chicago, IL, USA
| | - Dung Hoang
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Victor Zeng
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Olivia Lutz
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joana B Pereira
- Neuro Division, Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden; Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Sweden
| | - Elena I Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Giovanni Volpe
- Physics Department, University of Gothenburg, Gothenburg, Sweden
| | - Yanxun Xu
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Adam M Lee
- Department of Experimental and Clinical Pharmacology and Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Leah H Rubin
- Department of Neurology, Psychiatry and Behavioral Sciences, Molecular and Comparative Pathobiology, and Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Brett A Clementz
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - John A Sweeney
- Department of Psychiatry, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neurosciences, University of Chicago, Chicago, IL, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology and Psychiatry, University of Minnesota, Minneapolis, MN, USA
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Benson S, Karshikoff B. How Can Experimental Endotoxemia Contribute to Our Understanding of Pain? A Narrative Review. Neuroimmunomodulation 2023; 30:250-267. [PMID: 37797598 PMCID: PMC10619593 DOI: 10.1159/000534467] [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: 05/30/2023] [Accepted: 10/02/2023] [Indexed: 10/07/2023] Open
Abstract
The immune system and the central nervous system exchange information continuously. This communication is a prerequisite for adaptive responses to physiological and psychological stressors. While the implicate relationship between inflammation and pain is increasingly recognized in clinical cohorts, the underlying mechanisms and the possibilities for pharmacological and psychological approaches aimed at neuro-immune communication in pain are not fully understood yet. This calls for preclinical models which build a bridge from clinical research to laboratory research. Experimental models of systemic inflammation (experimental endotoxemia) in humans have been increasingly recognized as an approach to study the direct and causal effects of inflammation on pain perception. This narrative review provides an overview of what experimental endotoxemia studies on pain have been able to clarify so far. We report that experimental endotoxemia results in a reproducible increase in pain sensitivity, particularly for pressure and visceral pain (deep pain), which is reflected in responses of brain areas involved in pain processing. Increased levels of blood inflammatory cytokines are required for this effect, but cytokine levels do not always predict pain intensity. We address sex-dependent differences in immunological responses to endotoxin and discuss why these differences do not necessarily translate to differences in behavioral measures. We summarize psychological and cognitive factors that may moderate pain sensitization driven by immune activation. Together, studying the immune-driven changes in pain during endotoxemia offers a deeper mechanistic understanding of the role of inflammation in chronic pain. Experimental endotoxemia models can specifically help to tease out inflammatory mechanisms underlying individual differences, vulnerabilities, and comorbid psychological problems in pain syndromes. The model offers the opportunity to test the efficacy of interventions, increasing their translational applicability for personalized medical approaches.
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Affiliation(s)
- Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Medical Education, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Bianka Karshikoff
- Department of Social Studies, University of Stavanger, Stavanger, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Feldman MJ, Jolink TA, Alvarez GM, Fendinger NJ, Gaudier-Diaz MM, Lindquist KA, Muscatell KA. The roles of inflammation, affect, and interoception in predicting social perception. Brain Behav Immun 2023; 112:246-253. [PMID: 37263364 PMCID: PMC10528976 DOI: 10.1016/j.bbi.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/20/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023] Open
Abstract
"Sickness behavior" is an orchestrated suite of symptoms that commonly occur in the context of inflammation, and is characterized by changes in affect, social experience, and behavior. However, recent evidence suggests that inflammation may not always produce the same set of sickness behavior (e.g., fatigue, anhedonia, and social withdrawal). Rather, inflammation may be linked with different behavior across contexts and/or across individuals, though research in this area is under-developed to-date. In the present study (n = 30), we evaluated the influence of affective context and individual differences in difficulty detecting bodily sensations (i.e., interoceptive difficulty) on social perception following an inflammatory challenge. Inflammation was induced using the influenza vaccine and inflammatory reactivity was operationalized as changes in circulating levels of interleukin-6 (IL-6) before the vaccine and approximately 24 h later. Twenty-four hours after administration of the influenza vaccine, we manipulated affective context using a well-validated affect misattribution task in which participants made trustworthiness judgments of individuals with neutral facial expressions following the rapid presentation of "prime" images that were positive or negative in affective content. Interoceptive difficulty was measured at baseline using a validated self-report measure. Results revealed significant interactions between inflammatory reactivity to the influenza vaccine and affective context on social perception. Specifically, individuals with greater inflammatory reactivity were more biased by affective context when judging the trustworthiness of neutral faces. In addition, interoceptive difficulty and affective context interacted to predict social perception such that individuals with greater interoceptive difficulty were more biased by affective context in these judgments. In sum, we provide some of the first evidence that inflammation may amplify the saliency of affective cues during social decision making. Our findings also replicate prior work linking interoceptive ability to the use of affect-as-information during social perception, but in the novel context of inflammation.
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Affiliation(s)
| | - Tatum A Jolink
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | | | - Keely A Muscatell
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Innate immune tolerance against adolescent intermittent alcohol exposure-induced behavioral abnormalities in adult mice. Int Immunopharmacol 2022; 113:109250. [DOI: 10.1016/j.intimp.2022.109250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 11/05/2022]
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10
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The pro-inflammatory factors contribute to the EEG microstate abnormalities in patients with major depressive disorder. Brain Behav Immun Health 2022; 26:100523. [PMID: 36267834 PMCID: PMC9576533 DOI: 10.1016/j.bbih.2022.100523] [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: 05/28/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 11/22/2022] Open
Abstract
Pro-inflammatory factors may be associated with abnormalities in functional brain networks, which may be a mechanism in the pathogenesis of major depressive disorder (MDD). Electroencephalogram (EEG) microstates reflect the functioning of brain networks. However, the relationship between pro-inflammatory factors and the microstate abnormalities in patients with MDD is poorly understood. 24 MDD patients and 24 age-and sex-matched healthy controls (HC) were recruited. Montgomery-Asberg Depression Rating Scale(MADRS) were assessed. Serum (interleukin- 2(IL- 2), tumor necrosis factor-α (TNF-α) and hs-C-reactive protein (CRP)and EEG data were collected. K-means clustering was performed to characterize different microstates. For each microstate, duration, occurrence and coverage were estimated. Four microstates (e.g. A, B, C, D) were characterized, MDD group showed lower duration, occurrence and coverage of microstate B and microstate D, while higher duration of microstate A and microstate C and levels of IL-2, TNF-α, hs-CRP than HC group. The duration, occurrence and coverage of microstate D were negatively correlated with levels of pro-inflammatory factors (IL-2, TNF- α and hs- CRP) (all P < 0.05). Serum pro-inflammatory induced the abnormalities of microstate D. Together, these findings add to the understanding of the pathophysiology of MDD and point to pro-inflammatory factors contribute to EEG microstate abnormalities in patients with MDD.
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Jackson NA, Jabbi MM. Integrating biobehavioral information to predict mood disorder suicide risk. Brain Behav Immun Health 2022; 24:100495. [PMID: 35990401 PMCID: PMC9388879 DOI: 10.1016/j.bbih.2022.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/25/2022] Open
Abstract
The will to live and the ability to maintain one's well-being are crucial for survival. Yet, almost a million people die by suicide globally each year (Aleman and Denys, 2014), making premature deaths due to suicide a significant public health problem (Saxena et al., 2013). The expression of suicidal behaviors is a complex phenotype with documented biological, psychological, clinical, and sociocultural risk factors (Turecki et al., 2019). From a brain disease perspective, suicide is associated with neuroanatomical, neurophysiological, and neurochemical dysregulations of brain networks involved in integrating and contextualizing cognitive and emotional regulatory behaviors. From a symptom perspective, diagnostic measures of dysregulated mood states like major depressive symptoms are associated with over sixty percent of suicide deaths worldwide (Saxena et al., 2013). This paper reviews the neurobiological and clinical phenotypic correlates for mood dysregulations and suicidal phenotypes. We further propose machine learning approaches to integrate neurobiological measures with dysregulated mood symptoms to elucidate the role of inflammatory processes as neurobiological risk factors for suicide.
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Affiliation(s)
- Nicholas A. Jackson
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, USA
- Institute for Neuroscience, The University of Texas at Austin, USA
| | - Mbemba M. Jabbi
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, USA
- Mulva Clinics for the Neurosciences
- Institute for Neuroscience, The University of Texas at Austin, USA
- Department of Psychology, The University of Texas at Austin, USA
- Center for Learning and Memory, The University of Texas at Austin, USA
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Interactive Effects of HIV Infection and Cannabis Use on Insula Subregion Functional Connectivity. J Neuroimmune Pharmacol 2022; 17:289-304. [PMID: 34427866 DOI: 10.1007/s11481-021-10005-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/31/2021] [Indexed: 12/29/2022]
Abstract
Chronic inflammation in the central nervous system is one mechanism through which human immunodeficiency virus (HIV) may lead to progressive cognitive decline. Given cannabis's (CB's) anti-inflammatory properties, use prevalence among people living with HIV (PLWH), and evidence implicating the insula in both, we examined independent and interactive effects of HIV and CB on insular circuitry, cognition, and immune function. We assessed resting-state functional connectivity (rsFC) of three insula subregions among 106 participants across four groups (co-occurring: HIV+/CB+; HIV-only: HIV+/CB-; CB-only: HIV-/CB+; controls: HIV-/CB-). Participants completed a neurocognitive battery assessing functioning across multiple domains and self-reported somatic complaints. Blood samples quantified immune function (T-cell counts) and inflammation (tumor necrosis factor alpha [TNF-α]). We observed interactive HIV × CB effects on rsFC strength between two anterior insula (aI) subregions and sensorimotor cortices such that, CB appeared to normalize altered rsFC among non-using PLWH. Specifically, compared to controls, HIV-only and CB-only groups displayed decreased dorsal anterior insula (DI) - postcentral gyrus rsFC and increased ventral anterior insula (VI) - supplementary motor area rsFC, whereas the co-occurring group displayed DI and VI rsFC more akin to that of controls. Altered DI - postcentral rsFC correlated with decreased processing speed and somatic complaints, but did not significantly correlate with inflammation (TNF-α). These outcomes implicate insula - sensorimotor neurocircuitries in HIV and CB and are consistent with prior work suggesting that CB use may normalize insula functioning among PLWH.
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13
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McIntosh RC, Lobo J, Paparozzi J, Goodman Z, Kornfeld S, Nomi J. Neutrophil to lymphocyte ratio is a transdiagnostic biomarker of depression and structural and functional brain alterations in older adults. J Neuroimmunol 2022; 365:577831. [PMID: 35217366 PMCID: PMC11092564 DOI: 10.1016/j.jneuroim.2022.577831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/30/2022] [Accepted: 02/14/2022] [Indexed: 12/30/2022]
Abstract
The neutrophil to lymphocyte ratio (N:L) is an emergent transdiagnostic biomarker shown to predict peripheral inflammation as well as neuropsychiatric impairment. The afferent signaling of inflammation to the central nervous system has been implicated in the pathophysiology of sickness behavior and depression. Here, the N:L was compared to structural and functional limbic alterations found concomitant with depression within a geriatric cohort. Venous blood was collected for a complete blood count, and magnetic resonance imaging as well as phenotypic data were collected from the 66 community-dwelling older adults (aged 65-86 years). The N:L was regressed on gray matter volume and resting-state functional connectivity (rsFC) of the subgenual anterior cingulate (sgACC). Thresholded parameter estimates were extracted from structural and functional brain scans and bivariate associations tested with scores on the geriatric depression scale. Greater N:L predicted lower volume of hypothalamus and rsFC of sgACC with ventromedial prefrontal cortex. Both parameters were correlated (p < 0.05) with greater symptomology in those reporting moderate to severe levels of depression. These findings support the N:L as a transdiagnostic biomarker of limbic alteration underpinning mood disturbance in non-treated older adults.
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Affiliation(s)
- Roger C McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
| | - Judith Lobo
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America
| | - Jeremy Paparozzi
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America
| | - Zach Goodman
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America
| | - Salome Kornfeld
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America
| | - Jason Nomi
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America
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14
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Asthma Induces Psychiatric Impairments in Association With Default Mode and Salience Networks Alteration: A Resting-state EEG Study. Respir Physiol Neurobiol 2022; 300:103870. [DOI: 10.1016/j.resp.2022.103870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/19/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
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15
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Färber N, Manuel J, May M, Foadi N, Beissner F. The Central Inflammatory Network: A Hypothalamic fMRI Study of Experimental Endotoxemia in Humans. Neuroimmunomodulation 2022; 29:231-247. [PMID: 34610606 PMCID: PMC9254315 DOI: 10.1159/000519061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/25/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Inflammation is a mechanism of the immune system that is part of the reaction to pathogens or injury. The central nervous system closely regulates inflammation via neuroendocrine or direct neuroimmune mechanisms, but our current knowledge of the underlying circuitry is limited. Therefore, we aimed to identify hypothalamic centres involved in sensing or modulating inflammation and to study their association with known large-scale brain networks. METHODS Using high-resolution functional magnetic resonance imaging (fMRI), we recorded brain activity in healthy male subjects undergoing experimental inflammation from intravenous endotoxin. Four fMRI runs covered key phases of the developing inflammation: pre-inflammatory baseline, onset of endotoxemia, onset of pro-inflammatory cytokinemia, and peak of pro-inflammatory cytokinemia. Using masked independent component analysis, we identified functionally homogeneous subregions of the hypothalamus, which were further tested for changes in functional connectivity during inflammation and for temporal correlation with tumour necrosis factor and adrenocorticotropic hormone serum levels. We then studied the connection of these inflammation-associated hypothalamic subregions with known large-scale brain networks. RESULTS Our results show that there are at least 6 hypothalamic subregions associated with inflammation in humans including the paraventricular nucleus, supraoptic nucleus, dorsomedial hypothalamus, bed nucleus of the stria terminalis, lateral hypothalamic area, and supramammillary nucleus. They are functionally embedded in at least 3 different large-scale brain networks, namely a medial frontoparietal network, an occipital-pericentral network, and a midcingulo-insular network. CONCLUSION Measuring how the hypothalamus detects or modulates systemic inflammation is a first step to understand central nervous immunomodulation.
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Affiliation(s)
- Natalia Färber
- Somatosensory and Autonomic Therapy Research, Institute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hanover, Germany
- *Natalia Färber,
| | - Jorge Manuel
- Somatosensory and Autonomic Therapy Research, Institute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Marcus May
- CRC Core Facility, Hannover Medical School, Hanover, Germany
| | - Nilufar Foadi
- Clinic for Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany
| | - Florian Beissner
- Somatosensory and Autonomic Therapy Research, Institute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hanover, Germany
- **Florian Beissner,
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16
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Månsson KNT, Lasselin J, Karshikoff B, Axelsson J, Engler H, Schedlowski M, Benson S, Petrovic P, Lekander M. Anterior insula morphology and vulnerability to psychopathology-related symptoms in response to acute inflammation. Brain Behav Immun 2022; 99:9-16. [PMID: 34547400 DOI: 10.1016/j.bbi.2021.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The role of inflammation in common psychiatric diseases is now well acknowledged. However, the factors and mechanisms underlying inter-individual variability in the vulnerability to develop psychopathology-related symptoms in response to inflammation are not well characterized. Herein, we aimed at investigating morphological brain regions central for interoception and emotion regulation, and if these are associated with acute inflammation-induced sickness and anxiety responses. METHODS Systemic inflammation was induced using an intravenous injection of lipopolysaccharide (LPS) at a dose of 0.6 ng/kg body weight in 28 healthy individuals, while 21 individuals received an injection of saline (placebo). Individuals' gray matter volume was investigated by automated voxel-based morphometry technique on T1-weighted anatomical images derived from magnetic resonance imaging (MRI). Plasma concentrations of TNF-α and IL-6, sickness symptoms (SicknessQ), and state anxiety (STAI-S) were measured before and after the injection. RESULTS A stronger sickness response to LPS was significantly associated with a larger anterior insula gray matter volume, independently from increases in cytokine concentrations, age, sex and body mass index (R2 = 65.6%). Similarly, a greater LPS-induced state anxiety response was related to a larger anterior insula gray matter volume, and also by a stronger increase in plasma TNF-α concentrations (R2 = 40.4%). DISCUSSION Anterior insula morphology appears central in the sensitivity to develop symptoms of sickness and anxiety in response to inflammation, and could thus be one risk factor in inflammation-related psychopathologies. Because of the limited sample size, the current results need to be replicated.
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Affiliation(s)
- Kristoffer N T Månsson
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin/London, Germany/United Kingdom; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Cognitive and Computational Neuropsychiatry, Karolinska Institutet, Stockholm, Sweden.
| | - Julie Lasselin
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Medicine, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - Bianka Karshikoff
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - John Axelsson
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Manfred Schedlowski
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Predrag Petrovic
- Center for Cognitive and Computational Neuropsychiatry, Karolinska Institutet, Stockholm, Sweden; Neuro Division, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Medicine, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden
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17
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Dysconnectivity of a brain functional network was associated with blood inflammatory markers in depression. Brain Behav Immun 2021; 98:299-309. [PMID: 34450247 DOI: 10.1016/j.bbi.2021.08.226] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/09/2021] [Accepted: 08/19/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE There is increasing evidence for a subgroup of major depressive disorder (MDD) associated with heightened peripheral blood inflammatory markers. In this study, we aimed to understand the mechanistic brain-immune axis in inflammation-linked depression by investigating associations between functional connectivity (FC) of brain networks and peripheral blood immune markers in depression. METHODS Resting-state functional magnetic resonance imaging (fMRI) and peripheral blood inflammatory markers (C-reactive protein; CRP, interleukin-6; IL-6 and immune cells) were collected on N = 46 healthy controls (HC; CRP ≤ 3 mg/L) and N = 83 cases of depression, stratified further into low CRP cases (loCRP cases; ≤ 3 mg/L; N = 50) and high CRP cases (hiCRP cases; > 3 mg/L; N = 33). In a two-part analysis, network-based statistics (NBS) was firstly used to ascertain whole-brain FC differences in HC vs hiCRP cases. Secondly, we investigated the association between this network of interconnected brain regions and continuous measures of peripheral CRP (N = 83), IL-6 (N = 72), neutrophils and CD4+ T-cells (N = 36) in depression cases only. RESULTS Case-control NBS testing revealed a single network of abnormally attenuated FC in the high CRP depression cases compared to healthy controls. Connections within this network were mainly between brain regions located in the left insula/frontal operculum and posterior cingulate cortex, which were assigned to ventral attention and default mode canonical fMRI networks respectively. Within-group analysis across all depression cases, secondarily demonstrated that FC within the identified network significantly negatively scaled with CRP, IL-6 and neutrophils. CONCLUSIONS The findings suggest that inflammation is associated with disruption of functional connectivity within a brain network deemed critical for interoceptive signalling, e.g. accurate communication of peripheral bodily signals such as immune states to the brain, with implications for the pathogenesis of inflammation-linked depression.
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18
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Alvarez GM, Hackman DA, Miller AB, Muscatell KA. Systemic inflammation is associated with differential neural reactivity and connectivity to affective images. Soc Cogn Affect Neurosci 2021; 15:1024-1033. [PMID: 32441308 PMCID: PMC7657451 DOI: 10.1093/scan/nsaa065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 12/14/2022] Open
Abstract
Systemic inflammation is increasingly appreciated as a predictor of health and well-being. Further, inflammation has been shown to influence and be influenced by affective experiences. Although prior work has substantiated associations between inflammatory and affective processes, fewer studies have investigated the neurobiological correlates that underlie links between systemic, low-grade inflammation and affective reactivity. Thus, the current study examined whether markers of systemic inflammation (i.e. interleukin-6, C-reactive protein) are associated with differential patterns of neural activation and connectivity in corticolimbic regions in response to affective images. We investigated this question in a sample of 66 adults (44 women, M age = 54.98 years, range = 35–76) from the Midlife in the United States study. Higher levels of inflammation were associated with lower activity in limbic regions (i.e. amygdala, hippocampus, anterior insula, temporal pole) when viewing positive (vs neutral) images. Higher levels of inflammation were also associated with greater connectivity between the hippocampus and the medial prefrontal cortex in response to positive images. Inflammatory markers were not associated with significant differences in activation or connectivity to negative images. These findings highlight the utility of health neuroscience approaches in demonstrating that physiological processes such as inflammation are related to how our brains respond to affective information.
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Affiliation(s)
- Gabriella M Alvarez
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3270, USA
| | - Daniel A Hackman
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Adam Bryant Miller
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3270, USA
| | - Keely A Muscatell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3270, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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19
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Swartz JR, Carranza AF, Tully LM, Knodt AR, Jiang J, Irwin MR, Hostinar CE. Associations between peripheral inflammation and resting state functional connectivity in adolescents. Brain Behav Immun 2021; 95:96-105. [PMID: 33631285 PMCID: PMC8241234 DOI: 10.1016/j.bbi.2021.02.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022] Open
Abstract
Relatively little is known about associations between peripheral inflammation and neural function in humans. Neuroimaging studies in adults have suggested that elevated peripheral inflammatory markers are associated with altered resting state functional connectivity (rsFC) in several brain networks associated with mood and cognition. Few studies have examined these associations in adolescents, yet scarce data from adolescents point to different networks than adult studies. The current study examined the associations between peripheral inflammation and rsFC in a community sample of adolescents (n = 70; age, 12-15 years; 32 female, 36 male, 2 nonbinary). After blood sampling, an fMRI scan was performed to assess rsFC. Assay for serum inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP), was performed. Results indicated that higher TNF-α was associated with altered rsFC between the right amygdala and left striatum and between the right inferior frontal gyrus and left parietal cortex (p < 0.05 whole-brain corrected). Associations with IL-6 and CRP were not significant. In contrast with findings in adults, inflammation may have unique links with the connectivity of the developing adolescent brain. Results have implications for understanding how peripheral inflammation may influence connectivity during adolescence, when neural networks are undergoing major developmental changes.
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Affiliation(s)
- Johnna R Swartz
- Department of Human Ecology, University of California, Davis, CA, United States.
| | - Angelica F Carranza
- Department of Human Ecology, University of California, Davis, CA, United States
| | - Laura M Tully
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, United States
| | - Annchen R Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Janina Jiang
- Norman Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, United States
| | - Michael R Irwin
- Norman Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Camelia E Hostinar
- Department of Psychology, University of California, Davis, CA, United States
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20
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Increased peripheral inflammation in schizophrenia is associated with worse cognitive performance and related cortical thickness reductions. Eur Arch Psychiatry Clin Neurosci 2021; 271:595-607. [PMID: 33760971 DOI: 10.1007/s00406-021-01237-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 02/03/2021] [Indexed: 12/16/2022]
Abstract
While the biological substrates of brain and behavioural changes in persons with schizophrenia remain unclear, increasing evidence implicates that inflammation is involved. In schizophrenia, including first-episode psychosis and anti-psychotic naïve patients, there are numerous reports of increased peripheral inflammation, cognitive deficits and neuropathologies such as cortical thinning. Research defining the relationship between inflammation and schizophrenia symptomatology and neuropathology is needed. Therefore, we analysed the level of C-reactive protein (CRP), a peripheral inflammation marker, and its relationship with cognitive functioning in a cohort of 644 controls and 499 schizophrenia patients. In a subset of individuals who underwent MRI scanning (99 controls and 194 schizophrenia cases), we tested if serum CRP was associated with cortical thickness. CRP was significantly increased in schizophrenia patients compared to controls, co-varying for age, sex, overweight/obesity and diabetes (p < 0.006E-10). In schizophrenia, increased CRP was mildly associated with worse performance in attention, controlling for age, sex and education (R =- 0.15, p = 0.001). Further, increased CRP was associated with reduced cortical thickness in three regions related to attention: the caudal middle frontal, the pars opercularis and the posterior cingulate cortices, which remained significant after controlling for multiple comparisons (all p < 0.05). Together, these findings indicate that increased peripheral inflammation is associated with deficits in cognitive function and brain structure in schizophrenia, especially reduced attention and reduced cortical thickness in associated brain regions. Using CRP as a biomarker of peripheral inflammation in persons with schizophrenia may help to identify vulnerable patients and those that may benefit from adjunctive anti-inflammatory treatments.
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21
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Hansson LS, Axelsson J, Petrovic P, Paues Göranson S, Olsson MJ, Lekander M, Lasselin J. Regulation of emotions during experimental endotoxemia: A pilot study. Brain Behav Immun 2021; 93:420-424. [PMID: 33493626 DOI: 10.1016/j.bbi.2021.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 01/01/2023] Open
Abstract
Even though dysfunctional emotion regulation is prominent in depression and a link between depression and inflammation is well established, there is little knowledge about how inflammation affects the regulation of emotions. The aim of this pilot study was to explore the effect of experimentally induced inflammation on the cognitive reappraisal of emotions, and to assess domain specificity by comparing success in regulation of emotions towards two unpleasant stimuli classes (general negative stimuli and disgust stimuli). In a between-subject design, ten healthy participants were injected with an intravenous injection of lipopolysaccharide (2 ng/kg body weight) and eleven were injected with saline. Participants performed a cognitive reappraisal task, in which they had to down-regulate or up-regulate their emotions towards general negative stimuli and disgust stimuli, 5-6 h post-injection. Contrary to our hypotheses, participants injected with lipopolysaccharide reported greater success in down-regulating emotional responses towards unpleasant stimuli as compared to the saline group. In addition, both groups were poorer at down-regulating emotions towards disgust stimuli as compared to general negative stimuli. The current pilot study indicates that cognitive reappraisal of emotions is affected during experimental endotoxemia, and suggests that disgust stimuli might be difficult to reappraise.
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Affiliation(s)
- Lina S Hansson
- Stress Research Institute, Department of Psychology, Stockholm University, 10691 Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden
| | - John Axelsson
- Stress Research Institute, Department of Psychology, Stockholm University, 10691 Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Neuro Division, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden
| | - Sofie Paues Göranson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 18288 Stockholm, Sweden
| | - Mats J Olsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden
| | - Mats Lekander
- Stress Research Institute, Department of Psychology, Stockholm University, 10691 Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden; Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden
| | - Julie Lasselin
- Stress Research Institute, Department of Psychology, Stockholm University, 10691 Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden; Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden.
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22
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Konsman JP. So Many Faces, Phases, and Facets, Sickness Behavior Beyond Disciplines. Front Psychiatry 2021; 12:630331. [PMID: 33716828 PMCID: PMC7947683 DOI: 10.3389/fpsyt.2021.630331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/11/2021] [Indexed: 01/02/2023] Open
Abstract
Animals, including human beings, modify their behavior when they fall sick. Interestingly, sociology, biology, and psychology have at different times in their history developed constructs of illness or sickness behavior. The aims of the present paper are to consider sickness behavior in animals and humans and to evaluate to what extent the notions of sickness behavior would allow for interdisciplinary research. After distinguishing disease, illness, and sickness, the case will be made that illness behavior and sickness behavior can be considered heuristically as synonyms given the existence of some fluidity between the notion of illness and sickness. Based on this, different faces, phases, and facets of sickness behavior will be presented before addressing the question of how integration of constructs of sickness behaviors would be possible across biology, medicine, psychology, and sociology. It is concluded that interdisciplinary research on sickness behavior between biology, psychology, and sociology is possible and called for with regard to constructs, methods, and explanations, while keeping in mind differences in perspectives, for example between acute and chronic sickness behavior.
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Affiliation(s)
- Jan Pieter Konsman
- Aquitaine Institute for Integrative and Cognitive Neuroscience (INCIA) UMR CNRS 5287, University of Bordeaux, Bordeaux, France
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23
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Lasselin J, Lekander M, Benson S, Schedlowski M, Engler H. Sick for science: experimental endotoxemia as a translational tool to develop and test new therapies for inflammation-associated depression. Mol Psychiatry 2021; 26:3672-3683. [PMID: 32873895 PMCID: PMC8550942 DOI: 10.1038/s41380-020-00869-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/25/2020] [Accepted: 08/06/2020] [Indexed: 12/16/2022]
Abstract
Depression is one of the global leading causes of disability, but treatments remain limited and classical antidepressants were found to be ineffective in a substantial proportion of patients. Thus, novel effective therapies for the treatment of depression are urgently needed. Given the emerging role of inflammation in the etiology and pathophysiology of affective disorders, we herein illustrate how experimental endotoxemia, a translational model of systemic inflammation, could be used as a tool to develop and test new therapeutic options against depression. Our concept is based on the striking overlap of inflammatory, neural, and affective characteristics in patients with inflammation-associated depression and in endotoxin-challenged healthy subjects. Experimental administration of endotoxin in healthy volunteers is safe, well-tolerated, and without known long-term health risks. It offers a highly standardized translational approach to characterize potential targets of therapies against inflammation-associated depression, as well as to identify characteristics of patients that would benefit from these interventions, and, therefore, could contribute to improve personalization of treatment and to increase the overall rate of responders.
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Affiliation(s)
- Julie Lasselin
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. .,Stress Research Institute, Stockholm University, 10691, Stockholm, Sweden. .,Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177, Stockholm, Sweden. .,Osher Center for Integrative Medicine, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden.
| | - Mats Lekander
- grid.10548.380000 0004 1936 9377Stress Research Institute, Stockholm University, 10691 Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Osher Center for Integrative Medicine, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - Sven Benson
- grid.5718.b0000 0001 2187 5445Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Manfred Schedlowski
- grid.5718.b0000 0001 2187 5445Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden
| | - Harald Engler
- grid.5718.b0000 0001 2187 5445Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
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Exploring the Mechanism on the Medullary Visceral Zone Inhibiting the Cholinergic Anti-inflammatory Pathway Induced by Sepsis. Mediators Inflamm 2020; 2020:1320278. [PMID: 33061821 PMCID: PMC7542527 DOI: 10.1155/2020/1320278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/23/2020] [Accepted: 08/31/2020] [Indexed: 12/29/2022] Open
Abstract
Inflammatory storm is an important pathological mechanism of multiple organ dysfunction, and it is associated with most deaths in septic patients, deserving to be studied. Recent findings have confirmed that the Medullary Visceral Zone (MVZ) regulates inflammation and immunity through the cholinergic anti-inflammatory pathway (CAP), but how sepsis affects the MVZ and leads to uncontrolled inflammation remain unclear. The current study reported that sepsis induced MVZ to inhibit CAP which underlies the inflammation storm. Our studies have shown that the rat models of sepsis prepared by cecal ligation and puncture had a higher inflammatory level, higher mortality, and higher Murine Sepsis Score. In septic rats, some indicators of heart rate variability (HRV) such as SDNN, HF band, RMSSD, SD1, and SD2 significantly reduced. In MVZ of septic rats, many cholinergic and catecholaminergic neurons showed apoptotic, with low expressions of tyrosine hydroxylase and choline acetyltransferase. The α7nAChR agonist GTS-21 can improve these pathologies, while the α7nAChR antagonist MLA is the opposite. Our study demonstrates for the first time that cholinergic and catecholaminergic neurons in MVZ went through significant apoptosis and inactiveness in sepsis, which contributes to the inhibition of CAP and acceleration of the inflammation storm in early sepsis. Intervening with CAP has a significant effect on the activity and apoptosis of MVZ neurons while altering systemic inflammation and immunity; in addition, for the first time, we confirmed that some indicators of HRV such as SDNN, HF band, RMSSD, SD1, and SD2 can reflect the activity of CAP, but the CAP interference had little effect on these indicators.
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Elucidating vulnerability to inflammation-induced hyperalgesia: Predictors of increased musculoskeletal pain sensitivity during experimental endotoxemia. Brain Behav Immun 2020; 88:302-307. [PMID: 32592864 DOI: 10.1016/j.bbi.2020.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/15/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022] Open
Abstract
Despite broad clinical implications, the mechanisms linking inflammation and pain remain incompletely understood. Using human experimental endotoxemia as a translational model of systemic inflammation, we aimed to elucidate putative vulnerability factors of inflammation-induced musculoskeletal hyperalgesia. We pooled data from three published randomized controlled trials, resulting in a sample of N = 98 healthy volunteers who received either low-dose endotoxin (lipopolysaccharide) or vehicle (saline) intravenously. As measure of musculoskeletal pain sensitivity, pressure pain thresholds (PPTs) were assessed at baseline and 3 h post injection with a handheld algometer for the low back (erector spinae muscle), calf (gastrocnemius muscle), and shoulder region (deltoid muscle). Implementing multiple regression models, we tested the contribution of putative vulnerability factors on musculoskeletal hyperalgesia during systemic inflammation, including acute changes in pro-inflammatory cytokines, state anxiety and mood, as well as pre-existing symptoms of anxiety and depression. Endotoxin application led to significant increases in plasma cytokines, state anxiety, and negative mood, and significantly decreased PPTs for all muscle groups. Regression models revealed that greater M. erector spinae PPT changes were predicted by higher HADS-anxiety scores. Higher TNF-α concentration emerged as predictor for M. gastrocnemius PPT changes, and more pronounced TNF-α increase and higher HADS-anxiety were predictive for M. deltoideus PPTs. HADS scores emerged as predictor for a mean PPT score (computed across all body sites). Together, our results indicate that musculoskeletal hyperalgesia during systemic inflammation is related to pro-inflammatory cytokines, specifically TNF-α. Importantly, subclinical anxiety symptoms (even though in a low and normal range in this cohort of healthy volunteers) may contribute to inflammation-induced hyperalgesia, making individuals more vulnerable to the detrimental effects of systemic inflammation.
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Walker KA, Gross AL, Moghekar AR, Soldan A, Pettigrew C, Hou X, Lu H, Alfini AJ, Bilgel M, Miller MI, Albert MS, Walston J. Association of peripheral inflammatory markers with connectivity in large-scale functional brain networks of non-demented older adults. Brain Behav Immun 2020; 87:388-396. [PMID: 31935468 PMCID: PMC7316598 DOI: 10.1016/j.bbi.2020.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/13/2019] [Accepted: 01/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Systemic inflammation has emerged as a risk factor for cognitive decline and Alzheimer's disease, but inflammation's effect on distributed brain networks is unclear. We examined the relationship between peripheral inflammatory markers and subsequent functional connectivity within five large-scale cognitive networks and evaluated the modifying role of cortical amyloid and APOE ε4 status. METHODS Blood levels of soluble tumor necrosis factor-alpha receptor-1 and interleukin 6 were assessed in 176 participants (at baseline mean age: 65 (SD 9) years; 63% women; 85% cognitively normal, 15% mild cognitive impairment (MCI)) and were combined to derive an Inflammatory Index. Approximately six years later, participants underwent resting-state functional magnetic resonance imaging to quantify functional connectivity; a subset of 137 participants also underwent 11C Pittsburgh compound-B (PiB) PET imaging to assess cortical amyloid burden. RESULTS Using linear regression models adjusted for demographic characteristics and cardiovascular risk factors, a higher Inflammatory Index was associated with lower connectivity within the Default Mode (β = -0.013; 95% CI: -0.023, -0.003) and the Dorsal Attention Networks (β = -0.017; 95% CI: -0.028, -0.006). The strength of these associations did not vary by amyloid status (positive/negative). However, there was a significant interaction between Inflammatory Index and APOE ε4 status, whereby ε4-positive participants with a higher Inflammatory Index demonstrated lower connectivity. Inflammatory Index was unrelated to connectivity within other large-scale cognitive networks (Control, Limbic, and Salience/Ventral Attention networks). CONCLUSION Peripheral pro-inflammatory signaling in older adults without dementia, especially among APOE ε4-positive individuals, is associated with altered connectivity within two large-scale cognitive networks.
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Affiliation(s)
- Keenan A Walker
- Department of Neurology, Johns Hopkins University, Baltimore, United States.
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.
| | - Abhay R Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States.
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States.
| | - Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States.
| | - Xirui Hou
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, United States.
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, United States.
| | - Alfonso J Alfini
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, United States.
| | - Michael I Miller
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, United States.
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States.
| | - Jeremy Walston
- Division of Geriatric Medicine and Gerontology, Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, United States.
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李 红, 李 媛, 王 武, 彭 宗, 吴 芳. [Cholinergic anti-inflammatory pathway plays negative regulatory role in early inflammatory and immune responses in septic rats]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:647-653. [PMID: 32897210 PMCID: PMC7277322 DOI: 10.12122/j.issn.1673-4254.2020.05.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the role of cholinergic anti-inflammatory pathway (CAP) in neuro-regulation of inflammatory and immune response in the early stage of sepsis. METHODS Sixty-four SD rats were randomly divided into control Group (n=8) with normal feeding without any treatment; sham operation group (n=8) with laparotomy but without cecal ligation and puncture (CLP), followed by intraperitoneal injection 50 mg/kg piperacillin 3 times a day for 3 consecutive days; and sepsis group (n=48) with CLP-induced sepsis. The rat models of sepsis were randomized into model groups (n=16) with intraperitoneal injection of piperacillin (50 mg/kg) and normal saline (1 mL/100 g) for 3 times a day for 3 days; GTS-21 group (n=16) with additional intraperitoneal injection of 4 mg/kg GTS-21 (once a day for 3 days); and methyllycaconitine (MLA) group (n=16) with intraperitoneal injection of MLA (4.8 mg/kg) in addition to piperacillin (once a day for 3 days). Murine Sepsis Score (MSS) of the rats and short-range HRV analysis were recorded. Three days later, the rats were sacrificed and serum levels of TNF-α, IL-1α, IL-10, IL-6, HMGB1, and sCD14 were measured with ELISA. The percentages of CD4+CD25+ Treg and TH17 lymphocytes and their ratios were measured using flow cytometry. RESULTS Compared with the control rats, the septic rats had significantly increased MSS scores and lowered HRV indexes (SDNN, RMSSD, HF, SD1, and SD2; P < 0.05); treatment with GTS-21 significantly decreased while MLA increased MSS scores (P < 0.05), but neither of them obviously affected HRV of the rats. Serum levels TNF-α, IL-1α, IL-10, IL-6, HMGB1, and sCD14 and the percentages of CD4+CD25+ Treg and TH17-positive lymphocytes were significantly higher and Treg/TH17 ratio was significantly lower in the septic rats compared with those in the control group (P < 0.05); treatment with GTS-21 significantly decreased the levels of serum levels of TNF-α, IL-1α, IL-6, HMGB1, and sCD14 and TH17 lymphocyte percentage (P < 0.05), whereas MLA treatment significantly increased serum levels of TNF-α, IL-1α, IL-10, IL-6, HMGB1, and sCD14 and the percentages of CD4+ CD25+ Treg and TH17-positive lymphocytes and decreased Treg/TH17 ratio in the septic rats (P < 0.05). CONCLUSIONS CAP plays negative regulatory role in early inflammatory and immune response to sepsis, and some of the HRV indicators can well reflect the regulatory effect of CAP on inflammation and immunity in the septic rats.
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Affiliation(s)
- 红兵 李
- />贵阳市第一人民医院急诊科,贵州 贵阳 550002Department of Emergency Medicine, Guiyang First People's Hospital, Guiyang 550002, China
| | - 媛 李
- />贵阳市第一人民医院急诊科,贵州 贵阳 550002Department of Emergency Medicine, Guiyang First People's Hospital, Guiyang 550002, China
| | - 武石 王
- />贵阳市第一人民医院急诊科,贵州 贵阳 550002Department of Emergency Medicine, Guiyang First People's Hospital, Guiyang 550002, China
| | - 宗爽 彭
- />贵阳市第一人民医院急诊科,贵州 贵阳 550002Department of Emergency Medicine, Guiyang First People's Hospital, Guiyang 550002, China
| | - 芳 吴
- />贵阳市第一人民医院急诊科,贵州 贵阳 550002Department of Emergency Medicine, Guiyang First People's Hospital, Guiyang 550002, China
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Kim J, Yoon S, Lee S, Hong H, Ha E, Joo Y, Lee EH, Lyoo IK. A double-hit of stress and low-grade inflammation on functional brain network mediates posttraumatic stress symptoms. Nat Commun 2020; 11:1898. [PMID: 32313055 PMCID: PMC7171097 DOI: 10.1038/s41467-020-15655-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 03/18/2020] [Indexed: 12/12/2022] Open
Abstract
Growing evidence indicates a reciprocal relationship between low-grade systemic inflammation and stress exposure towards increased vulnerability to neuropsychiatric disorders, including posttraumatic stress disorder (PTSD). However, the neural correlates of this reciprocity and their influence on the subsequent development of PTSD are largely unknown. Here we investigated alterations in functional connectivity among brain networks related to low-grade inflammation and stress exposure using two large independent data sets. Functional couplings among the higher-order cognitive network system including the salience, default mode, and central executive networks were reduced in association with low-grade inflammation and stress exposure. This reduced functional coupling may also be related to subsequent posttraumatic stress symptom severity. The current findings propose functional couplings among the higher-order cognitive network system as neural correlates of low-grade inflammation and stress exposure, and suggest that low-grade inflammation, alongside with stress, may render individuals more vulnerable to PTSD.
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Affiliation(s)
- Jungyoon Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Suji Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Haejin Hong
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Yoonji Joo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Eun Hee Lee
- Green Cross Laboratories, Yongin, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea. .,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea. .,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea. .,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, UT, USA.
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29
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Andreasson A, McNaughton D, Beath A, Lodin K, Wicksell RK, Lekander M, Jones MP. Properties of the Sickness Questionnaire in an Australian sample with chronic medically unexplained symptoms. Brain Behav Immun Health 2020; 3:100059. [PMID: 34589841 PMCID: PMC8474179 DOI: 10.1016/j.bbih.2020.100059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 12/15/2022] Open
Abstract
Sickness behavior including malaise, fatigue and increased pain sensitivity is thought to be adaptive and facilitate recovery from disease. However, it may also reduce functioning and health if symptoms persists, which is why validated instruments for its assessment are needed. We evaluated the English translation of the Sickness Questionnaire (SicknessQ) in an Australian population of 156 participants with high level of persistent musculoskeletal pain and/or gastrointestinal symptoms without an organic explanation. The SicknessQ total score had an adequate model fit and no other models were found to fit data better. The SicknessQ correlated most strongly with fatigue, stress, anxiety and depression, which explained 62% of the variance in SicknessQ, but not with physical functioning. The mean score (8.9; 95 %CI: 8.0–9.8) was in between those previously reported in a general population sample and in primary care patients. In conclusion, the evaluation of the English version of the SicknessQ in an Australian sample with significant, chronic unexplained medical symptoms supports the use of the English version of the total SicknessQ score as an overall measure of sickness behavior.
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Affiliation(s)
- Anna Andreasson
- Department of Psychology, Macquarie University, Australia.,Stress Research Institute, Stockholm University, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | | | - Alissa Beath
- Department of Psychology, Macquarie University, Australia
| | - Karin Lodin
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | | | - Mats Lekander
- Stress Research Institute, Stockholm University, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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30
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Modeling Resilience to Damage in Multiple Sclerosis: Plasticity Meets Connectivity. Int J Mol Sci 2019; 21:ijms21010143. [PMID: 31878257 PMCID: PMC6981966 DOI: 10.3390/ijms21010143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/05/2019] [Accepted: 12/20/2019] [Indexed: 02/03/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) characterized by demyelinating white matter lesions and neurodegeneration, with a variable clinical course. Brain network architecture provides efficient information processing and resilience to damage. The peculiar organization characterized by a low number of highly connected nodes (hubs) confers high resistance to random damage. Anti-homeostatic synaptic plasticity, in particular long-term potentiation (LTP), represents one of the main physiological mechanisms underlying clinical recovery after brain damage. Different types of synaptic plasticity, including both anti-homeostatic and homeostatic mechanisms (synaptic scaling), contribute to shape brain networks. In MS, altered synaptic functioning induced by inflammatory mediators may represent a further cause of brain network collapse in addition to demyelination and grey matter atrophy. We propose that impaired LTP expression and pathologically enhanced upscaling may contribute to disrupting brain network topology in MS, weakening resilience to damage and negatively influencing the disease course.
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31
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Kaplan C, Minc A, Basu N, Schrepf A. Inflammation and the Central Nervous System in Inflammatory Rheumatic Disease. Curr Rheumatol Rep 2019; 21:67. [PMID: 31807958 DOI: 10.1007/s11926-019-0870-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW To review how peripheral inflammation in rheumatic disease influences the central nervous system. We consider recent studies of rheumatic disease that employ functional and structural neuroimaging in the context of inflammation, as well as recent studies considering how immunosuppressive therapy is associated with changes in brain function and structure. RECENT FINDINGS The most compelling evidence thus far comes from studies of rheumatoid arthritis and indicates that higher levels of inflammation are associated with changes in cognitive, affective, and pain-processing brain regions, some of which may be rectified by anti-inflammatory treatment. Comorbid symptoms such as widespread pain and fatigue may also be associated with these changes. Inflammation may be associated with compensatory activation of brain regions to offset structural changes. This emerging line of evidence suggests that communication between the brain and immune system are an important and underappreciated aspect of inflammatory rheumatic disease.
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Affiliation(s)
- Chelsea Kaplan
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Health System, Domino's Farms, Lobby M, 24 Frank Lloyd Wright Dr., PO Box 385, Ann Arbor, MI, 48106, USA
| | | | - Neil Basu
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | - Andrew Schrepf
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Health System, Domino's Farms, Lobby M, 24 Frank Lloyd Wright Dr., PO Box 385, Ann Arbor, MI, 48106, USA.
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Myalgic encephalomyelitis/chronic fatigue syndrome: From pathophysiological insights to novel therapeutic opportunities. Pharmacol Res 2019; 148:104450. [PMID: 31509764 DOI: 10.1016/j.phrs.2019.104450] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/26/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022]
Abstract
Myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS) is a common and disabling condition with a paucity of effective and evidence-based therapies, reflecting a major unmet need. Cognitive behavioural therapy and graded exercise are of modest benefit for only some ME/CFS patients, and many sufferers report aggravation of symptoms of fatigue with exercise. The presence of a multiplicity of pathophysiological abnormalities in at least the subgroup of people with ME/CFS diagnosed with the current international consensus "Fukuda" criteria, points to numerous potential therapeutic targets. Such abnormalities include extensive data showing that at least a subgroup has a pro-inflammatory state, increased oxidative and nitrosative stress, disruption of gut mucosal barriers and mitochondrial dysfunction together with dysregulated bioenergetics. In this paper, these pathways are summarised, and data regarding promising therapeutic options that target these pathways are highlighted; they include coenzyme Q10, melatonin, curcumin, molecular hydrogen and N-acetylcysteine. These data are promising yet preliminary, suggesting hopeful avenues to address this major unmet burden of illness.
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Forsberg A, Lampa J, Estelius J, Cervenka S, Farde L, Halldin C, Lekander M, Olgart Höglund C, Kosek E. Disease activity in rheumatoid arthritis is inversely related to cerebral TSPO binding assessed by [ 11C]PBR28 positron emission tomography. J Neuroimmunol 2019; 334:577000. [PMID: 31260948 DOI: 10.1016/j.jneuroim.2019.577000] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 06/20/2019] [Indexed: 12/12/2022]
Abstract
Reumatoid Arthritis (RA) is an autoimmune disorder characterized by peripheral joint inflammation. Recently, an engagement of the brain immune system has been proposed. The aim with the current investigation was to study the glial cell activation marker translocator protein (TSPO) in a well characterized cohort of RA patients and to relate it to disease activity, peripheral markers of inflammation and autonomic activity. Fifteen RA patients and fifteen healthy controls matched for age, sex and TSPO genotype (rs6971) were included in the study. TSPO was measured using Positron emission tomography (PET) and the radioligand [11C]PBR28. The outcome measure was total distribution volume (VT) estimated using Logan graphical analysis, with grey matter (GM) as the primary region of interest. Additional regions of interest analyses as well as voxel-wise analyses were also performed. Clinical evaluation of disease activity, symptom assessments, serum analyses of cytokines and heart rate variability (HRV) analysis of 24 h ambulatory ECG were performed in all subjects. There were no statistically significant group differences in TSPO binding, either when using the primary outcome VT or when normalizing VT to the lateral occipital cortex (p > 0.05). RA patients had numerically lower VT values than healthy controls (Cohen's D for GM = -0.21). In the RA group, there was a strong negative correlation between [11C]PBR28 VT in GM and disease activity (DAS28)(r = -0.745, p = 0.002, corrected for rs6971 genotype). Higher serum levels of IFNγ and TNF-α were found in RA patients compared to controls (p < 0.05) and several measures of autonomic activity showed significant differences between RA and controls (p < 0.05). However, no associations between markers of systemic inflammation or autonomic activity and cerebral TSPO binding were found. In conclusion, no statistically significant group differences in TSPO binding as measured with [11C]PBR28 PET were detected. Within the RA group, lower cerebral TSPO binding was associated with higher disease activity, suggesting that cerebral TSPO expression may be related to disease modifying mechanisms in RA. In light of the earlier confirmed neuro-immune features of RA, these results warrant further investigations regarding neuro-immune joint-to-CNS signalling to open up for potentially new treatment strategies.
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Affiliation(s)
- A Forsberg
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden.
| | - J Lampa
- Department of Medicine, Rheumatology Unit, Center for Molecular Medicine (CMM), Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - J Estelius
- Department of Medicine, Rheumatology Unit, Center for Molecular Medicine (CMM), Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - S Cervenka
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
| | - L Farde
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden; PET Science Centre, Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Karolinska Institutet, Sweden
| | - C Halldin
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
| | - M Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - C Olgart Höglund
- Department of Medicine and Center for Molecular Medicine (CMM), Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - E Kosek
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Systemic Inflammation Impairs Mood Function by Disrupting the Resting-State Functional Network in a Rat Animal Model Induced by Lipopolysaccharide Challenge. Mediators Inflamm 2019; 2019:6212934. [PMID: 31210750 PMCID: PMC6532295 DOI: 10.1155/2019/6212934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/15/2019] [Accepted: 04/23/2019] [Indexed: 11/18/2022] Open
Abstract
Background Systemic inflammation impairs cognitive performance, yet the brain networks mediating this process remain to be elucidated. The purpose of the current study was to use resting-state functional magnetic resonance imaging (fMRI) to explore changes in the functional connectivity in a lipopolysaccharide- (LPS-) induced systemic inflammation animal model. Materials and Methods We used the regional homogeneity (ReHo) method to examine abnormal brain regions between the control and LPS groups and then considered them as seeds of functional connectivity analysis. Results Compared with the control group, our study showed that (1) LPS impaired mood function, as reflected by a depression-like behavior in the forced swim test; (2) LPS induced significantly increased ReHo values in the anterior cingulate cortex (ACC) and caudate putamen (CPu); (3) the ACC seed showed increased functional connectivity with the retrosplenial cortex, superior colliculus, and inferior colliculus; and (4) the right CPu seed showed increased functional connectivity with the left CPu. Linear regression analysis showed a LPS-induced depression-like behavior which was associated with increased ReHo values in the ACC and right CPu. Moreover, the LPS-induced depression-like behavior was related to increased functional connectivity between the right CPu and left CPu. Conclusion This is the first study to show that systemic inflammation impairs mood function that is associated with an altered resting-state functional network based on ReHo analysis, providing evidence of the abnormal regional brain spontaneous activity which might be involved in inflammation-related neurobehavioral abnormalities.
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Morris G, Maes M, Berk M, Puri BK. Myalgic encephalomyelitis or chronic fatigue syndrome: how could the illness develop? Metab Brain Dis 2019; 34:385-415. [PMID: 30758706 PMCID: PMC6428797 DOI: 10.1007/s11011-019-0388-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 01/23/2019] [Indexed: 12/19/2022]
Abstract
A model of the development and progression of chronic fatigue syndrome (myalgic encephalomyelitis), the aetiology of which is currently unknown, is put forward, starting with a consideration of the post-infection role of damage-associated molecular patterns and the development of chronic inflammatory, oxidative and nitrosative stress in genetically predisposed individuals. The consequences are detailed, including the role of increased intestinal permeability and the translocation of commensal antigens into the circulation, and the development of dysautonomia, neuroinflammation, and neurocognitive and neuroimaging abnormalities. Increasing levels of such stress and the switch to immune and metabolic downregulation are detailed next in relation to the advent of hypernitrosylation, impaired mitochondrial performance, immune suppression, cellular hibernation, endotoxin tolerance and sirtuin 1 activation. The role of chronic stress and the development of endotoxin tolerance via indoleamine 2,3-dioxygenase upregulation and the characteristics of neutrophils, monocytes, macrophages and T cells, including regulatory T cells, in endotoxin tolerance are detailed next. Finally, it is shown how the immune and metabolic abnormalities of chronic fatigue syndrome can be explained by endotoxin tolerance, thus completing the model.
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Affiliation(s)
- Gerwyn Morris
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
- Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
| | - Basant K Puri
- Department of Medicine, Imperial College London, Hammersmith Hospital, London, England, W12 0HS, UK.
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Woelfer M, Kasties V, Kahlfuss S, Walter M. The Role of Depressive Subtypes within the Neuroinflammation Hypothesis of Major Depressive Disorder. Neuroscience 2019; 403:93-110. [DOI: 10.1016/j.neuroscience.2018.03.034] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/25/2018] [Accepted: 03/20/2018] [Indexed: 12/21/2022]
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Müller CP, Chu C, Qin L, Liu C, Xu B, Gao H, Ruggeri B, Hieber S, Schneider J, Jia T, Tay N, Akira S, Satoh T, Banaschewski T, Bokde ALW, Bromberg U, Büchel C, Quinlan EB, Flor H, Frouin V, Garavan H, Gowland P, Heinz A, Ittermann B, Martinot JL, Martinot MLP, Artiges E, Lemaitre H, Nees F, Papadopoulos Orfanos D, Paus T, Poustka L, Millenet S, Fröhner JH, Smolka MN, Walter H, Whelan R, Bakalkin G, Liu Y, Desrivières S, Elliott P, Eulenburg V, Levy D, Crews F, Schumann G. The Cortical Neuroimmune Regulator TANK Affects Emotional Processing and Enhances Alcohol Drinking: A Translational Study. Cereb Cortex 2019; 29:1736-1751. [PMID: 30721969 PMCID: PMC6430980 DOI: 10.1093/cercor/bhy341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/14/2018] [Accepted: 12/19/2018] [Indexed: 12/22/2022] Open
Abstract
Alcohol abuse is a major public health problem worldwide. Understanding the molecular mechanisms that control regular drinking may help to reduce hazards of alcohol consumption. While immunological mechanisms have been related to alcohol drinking, most studies reported changes in immune function that are secondary to alcohol use. In this report, we analyse how the gene "TRAF family member-associated NF-κB activator" (TANK) affects alcohol drinking behavior. Based on our recent discovery in a large GWAS dataset that suggested an association of TANK, SNP rs197273, with alcohol drinking, we report that SNP rs197273 in TANK is associated both with gene expression (P = 1.16 × 10-19) and regional methylation (P = 5.90 × 10-25). A tank knock out mouse model suggests a role of TANK in alcohol drinking, anxiety-related behavior, as well as alcohol exposure induced activation of insular cortex NF-κB. Functional and structural neuroimaging studies among up to 1896 adolescents reveal that TANK is involved in the control of brain activity in areas of aversive interoceptive processing, including the insular cortex, but not in areas related to reinforcement, reward processing or impulsiveness. Our findings suggest that the cortical neuroimmune regulator TANK is associated with enhanced aversive emotional processing that better protects from the establishment of alcohol drinking behavior.
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Affiliation(s)
- Christian P Müller
- Section of Addiction Medicine, Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, Erlangen, Germany
| | - Congying Chu
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
| | - Liya Qin
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina, Chapel Hill NC, USA
| | - Chunyu Liu
- The Framingham Heart Study, 73 Mt Wayte Ave, Framingham MA, USA
- The Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda MD, USA
- Boston University School of Public Health, 715 Albany St, Boston MA, USA
| | - Bing Xu
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
| | - He Gao
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Barbara Ruggeri
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
| | - Saskia Hieber
- Section of Addiction Medicine, Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, Erlangen, Germany
| | - Julia Schneider
- Institute for Biochemistry and Molecular Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Fahrstrasse 17, Erlangen, Germany
| | - Tianye Jia
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
| | - Nicole Tay
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
| | - Shizuo Akira
- Laboratory of Host Defense, World Premier International Immunology Frontiern Research Center, Research Institute for Microbial Diseases, Osaka University, 1-1 Yamadaoka, Suita, Osaka, Osaka, Japan
| | - Takashi Satoh
- Laboratory of Host Defense, World Premier International Immunology Frontiern Research Center, Research Institute for Microbial Diseases, Osaka University, 1-1 Yamadaoka, Suita, Osaka, Osaka, Japan
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, James's Street, Dublin, Ireland
| | - Uli Bromberg
- University Medical Centre Hamburg-Eppendorf, House W34, 3.OG, Martinistr. 52, Hamburg, Germany
| | - Christian Büchel
- University Medical Centre Hamburg-Eppendorf, House W34, 3.OG, Martinistr. 52, Hamburg, Germany
| | - Erin Burke Quinlan
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Vincent Frouin
- NeuroSpin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, UK
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany [ Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2—12, Berlin, Germany]
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 “Neuroimaging & Psychiatry”, University Paris Sud—University Paris Saclay, DIGITEO Labs, Rue Noetzlin, Gif sur Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 “Neuroimaging & Psychiatry”, University Paris Sud—Paris Saclay, University Paris Descartes; and AP-HP, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, Paris, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 “Neuroimaging & Psychiatry”, University Paris Sud—University Paris Saclay, DIGITEO Labs, Gif sur Yvette; and Psychiatry Department, Orsay Hospital, Orsay, France
| | - Herve Lemaitre
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 “Neuroimaging & Psychiatry”, University Paris-Sud Medical School, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, Mannheim, Germany
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, Mannheim, Germany
| | | | - Tomáš Paus
- Rotman Research Institute, Baycrest and Departments of Psychology and Psychiatry, University of Toronto, 3560 Bathurst Street, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, Göttingen, Germany
- Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Chemnitzer Str. 46a01187 Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Chemnitzer Str. 46a01187 Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Aras an Phiarsaigh Trinity College Dublin, Dublin, Ireland
| | - Georgy Bakalkin
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical, Biosciences, Uppsala University, Husargatan 3, Uppsala, Sweden
| | - Yun Liu
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education; Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai, P.R. China
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Volker Eulenburg
- Institute for Biochemistry and Molecular Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Fahrstrasse 17, Erlangen, Germany
- Department of Anaesthesiology and Intensive Care Medicine, University of Leipzig, Liebigstrasse 20, Leipzig, Germany
| | - Daniel Levy
- The Framingham Heart Study, 73 Mt Wayte Ave, Framingham MA, USA
- The Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda MD, USA
| | - Fulton Crews
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina, Chapel Hill NC, USA
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College De Crespigny Park, London, UK
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The effect of a transient immune activation on subjective health perception in two placebo controlled randomised experiments. PLoS One 2019; 14:e0212313. [PMID: 30840633 PMCID: PMC6402640 DOI: 10.1371/journal.pone.0212313] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/31/2019] [Indexed: 02/02/2023] Open
Abstract
Background Patient-reported outcomes predict mortality and play increasingly important roles in care, but factors that modify central measures such as health ratings have been little investigated. Building on designated immune-to-brain pathways, we aimed to determine how a short-term induced inflammation response impacts self-reported health status. Methods Lipopolysaccharide injections were used to provoke acute systemic inflammatory responses in healthy men and women and were compared to placebo in two double-blind randomized experiments. In Experiment 1, 8 individuals (mean 24 years; SD = 3.7) received lipopolysaccharide 0.8 ng/kg once and placebo once in a cross-over design, and in Experiment 2, 52 individuals received either lipopolysaccharide 0.6 ng/kg or placebo once (28.6 years; SD = 7.1). Main outcomes were perceived health (general and current), sickness behaviour (like fatigue, pain and negative affect), and plasma interleukin-6, interleukin-8 and tumour necrosis factor-α, before and after injection. Results Compared to placebo, lipopolysaccharide lead to a deterioration in both self-rated general (Experiment 1, b = 1.88 for 0.8 ng/kg) and current health (Experiment 1 b = -3.00; and Experiment 2 b = -1.79) 1.5h after injection (p’s<0.01), effects that remained after 4.5 to 5 hours (p’s<0.05). The effect on current health in Experiment 2 was mediated by increased inflammation and sickness behaviour in response to lipopolysaccharide injection (β = -0.28, p = 0.01). Conclusion Health is drastically re-evaluated during inflammatory activation. The findings are consistent with notions that inflammation forms part of health-relevant interoceptive computations of bodily state, and hint at one mechanism as to why subjective health predicts longevity.
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Labrenz F, Ferri F, Wrede K, Forsting M, Schedlowski M, Engler H, Elsenbruch S, Benson S, Costantini M. Altered temporal variance and functional connectivity of BOLD signal is associated with state anxiety during acute systemic inflammation. Neuroimage 2018; 184:916-924. [PMID: 30243957 DOI: 10.1016/j.neuroimage.2018.09.056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/17/2018] [Indexed: 12/16/2022] Open
Abstract
Systemic inflammation is accompanied by complex behavioral changes and disturbed emotion regulation that have been related to the pathophysiology of mood disorders including depression and anxiety. However, the causal role of systemic inflammation on mood disorders is still unclear. We herein investigated neural resting state patterns of temporal variance of the amygdala and functional connectivity within the salience network underlying changes in state anxiety during experimentally-induced systemic inflammation. In this randomized, double-blind study, N = 43 healthy men received an intravenous injection of either low-dose lipopolysaccharide (LPS, 0.4 ng/kg body weight) or saline. Resting state functional magnetic resonance imaging was assessed before and 3.5 h after injection. State anxiety, assessed with a standardized questionnaire, and plasma cytokine concentrations were repeatedly measured. LPS administration induced a transient systemic inflammatory response reflected in increases in plasma Interleukin (IL)-6 and Tumor Necrosis Factor (TNF)-α concentration. Compared to placebo, state anxiety and temporal variance in the amygdala significantly increased while functional connectivity in the salience network decreased during LPS-induced systemic inflammation. Together, these data indicate that acute systemic inflammation alters temporal variance of the BOLD signal as well as functional connectivity in brain regions and networks implicated in emotion processing and regulation. These results are of translational importance to encourage further research on the role of inflammatory pathways in the pathophysiology of neuropsychiatric conditions including anxiety disorders.
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Affiliation(s)
- Franziska Labrenz
- Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Francesca Ferri
- Centre for Brain Science, Department of Psychology, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, United Kingdom
| | - Karsten Wrede
- Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Michael Forsting
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Sigrid Elsenbruch
- Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Sven Benson
- Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Marcello Costantini
- Department of Neuroscience, Imaging and Clinical Science, University G. d'Annunzio, Via dei Vestini 31, Chieti, Italy.
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Ji M, Xia J, Tang X, Yang J. Altered functional connectivity within the default mode network in two animal models with opposing episodic memories. PLoS One 2018; 13:e0202661. [PMID: 30226886 PMCID: PMC6143184 DOI: 10.1371/journal.pone.0202661] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 08/07/2018] [Indexed: 12/31/2022] Open
Abstract
Memory enhancement and memory decline are two opposing cognitive performances commonly observed in clinical practice, yet the neural mechanisms underlying these two different phenomena remain poorly understood. Accumulating evidence has demonstrated that the default-mode network (DMN) is implicated in diverse cognitive, social, and affective processes. In the present study, we used the retrosplenial cortex as a seed region to study the functional connectivity within the DMN in two animal models with opposing episodic memories, of which memory enhancement was induced by footshocks to mimic posttraumatic stress disorder (PTSD) and memory decline was induced by lipopolysaccharide (LPS) challenge to mimic sepsis-associated encephalopathy (SAE). Our results showed that LPS challenge and footshocks induced opposing episodic memories. With regard to the imaging data, there were significant differences in the functional connectivity between the retrosplenial cortex and the medial prefrontal cortex (mPFC), insular lobe, left piriform cortex, left sensory cortex, and right visual cortex among the three groups. Post-hoc comparisons showed the LPS group had a significantly increased functional connectivity between the retrosplenial cortex and mPFC as compared with the control group. Compared with the LPS group, the PTSD group displayed significantly decreased functional connectivity between the retrosplenial cortex and the right visual cortex, retrosplenial cortex, insular lobe, left piriform cortex, and left sensory cortex. In summary, our study suggests that there is a significant difference in the functional connectivity within the DMN between SAE and PTSD rats.
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Affiliation(s)
- Muhuo Ji
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Jiangyan Xia
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Xiaohui Tang
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Jianjun Yang
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
- * E-mail:
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Kotulla S, Elsenbruch S, Roderigo T, Brinkhoff A, Wegner A, Engler H, Schedlowski M, Benson S. Does Human Experimental Endotoxemia Impact Negative Cognitions Related to the Self? Front Behav Neurosci 2018; 12:183. [PMID: 30186124 PMCID: PMC6113574 DOI: 10.3389/fnbeh.2018.00183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/02/2018] [Indexed: 12/27/2022] Open
Abstract
A role of inflammatory processes in the pathophysiology of depression is increasingly recognized. Experimental endotoxemia offers an established model to induce transient systemic inflammation in healthy humans, and has been proposed as an experimental paradigm of depression. Indeed, different symptoms of depression can be observed during experimental endotoxemia, including negative mood or dysthymia as key symptoms of depression. Hopelessness and low self-esteem constitute common cognitive symptoms in depression, but have not been specifically assessed during endotoxemia. Thus, we pooled data from healthy volunteers who received low-dose endotoxin (i.e., 0.4 or 0.8 ng/kg lipopolysaccharide, LPS) or placebo in three randomized, controlled studies to investigate the effects of LPS on cognitive schemata related to depression. Validated questionnaires were used to assess self-esteem, hopelessness and the vulnerability factor intolerance of uncertainty after intravenous injection of LPS or placebo. Plasma tumor necrosis factor (TNF)-α and interleukin (IL)-6 were repeatedly assessed, along with self-reported mood. Because not all questionnaires were available from primary studies, data were analyzed in two separate data sets: In data set 1, self-esteem and intolerance of uncertainty were assessed in N = 87 healthy volunteers, who randomly received either 0.4 or 0.8 ng/kg LPS or placebo. In data set 2, hopelessness was measured in N = 59 volunteers who randomly received either LPS (0.8 ng/kg) or placebo. In both data sets, LPS-application led to significant increases in TNF-α and IL-6, reflecting systemic inflammation. Positive mood was significantly decreased in response to LPS, in line with inflammation-induced mood impairment. General self-esteem, intolerance of uncertainty and hopelessness did not differ between LPS- and placebo groups, suggesting that these negative cognitive schemata are not responsive to acute LPS-induced systemic inflammation. Interestingly, LPS-treated volunteers reported significantly lower body-related self-esteem, which was associated with increased TNF-α concentration. Thus, certain aspects of self-esteem related to physical attractiveness and sportiness were reduced. It is conceivable that this effect is primarily related to physical sickness symptoms and reduced physical ability during experimental endotoxemia. With respect to cognitive symptoms of depression, it is conceivable that LPS affects cognitive processes, but not negative cognitive schemata, which are rather based on learning and repeated experiences.
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Affiliation(s)
- Simone Kotulla
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sigrid Elsenbruch
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Till Roderigo
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexandra Brinkhoff
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander Wegner
- Clinic for Trauma and Orthopedic Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Kraynak TE, Marsland AL, Wager TD, Gianaros PJ. Functional neuroanatomy of peripheral inflammatory physiology: A meta-analysis of human neuroimaging studies. Neurosci Biobehav Rev 2018; 94:76-92. [PMID: 30067939 DOI: 10.1016/j.neubiorev.2018.07.013] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 07/18/2018] [Accepted: 07/22/2018] [Indexed: 01/18/2023]
Abstract
Communication between the brain and peripheral mediators of systemic inflammation is implicated in numerous psychological, behavioral, and physiological processes. Functional neuroimaging studies have identified brain regions that associate with peripheral inflammation in humans, yet there are open questions about the consistency, specificity, and network characteristics of these findings. The present systematic review provides a meta-analysis to address these questions. Multilevel kernel density analysis of 24 studies (37 statistical maps; 264 coordinates; 457 participants) revealed consistent effects in the amygdala, hippocampus, hypothalamus, striatum, insula, midbrain, and brainstem, as well as prefrontal and temporal cortices. Effects in some regions were specific to particular study designs and tasks. Spatial pattern analysis revealed significant overlap of reported effects with limbic, default mode, ventral attention, and corticostriatal networks, and co-activation analyses revealed functional ensembles encompassing the prefrontal cortex, insula, and midbrain/brainstem. Together, these results characterize brain regions and networks associated with peripheral inflammation in humans, and they provide a functional neuroanatomical reference point for future neuroimaging studies on brain-body interactions.
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Affiliation(s)
- Thomas E Kraynak
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA; Center for the Neural Basis of Cognition, Pittsburgh, PA, 15260, USA.
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Tor D Wager
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA; Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA; Center for the Neural Basis of Cognition, Pittsburgh, PA, 15260, USA
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Quadt L, Critchley HD, Garfinkel SN. The neurobiology of interoception in health and disease. Ann N Y Acad Sci 2018; 1428:112-128. [PMID: 29974959 DOI: 10.1111/nyas.13915] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/30/2018] [Accepted: 06/05/2018] [Indexed: 12/13/2022]
Abstract
Interoception is the sensing of internal bodily sensations. Interoception is an umbrella term that encompasses (1) the afferent (body-to-brain) signaling through distinct neural and humoral (including immune and endocrine) channels; (2) the neural encoding, representation, and integration of this information concerning internal bodily state; (3) the influence of such information on other perceptions, cognitions, and behaviors; (4) and the psychological expression of these representations as consciously accessible physical sensations and feelings. Interoceptive mechanisms ensure physiological health through the cerebral coordination of homeostatic reflexes and allostatic responses that include motivational behaviors and associated affective and emotional feelings. Furthermore, the conscious, unitary sense of self in time and space may be grounded in the primacy and lifelong continuity of interoception. Body-to-brain interactions influence physical and mental well-being. Consequently, we show that systematic investigation of how individual differences, and within-individual changes, in interoceptive processing can contribute to the mechanistic understanding of physical and psychological disorders. We present a neurobiological overview of interoception and describe how interoceptive impairments at different levels relate to specific physical and mental health conditions, including sickness behaviors and fatigue, depression, eating disorders, autism, and anxiety. We frame these findings in an interoceptive predictive processing framework and highlight potential new avenues for treatments.
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Affiliation(s)
- Lisa Quadt
- Department of Psychiatry and Neuroscience, Brighton and Sussex Medical School (BSMS), Trafford Centre, University of Sussex, Brighton, United Kingdom
| | - Hugo D Critchley
- Department of Psychiatry and Neuroscience, Brighton and Sussex Medical School (BSMS), Trafford Centre, University of Sussex, Brighton, United Kingdom.,Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Sarah N Garfinkel
- Department of Psychiatry and Neuroscience, Brighton and Sussex Medical School (BSMS), Trafford Centre, University of Sussex, Brighton, United Kingdom.,Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
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Lasselin J, Lekander M, Axelsson J, Karshikoff B. Sex differences in how inflammation affects behavior: What we can learn from experimental inflammatory models in humans. Front Neuroendocrinol 2018; 50:91-106. [PMID: 29935190 DOI: 10.1016/j.yfrne.2018.06.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/29/2018] [Accepted: 06/19/2018] [Indexed: 12/12/2022]
Abstract
Human models demonstrate that experimental activation of the innate immune system has profound effects on brain activation and behavior, inducing fatigue, worsened mood and pain sensitivity. It has been proposed that inflammation is a mechanism involved in the etiology and maintenance of depression, chronic pain and long-term fatigue. These diseases show a strong female overrepresentation, suggesting that a better understanding of sex differences in how inflammation drives behavior could help the development of individualized treatment interventions. For this purpose, we here review sex differences in studies using experimental inflammatory models to investigate changes in brain activity and behavior. We suggest a model in which inflammation accentuates sex differences in brain networks and pre-existing vulnerability factors. This effect could render women more vulnerable to the detrimental effects of immune-to-brain communication over time. We call for systematic and large scale investigations of vulnerability factors for women in the behavioral response to inflammation.
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Affiliation(s)
- Julie Lasselin
- Stress Research Institute, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Essen, Germany
| | - Mats Lekander
- Stress Research Institute, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - John Axelsson
- Stress Research Institute, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Bianka Karshikoff
- Stress Research Institute, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, USA.
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Savitz J, Harrison NA. Interoception and Inflammation in Psychiatric Disorders. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:514-524. [PMID: 29884282 PMCID: PMC5995132 DOI: 10.1016/j.bpsc.2017.12.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/28/2017] [Accepted: 12/21/2017] [Indexed: 02/07/2023]
Abstract
Despite a historical focus on neurally mediated interoceptive signaling mechanisms, humoral (and even cellular) signals also play an important role in communicating bodily physiological state to the brain. These signaling pathways can perturb neuronal structure, chemistry, and function, leading to discrete changes in behavior. They are also increasingly implicated in the pathophysiology of psychiatric disorders. The importance of these humoral signaling pathways is perhaps most powerfully illustrated in the context of infection and inflammation. Here we provide an overview of how interaction of immune activation of neural and humoral interoceptive mechanisms mediates discrete changes in brain and behavior and highlight how activation of these pathways at specific points in neural development may predispose to psychiatric disorder. As our mechanistic understanding of these interoceptive pathways continues to emerge, it is revealing novel therapeutic targets, potentially heralding an exciting new era of immunotherapies in psychiatry.
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Affiliation(s)
- Jonathan Savitz
- Laureate Institute for Brain Research, the University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, the University of Tulsa, Tulsa, Oklahoma
| | - Neil A Harrison
- Clinical Imaging Sciences Centre, Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom; Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom; Sussex Partnership NHS Foundation Trust, Brighton, United Kingdom.
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Evidence of fatigue, disordered sleep and peripheral inflammation, but not increased brain TSPO expression, in seasonal allergy: A [ 11C]PBR28 PET study. Brain Behav Immun 2018; 68:146-157. [PMID: 29054675 DOI: 10.1016/j.bbi.2017.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/07/2017] [Accepted: 10/16/2017] [Indexed: 02/05/2023] Open
Abstract
Allergy is associated with non-specific symptoms such as fatigue, sleep problems and impaired cognition. One explanation could be that the allergic inflammatory state includes activation of immune cells in the brain, but this hypothesis has not been tested in humans. The aim of the present study was therefore to investigate seasonal changes in the glial cell marker translocator protein (TSPO), and to relate this to peripheral inflammation, fatigue and sleep, in allergy. We examined 18 patients with severe seasonal allergy, and 13 healthy subjects in and out-of pollen season using positron emission tomography (n = 15/13) and the TSPO radioligand [11C]PBR28. In addition, TNF-α, IL-5, IL-6, IL-8 and IFN-γ were measured in peripheral blood, and subjective ratings of fatigue and sleepiness as well as objective and subjective sleep were investigated. No difference in levels of TSPO was seen between patients and healthy subjects, nor in relation to pollen season. However, allergic subjects displayed both increased fatigue, sleepiness and increased percentage of deep sleep, as well as increased levels of IL-5 and TNF-α during pollen season, compared to healthy subjects. Allergic subjects also had shorter total sleep time, regardless of season. In conclusion, allergic subjects are indicated to respond to allergen exposure during pollen season with a clear pattern of behavioral disruption and peripheral inflammatory activation, but not with changes in brain TSPO levels. This underscores a need for development and use of more specific markers to understand brain consequences of peripheral inflammation that will be applicable in human subjects.
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Dowell NG, Bouyagoub S, Tibble J, Voon V, Cercignani M, Harrison NA. Interferon-alpha-Induced Changes in NODDI Predispose to the Development of Fatigue. Neuroscience 2017; 403:111-117. [PMID: 29292074 PMCID: PMC6458994 DOI: 10.1016/j.neuroscience.2017.12.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 12/14/2022]
Abstract
NODDI, was used to probe subtle changes to tissue microstructure associated with IFN-α. We found a strong correlation between changes in neurite density index with acute and long-term fatigue following IFN-α. This observation confirms that the striatum is a key brain area targeted by IFN with implications for impaired motivation.
Interferon-alpha (IFN-α) is an important mediator of antiviral immune responses. It is also used clinically in the treatment of hepatitis-C infection. Though effective, IFN-α-based therapies can often impair mood, motivation and cognition, which when severe can appear indistinguishable from major depression. In susceptible patients, fatigue and motivational impairment emerge early and have been linked to changes in basal ganglia (striatal) metabolism, neurochemistry and microstructural integrity. Here we use neurite orientation dispersion and density imaging (NODDI) modeling of multi-shell diffusion MRI to investigate whether changes in orientation-dispersion index (ODI) or neurite density index (NDI) can predict the later emergence of IFN-α-induced fatigue. Eighteen patients initiating IFN-α-based treatment for hepatitis-C underwent diffusion MRI and blood sampling at baseline and 4 h after their first IFN-α injection. They were then followed up with regular psychological assessments for 12 weeks of treatment. IFN-α injection stimulated an acute inflammatory cytokine response and evoked acute fatigue that peaked between 4 and 12 weeks of treatment. Within the brain, IFN-α induced an acute increase in NDI in patients that experienced a simultaneous increase in IFN-α-induced fatigue but not in patients that did not. Acute changes in striatal microstructure additionally predicted the continued development of fatigue but not mood symptoms 4 and 8 weeks later into treatment. Our findings highlight the value of NODDI as a potential in vivo biomarker of the central effects of peripheral inflammation. We highlight the exquisite sensitivity of the striatum to IFN-α and further implicate striatal perturbation in IFN-α-induced fatigue.
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Affiliation(s)
- N G Dowell
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9RR, UK.
| | - S Bouyagoub
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9RR, UK
| | - J Tibble
- Department of Gastroenterology, Brighton & Sussex University Hospitals, Brighton, UK
| | - V Voon
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0QQ, UK
| | - M Cercignani
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9RR, UK; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy
| | - N A Harrison
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9RR, UK; Sackler Centre for Consciousness Science, University of Sussex, Falmer BN1 9RR, UK; Sussex Partnership NHS Foundation Trust, Brighton, UK
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Effects of acute systemic inflammation on the interplay between sad mood and affective cognition. Transl Psychiatry 2017; 7:1281. [PMID: 29225332 PMCID: PMC5802562 DOI: 10.1038/s41398-017-0043-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/31/2017] [Accepted: 09/15/2017] [Indexed: 12/27/2022] Open
Abstract
Experimental endotoxemia is a translational model to study inflammatory mechanisms involved in the pathophysiology of mood disorders including depression. Disturbed affective cognition constitutes a core aspect in depression, but has never been studied in the context of inflammation. We combined experimental endotoxemia with an established experimental mood induction procedure to assess the interaction between acute inflammation and sad mood and their effects on affective cognition. In this randomized cross-over study, N = 15 healthy males received endotoxin (0.8 ng/kg lipopolysaccharide iv) on one study day and placebo an otherwise identical study day. The affective Go/Nogo task was conducted after experimental induction of neutral and sad mood. Inflammatory markers were assessed hourly. Endotoxin application induced a transient systemic inflammation, characterized by increased leukocyte counts, TNF-alpha and interleukin-6 plasma concentrations (all p < 0.01, interaction effects). Mood induction led to greater sadness ratings, with highest ratings when sad mood was induced during inflammation (p < 0.05, interaction effect). Based on a 2 (endotoxin vs. placebo) × 2 (sad vs. neutral mood) × 2 (sad vs. happy Go/Nogo target words) factorial design, we observed a significant target × endotoxin condition interaction (p < 0.01) reflecting slower responses to sad targets during endotoxemia. Additionally, we found a valence × mood interaction (p < 0.05), reflecting slower reaction times to sad targets in sad mood. In summary, acute inflammation and sad mood are risk factors for disturbed affective cognition. The results may reflect a mood-congruency effect, with prolonged and sustained processing of mood-congruent information during acute inflammation, which may contribute to depression risk.
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The impact of chronic mild stress on long-term depressive behavior in rats which have survived sepsis. J Psychiatr Res 2017; 94:47-53. [PMID: 28662375 DOI: 10.1016/j.jpsychires.2017.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/22/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022]
Abstract
The present study was created to investigate the effects of chronic mild stress (CMS) on the depressive behavior and neurochemical parameters of rats that were subjected to sepsis. Wistar rats were subjected to a CMS protocol, and sepsis was induced by cecal ligation and perforation (CLP). The animals were then divided into 4 separate groups; Control + Sham (n = 20), Control + CLP (n = 30), CMS + Sham (n = 20) and CMS + CLP (n = 30). Body weight, food and water intake and mortality were measured on a daily basis for a period of 10 days after the induction of sepsis. Locomotor activity, splash and forced swimming tests were performed ten days after CLP. At the end of the test period, the animals were euthanized, and the prefrontal cortex and hippocampus were removed to determine the levels of cytokines and oxidative damage. Our results show that there was no significant interaction between CMS and CLP in relation to locomotor activity and the forced swimming test. However, we did observe a significant decrease in total grooming time in the Control + CLP and CMS + Sham groups, with the CMS + CLP group showing behavior similar to that of the control animals. This was found to be related to a decrease in the levels of brain cytokines, and not to oxidative damage parameters. Collectively, our results suggest that a previous stress caused by CMS can protect the brain against the systemic acute and severe stress elicited by sepsis.
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Longitudinal co-variations between inflammatory cytokines, lung function and patient reported outcomes in patients with asthma. PLoS One 2017; 12:e0185019. [PMID: 28915273 PMCID: PMC5600400 DOI: 10.1371/journal.pone.0185019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/04/2017] [Indexed: 11/19/2022] Open
Abstract
Background Asthma is a chronic inflammatory respiratory disorder associated with reduced lung function and poor quality of life. The condition is also associated with poor self-rated health, a major predictor of objective health trajectories. Of biological correlates to self-rated health, evidence suggests a role for inflammatory cytokines and related sickness behaviours. However, this is mainly based on cross-sectional data, and the relation has not been investigated in patients with chronic inflammatory conditions. Objective To investigate inflammatory cytokines, lung function, sickness behaviour and asthma-related quality of life as determinants of self-rated health in patients with asthma, and to investigate if these variables co-vary over time. Methods Plasma cytokines (IL-5, IL-6), lung function (FEV1), sickness behaviour, asthma-related quality of life and self-rated health were assessed in 181 patients with allergic asthma aged 18–64 years in a one-year longitudinal study. Mixed effect regression models and Spearman’s correlation were performed to analyse the associations between repeated measurements. Results More sickness behaviour and poorer asthma-related quality of life were associated with poorer self-rated health (p’s<0.001). In men, both low and high levels of interleukin (IL)-6 and poorer lung function were related with poorer self-rated health (p’s<0.05). Over the year, improved asthma-related quality of life was associated with better self-rated health (Spearman’s rho = -0.34 women,-0.36 men, p’s<0.01). Further, if sickness behaviour decreased, self-rated health improved, but only in women (Rho = -0.21, p<0.05). Increased FEV1 in men was associated with an increase in IL-6 (Rho = 0.24, p<0.05) as well as improved self-rated health (Rho = -0.21, p<0.05) and asthma-related quality of life (Rho = 0.29, p<0.01) over the year. Conclusion The study highlights the importance of subjectively perceived sickness behaviour and asthma-related quality of life together with lung function as determinants of self-rated health in asthmatic patients. The importance of inflammatory activation for patient reported outcomes in chronic inflammatory conditions need further investigation.
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