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Bartlett EA, Lesanpezeshki M, Anishchenko S, Shkolnik I, Ogden RT, Mann JJ, Beylin D, Miller JM, Zanderigo F. Dynamic Human Brain Imaging with a Portable PET Camera: Comparison to a Standard Scanner. J Nucl Med 2024; 65:320-326. [PMID: 38124218 PMCID: PMC10858383 DOI: 10.2967/jnumed.122.265309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 10/19/2023] [Indexed: 12/23/2023] Open
Abstract
Portable, cost-effective PET cameras can radically expand the applicability of PET. We present here a within-participant comparison of fully quantified [18F]FDG dynamic scans in healthy volunteers using the standard Biograph mCT scanner and portable CerePET scanner. Methods: Each of 20 healthy volunteers underwent dynamic [18F]FDG imaging with both scanners (1-154 d apart) and concurrent arterial blood sampling. Tracer SUV, net influx rate (Ki), and the corresponding cerebral metabolic rate of glucose (CMRglu) were quantified at regional and voxel levels. Results: At the regional level, CerePET outcome measure estimates within participants robustly correlated with Biograph mCT estimates in the neocortex, wherein the average Pearson correlation coefficients across participants ± SD were 0.83 ± 0.07 (SUV) and 0.85 ± 0.08 (Ki and CMRglu). There was also strong agreement between CerePET and Biograph mCT estimates, wherein the average regression slopes across participants were 0.84 ± 0.17 (SUV), 0.83 ± 0.17 (Ki), and 0.85 ± 0.18 (CMRglu). There was similar bias across participants but higher correlation and less variability in subcortical regions than in cortical regions. Pearson correlation coefficients for subcortical regions equaled 0.97 ± 0.02 (SUV) and 0.97 ± 0.03 (Ki and CMRglu), and average regression slopes equaled 0.79 ± 0.14 (SUV), 0.83 ± 0.11 (Ki), and 0.86 ± 0.11 (CMRglu). In voxelwise assessment, CerePET and Biograph mCT estimates across outcome measures were significantly different only in a cluster of left frontal white matter. Conclusion: Our results indicate robust correlation and agreement between semi- and fully quantitative brain glucose metabolism measurements from portable CerePET and standard Biograph mCT scanners. The results obtained with a portable PET scanner in this comparison in humans require follow-up but lend confidence to the feasibility of more flexible and portable brain imaging with PET.
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Affiliation(s)
- Elizabeth A Bartlett
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York;
- Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - Mohammad Lesanpezeshki
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York
| | | | | | - R Todd Ogden
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University Medical Center, New York, New York
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; and
| | - J John Mann
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University Medical Center, New York, New York
- Department of Radiology, Columbia University Medical Center, New York, New York
| | | | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - Francesca Zanderigo
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University Medical Center, New York, New York
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Grifoni J, Pagani M, Persichilli G, Bertoli M, Bevacqua MG, L'Abbate T, Flamini I, Brancucci A, Cerniglia L, Paulon L, Tecchio F. Auditory Personalization of EMDR Treatment to Relieve Trauma Effects: A Feasibility Study [EMDR+]. Brain Sci 2023; 13:1050. [PMID: 37508982 PMCID: PMC10377614 DOI: 10.3390/brainsci13071050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
According to the WHO (World Health Organization), Eye Movement Desensitization and Reprocessing (EMDR) is an elective therapy to treat people with post-traumatic stress disorders (PTSD). In line with the personalization of therapeutic strategies, through this pilot study, we assessed in people suffering from the effects of trauma the feasibility, safety, acceptance, and efficacy of EMDR enriched with sound stimulation (by administering neutral sounds synchronized with the guided bilateral alternating stimulation of the gaze) and musical reward (musical listening based on the patients' predisposition and personal tastes). Feasibility, quantified by the number of patients who completed the treatment, was excellent as this was the case in 12 out of the 12 enrolled people with psychological trauma. Safety and acceptance, assessed by self-compiled questionnaires, were excellent, with an absence of side effects and high satisfaction. Efficacy, quantified by the number of EMDR treatment sessions required to reach the optimal scores on the Subjective Units of Disturbance (SUD) and Validity of Cognition (VOC) scales typical of EMDR protocols, revealed an average duration of 8.5 (SD 1.2) sessions, which is well below the 12 sessions considered a standard EMDR treatment duration. EMDR+ appears to be a relevant personalization of EMDR, particularly in music-sensitive people, consolidating the therapeutic alliance through a multisensory communicative bond for trauma treatment.
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Affiliation(s)
- Joy Grifoni
- International Telematic University Uninettuno, 00186 Rome, Italy
- LET'S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy
| | - Marco Pagani
- International Telematic University Uninettuno, 00186 Rome, Italy
- LET'S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy
| | - Giada Persichilli
- LET'S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy
| | - Massimo Bertoli
- International Telematic University Uninettuno, 00186 Rome, Italy
- LET'S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy
| | | | - Teresa L'Abbate
- International Telematic University Uninettuno, 00186 Rome, Italy
- LET'S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy
| | | | - Alfredo Brancucci
- Dipartimento di Scienze Motorie, Umane e della Salute, Università di Roma 'Foro Italico', 00135 Rome, Italy
| | - Luca Cerniglia
- International Telematic University Uninettuno, 00186 Rome, Italy
| | - Luca Paulon
- LET'S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy
- Luca Paulon, Engineer Freelance, 00159 Rome, Italy
| | - Franca Tecchio
- LET'S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy
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3
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Fu H, Rong J, Chen Z, Zhou J, Collier T, Liang SH. Positron Emission Tomography (PET) Imaging Tracers for Serotonin Receptors. J Med Chem 2022; 65:10755-10808. [PMID: 35939391 DOI: 10.1021/acs.jmedchem.2c00633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Serotonin (5-hydroxytryptamine, 5-HT) and 5-HT receptors (5-HTRs) have crucial roles in various neuropsychiatric disorders and neurodegenerative diseases, making them attractive diagnostic and therapeutic targets. Positron emission tomography (PET) is a noninvasive nuclear molecular imaging technique and is an essential tool in clinical diagnosis and drug discovery. In this context, numerous PET ligands have been developed for "visualizing" 5-HTRs in the brain and translated into human use to study disease mechanisms and/or support drug development. Herein, we present a comprehensive repertoire of 5-HTR PET ligands by focusing on their chemotypes and performance in PET imaging studies. Furthermore, this Perspective summarizes recent 5-HTR-focused drug discovery, including biased agonists and allosteric modulators, which would stimulate the development of more potent and subtype-selective 5-HTR PET ligands and thus further our understanding of 5-HTR biology.
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Affiliation(s)
- Hualong Fu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Jian Rong
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114, United States.,Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Zhen Chen
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, International Innovation Center for Forest Chemicals and Materials, College of Chemical Engineering, Nanjing Forestry University, Nanjing, Jiangsu 210037, China
| | - Jingyin Zhou
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Thomas Collier
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114, United States.,Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Steven H Liang
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114, United States.,Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115, United States
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4
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Dahl K, Johnström P, Forsberg-Morén A, Gustafsson B, Miranda-Azpiazu P, Khani Y, Halldin C, Farde L, Elmore CS, Schou M. Synthesis and Preclinical Evaluation of [ 11C]AZ11895530 for PET Imaging of the Serotonin 1A Receptor. ACS Chem Neurosci 2022; 13:2078-2083. [PMID: 35802379 DOI: 10.1021/acschemneuro.2c00205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The serotonin 1A (5-HT1A) receptor is a G-protein-coupled receptor implicated in the pathophysiology of several neuropsychiatric and neurodegenerative disorders. We here report the preparation of two candidate 5-HT1A radioligands, [11C]AZ11132132 ([11C]3) and [11C]AZ11895530 ([11C]4), and their subsequent evaluation in vitro using autoradiography and in vivo using positron emission tomography (PET). Compounds 3 and 4 were radiolabeled at high radiochemical purity (>99%) and high molar activity (>38 GBq/μmol) by heteroatom methylation with [11C]methyl iodide. Autoradiography on whole hemispheres from post-mortem human brain revealed substantial nonspecific binding of [11C]3, while the binding of [11C]4 to brain tissue was consistent with the distribution of 5-HT1A receptors and sensitive to co-incubation with the reference 5-HT1A antagonist WAY-100635 (10 μM). Following intravenous injection of [11C]4 into a cynomolgus monkey, brain radioactivity concentration (Cmax ∼ 2.2 SUV) was high whereafter it decreased rapidly. The regional binding potential (BPND) values were calculated using the simplified reference tissue model with cerebellum as reference region. The values varied between 0.2 and 1.0 for temporal cortex, raphe nuclei, frontal cortex, and hippocampus which is consistent with the known 5-HT1A expression pattern. After pretreatment with WAY100635 (0.5 mg/kg), a homogeneous distribution of radioactivity was observed in non-human primate (NHP) brain. Although [11C]4 fulfilled important criteria for successful in vivo neuroimaging, including good blood-brain-barrier permeability and high specific binding in vitro to human brain tissue, the regional BPND values for [11C]4 in NHP brain were low when compared to those obtained with existing radioligands and thus do not merit further investigation of [11C]4. Evaluation of structurally related analogues is underway in our laboratory to identify improved candidates for clinical imaging.
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Affiliation(s)
- Kenneth Dahl
- Department of Radiopharmacy, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.,Department of Oncology and Pathology, Kaolinska Institutet, SE-171 76 Stockholm, Sweden
| | - Peter Johnström
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden.,PET Science Centre at Karolinska Institutet, Precision Medicine and Biosamples, AstraZeneca, S-171 76 Stockholm, Sweden
| | - Anton Forsberg-Morén
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden
| | - Björn Gustafsson
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden
| | - Patricia Miranda-Azpiazu
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden
| | - Yaser Khani
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden
| | - Christer Halldin
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden
| | - Lars Farde
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden
| | - Charles S Elmore
- Isotope Chemistry, Early Chemical Development, Pharmaceutical Science, R&D, AstraZeneca, 431 50 Mölndal, Sweden
| | - Magnus Schou
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Hospital, S-171 76 Stockholm, Sweden.,PET Science Centre at Karolinska Institutet, Precision Medicine and Biosamples, AstraZeneca, S-171 76 Stockholm, Sweden
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5
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Lan MJ, Zanderigo F, Pantazatos SP, Sublette ME, Miller J, Ogden RT, Mann JJ. Serotonin 1A Receptor Binding of [11C]CUMI-101 in Bipolar Depression Quantified Using Positron Emission Tomography: Relationship to Psychopathology and Antidepressant Response. Int J Neuropsychopharmacol 2022; 25:534-544. [PMID: 34996114 PMCID: PMC9352178 DOI: 10.1093/ijnp/pyac001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/15/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The pathophysiology of bipolar disorder (BD) remains largely unknown despite it causing significant disability and suicide risk. Serotonin signaling may play a role in the pathophysiology, but direct evidence for this is lacking. Treatment of the depressed phase of the disorder is limited. Previous studies have indicated that positron emission tomography (PET) imaging of the serotonin 1A receptor (5HT1AR) may predict antidepressant response. METHODS A total of 20 participants with BD in a current major depressive episode and 16 healthy volunteers had PET imaging with [11C]CUMI-101, employing a metabolite-corrected input function for quantification of binding potential to the 5HT1AR. Bipolar participants then received an open-labeled, 6-week clinical trial with a selective serotonin reuptake inhibitor (SSRI) in addition to their mood stabilizer. Clinical ratings were obtained at baseline and during SSRI treatment. RESULTS Pretreatment binding potential (BPF) of [11C]CUMI-101 was associated with a number of pretreatment clinical variables within BD participants. Within the raphe nucleus, it was inversely associated with the baseline Montgomery Åsberg Rating Scale (P = .026), the Beck Depression Inventory score (P = .0023), and the Buss Durkee Hostility Index (P = .0058), a measure of lifetime aggression. A secondary analysis found [11C]CUMI-101 BPF was higher in bipolar participants compared with healthy volunteers (P = .00275). [11C]CUMI-101 BPF did not differ between SSRI responders and non-responders (P = .907) to treatment and did not predict antidepressant response (P = .580). Voxel-wise analyses confirmed the results obtained in regions of interest analyses. CONCLUSIONS A disturbance of serotonin system function is associated with both the diagnosis of BD and its severity of depression. Pretreatment 5HT1AR binding did not predict SSRI antidepressant outcome.The study was listed on clinicaltrials.gov with identifier NCT02473250.
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Affiliation(s)
- Martin J Lan
- Correspondence: Martin Lan, MD, PhD, 1051 Riverside Dr., Unit 42, New York, NY 10032, USA ()
| | - Francesca Zanderigo
- Department of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, New York, NY, USA,Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
| | - Spiro P Pantazatos
- Department of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, New York, NY, USA,Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
| | - M Elizabeth Sublette
- Department of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, New York, NY, USA,Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
| | - Jeffrey Miller
- Department of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, New York, NY, USA,Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
| | - R Todd Ogden
- Department of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, New York, NY, USA,Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
| | - J John Mann
- Department of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, New York, NY, USA,Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA,Department of Radiology, Vagelos College of Physicians and Surgeons at Columbia University, New York, NY, USA
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6
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Kondaurova EM, Plyusnina AV, Ilchibaeva TV, Eremin DV, Rodnyy AY, Grygoreva YD, Naumenko VS. Effects of a Cc2d1a/Freud-1 Knockdown in the Hippocampus on Behavior, the Serotonin System, and BDNF. Int J Mol Sci 2021; 22:ijms222413319. [PMID: 34948116 PMCID: PMC8707087 DOI: 10.3390/ijms222413319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/04/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
The serotonin 5-HT1A receptor is one of the most abundant and widely distributed brain serotonin (5-HT) receptors that play a major role in the modulation of emotions and behavior. The 5-HT1A receptor gene (Htr1a) is under the control of transcription factor Freud-1 (also known as Cc2d1a/Freud-1). Here, using adeno-associated virus (AAV) constructs in vivo, we investigated effects of a Cc2d1a/Freud-1 knockdown in the hippocampus of C57BL/6J mice on behavior, the brain 5-HT system, and brain-derived neurotrophic factor (BDNF). AAV particles carrying the pAAV_H1-2_shRNA-Freud-1_Syn_EGFP plasmid encoding a short-hairpin RNA targeting mouse Cc2d1a/Freud-1 mRNA had an antidepressant effect in the forced swim test 5 weeks after virus injection. The knockdown impaired spatiotemporal memory as assessed in the Morris water maze. pAAV_H1-2_shRNA-Freud-1_Syn_EGFP decreased Cc2d1a/Freud-1 mRNA and protein levels. Furthermore, the Cc2d1a/Freud-1 knockdown upregulated 5-HT and its metabolite 5-hydroxyindoleacetic acid but not their ratio. The Cc2d1a/Freud-1 knockdown failed to increase mRNA and protein levels of Htr1a but diminished a 5-HT1A receptor functional response. Meanwhile, the Cc2d1a/Freud-1 knockdown reduced Creb mRNA expression and CREB phosphorylation and upregulated cFos mRNA. The knockdown enhanced the expression of a BDNF precursor (proBDNF protein), which is known to play a crucial part in neuroplasticity. Our data indicate that transcription factor Cc2d1a/Freud-1 is implicated in the pathogenesis of depressive disorders not only via the 5-HT1A receptor and transcription factor CREB but also through an influence on BDNF.
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Zhang L, Zhu J, Zhang T, Jia Q, Hui L, Zhu H, Tang Y, Wang J. Comparative efficacy of add-on rTMS in treating the somatic and psychic anxiety symptoms of depression comorbid with anxiety in adolescents, adults, and elderly patients-A real-world clinical application. J Affect Disord 2020; 276:305-311. [PMID: 32871660 DOI: 10.1016/j.jad.2020.05.151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is an effective adjuvant treatment for depression. Many patients with depression have comorbid anxiety symptoms. However, previous rTMS studies have focused on patients with depression, and often excluded comorbid anxiety. This real-world study aimed to investigate the comparative efficacy of add-on rTMS in treating the somatic and psychic anxiety symptoms of depression comorbid with anxiety in adolescents, adults and elderly patients. METHODS This study included 147 depression patients with anxiety symptoms who were treated with at least 10 sessions of rTMS. The symptoms of anxiety and depression were assessed with the Hamilton Rating Scale for Anxiety (HAMA) and the Hamilton Rating Scale for Depression (HAMD) at baseline and after 2 and 4 weeks of treatment. This was done to compare the improvement degree of add-on rTMS on somatic and psychic anxiety symptoms in adolescents, adults and elderly patients respectively. RESULTS Both somatic and psychic anxiety symptoms were significantly improved after the add-on rTMS in adolescents, adults and elderly patients. The improvement of somatic anxiety was better than that of psychic anxiety after rTMS treatment in elderly patients (t2w=3.895, P<0.001; t4w=2.823, P = 0.008). LIMITATION The overall sample was mostly composed of elderly patients, while adolescents and adult patients were fewer. CONCLUSIONS The add-on rTMS treatment can improve somatic anxiety better than psychic anxiety in depression with anxiety symptoms, especially in elderly patients.
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Affiliation(s)
- Ling Zhang
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, China
| | - Junjuan Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Qiufang Jia
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, China
| | - Li Hui
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, China
| | - Hongliang Zhu
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
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8
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Narayanaswami V, Tong J, Fiorino F, Severino B, Sparaco R, Magli E, Giordano F, Bloomfield PM, Prabhakaran J, Mann JJ, Vasdev N, Dahl K, Kumar JSD. Synthesis, in vitro and in vivo evaluation of 11C-O-methylated arylpiperazines as potential serotonin 1A (5-HT 1A) receptor antagonist radiotracers. EJNMMI Radiopharm Chem 2020; 5:13. [PMID: 32430632 PMCID: PMC7237647 DOI: 10.1186/s41181-020-00096-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/23/2020] [Indexed: 01/23/2023] Open
Abstract
Background Serotonin 1A (5-HT1A) receptors are implicated in the pathogenesis of several psychiatric and neurodegenerative disorders motivating the development of suitable radiotracers for in vivo positron emission tomography (PET) neuroimaging. The gold standard PET imaging agent for this target is [carbonyl-11C]WAY-100635, labeled via a technically challenging multi-step reaction that has limited its widespread use. While several antagonist and agonist-based PET radiotracers for 5-HT 1A receptors have been developed, their clinical translation has been hindered by methodological challenges and/or and non-specific binding. As a result, there is continued interest in the development of new and more selective 5-HT1A PET tracers having a relatively easier and reliable radiosynthesis process for routine production and with favorable metabolism to facilitate tracer-kinetic modeling. The purpose of the current study was to develop and characterize a radioligand with suitable characteristics for imaging 5-HT1A receptors in the brain. The current study reports the in vitro characterization and radiosyntheses of three candidate 5-HT1A receptor antagonists, DF-100 (1), DF-300 (2) and DF-400 (3), to explore their suitability as potential PET radiotracers. Results Syntheses of 1–3 and corresponding precursors for radiolabeling were achieved from isonicotinic, picolinic acid or picolino nitrile. In vitro binding studies demonstrated nanomolar affinity of the compounds for 5-HT1A receptors. Binding of 1–3 for other biogenic amines, neurotransmitter receptors, and transporters was negligible with the exception of moderate affinities for α1-adrenergic receptors (4–6-fold less potent than that for 5-HT1A receptor). Radioligands [11C]1–3 were efficiently prepared by 11C-O-methylation of the corresponding phenolic precursor in non-decay corrected radiochemical yields of 7–11% with > 99% chemical and radiochemical purities. Dynamic PET studies in rats demonstrated negligible brain uptake of [11C]1 and [11C]2. In contrast, significant brain uptake of [11C]3 was observed with an early peak SUV of 4–5. However, [11C]3 displayed significant off-target binding attributed to α1-adrenergic receptors based on regional distribution (thalamus>hippocampus) and blocking studies. Conclusion Despite efficient radiolabeling, results from PET imaging experiments limit the application of [11C]3 for in vivo quantification of 5-HT1A receptors. Nevertheless, derivatives of compound 3 may provide a scaffold for alternative PET radiotracers with improved selectivity for 5-HT 1A receptors or α1-adrenergic receptors.
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Affiliation(s)
- Vidya Narayanaswami
- Azrieli Centre for Neuro-Radiochemistry, Research Imaging Centre & Preclinical Imaging, Centre for Addiction and Mental Health, Toronto, Ontario, M5T-1R8, Canada
| | - Junchao Tong
- Azrieli Centre for Neuro-Radiochemistry, Research Imaging Centre & Preclinical Imaging, Centre for Addiction and Mental Health, Toronto, Ontario, M5T-1R8, Canada
| | - Ferdinando Fiorino
- Department of Pharmacy, University of Naples, Via D. Montesano, 49, 8013, Naples, Italy
| | - Beatrice Severino
- Department of Pharmacy, University of Naples, Via D. Montesano, 49, 8013, Naples, Italy
| | - Rosa Sparaco
- Department of Pharmacy, University of Naples, Via D. Montesano, 49, 8013, Naples, Italy
| | - Elisa Magli
- Department of Pharmacy, University of Naples, Via D. Montesano, 49, 8013, Naples, Italy
| | - Flavia Giordano
- Department of Pharmacy, University of Naples, Via D. Montesano, 49, 8013, Naples, Italy
| | - Peter M Bloomfield
- Azrieli Centre for Neuro-Radiochemistry, Research Imaging Centre & Preclinical Imaging, Centre for Addiction and Mental Health, Toronto, Ontario, M5T-1R8, Canada
| | - Jaya Prabhakaran
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA
| | - J John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA.,Department of Psychiatry, Columbia University Medical Center, New York, USA
| | - Neil Vasdev
- Azrieli Centre for Neuro-Radiochemistry, Research Imaging Centre & Preclinical Imaging, Centre for Addiction and Mental Health, Toronto, Ontario, M5T-1R8, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T-1R8, Canada
| | - Kenneth Dahl
- Azrieli Centre for Neuro-Radiochemistry, Research Imaging Centre & Preclinical Imaging, Centre for Addiction and Mental Health, Toronto, Ontario, M5T-1R8, Canada.
| | - J S Dileep Kumar
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA.
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9
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Beaurain M, Salabert AS, Ribeiro MJ, Arlicot N, Damier P, Le Jeune F, Demonet JF, Payoux P. Innovative Molecular Imaging for Clinical Research, Therapeutic Stratification, and Nosography in Neuroscience. Front Med (Lausanne) 2019; 6:268. [PMID: 31828073 PMCID: PMC6890558 DOI: 10.3389/fmed.2019.00268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 11/01/2019] [Indexed: 01/06/2023] Open
Abstract
Over the past few decades, several radiotracers have been developed for neuroimaging applications, especially in PET. Because of their low steric hindrance, PET radionuclides can be used to label molecules that are small enough to cross the blood brain barrier, without modifying their biological properties. As the use of 11C is limited by its short physical half-life (20 min), there has been an increasing focus on developing tracers labeled with 18F for clinical use. The first such tracers allowed cerebral blood flow and glucose metabolism to be measured, and the development of molecular imaging has since enabled to focus more closely on specific targets such as receptors, neurotransmitter transporters, and other proteins. Hence, PET and SPECT biomarkers have become indispensable for innovative clinical research. Currently, the treatment options for a number of pathologies, notably neurodegenerative diseases, remain only supportive and symptomatic. Treatments that slow down or reverse disease progression are therefore the subject of numerous studies, in which molecular imaging is proving to be a powerful tool. PET and SPECT biomarkers already make it possible to diagnose several neurological diseases in vivo and at preclinical stages, yielding topographic, and quantitative data about the target. As a result, they can be used for assessing patients' eligibility for new treatments, or for treatment follow-up. The aim of the present review was to map major innovative radiotracers used in neuroscience, and explain their contribution to clinical research. We categorized them according to their target: dopaminergic, cholinergic or serotoninergic systems, β-amyloid plaques, tau protein, neuroinflammation, glutamate or GABA receptors, or α-synuclein. Most neurological disorders, and indeed mental disorders, involve the dysfunction of one or more of these targets. Combinations of molecular imaging biomarkers can afford us a better understanding of the mechanisms underlying disease development over time, and contribute to early detection/screening, diagnosis, therapy delivery/monitoring, and treatment follow-up in both research and clinical settings.
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Affiliation(s)
- Marie Beaurain
- CHU de Toulouse, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, Inserm U1214, Toulouse, France
| | - Anne-Sophie Salabert
- CHU de Toulouse, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, Inserm U1214, Toulouse, France
| | - Maria Joao Ribeiro
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Inserm CIC 1415, University Hospital, Tours, France.,CHRU Tours, Tours, France
| | - Nicolas Arlicot
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Inserm CIC 1415, University Hospital, Tours, France.,CHRU Tours, Tours, France
| | - Philippe Damier
- Inserm U913, Neurology Department, University Hospital, Nantes, France
| | | | - Jean-François Demonet
- Leenards Memory Centre, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Pierre Payoux
- CHU de Toulouse, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, Inserm U1214, Toulouse, France
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10
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Metts AV, Rubin-Falcone H, Ogden RT, Lin X, Wilner DE, Burke AK, Sublette ME, Oquendo MA, Miller JM, Mann JJ. Antidepressant medication exposure and 5-HT 1A autoreceptor binding in major depressive disorder. Synapse 2019; 73:e22089. [PMID: 30693567 DOI: 10.1002/syn.22089] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/13/2019] [Accepted: 01/23/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE We have previously reported higher brain serotonin 1A (5-HT1A ) autoreceptor binding in antidepressant-naïve patients with Major Depressive Disorder (MDD) compared with healthy volunteers, and a decrease in binding in MDD after selective serotonin reuptake inhibitor (SSRI) treatment. This SSRI effect is also present in rodents administered SSRIs chronically. We therefore sought to determine the duration of antidepressant medication effects on 5-HT1A receptor binding after medication discontinuation. METHODS Positron emission tomography (PET) imaging with the 5-HT1A receptor radioligand [11 C]WAY-100635 was performed in 66 individuals with current DSM-IV MDD to examine relationships between 5-HT1A binding and time since most recent antidepressant treatment. All subjects were medication-free for at least 2 weeks prior to scanning. Thirty-two additional MDD comparison subjects were antidepressant naïve. RESULTS No differences in [11 C]WAY-100635 binding were observed between antidepressant naïve and antidepressant exposed MDD groups in 13 a priori cortical and subcortical regions of interest, including raphe autoreceptors, assessed simultaneously in linear mixed effects models. Furthermore, [11 C]WAY-100635 binding did not correlate with time off antidepressants in the antidepressant exposed patients considering these ROIs. The same results were observed when effects of treatment discontinuation of any psychotropic medication used to treat their depression was examined. CONCLUSION These results indicate that any antidepressant-associated downregulation of 5-HT1A autoreceptor binding reverses within 2 weeks of medication discontinuation. Since this effect is hypothesized to mediate the antidepressant action of SSRIs, and perhaps other antidepressants, it suggests that patients who need ongoing treatment may relapse rapidly when medication is discontinued. Moreover, 2 weeks appears to be a sufficiently long washout of antidepressant medications for a reliable measure of illness-related binding levels.
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Affiliation(s)
- A V Metts
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - H Rubin-Falcone
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - R T Ogden
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - X Lin
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - D E Wilner
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - A K Burke
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - M E Sublette
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - M A Oquendo
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - J M Miller
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
| | - J J Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York
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11
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Liu Y, Zhao J, Fan X, Guo W. Dysfunction in Serotonergic and Noradrenergic Systems and Somatic Symptoms in Psychiatric Disorders. Front Psychiatry 2019; 10:286. [PMID: 31178761 PMCID: PMC6537908 DOI: 10.3389/fpsyt.2019.00286] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/12/2019] [Indexed: 12/20/2022] Open
Abstract
Somatic symptoms include a range of physical experiences, such as pain, muscle tension, body shaking, difficulty in breathing, heart palpitation, blushing, fatigue, and sweating. Somatic symptoms are common in major depressive disorder (MDD), anxiety disorders, and some other psychiatric disorders. However, the etiology of somatic symptoms remains unclear. Somatic symptoms could be a response to emotional distress in patients with those psychiatric conditions. Increasing evidence supports the role of aberrant serotoninergic and noradrenergic neurotransmission in somatic symptoms. The physiological alterations underlying diminished serotonin (5-HT) and norepinephrine (NE) signaling may contribute to impaired signal transduction, reduced 5-HT, or NE release from terminals of presynaptic neurons, and result in alternations in function and/or number of receptors and changes in intracellular signal processing. Multiple resources of data support each of these mechanisms. Animal models have shown physiological responses, similar to somatic symptoms seen in psychiatric patients, after manipulations of 5-HT and NE neurotransmission. Human genetic studies have identified many single-nucleotide polymorphisms risk loci associated with somatic symptoms. Several neuroimaging findings support that somatic symptoms are possibly associated with a state of reduced receptor binding. This narrative literature review aimed to discuss the involvement of serotonergic and noradrenergic systems in the pathophysiology of somatic symptoms. Future research combining neuroimaging techniques and genetic analysis to further elucidate the biological mechanisms of somatic symptoms and to develop novel treatment strategies is needed.
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Affiliation(s)
- Yi Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Xiaoduo Fan
- University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA, United States
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
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12
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Zagórska A, Partyka A, Bucki A, Kołaczkowski M, Jastrzębska‐Więsek M, Czopek A, Siwek A, Głuch‐Lutwin M, Bednarski M, Bajda M, Jończyk J, Piska K, Koczurkiewicz P, Wesołowska A, Pawłowski M. Characteristics of metabolic stability and the cell permeability of 2‐pyrimidinyl‐piperazinyl‐alkyl derivatives of 1H‐imidazo[2,1
‐f
]purine‐2,4(3
H
,8
H
)‐dione with antidepressant‐ and anxiolytic‐like activities. Chem Biol Drug Des 2018; 93:511-521. [DOI: 10.1111/cbdd.13442] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/29/2018] [Accepted: 11/03/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Agnieszka Zagórska
- Department of Medicinal ChemistryJagiellonian University Medical College Kraków Poland
| | - Anna Partyka
- Department of Clinical PharmacyJagiellonian University Medical College Kraków Poland
| | - Adam Bucki
- Department of Medicinal ChemistryJagiellonian University Medical College Kraków Poland
| | - Marcin Kołaczkowski
- Department of Medicinal ChemistryJagiellonian University Medical College Kraków Poland
| | | | - Anna Czopek
- Department of Medicinal ChemistryJagiellonian University Medical College Kraków Poland
| | - Agata Siwek
- Department of PharmacobiologyJagiellonian University Medical College Kraków Poland
| | - Monika Głuch‐Lutwin
- Department of PharmacodynamicsJagiellonian University Medical College Kraków Poland
| | - Marek Bednarski
- Department of PharmacodynamicsJagiellonian University Medical College Kraków Poland
| | - Marek Bajda
- Department of Physicochemical Drug AnalysisJagiellonian University Medical College Kraków Poland
| | - Jakub Jończyk
- Department of Physicochemical Drug AnalysisJagiellonian University Medical College Kraków Poland
| | - Kamil Piska
- Department of Pharmaceutical BiochemistryJagiellonian University Medical College Kraków Poland
| | - Paulina Koczurkiewicz
- Department of Pharmaceutical BiochemistryJagiellonian University Medical College Kraków Poland
| | - Anna Wesołowska
- Department of Clinical PharmacyJagiellonian University Medical College Kraków Poland
| | - Maciej Pawłowski
- Department of Medicinal ChemistryJagiellonian University Medical College Kraków Poland
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13
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Liu Y, Zhao J, Guo W. Emotional Roles of Mono-Aminergic Neurotransmitters in Major Depressive Disorder and Anxiety Disorders. Front Psychol 2018; 9:2201. [PMID: 30524332 PMCID: PMC6262356 DOI: 10.3389/fpsyg.2018.02201] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/24/2018] [Indexed: 12/17/2022] Open
Abstract
A growing body of researches support a role for dysfunction of serotoninergic, noradrenergic, and dopaminergic systems in the neurobiological processes involved in major depression disorder (MDD) and anxiety disorders (ADs). The physiological changes underlying abnormal signaling of 5-HT, NE, and DA may be due to either reduced presynaptic release of these neurotransmitters or aberrant signal transductions, and thus contributing to the alterations in regulation or function of receptors and/or impaired intracellular signal processing. Animal models demonstrate crucial responsiveness to disturbance of 5-HT, NE, and DA neurotransmissions. Postmortem and biochemical studies have shown altered concentrations of 5-HT, NE, and DA metabolites in brain regions that contribute importantly to regulation of mood and motivation in patients with MDD or ADs. Neuroimaging studies have found abnormal 5-HT, NE, and DA receptors binding and regulation in regard to receptor numbers. Medications that act on 5-HT, NE, and DA neurons or receptors, such as SSRIs and SNRIs, show efficacy in both MDD and ADs. The overlapping treatment response presumably suggests a common mechanism underlying the interaction of these disorders. In this paper, we reviewed studies from multiple disciplines to interpret the role of altered 5-HT, NE and DA mono-amine neurotransmitter functions in both MDD and ADs.
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Affiliation(s)
- Yi Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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14
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Parris MS, Marver JE, Chaudhury SR, Ellis SP, Metts AV, Keilp JG, Burke AK, Oquendo MA, Mann JJ, Grunebaum MF. Effects of anxiety on suicidal ideation: exploratory analysis of a paroxetine versus bupropion randomized trial. Int Clin Psychopharmacol 2018; 33:249-254. [PMID: 29864037 PMCID: PMC6066420 DOI: 10.1097/yic.0000000000000225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
It is unclear whether anxiety increases or decreases suicidal risk. This may contribute to the lack of guidance on which antidepressant medications are best for suicidal depressed patients who present with high anxiety. This study explored whether anxiety predicts suicidal ideation in depressed individuals treated with paroxetine or bupropion. An 8-week double-blind trial comparing controlled-release paroxetine (N=36) versus extended-release bupropion (N=38) for effect on suicidal ideation and behavior in depressed patients with suicidal ideation, past attempt, or both found an advantage for paroxetine, but anxiety effects were not investigated. This secondary analysis explored the relationship, measured at baseline and weekly, of anxiety with suicidal ideation. Anxiety severity measured weekly correlated with suicidal ideation severity irrespective of treatment (P=0.012). Patients with high baseline anxiety showed a trend toward faster reduction of suicidal ideation with paroxetine compared with bupropion treatment (standard P=0.047; bootstrap P=0.077). The latter finding, if confirmed in larger samples, could enhance choice of antidepressant medication for suicidal, depressed patients presenting with high levels of anxiety.
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Affiliation(s)
- Michelle S Parris
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - Julia E Marver
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - Sadia R Chaudhury
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - Steven P Ellis
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - Allison V Metts
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - John G Keilp
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - Ainsley K Burke
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joseph J Mann
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
| | - Michael F Grunebaum
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, New York
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15
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Philippe TJ, Vahid-Ansari F, Donaldson ZR, Le François B, Zahrai A, Turcotte-Cardin V, Daigle M, James J, Hen R, Merali Z, Albert PR. Loss of MeCP2 in adult 5-HT neurons induces 5-HT1A autoreceptors, with opposite sex-dependent anxiety and depression phenotypes. Sci Rep 2018; 8:5788. [PMID: 29636529 PMCID: PMC5893553 DOI: 10.1038/s41598-018-24167-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/27/2018] [Indexed: 12/11/2022] Open
Abstract
The 5-HT1A autoreceptor mediates feedback inhibition of serotonin (5-HT) neurons, and is implicated in major depression. The human 5-HT1A gene (HTR1A) rs6295 risk allele prevents Deaf1 binding to HTR1A, resulting in increased 5-HT1A autoreceptor transcription. Since chronic stress alters HTR1A methylation and expression, we addressed whether recruitment of methyl-binding protein MeCP2 may alter Deaf1 regulation at the HTR1A locus. We show that MeCP2 enhances Deaf1 binding to its HTR1A site and co-immunoprecipitates with Deaf1 in cells and brain tissue. Chromatin immunoprecipitation assays showed Deaf1-dependent recruitment of MeCP2 to the mouse HTR1A promoter, and MeCP2 modulated human and mouse HTR1A gene transcription in a Deaf1-dependent fashion, enhancing Deaf1-induced repression at the Deaf1 site. To address the role of MeCP2 in HTR1A regulation in vivo, mice with conditional knockout of MeCP2 in adult 5-HT neurons (MeCP2 cKO) were generated. These mice exhibited increased 5-HT1A autoreceptor levels and function, consistent with MeCP2 enhancement of Deaf1 repression in 5-HT neurons. Interestingly, female MeCP2-cKO mice displayed reduced anxiety, while males showed increased anxiety and reduced depression-like behaviors. These data uncover a novel role for MeCP2 in 5-HT neurons to repress HTR1A expression and drive adult anxiety- and depression-like behaviors in a sex-specific manner.
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Affiliation(s)
- Tristan J Philippe
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Faranak Vahid-Ansari
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Zoe R Donaldson
- Department of Molecular, Cellular, and Developmental Biology and Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Brice Le François
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Amin Zahrai
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Valérie Turcotte-Cardin
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Mireille Daigle
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Jonathan James
- The Royal's Institute of Mental Health, affiliated with the University of Ottawa, Ottawa, ON, Canada
| | - René Hen
- New York State Psychiatric Institute, Columbia University Medical Center and Research Foundation for Mental Hygiene, New York, NY, USA.,Department of Psychiatry, Columbia University, New York, NY, USA
| | - Zul Merali
- The Royal's Institute of Mental Health, affiliated with the University of Ottawa, Ottawa, ON, Canada
| | - Paul R Albert
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada. .,Department of Cellular and Molecular Medicine, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada.
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16
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Iscan Z, Rakesh G, Rossano S, Yang J, Zhang M, Miller J, Sullivan GM, Sharma P, McClure M, Oquendo MA, Mann JJ, Parsey RV, DeLorenzo C. A positron emission tomography study of the serotonergic system in relation to anxiety in depression. Eur Neuropsychopharmacol 2017; 27:1011-1021. [PMID: 28811068 PMCID: PMC5623123 DOI: 10.1016/j.euroneuro.2017.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 06/02/2017] [Accepted: 07/29/2017] [Indexed: 12/17/2022]
Abstract
Symptoms of anxiety are highly comorbid with major depressive disorder (MDD) and are known to alter the course of the disease. To help elucidate the biological underpinnings of these prevalent disorders, we previously examined the relationship between components of anxiety (somatic, psychic and motoric) and serotonin 1A receptor (5-HT1A) binding in MDD and found that higher psychic and lower somatic anxiety was associated with greater 5-HT1A binding. In this work, we sought to examine the correlation between these anxiety symptom dimensions and 5-HTT binding. Positron emission tomography with [11C]-3-amino-4-(3-dimethylamino-methylphenylsulfanyl)-benzonitrile ([11C]DASB) and a metabolite-corrected arterial input function were used to estimate regional 5-HTT binding in 55 subjects with MDD and anxiety symptoms. Somatic anxiety was negatively correlated with 5-HTT binding in the thalamus (β=-.33, p=.025), amygdala (β=-.31, p=.007) and midbrain (β=-.72, p<.001). Psychic anxiety was positively correlated with 5-HTT binding in midbrain only (β=.46, p=.0025). To relate to our previous study, correlation between 5-HT1A and 5-HTT binding was examined, and none was found. We also examined how much of the variance in anxiety symptom dimensions could be explained by both 5-HTT and 5-HT1A binding. The developed model was able to explain 68% (p<.001), 38% (p=.012) and 32% (p=.038) of the total variance in somatic, psychic, and motoric anxiety, respectively. Results indicate the tight coupling between the serotonergic system and anxiety components, which may be confounded when using aggregate anxiety measures. Uncovering serotonin's role in anxiety and depression in this way may give way to a new generation of therapeutics and treatment strategies.
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Affiliation(s)
- Zafer Iscan
- Centre for Cognition and Decision Making, National Research University, Higher School of Economics, Russian Federation; Cognitive Neuroimaging Unit, CEA DRF/Joliot Institute, INSERM, Université Paris-Sud, Université Paris-Saclay, NeuroSpin Center, 91191 Gif-sur-Yvette, France.
| | | | - Samantha Rossano
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Jie Yang
- Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Mengru Zhang
- Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jeffrey Miller
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Gregory M Sullivan
- Tonix Pharmaceuticals, Inc., 509 Madison Avenue Suite 306, New York, NY, USA
| | - Priya Sharma
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Matthew McClure
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Maria A Oquendo
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - J John Mann
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
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17
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Kaneko F, Kawahara Y, Kishikawa Y, Hanada Y, Yamada M, Kakuma T, Kawahara H, Nishi A. Long-Term Citalopram Treatment Alters the Stress Responses of the Cortical Dopamine and Noradrenaline Systems: the Role of Cortical 5-HT1A Receptors. Int J Neuropsychopharmacol 2016; 19:pyw026. [PMID: 27029212 PMCID: PMC5006198 DOI: 10.1093/ijnp/pyw026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 03/23/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cortical dopamine and noradrenaline are involved in the stress response. Citalopram, a selective serotonin reuptake inhibitor, has direct and indirect effects on the serotonergic system. Furthermore, long-term treatment with citalopram affects the dopamine and noradrenaline systems, which could contribute to the therapeutic action of antidepressants. METHODS The effects of long-term treatment with citalopram on the responses of the dopamine and noradrenaline systems in the rat prefrontal cortex to acute handling stress were evaluated using in vivo microdialysis. RESULTS Acute handling stress increased dopamine and noradrenaline levels in the prefrontal cortex. The dopamine and noradrenaline responses were suppressed by local infusion of a 5-HT1A receptor agonist, 7-(Dipropylamino)-5,6,7,8-tetrahydronaphthalen-1-ol;hydrobromide, into the prefrontal cortex. The dopamine response was abolished by long-term treatment with citalopram, and the abolished dopamine response was reversed by local infusion of a 5-HT1A receptor antagonist, (Z)-but-2-enedioic acid;N-[2-[4-(2-methoxyphenyl)piperazin-1-yl]ethyl]-N-pyridin-2-ylcyclohexanecarboxamide into the prefrontal cortex. On the other hand, long-term treatment with citalopram reduced the basal noradrenaline levels (approximately 40% of the controls), but not the basal dopamine levels. The noradrenaline response was maintained despite the low basal noradrenaline levels. Signaling from the 5-HT1A receptors and α2-adrenoceptors was not involved in the decrease in the basal noradrenaline levels but partially affected the noradrenaline response. CONCLUSIONS Chronic citalopram treatment differentially suppresses the dopamine and noradrenaline systems in the prefrontal cortex, and the dopamine stress response was preferentially controlled by upregulating 5-HT1A receptor signaling. Our findings provide insight into how antidepressants modulate the dopamine and noradrenaline systems to overcome acute stress.
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Affiliation(s)
| | - Yukie Kawahara
- Department of Pharmacology, Kurume University School of Medicine, Kurume, Fukuoka, Japan (Ms Kaneko and Drs Kawahara, Kishikawa, Hanada, and Nishi); Department of Psychiatry, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan (Dr Yamada); Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan (Dr Kakuma); Department of Dental Anesthesiology, School of Dentistry, Tsurumi University, Tsurumi-ku, Yokohama, Kanagawa, Japan (Dr Kawahara).
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18
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Miller JM, Everett BA, Oquendo MA, Ogden RT, Mann JJ, Parsey RV. Positron emission tomography quantification of serotonin transporter binding in medication-free bipolar disorder. Synapse 2016; 70:24-32. [PMID: 26426356 PMCID: PMC4654655 DOI: 10.1002/syn.21868] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/26/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) is associated with abnormalities in the serotonin transporter (5-HTT), but specific in vivo findings have been discrepant. Using positron emission tomography (PET) and [(11)C]DASB, we compared 5-HTT binding between unmedicated depressed BD subjects and healthy volunteers (HVs). EXPERIMENTAL DESIGN 5-HTT binding in six brain regions was compared between 17 depressed, unmedicated BD subjects and 31 HVs, using the outcome measure of VT/fP (proportional to the total number of available transporters). Alternative outcome measures were examined as well. 47% of BD were BP I; and 65% reported a prior suicide attempt. PRINCIPAL OBSERVATIONS 5-HTT binding (VT/fP ) did not differ between BD and HV groups considering six brain regions of interest simultaneously (P = 0.24). In contrast, alternative outcome measures (BPF*, BPP*, and BPND*) indicated lower binding in BD compared with HV across these six regions of interest (BPF*: P = 0.047; BPP*: P = 0.032; BPND*: P = 0.031). 5-HTT binding was unrelated to suicide attempt history, depression severity, bipolar subtype, or history of past substance use disorder. CONCLUSIONS Choice of outcome measure strongly affects comparisons of serotonin transporter binding using PET with [(11)C]DASB. We do not find evidence of abnormal 5-HTT binding in bipolar depression using our primary outcome measure, VT /fP . However, we did observe lower 5-HTT binding in BD with alternative outcome measures that are frequently used with [(11)C]DASB. Relative merits and assumptions of different outcome measures are discussed. Evaluation in larger samples and during different mood states, including remission, is warranted.
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Affiliation(s)
- Jeffrey M. Miller
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
| | - Benjamin A. Everett
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - Maria A. Oquendo
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
| | - R. Todd Ogden
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - J. John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
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Beliveau V, Svarer C, Frokjaer VG, Knudsen GM, Greve DN, Fisher PM. Functional connectivity of the dorsal and median raphe nuclei at rest. Neuroimage 2015; 116:187-95. [PMID: 25963733 DOI: 10.1016/j.neuroimage.2015.04.065] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/31/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022] Open
Abstract
Serotonin (5-HT) is a neurotransmitter critically involved in a broad range of brain functions and implicated in the pathophysiology of neuropsychiatric illnesses including major depression, anxiety and sleep disorders. Despite being widely distributed throughout the brain, there is limited knowledge on the contribution of 5-HT to intrinsic brain activity. The dorsal raphe (DR) and median raphe (MR) nuclei are the source of most serotonergic neurons projecting throughout the brain and thus provide a compelling target for a seed-based probe of resting-state activity related to 5-HT. Here we implemented a novel multimodal neuroimaging approach for investigating resting-state functional connectivity (FC) between DR and MR and cortical, subcortical and cerebellar target areas. Using [(11)C]DASB positron emission tomography (PET) images of the brain serotonin transporter (5-HTT) combined with structural MRI from 49 healthy volunteers, we delineated DR and MR and performed a seed-based resting-state FC analysis. The DR and MR seeds produced largely similar FC maps: significant positive FC with brain regions involved in cognitive and emotion processing including anterior cingulate, amygdala, insula, hippocampus, thalamus, basal ganglia and cerebellum. Significant negative FC was observed within pre- and postcentral gyri for the DR but not for the MR seed. We observed a significant association between DR and MR FC and regional 5-HTT binding. Our results provide evidence for a resting-state network related to DR and MR and comprising regions receiving serotonergic innervation and centrally involved in 5-HT related behaviors including emotion, cognition and reward processing. These findings provide a novel advance in estimating resting-state FC related to 5-HT signaling, which can benefit our understanding of its role in behavior and neuropsychiatric illnesses.
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Affiliation(s)
- Vincent Beliveau
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Claus Svarer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Douglas N Greve
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Patrick M Fisher
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark.
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Sullivan GM, Oquendo MA, Milak M, Miller JM, Burke A, Ogden RT, Parsey RV, Mann JJ. Positron emission tomography quantification of serotonin(1A) receptor binding in suicide attempters with major depressive disorder. JAMA Psychiatry 2015; 72:169-78. [PMID: 25549105 PMCID: PMC4329977 DOI: 10.1001/jamapsychiatry.2014.2406] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Serotonergic system dysfunction has been associated with increased lethal suicide attempts and suicide. Dysfunction includes higher binding of serotonin(1A) autoreceptor in the brainstem raphe of individuals who die by suicide. OBJECTIVES To determine the relationships between brain serotonin(1A) binding and suicidal behavior in vivo in major depressive disorder (MDD) using positron emission tomography and the serotonin(1A) antagonist radiotracer carbon C 11 [11C]-labeled WAY-100635. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional positron emission tomography study at an academic medical center from 1999 through 2009. We compared serotonin(1A) binding between individuals with MDD who did not attempt suicide (nonattempters) (n = 62) and those who attempted suicide (attempters) (n = 29). We subdivided the attempters into those with lower (n = 16) and higher (n = 13) levels of lethality. MAIN OUTCOMES AND MEASURES The binding potential (BPF) of [11C]WAY-100635 (calculated as the number of receptors available divided by affinity) in the prefrontal cortex (PFC) and brainstem, estimated by kinetic modeling with an arterial input function; the severity of suicidal behaviors, including lethality and intent of suicide attempts; and suicidal ideation. RESULTS Using a linear mixed-effects model, we found no difference between attempters and nonattempters with MDD in serotonin(1A) BPF in the PFC regions (F1,88 = 0.03; P = .87) or in the raphe nuclei (F1,88 = 0.29; P = .59). Raphe nuclei serotonin(1A) BPF was 45.1% greater in higher-lethality attempters compared with lower-lethality attempters (F1,25 = 7.33; P = .01), whereas no difference was observed in the PFC regions (F1,25 = 0.12; P = .73). Serotonin(1A )BPF in the raphe nuclei of suicide attempters was positively correlated with the lethality rating (F1,25 = 10.56; P = .003) and the subjective lethal intent factor (F1,25 = 10.63; P = .003; R2 = 0.32) based on the most recent suicide attempt. Suicide ideation in participants with MDD was positively correlated with serotonin(1A) BPF in the PFC regions (F1,88 = 5.19; P = .03) and in the raphe nuclei (F1,87 = 7.38; P = .008; R2 = 0.12). CONCLUSIONS AND RELEVANCE Higher brainstem raphe serotonin(1A)BPF observed in higher-lethality suicide attempters with MDD is in agreement with findings in suicide studies and also with the finding of low cerebrospinal fluid levels of 5-hydroxyindoleacetic acid in higher-lethality suicide attempters. Higher brainstem raphe serotonin(1A) BPF would be consistent with lower levels of serotonin neuron firing and release and supports a model of impaired serotonin signaling in suicide and higher-lethality suicidal behavior. Severity of suicidal ideation in MDD is related to brainstem and prefrontal serotonin(1A) BPF, suggesting a role for both regions in suicidal ideation. Lower levels of serotonin release at key brain projection sites, such as the prefrontal regions, may favor more severe suicidal ideation and higher-lethality suicide attempts.
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Affiliation(s)
- Gregory M. Sullivan
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York2Department of Psychiatry, Columbia University, New York, New York3currently with Tonix Pharmaceuticals, LLC, New York, New York
| | - Maria A. Oquendo
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York2Department of Psychiatry, Columbia University, New York, New York
| | - Matthew Milak
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York2Department of Psychiatry, Columbia University, New York, New York
| | - Jeffrey M. Miller
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York2Department of Psychiatry, Columbia University, New York, New York
| | - Ainsley Burke
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York2Department of Psychiatry, Columbia University, New York, New York
| | - R. Todd Ogden
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York2Department of Psychiatry, Columbia University, New York, New York4Department of Biostatistics, Mailman School of Public Health, Columbia University, New York
| | - Ramin V. Parsey
- currently with Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, Stony Brook, New York
| | - J. John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York2Department of Psychiatry, Columbia University, New York, New York6Department of Radiology, Columbia University, New York, New York
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Mann JJ, Oquendo MA, Watson KT, Boldrini M, Malone KM, Ellis SP, Sullivan G, Cooper TB, Xie S, Currier D. Anxiety in major depression and cerebrospinal fluid free gamma-aminobutyric acid. Depress Anxiety 2014; 31:814-21. [PMID: 24865448 PMCID: PMC4797625 DOI: 10.1002/da.22278] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 01/22/2014] [Accepted: 04/18/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Low gamma-aminobutyric acid (GABA) is implicated in both anxiety and depression pathophysiology. They are often comorbid, but most clinical studies have not examined these relationships separately. We investigated the relationship of cerebrospinal fluid (CSF) free GABA to the anxiety and depression components of a major depressive episode (MDE) and to monoamine systems. METHODS AND MATERIALS Patients with a DSM-IV major depressive episode (N = 167: 130 major depressive disorder; 37 bipolar disorder) and healthy volunteers (N = 38) had CSF free GABA measured by gas chromatography mass spectroscopy. Monoamine metabolites were assayed by high performance liquid chromatography. Symptomatology was assessed by Hamilton depression rating scale. RESULTS Psychic anxiety severity increased with age and correlated with lower CSF free GABA, controlling for age. CSF free GABA declined with age but was not related to depression severity. Other monoamine metabolites correlated positively with CSF GABA but not with psychic anxiety or depression severity. CSF free GABA was lower in MDD compared with bipolar disorder and healthy volunteers. GABA levels did not differ based on a suicide attempt history in mood disorders. Recent exposure to benzodiazepines, but not alcohol or past alcoholism, was associated with a statistical trend for more severe anxiety and lower CSF GABA. CONCLUSIONS Lower CSF GABA may explain increasing severity of psychic anxiety in major depression with increasing age. This relationship is not seen with monoamine metabolites, suggesting treatments targeting the GABAergic system should be evaluated in treatment-resistant anxious major depression and in older patients.
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Affiliation(s)
- J. John Mann
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, New York,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, New York,Department of Radiology, Columbia University, 1051 Riverside Drive, New York, New York,Correspondence to: J. John Mann M.D., Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Box 42, New York, NY 10032.
| | - Maria A. Oquendo
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, New York,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, New York
| | - Kalycia Trishana Watson
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, New York,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, New York
| | - Maura Boldrini
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, New York,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, New York
| | - Kevin M. Malone
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, New York,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, New York
| | - Steven P. Ellis
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, New York,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, New York
| | - Gregory Sullivan
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, New York,Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, New York
| | - Thomas B. Cooper
- Department of Analytical Psychopharmacology, the Nathan Klein Institute, Columbia University, 1051 Riverside Drive, New York, New York
| | - Shan Xie
- Department of Analytical Psychopharmacology, the Nathan Klein Institute, Columbia University, 1051 Riverside Drive, New York, New York
| | - Dianne Currier
- The Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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García G, Abet V, Alajarín R, Álvarez-Builla J, Delgado M, García-García L, Bascuñana-Almarcha P, Peña-Salcedo C, Kelly J, Pozo MA. N-(4-[(18)F]-fluoropyridin-2-yl)-N-{2-[4-(2-methoxyphenyl)piperazin-1-yl]ethyl}carboxamides as analogs of WAY100635. New PET tracers of serotonin 5-HT(1A) receptors. Eur J Med Chem 2014; 85:795-806. [PMID: 25171752 DOI: 10.1016/j.ejmech.2014.07.096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/24/2014] [Accepted: 07/25/2014] [Indexed: 10/25/2022]
Abstract
N-(4-[(18)F]-Fluoropyridin-2-yl)-N-{2-[4-(2-methoxyphenyl)piperazin-1-yl]ethyl}-carboxamides were prepared by labeling their 4-nitropyridin-2-yl precursors through nitro substitution by the (18)F anion. In vitro and in vivo tests showed that the cyclohexanecarboxamide derivative is a reversible, selective and high affinity 5-HT1A receptor antagonist (IC50 = 0.29 nM, ki = 0.18 nM) with high brain uptake, slow brain clearance and stability to defluorination when compared with conventional standards. This PET radioligand is a promising candidate for an improved in vivo quantification of 5-HT1A receptors in neuropsychiatric disorders.
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Affiliation(s)
- Gonzalo García
- Departamento de Química Orgánica, Universidad de Alcalá, Alcalá de Henares, Madrid 28871, Spain
| | - Valentina Abet
- Departamento de Química Orgánica, Universidad de Alcalá, Alcalá de Henares, Madrid 28871, Spain
| | - Ramón Alajarín
- Departamento de Química Orgánica, Universidad de Alcalá, Alcalá de Henares, Madrid 28871, Spain
| | - Julio Álvarez-Builla
- Departamento de Química Orgánica, Universidad de Alcalá, Alcalá de Henares, Madrid 28871, Spain.
| | - Mercedes Delgado
- CAI Cartografía Cerebral, Instituto Pluridisciplinar UCM, Paseo Juan XXIII, 1, Madrid 28040, Spain
| | - Luis García-García
- CAI Cartografía Cerebral, Instituto Pluridisciplinar UCM, Paseo Juan XXIII, 1, Madrid 28040, Spain
| | - Pablo Bascuñana-Almarcha
- CAI Cartografía Cerebral, Instituto Pluridisciplinar UCM, Paseo Juan XXIII, 1, Madrid 28040, Spain
| | - Carmen Peña-Salcedo
- Instituto Tecnológico PET, Calle Manuel Bartolomé Cossío 10, Madrid 28040, Spain
| | - James Kelly
- Instituto Tecnológico PET, Calle Manuel Bartolomé Cossío 10, Madrid 28040, Spain
| | - Miguel A Pozo
- CAI Cartografía Cerebral, Instituto Pluridisciplinar UCM, Paseo Juan XXIII, 1, Madrid 28040, Spain; Instituto Tecnológico PET, Calle Manuel Bartolomé Cossío 10, Madrid 28040, Spain.
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Miller JM, Hesselgrave N, Ogden RT, Zanderigo F, Oquendo MA, Mann JJ, Parsey RV. Brain serotonin 1A receptor binding as a predictor of treatment outcome in major depressive disorder. Biol Psychiatry 2013; 74:760-7. [PMID: 23664414 PMCID: PMC4066966 DOI: 10.1016/j.biopsych.2013.03.021] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 03/22/2013] [Accepted: 03/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND We previously reported higher serotonin 1A receptor (5-HT1A) binding in subjects with major depressive disorder (MDD) during a major depressive episode using positron emission tomography imaging with [(11)C]WAY-100635. 5-HT1A receptor binding is also associated with treatment outcome after nonstandardized antidepressant treatment. We examined whether pretreatment 5-HT1A binding is associated with treatment outcome following standardized escitalopram treatment in MDD. We also compared 5-HT1A binding between all MDD subjects in this cohort and a sample of healthy control subjects. METHODS Twenty-four MDD subjects in a current major depressive episode and 51 previously studied healthy control subjects underwent positron emission tomography scanning with [(11)C]WAY-100635, acquiring a metabolite-corrected arterial input function and free-fraction measurement to estimate 5-HT1A binding potential (BPF = Bmax/KD, where Bmax = available receptors and KD = dissociation constant). Major depressive disorder subjects then received 8 weeks of treatment with escitalopram; remission was defined as a posttreatment 24-item Hamilton Depression Rating Scale <10 and ≥ 50% reduction in Hamilton Depression Rating Scale. RESULTS Remitters to escitalopram had 33% higher baseline 5-HT1A binding in the raphe nuclei than nonremitters (p = .047). Across 12 cortical and subcortical regions, 5-HT1A binding did not differ between remitters and nonremitters (p = .86). Serotonin 1A receptor binding was higher in MDD than control subjects across all regions (p = .0003). Remitters did not differ from nonremitters in several relevant clinical measures. CONCLUSIONS Elevated 5-HT1A binding in raphe nuclei is associated with subsequent remission with the selective serotonin reuptake inhibitor escitalopram; this is consistent with data from a separate cohort receiving naturalistic antidepressant treatment. We confirmed our previous findings of higher 5-HT1A binding in current MDD compared with control subjects.
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Affiliation(s)
- Jeffrey M Miller
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York; Department of Psychiatry, Columbia University, New York.
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Serotonin 5-HT1A receptors as targets for agents to treat psychiatric disorders: rationale and current status of research. CNS Drugs 2013; 27:703-16. [PMID: 23757185 DOI: 10.1007/s40263-013-0071-0] [Citation(s) in RCA: 225] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Psychiatric disorders represent a large economic burden in modern societies. However, pharmacological treatments are still far from optimal. Drugs used in the treatment of major depressive disorder (MDD) and anxiety disorders (selective serotonin [5-HT] reuptake inhibitors [SSRIs] and serotonin-noradrenaline reuptake inhibitors [SNRIs]) are pharmacological refinements of first-generation tricyclic drugs, discovered by serendipity, and show low efficacy and slowness of onset. Moreover, antipsychotic drugs are partly effective in positive symptoms of schizophrenia, yet they poorly treat negative symptoms and cognitive deficits. The present article reviews the neurobiological basis of 5-HT1A receptor (5-HT1A-R) function and the role of pre- and postsynaptic 5-HT1A-Rs in the treatment of MDD, anxiety and psychotic disorders. The activation of postsynaptic 5-HT1A-Rs in corticolimbic areas appears beneficial for the therapeutic action of antidepressant drugs. However, presynaptic 5-HT1A-Rs play a detrimental role in MDD, since individuals with high density or function of presynaptic 5-HT1A-Rs are more susceptible to mood disorders and suicide, and respond poorly to antidepressant drugs. Moreover, the indirect activation of presynaptic 5-HT1A-Rs by SSRIs/SNRIs reduces 5-HT neuron activity and terminal 5-HT release, thus opposing the elevation of extracellular 5-HT produced by blockade of the serotonin transporter (SERT) in the forebrain. Chronic antidepressant treatment desensitizes presynaptic 5-HT1A-Rs, thus reducing the effectiveness of the 5-HT1A autoreceptor-mediated negative feedback. The prevention of this process by the non-selective partial agonist pindolol accelerates clinical antidepressant effects. Two new antidepressant drugs, vilazodone (marketed in the USA) and vortioxetine (in development) incorporate partial 5-HT1A-R agonist properties with SERT blockade. Several studies with transgenic mice have also established the respective role of pre- and postsynaptic 5-HT1A-Rs in MDD and anxiety. In agreement with pharmacological studies, presynaptic and postsynaptic 5-HT1A-R activation appears necessary for anxiolytic and antidepressant effects, respectively, yet, neurodevelopmental roles for 5-HT1A-Rs are also involved. Likewise, the use of small interference RNA has enabled the showing of robust antidepressant-like effects in mice after selective knock-down of 5-HT1A autoreceptors. Postsynaptic 5-HT1A-Rs in the prefrontal cortex (PFC) also appear important for the superior clinical effects of clozapine and other second-generation (atypical) antipsychotic drugs in the treatment of schizophrenia and related psychotic disorders. Despite showing a moderate in vitro affinity for 5-HT1A-Rs in binding assays, clozapine displays functional agonist properties at this receptor type in vivo. The stimulation of 5-HT1A-Rs in the PFC leads to the distal activation of the mesocortical pathway and to an increased dopamine release in PFC, an effect likely involved in the clinical actions of clozapine in negative symptoms and cognitive deficits in schizophrenia. The anxiolytic/antidepressant properties of 5-HT1A-R agonists in preclinical tests raised expectations enormously. However, these agents have achieved little clinical success, possibly due to their partial agonist character at postsynaptic 5-HT1A-Rs, together with full agonist properties at presynaptic 5-HT1A autoreceptors, as well as their gastrointestinal side effects. The partial 5-HT1A-R agonists buspirone, gepirone, and tandospirone are marketed as anxiolytic drugs, and buspirone is also used as an augmentation strategy in MDD. The development of new 5-HT1A-R agonists with selectivity for postsynaptic 5-HT1A-Rs may open new perspectives in the field.
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Miller JM, Hesselgrave N, Ogden RT, Sullivan GM, Oquendo MA, Mann JJ, Parsey RV. Positron emission tomography quantification of serotonin transporter in suicide attempters with major depressive disorder. Biol Psychiatry 2013; 74:287-95. [PMID: 23453288 PMCID: PMC3725207 DOI: 10.1016/j.biopsych.2013.01.024] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/12/2012] [Accepted: 01/18/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Several lines of evidence implicate abnormal serotonergic function in suicidal behavior and completed suicide, including low serotonin transporter binding in postmortem studies of completed suicide. We have also reported low in vivo serotonin transporter binding in major depressive disorder (MDD) during a major depressive episode using positron emission tomography (PET) with [(11)C]McN5652. We quantified regional brain serotonin transporter binding in vivo in depressed suicide attempters, depressed nonattempters, and healthy controls using PET and a superior radiotracer, [(11)C]DASB. METHODS Fifty-one subjects with DSM-IV current MDD, 15 of whom were past suicide attempters, and 32 healthy control subjects underwent PET scanning with [(11)C]DASB to quantify in vivo regional brain serotonin transporter binding. Metabolite-corrected arterial input functions and plasma free-fraction were acquired to improve quantification. RESULTS Depressed suicide attempters had lower serotonin transporter binding in midbrain compared with depressed nonattempters (p = .031) and control subjects (p = .0093). There was no difference in serotonin transporter binding comparing all depressed subjects with healthy control subjects considering six a priori regions of interest simultaneously (p = .41). CONCLUSIONS Low midbrain serotonin transporter binding appears to be related to the pathophysiology of suicidal behavior rather than of major depressive disorder. This is consistent with postmortem work showing low midbrain serotonin transporter binding capacity in depressed suicides and may partially explain discrepant in vivo findings quantifying serotonin transporter in depression. Future studies should investigate midbrain serotonin transporter binding as a predictor of suicidal behavior in MDD and determine the cause of low binding.
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Affiliation(s)
- Jeffrey M Miller
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY 10043, USA.
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Zhu H, Bogdanov MB, Boyle SH, Matson W, Sharma S, Matson S, Churchill E, Fiehn O, Rush JA, Krishnan RR, Pickering E, Delnomdedieu M, Kaddurah-Daouk R. Pharmacometabolomics of response to sertraline and to placebo in major depressive disorder - possible role for methoxyindole pathway. PLoS One 2013; 8:e68283. [PMID: 23874572 PMCID: PMC3714282 DOI: 10.1371/journal.pone.0068283] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 05/28/2013] [Indexed: 12/05/2022] Open
Abstract
Therapeutic response to selective serotonin (5-HT) reuptake inhibitors in Major Depressive Disorder (MDD) varies considerably among patients, and the onset of antidepressant therapeutic action is delayed until after 2 to 4 weeks of treatment. The objective of this study was to analyze changes within methoxyindole and kynurenine (KYN) branches of tryptophan pathway to determine whether differential regulation within these branches may contribute to mechanism of variation in response to treatment. Metabolomics approach was used to characterize early biochemical changes in tryptophan pathway and correlated biochemical changes with treatment outcome. Outpatients with MDD were randomly assigned to sertraline (n = 35) or placebo (n = 40) in a double-blind 4-week trial; response to treatment was measured using the 17-item Hamilton Rating Scale for Depression (HAMD17). Targeted electrochemistry based metabolomic platform (LCECA) was used to profile serum samples from MDD patients. The response rate was slightly higher for sertraline than for placebo (21/35 [60%] vs. 20/40 [50%], respectively, χ2(1) = 0.75, p = 0.39). Patients showing a good response to sertraline had higher pretreatment levels of 5-methoxytryptamine (5-MTPM), greater reduction in 5-MTPM levels after treatment, an increase in 5-Methoxytryptophol (5-MTPOL) and Melatonin (MEL) levels, and decreases in the (KYN)/MEL and 3-Hydroxykynurenine (3-OHKY)/MEL ratios post-treatment compared to pretreatment. These changes were not seen in the patients showing poor response to sertraline. In the placebo group, more favorable treatment outcome was associated with increases in 5-MTPOL and MEL levels and significant decreases in the KYN/MEL and 3-OHKY/MEL; changes in 5-MTPM levels were not associated with the 4-week response. These results suggest that recovery from a depressed state due to treatment with drug or with placebo could be associated with preferential utilization of serotonin for production of melatonin and 5-MTPOL.
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Affiliation(s)
- Hongjie Zhu
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
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Sullivan GM, Ogden RT, Huang YY, Oquendo MA, Mann JJ, Parsey RV. Higher in vivo serotonin-1a binding in posttraumatic stress disorder: a PET study with [11C]WAY-100635. Depress Anxiety 2013; 30:197-206. [PMID: 23408467 PMCID: PMC3785097 DOI: 10.1002/da.22019] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 09/26/2012] [Accepted: 10/06/2012] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Brain serotonin-1A receptors (5-HT1A ) are implicated in anxiety. We compared regional brain 5-HT1A binding in medication-free participants with posttraumatic stress disorder (PTSD) and healthy volunteers using fully quantitative positron emission tomography (PET) methods. METHODS Twenty patients with DSM-IV PTSD (13 with comorbid major depressive disorder, [MDD]) and 49 healthy volunteers underwent PET imaging with 5-HT1A antagonist radioligand [C-11]WAY100635. Arterial blood sampling provided a metabolite-corrected input function and the concentration of free ligand in plasma (fP ) for estimation of regional binding potential, BPF ( = Bavailable / KD ). Linear mixed modeling compared BPF between groups across regions of interest (ROIs). RESULTS The PTSD group had higher 5-HT1A BPF across brain ROIs (P = .0006). Post hoc comparisons showed higher 5-HT1A BPF in PTSD in all cortical ROIs (26-33%), amygdala (34%), and brainstem raphe nuclei (43%), but not hippocampus. The subgroup of seven PTSD patients without comorbid MDD had higher 5-HT1A BPF compared with healthy volunteers (P = .03). CONCLUSIONS This is the first report of higher brainstem and forebrain 5-HT1A binding in vivo in PTSD. The finding is independent of MDD. PTSD and MDD have in common an upregulation of 5-HT1A binding including midbrain autoreceptors that would favor less firing and serotonin release. This abnormality may represent a common biomarker of these stress-associated brain disorders.
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Affiliation(s)
- Gregory M. Sullivan
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York,Correspondence to: Gregory M. Sullivan, M.D., Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, Unit #41, New York, NY 10032.
| | - R. Todd Ogden
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York,Department of Biostatistics Columbia University School of Public Health, New York, New York
| | - Yung-yu Huang
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
| | - Maria A. Oquendo
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
| | - J. John Mann
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York,Department of Radiology, Columbia University College of Physicians & Surgeons, New York, New York
| | - Ramin V. Parsey
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
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Hesselgrave N, Parsey RV. Imaging the serotonin 1A receptor using [11C]WAY100635 in healthy controls and major depression. Philos Trans R Soc Lond B Biol Sci 2013; 368:20120004. [PMID: 23440462 DOI: 10.1098/rstb.2012.0004] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
As a neurotransmitter, serotonin (5-HT) is widely used throughout the brain and known to play a role in many processes including emotion and brain development. Of the 15 subtypes of 5-HT receptors, the 1A receptor (5-HT(1A)) has been implicated in depression and suicide. Using the [carbonyl-(11)C]WAY100635 ([(11)C]WAY) ligand and positron emission tomography, we have studied the 5-HT(1A) receptor, first in a group of healthy controls, then in two separate groups of subjects with major depressive disorder (MDD) (antidepressant exposed and not recently medicated), and, lastly, in a group of subjects remitted from MDD. All MDD subjects were medication-free at the time of scan. We found higher 5-HT(1A) binding potential (BP(F)) in MDD subjects not recently exposed to an antidepressant compared with controls and recently medicated MDD subjects; and higher BP(F) in subjects with the C(-1019)G promoter polymorphism. We replicated these findings in a novel cohort and reconciled our discrepant findings with other groups using alternate quantification techniques. We also reported higher BP(F) in subjects remitted from a major depressive episode than in controls. From this work, we proposed a temporal model in which 5-HT(1A) BP(F) may be a trait abnormality of MDD. To further explore the genetic components of MDD and utility of 5-HT(1A) imaging as a potential tool for biomarker or treatment response prediction, these findings should be replicated in a larger cohort using the [(11)C]CUMI-101 agonist tracer.
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Affiliation(s)
- Natalie Hesselgrave
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY 10043, USA
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Albert PR. Transcriptional regulation of the 5-HT1A receptor: implications for mental illness. Philos Trans R Soc Lond B Biol Sci 2012; 367:2402-15. [PMID: 22826341 DOI: 10.1098/rstb.2011.0376] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The serotonin-1A (5-HT(1A)) receptor is an abundant post-synaptic 5-HT receptor (heteroreceptor) implicated in regulation of mood, emotion and stress responses and is the major somatodendritic autoreceptor that negatively regulates 5-HT neuronal activity. Based on animal models, an integrated model for opposing roles of pre- and post-synaptic 5-HT(1A) receptors in anxiety and depression phenotypes and response to antidepressants is proposed. Understanding differential transcriptional regulation of pre- versus post-synaptic 5-HT(1A) receptors could provide better tools for their selective regulation. This review examines the transcription factors that regulate brain region-specific basal and stress-induced expression of the 5-HT(1A) receptor gene (Htr1a). A functional polymorphism, rs6295 in the Htr1a promoter region, blocks the function of specific repressors Hes1, Hes5 and Deaf1, resulting in increased 5-HT(1A) autoreceptor expression in animal models and humans. Its association with altered 5-HT(1A) expression, depression, anxiety and antidepressant response are related to genotype frequency in different populations, sample homogeneity, disease outcome measures and severity. Preliminary evidence from gene × environment studies suggests the potential for synergistic interaction of stress-mediated repression of 5-HT(1A) heteroreceptors, and rs6295-induced upregulation of 5-HT(1A) autoreceptors. Targeted therapeutics to inhibit 5-HT(1A) autoreceptor expression and induce 5-HT(1A) heteroreceptor expression may ameliorate treatment of anxiety and major depression.
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Affiliation(s)
- Paul R Albert
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa, , 451 Smyth Road, Ottawa, ON, Canada , K1H 8M5.
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Bailer UF, Bloss CS, Frank GK, Price JC, Meltzer CC, Mathis CA, Geyer MA, Wagner A, Becker CR, Schork NJ, Kaye WH. 5-HT₁A receptor binding is increased after recovery from bulimia nervosa compared to control women and is associated with behavioral inhibition in both groups. Int J Eat Disord 2011; 44:477-87. [PMID: 20872754 PMCID: PMC4286242 DOI: 10.1002/eat.20843] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2010] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Because altered serotonin (5-HT) function appears to persist after recovery from bulimia nervosa (RBN), we investigated the 5-HT(1A) receptor, which could contribute to regulation of appetite, mood, impulse control, or the response to antidepressants. METHOD Thirteen RBN individuals were compared to 21 healthy control women (CW) using positron emission tomography and [carbonyl-(11)C]WAY100635 ([(11)C]WAY). RESULTS RBN had a 23-34% elevation of [(11)C]WAY binding potential (BP)(P) in subgenual cingulate, mesial temporal, and parietal regions after adjustments for multiple comparisons. For CW, [(11)C]WAY BP(P) was related negatively to novelty seeking, whereas for RBN, [(11)C]WAY BP(P) was related positively to harm avoidance and negatively related to sensation seeking. DISCUSSION Alterations of 5-HT(1A) receptor function may provide new insight into efficacy of 5-HT medication in BN, as well as symptoms such as the ability to inhibit or self-control the expression of behaviors related to stimulus seeking, aggression, and impulsivity.
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Affiliation(s)
- Ursula F. Bailer
- Department of Psychiatry and Psychotherapy, Division of Biological Psychiatry, Medical University Vienna, Vienna, Austria,Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Cinnamon S. Bloss
- Scripps Genomic Medicine, Scripps Translational Science Institute (STSI), and Scripps Health, La Jolla, California
| | - Guido K. Frank
- University of Colorado at Denver and Health Sciences Center, Department of Psychiatry, The Children’s Hospital, Aurora, Colorado
| | - Julie C. Price
- University of Pittsburgh, School of Medicine, Department of Radiology, Presbyterian University Hospital, Pittsburgh, Pennsylvania
| | - Carolyn C. Meltzer
- Emory School of Medicine, Departments of Radiology, Neurology, and Psychiatry and Behavioral Sciences, Atlanta, Georgia, and Adjunct Professor of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Chester A. Mathis
- University of Pittsburgh, School of Medicine, Department of Radiology, Presbyterian University Hospital, Pittsburgh, Pennsylvania
| | - Mark A. Geyer
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Angela Wagner
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Carl R. Becker
- University of Pittsburgh, School of Medicine, Department of Radiology, Presbyterian University Hospital, Pittsburgh, Pennsylvania
| | - Nicholas J. Schork
- Scripps Genomic Medicine, Scripps Translational Science Institute (STSI), and Scripps Health, La Jolla, California
| | - Walter H. Kaye
- Department of Psychiatry, University of California, San Diego, La Jolla, California,Correspondence to: Walter H. Kaye, MD, UCSD Department of Psychiatry University of California, San Diego, 8950 Villa La Jolla Drive, Suite C - 207, La Jolla, California 92037.
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Pretreatment metabotype as a predictor of response to sertraline or placebo in depressed outpatients: a proof of concept. Transl Psychiatry 2011; 1. [PMID: 22162828 PMCID: PMC3232004 DOI: 10.1038/tp.2011.22] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The purpose of this study was to determine whether the baseline metabolic profile (that is, metabotype) of a patient with major depressive disorder (MDD) would define how an individual will respond to treatment. Outpatients with MDD were randomly assigned to sertraline (up to 150 mg per day) (N=43) or placebo (N=46) in a double-blind 4-week trial. Baseline serum samples were profiled using the liquid chromatography electrochemical array; the output was digitized to create a 'digital map' of the entire measurable response for a particular sample. Response was defined as ≥50% reduction baseline to week 4 in the 17-item Hamilton Rating Scale for Depression total score. Models were built using the one-out method for cross-validation. Multivariate analyses showed that metabolic profiles partially separated responders and non-responders to sertraline or to placebo. For the sertraline models, the overall correct classification rate was 81% whereas it was 72% for the placebo models. Several pathways were implicated in separation of responders and non-responders on sertraline and on placebo including phenylalanine, tryptophan, purine and tocopherol. Dihydroxyphenylacetic acid, tocopherols and serotonin were common metabolites in separating responders and non-responders to both drug and placebo. Pretreatment metabotypes may predict which depressed patients will respond to acute treatment (4 weeks) with sertraline or placebo. Some pathways were informative for both treatments whereas other pathways were unique in predicting response to either sertraline or placebo. Metabolomics may inform the biochemical basis for the early efficacy of sertraline.
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Albert PR, Le François B, Millar AM. Transcriptional dysregulation of 5-HT1A autoreceptors in mental illness. Mol Brain 2011; 4:21. [PMID: 21619616 PMCID: PMC3130656 DOI: 10.1186/1756-6606-4-21] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 05/27/2011] [Indexed: 12/15/2022] Open
Abstract
The serotonin-1A (5-HT1A) receptor is among the most abundant and widely distributed 5-HT receptors in the brain, but is also expressed on serotonin neurons as an autoreceptor where it plays a critical role in regulating the activity of the entire serotonin system. Over-expression of the 5-HT1A autoreceptor has been implicated in reducing serotonergic neurotransmission, and is associated with major depression and suicide. Extensive characterization of the transcriptional regulation of the 5-HT1A gene (HTR1A) using cell culture systems has revealed a GC-rich "housekeeping" promoter that non-selectively drives its expression; this is flanked by a series of upstream repressor elements for REST, Freud-1/CC2D1A and Freud-2/CC2D1B factors that not only restrict its expression to neurons, but may also regulate the level of expression of 5-HT1A receptors in various subsets of neurons, including serotonergic neurons. A separate set of allele-specific factors, including Deaf1, Hes1 and Hes5 repress at the HTR1A C(-1019)G (rs6295) polymorphism in serotonergic neurons in culture, as well as in vivo. Pet1, an obligatory enhancer for serotonergic differentiation, has been identified as a potent activator of 5-HT1A autoreceptor expression. Taken together, these results highlight an integrated regulation of 5-HT1A autoreceptors that differs in several aspects from regulation of post-synaptic 5-HT1A receptors, and could be selectively targeted to enhance serotonergic neurotransmission.
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Affiliation(s)
- Paul R Albert
- Ottawa Hospital Research Institute (Neuroscience), University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada.
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33
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Parsey RV, Ogden RT, Miller JM, Tin A, Hesselgrave N, Goldstein E, Mikhno A, Milak M, Zanderigo F, Sullivan GM, Oquendo MA, Mann JJ. Higher serotonin 1A binding in a second major depression cohort: modeling and reference region considerations. Biol Psychiatry 2010; 68:170-8. [PMID: 20497898 PMCID: PMC2900398 DOI: 10.1016/j.biopsych.2010.03.023] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 02/24/2010] [Accepted: 03/02/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND Serotonin 1A receptors (5-HT(1A)) are implicated in major depressive disorder (MDD). We previously reported higher 5-HT(1A) binding potential (BP(F)) in antidepressant naive MDD subjects compared with control subjects, while other studies report lower BP(ND). Discrepancies can be related to differences in study population or methodology. We sought to replicate our findings in a novel cohort and determine whether choice of reference region and outcome measure could explain discrepancies. METHODS Nine new control subjects and 22 new not recently medicated (NRM) MDD subjects underwent positron emission tomography. BP(F) and BP(ND) were determined using a metabolite and free fraction corrected arterial input function. BP(ND) was also determined using cerebellar gray matter (CGM) and cerebellar white matter (CWM) reference regions as input functions. RESULTS BP(F) was higher in the new NRM cohort (p = .037) compared with new control subjects, comparable to the previous cohort (p = .04). Cohorts were combined to examine the reference region and outcome measure. BP(F) was higher in the NRM compared with control subjects (p = .0001). Neither BP(ND) using CWM (p = .86) nor volume of distribution (V(T)) (p = .374) differed between groups. When CGM was used, the NRM group had lower 5-HT(1A) BP(ND) compared with control subjects (p = .03); CGM V(T) was higher in NRM compared with control subjects (p = .007). CONCLUSIONS Choice of reference region and outcome measure can produce different 5-HT(1A) findings. Higher 5-HT(1A) BP(F) in MDD was found with the method with fewest assumptions about nonspecific binding and a reference region without receptors.
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Affiliation(s)
- Ramin V Parsey
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
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Albert PR, François BL. Modifying 5-HT1A Receptor Gene Expression as a New Target for Antidepressant Therapy. Front Neurosci 2010; 4:35. [PMID: 20661455 PMCID: PMC2907233 DOI: 10.3389/fnins.2010.00035] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 05/10/2010] [Indexed: 12/30/2022] Open
Abstract
Major depression is the most common form of mental illness, and is treated with antidepressant compounds that increase serotonin (5-HT) neurotransmission. Increased 5-HT1A autoreceptor levels in the raphe nuclei act as a “brake” to inhibit the 5-HT system, leading to depression and resistance to antidepressants. Several 5-HT1A receptor agonists (buspirone, flesinoxan, ipsapirone) that preferentially desensitize 5-HT1A autoreceptors have been tested for augmentation of antidepressant drugs with mixed results. One explanation could be the presence of the C(−1019)G 5-HT1A promoter polymorphism that prevents gene repression of the 5-HT1A autoreceptor. Furthermore, down-regulation of 5-HT1A autoreceptor expression, not simply desensitization of receptor signaling, appears to be required to enhance and accelerate antidepressant action. The current review focuses on the transcriptional regulators of 5-HT1A autoreceptor expression, their roles in permitting response to 5-HT1A-targeted treatments and their potential as targets for new antidepressant compounds for treatment-resistant depression.
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Affiliation(s)
- Paul R Albert
- Department of Neuroscience, Ottawa Hospital Research Institute, University of Ottawa Ottawa, ON, Canada
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Lu S, Liow JS, Zoghbi SS, Hong J, Innis RB, Pike VW. Evaluation of [C]S14506 and [F]S14506 in rat and monkey as agonist PET radioligands for brain 5-HT(1A) receptors. Curr Radiopharm 2010; 3:9-18. [PMID: 20657759 DOI: 10.2174/1874471011003010009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In vitro and ex vivo measurements have shown that the binding of the selective high-affinity agonist, S14506 (1-[2-(4-fluorobenzoylamino)ethyl]-4-(7-methoxy-naphthyl)piperazine), to 5-HT(1A) receptors, is similar in affinity (K(d) = 0.79 nM) and extent (B(max)) to that of the antagonist, WAY 100635. We aimed to test whether S14506, labeled with a positron-emitter, might serve as a radioligand for imaging brain 5-HT(1A) receptors in vivo with positron emission tomography (PET). Here we evaluated [(11)C]S14506 and [(18)F]S14506 in rat and rhesus monkey in vivo. After intravenous administration of [(11)C]S14506 into rat, radioactivity entered brain, reaching 210% SUV at 2 min. Radioactivity uptake into brain was higher (~ 350% SUV) in rats pre-treated with the P-glycoprotein (P-gp) inhibitor, cyclosporin A. In rhesus monkey, peak brain uptake of radioactivity after administration of [(11)C]S14506 or [(18)F]S14506 was also moderate and for [(11)C]S14506 increased from ~ 170% SUV after 7 min, to 240% SUV in a monkey pre-treated with the P-gp inhibitor, tariquidar. The ratios of radioactivity in 5-HT(1A) receptor-rich regions, such as cingulate or hippocampus to that in receptor-poor cerebellum reached between 1.35 and 1.5 at 60 min for both [(11)C]S14506 and [(18)F]S14506. [(11)C]S14506 gave one major polar radiometabolite in monkey plasma, and [(18)F]S14506 gave three and two more polar radiometabolites in rat and monkey plasma, respectively. The rat radiometabolites of [(18)F]S14506 did not accumulate in brain. [(18)F]S14506 was not radiodefluorinated in monkey. Thus, despite high-affinity and lack of troublesome brain radiometabolites, both [(11)C]S14506 and [(18)F]S14506 were ineffective for imaging rat or monkey brain 5-HT(1A) receptors in vivo, even under P-gp inhibited conditions. Explanations for the failure of these radioligands are offered.
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Affiliation(s)
- Shuiyu Lu
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, 10 Center Drive, Room B3C346, Bethesda MD 20892-1003, USA
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The serotonin-1A receptor in anxiety disorders. Biol Psychiatry 2009; 66:627-35. [PMID: 19423077 DOI: 10.1016/j.biopsych.2009.03.012] [Citation(s) in RCA: 233] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 02/14/2009] [Accepted: 03/12/2009] [Indexed: 12/22/2022]
Abstract
The serotonin system plays an important role in the neural processing of anxiety. The involvement of the main inhibitory serotonergic receptor, the serotonin-1A (5-HT1A) subtype, in dysfunctional forms of anxiety has been supported by findings from a wide range of preclinical research and clinical trials, including treatment studies, genetic research, and neuroimaging data. The following article summarizes preclinical results with a focus on 5-HT1A receptor knockout and transgenic mice as genetic models of anxiety. Behavioral, autonomic, and endocrinological changes in these mice are reported. This article also presents genetic polymorphisms in humans associated with increased anxiety scores and pharmacological data focused on 5-HT1A receptor agonists and antagonists. Furthermore, molecular neuroimaging results are presented. Recent positron emission tomography (PET) studies have reported reduced 5-HT1A receptor binding in patients with panic disorder and social anxiety disorder, but not in posttraumatic stress disorder. In healthy subjects, increased anxiety scores might be associated with lower 5-HT1A receptor binding. This overview of preclinical and clinical data provides strong evidence for the key role of the 5-HT1A receptor in the serotonergic dysregulation of anxiety disorders.
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Miller JM, Brennan KG, Ogden TR, Oquendo MA, Sullivan GM, Mann JJ, Parsey RV. Elevated serotonin 1A binding in remitted major depressive disorder: evidence for a trait biological abnormality. Neuropsychopharmacology 2009; 34:2275-84. [PMID: 19458612 PMCID: PMC2760406 DOI: 10.1038/npp.2009.54] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Several biological abnormalities in major depressive disorder (MDD) persist during episode remission, including altered serotonin neurotransmission, and may reflect underlying pathophysiology. We previously described elevated brain serotonin 1A (5-HT(1A)) receptor binding in antidepressant-naive (AN) subjects with MDD within a major depressive episode (MDE) compared with that in healthy controls using positron emission tomography (PET). In this study, we measured 5-HT(1A) receptor binding in unmedicated subjects with MDD during sustained remission, hypothesizing higher binding compared with that in healthy controls, and binding comparable with currently depressed AN subjects, indicative of a biological trait. We compared 5-HT(1A) binding potential (BP(F)) assessed through PET scanning with [(11)C]WAY-100635 in 15 subjects with recurrent MDD in remission for >or=12 months and off antidepressant medication for >or=6 months, 51 healthy controls, and 13 AN MDD subjects in a current MDE. Metabolite-corrected arterial input functions were acquired for the estimation of BP(F). Remitted depressed subjects had higher 5-HT(1A) BP(F) compared with healthy controls; this group difference did not vary significantly in magnitude across brain regions. 5-HT(1A) BP(F) was comparable in remitted and currently depressed subjects. Elevated 5-HT(1A) BP(F) level among subjects with remitted MDD appears to be a trait abnormality in MDD, which may underlie recurrent MDEs. Future studies should evaluate the role of genetic and environmental factors in producing elevated 5-HT(1A) BP(F) and MDD, and should examine whether 5-HT(1A) BP(F) is a vulnerability factor to MDEs that could have a role in screening high-risk populations for MDD.
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Affiliation(s)
- Jeffrey M Miller
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, New York, NY 10033, USA.
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Hadjighassem MR, Austin MC, Szewczyk B, Daigle M, Stockmeier CA, Albert PR. Human Freud-2/CC2D1B: a novel repressor of postsynaptic serotonin-1A receptor expression. Biol Psychiatry 2009; 66:214-22. [PMID: 19423080 PMCID: PMC4084727 DOI: 10.1016/j.biopsych.2009.02.033] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Revised: 02/11/2009] [Accepted: 02/28/2009] [Indexed: 01/24/2023]
Abstract
BACKGROUND Altered expression of serotonin-1A (5-HT1A) receptors, both presynaptic in the raphe nuclei and post-synaptic in limbic and cortical target areas, has been implicated in mood disorders such as major depression and anxiety. Within the 5-HT1A receptor gene, a powerful dual repressor element (DRE) is regulated by two protein complexes: Freud-1/CC2D1A and a second, unknown repressor. Here we identify human Freud-2/CC2D1B, a Freud-1 homologue, as the second repressor. METHODS Freud-2 distribution was examined with Northern and Western blot, reverse transcriptase polymerase chain reaction, and immunohistochemistry/immunofluorescence; Freud-2 function was examined by electrophoretic mobility shift, reporter assay, and Western blot. RESULTS Freud-2 RNA was widely distributed in brain and peripheral tissues. Freud-2 protein was enriched in the nuclear fraction of human prefrontal cortex and hippocampus but was weakly expressed in the dorsal raphe nucleus. Freud-2 immunostaining was co-localized with 5-HT1A receptors, neuronal and glial markers. In prefrontal cortex, Freud-2 was expressed at similar levels in control and depressed male subjects. Recombinant hFreud-2 protein bound specifically to 5' or 3' human DRE adjacent to the Freud-1 site. Human Freud-2 showed strong repressor activity at the human 5-HT1A or heterologous promoter in human HEK-293 5-HT1A-negative cells and neuronal SK-N-SH cells, a model of postsynaptic 5-HT1A receptor-positive cells. Furthermore, small interfering RNA knockdown of endogenous hFreud-2 expression de-repressed 5-HT1A promoter activity and increased levels of 5-HT1A receptor protein in SK-N-SH cells. CONCLUSIONS Human Freud-2 binds to the 5-HT1A DRE and represses the human 5-HT1A receptor gene to regulate its expression in non-serotonergic cells and neurons.
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Affiliation(s)
- Mahmoud R. Hadjighassem
- Ottawa Health Research Institute (Neuroscience)1, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H-8M5
| | - Mark C. Austin
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MI, U.S.A
| | - Bernadeta Szewczyk
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MI, U.S.A,Institute of Pharmacology Polish Academy of Sciences, Krakow, Poland
| | - Mireille Daigle
- Ottawa Health Research Institute (Neuroscience)1, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H-8M5
| | - Craig A. Stockmeier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MI, U.S.A,Department of Psychiatry, Case Western Reserve University, Cleveland, OH, U.S.A
| | - Paul R. Albert
- Ottawa Health Research Institute (Neuroscience)1, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H-8M5,To whom correspondence should be addressed, phone: (613) 562-5800 ext. 8307, Fax: (613) 562-5403;
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Miller JM, Kinnally EL, Ogden RT, Oquendo MA, Mann JJ, Parsey RV. Reported childhood abuse is associated with low serotonin transporter binding in vivo in major depressive disorder. Synapse 2009; 63:565-73. [PMID: 19288578 PMCID: PMC2858631 DOI: 10.1002/syn.20637] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Physical or psychological adversity in childhood is associated with a higher risk for depression in adulthood, and with persistent serotonergic abnormalities in humans and in animal models. We hypothesized that reported childhood abuse would be associated with lower brain serotonin transporter (5-HTT) binding potential (BP(P), proportional to the number of available transporters) in adults. We examined healthy volunteers and subjects with major depressive disorder, a sample enriched for childhood abuse. METHODS Regional brain 5-HTT BP(P) was measured using positron emission tomography (PET) with [(11)C]McN 5652 and a metabolite-corrected arterial input function in 43 healthy volunteers and 23 subjects in a major depressive episode, ten of whom reported a history of sexual and/or physical abuse before age 15, and 13 of whom did not. As only two healthy volunteers reported childhood abuse, primary analyses were restricted to the depressed sample, with healthy controls presented as comparators. RESULTS Depressed subjects reporting childhood abuse had lower 5-HTT BP(P) than nonabused depressed subjects across all brain regions examined (P = 0.017). The groups did not differ in relevant demographic or clinical variables. Genotype frequencies of a functional polymorphism in the 5-HTT gene promoter (5-HTTLPR) did not differ between the groups. CONCLUSIONS Reported childhood abuse is associated with lower 5-HTT BP(P) in this sample of subjects with major depression, consistent with other reports that childhood adversity can lower serotonergic function permanently. Lower 5-HTT BP(P) may represent a biological pathway through which early life stress predisposes to the development of subsequent psychiatric illness, including major depressive disorder.
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Affiliation(s)
- Jeffrey M Miller
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA.
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Parkel S, Näsman J, Rinken A. Enhancement of agonist binding to 5-HT1A receptors in rat brain membranes by millimolar Mn2+. Neurosci Lett 2009; 457:32-5. [DOI: 10.1016/j.neulet.2009.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 04/01/2009] [Accepted: 04/02/2009] [Indexed: 11/28/2022]
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Leventhal AM, Pettit JW, Lewinsohn PM. Characterizing major depression phenotypes by presence and type of psychomotor disturbance in adolescents and young adults. Depress Anxiety 2008; 25:575-92. [PMID: 17385727 DOI: 10.1002/da.20328] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Major depressive disorder (MDD) is phenomenologically heterogeneous, which has prompted investigation of intermediate MDD phenotypes based on specific key symptoms. Presence and type of psychomotor disturbance may be an important psychopathologic feature that differentiates clinically distinct forms of juvenile MDD. This study examined the phenotypic status of three putative MDD phenotypes in a community sample of 941 youths: (1) agitated depression (MDD with psychomotor agitation), (2) retarded depression (MDD with psychomotor retardation), and (3) agitated-retarded depression (MDD with psychomotor agitation and retardation within an episode). Hasler et al.'s [2004: Neuropsychopharmacology 29:1765-1781] criteria of specificity (degree of association with relevant symptoms and conditions related to the disease of interest versus other psychiatric conditions), stability (degree of stability over time), and heritability (degree of familial aggregation with relevant conditions) were used to evaluate the phenotypic significance of these subtypes. Results were suggestive that agitated depression was a relatively specific phenotypic syndrome characterized by irritability, arousal, physical complaints, and vulnerability to anxiety disorders and alcohol dependence; low stability across depressive episodes; and low heritability. Agitated-retarded depression was relatively specific and characterized by increased severity, recurrence, vegetative symptoms, suicidal ideation, social impairment, endogeneity, and vulnerability to anxiety disorders and bulimia; low stability across episodes; and modest heritability. Although retarded depression was associated with some specific distinguishing characteristics, most associations were explained by the increased severity of this phenotype. Retarded depression evidenced little stability or heritability. These findings offer partial support of the phenotypic status of agitated and agitated-retarded depression in youths.
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Affiliation(s)
- Adam M Leventhal
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island 02912, USA.
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Miller JM, Oquendo MA, Ogden RT, Mann JJ, Parsey RV. Serotonin transporter binding as a possible predictor of one-year remission in major depressive disorder. J Psychiatr Res 2008; 42:1137-44. [PMID: 18331740 PMCID: PMC2670200 DOI: 10.1016/j.jpsychires.2008.01.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 01/14/2008] [Accepted: 01/17/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Lower serotonin transporter (5-HTT) binding (BP(P)=f(P)B(avail)/K(D)) is reported during a major depressive episode (MDE) compared to healthy controls. Higher 5-HTT binding in the diencephalon has previously been associated with acute response to antidepressant treatment. We assessed baseline 5-HTT binding as a predictor of one-year remission from a MDE, examining binding in brain regions implicated in the pathophysiology of major depressive disorder (MDD). METHODS 5-HTT binding was quantified using positron emission tomography (PET) with [(11)C]McN5652 in 19 currently depressed subjects with MDD and 41 healthy controls. Depressed subjects received open, naturalistic antidepressant treatment. Remission status was determined one year after PET scan and treatment initiation. RESULTS Significant differences in 5-HTT binding among the three groups (healthy controls, remitters, and non-remitters) were observed in a linear mixed-effects model. Post hoc, non-remitters had lower 5-HTT binding than controls in midbrain, amygdala, and anterior cingulate. Remitters did not differ significantly from controls or non-remitters in 5-HTT binding. Remitters did not differ from non-remitters in clinical characteristics apart from greater family history of depression among non-remitters. A logistic regression model fit to determine the capacity of baseline 5-HTT binding to predict remission status at one year yielded a coefficient that was suggestive but not significant (p=0.057). LIMITATIONS The small sample size and heterogeneous treatments received reduced statistical power to detect differences in binding based on clinical outcome. CONCLUSIONS Lower pretreatment 5-HTT binding may be predictive of non-remission from major depression following one year of naturalistic antidepressant treatment. Future studies using standardized treatment are warranted.
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Affiliation(s)
- Jeffrey M Miller
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, Unit 42, New York, NY, United States.
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Lothe A, Didelot A, Hammers A, Costes N, Saoud M, Gilliam F, Ryvlin P. Comorbidity between temporal lobe epilepsy and depression: a [18F]MPPF PET study. Brain 2008; 131:2765-82. [PMID: 18765418 DOI: 10.1093/brain/awn194] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Brain and brainstem changes of serotoninergic 5-hydroxytryptophan (5-HT)(1A) receptor density have been reported in patients with major depressive disorder as well as in patients with temporal lobe epilepsy (TLE), using PET and the selective antagonist radiotracers [(11)C]WAY-100635 or [(18)F]FC-WAY. We used a distinct 5-HT(1A) antagonist, [(18)F]MPPF, whose binding potential depends on both receptor density and extracellular serotonin concentration, in 24 patients with drug-resistant TLE and MRI evidence of hippocampal sclerosis but without prior antidepressant exposure. Their Beck Depression Inventory (BDI-2) score ranged from 0 to 34, with nine patients having a score >11. We used a simplified reference tissue model, statistical parametric mapping and anatomical regions of interest (ROIs) to correlate parametric images of [(18)F]MPPF BP with the total BDI score and its four subclasses. The total BDI score, as well as symptoms of psychomotor anhedonia and negative cognition, correlated positively with [(18)F]MPPF BP in the raphe nuclei and in the insula contralateral to seizure onset, whereas somatic symptoms correlated positively with [(18)F]MPPF binding potential in the hippocampal/parahippocampal region ipsilateral to seizure onset, the left mid-cingulate gyrus and the inferior dorsolateral frontal cortex, bilaterally. We confirm an association of depressive symptoms in TLE patients with changes of the central serotoninergic pathways, in particular within the raphe nuclei, insula, cingulate gyrus and epileptogenic hippocampus. These changes are likely to reflect lower extracellular serotonin concentration in more depressed patients, with an upregulation of receptors a less likely alternative.
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Affiliation(s)
- A Lothe
- CTRS-IDEE, Hospices Civils de Lyon, University Claude Bernard Lyon 1 and Neuroscience Federative Institute of Lyon, Lyon, France
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Hettema J, An S, van den Oord E, Neale M, Kendler K, Chen X. Association study between the serotonin 1A receptor (HTR1A) gene and neuroticism, major depression, and anxiety disorders. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:661-6. [PMID: 18163385 PMCID: PMC2859302 DOI: 10.1002/ajmg.b.30656] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The serotonin neurotransmitter system in general, and the serotonin 1A receptor in particular, has been broadly implicated in the pathophysiology of mood and anxiety disorders, although the results of genetic association studies have been mixed. In this study, we examined the serotonin 1A receptor gene, HTR1A, for its association with shared genetic risk across a range of anxiety and depression-related phenotypes. Using multivariate structural equation modeling, we selected twin pairs from the population-based Virginia Adult Twin Study of Psychiatric and Substance Use Disorders scoring at the extremes of a latent genetic risk factor that underlies susceptibility to neuroticism, major depression, and several anxiety disorders. One member from each selected pair was entered into a 2-stage, case-control association study for the HTR1A gene. In the resulting sample of 589 cases and 539 controls, four SNPs spanning the HTR1A locus, including the C(-1019)G functional promoter polymorphism (rs6295), were screened in stage 1, the positive results of which were tested for replication in stage 2. While one marker met threshold significance criteria in stage 1, this association was not replicated in stage 2. Post-hoc analyses did not reveal association to any of the specific psychiatric phenotypes. Our data suggests that the HTR1A gene may not play a major role in the genetic susceptibility underlying depressive and anxiety-related phenotypes.
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Affiliation(s)
- J.M. Hettema
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia,Correspondence to: Dr. J.M. Hettema, Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, P.O. Box 980126, Richmond, Virginia 23298-0126.
| | - S.S. An
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - E.J.C.G van den Oord
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia,Department of Pharmacy, Center for Biomarker Research and Personalized Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - M.C. Neale
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia,Department of Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - K.S. Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia,Department of Human Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - X. Chen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
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Decreased brain serotonin 5-HT1A receptor availability in medication-naive patients with major depressive disorder: an in-vivo imaging study using PET and [carbonyl-11C]WAY-100635. Int J Neuropsychopharmacol 2008; 11:465-76. [PMID: 17971260 DOI: 10.1017/s1461145707008140] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Serotonin (5-HT) is involved in the pathophysiology of major depressive disorder (MDD). Among the numerous serotonergic receptors, the 5-HT1A receptor subtype is of interest because of its involvement in cognition, hippocampal neurogenesis, and mechanism of action of antidepressant drugs. Previous imaging studies have suggested altered availability of 5-HT1A receptors in MDD but prior antidepressant medication and chronicity of the illness may confound the interpretation. We examined 21 drug-naive primary-care patients with MDD using positron emission tomography (PET) imaging with [carbonyl-11C]WAY-100635, a radioligand for 5-HT1A receptors, along with 15 healthy control subjects. Binding to receptors was assessed both regionally and at voxel level with the binding potential (BP) that was estimated using arterial blood input. Compared with healthy controls, the BP of [carbonyl-11C]WAY-100635 was reduced in patients with MDD in most brain regions, ranging from -9% to -25%. Voxel-level analysis confirmed this finding by showing a widespread reduction of [carbonyl-11C]WAY-100635 BP. No statistically significant associations were observed between BP and total HAMD scores in the patients, but lower BP was associated with higher likelihood of insomnia. This study demonstrated a widespread reduction in the availability of serotonin 5-HT1A receptors in a relatively large sample of drug-naive primary-care patients with MDD, suggesting the involvement of this receptor subtype in the pathophysiology of the illness. Lack of correlation with overall severity of the illness may relate to a largely trait-like nature of this abnormality in depressive disorders.
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Holmes A. Genetic variation in cortico-amygdala serotonin function and risk for stress-related disease. Neurosci Biobehav Rev 2008; 32:1293-314. [PMID: 18439676 DOI: 10.1016/j.neubiorev.2008.03.006] [Citation(s) in RCA: 198] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 02/20/2008] [Indexed: 01/09/2023]
Abstract
The serotonin system is strongly implicated in the pathophysiology and therapeutic alleviation of stress-related disorders such as anxiety and depression. Serotonergic modulation of the acute response to stress and the adaptation to chronic stress is mediated by a myriad of molecules controlling serotonin neuron development (Pet-1), synthesis (tryptophan hydroxylase 1 and 2 isozymes), packaging (vesicular monoamine transporter 2), actions at presynaptic and postsynaptic receptors (5-HT1A, 5-HT1B, 5-HT2A, 5-HT2C, 5-HT3A, 5-HT4, 5-HT5A, 5-HT6, 5-HT7), reuptake (serotonin transporter), and degradation (monoamine oxidase A). A growing body of evidence from preclinical rodents models, and especially genetically modified mice and inbred mouse strains, has provided significant insight into how genetic variation in these molecules can affect the development and function of a key neural circuit between the dorsal raphe nucleus, medial prefrontal cortex and amygdala. By extension, such variation is hypothesized to have a major influence on individual differences in the stress response and risk for stress-related disease in humans. The current article provides an update on this rapidly evolving field of research.
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Affiliation(s)
- Andrew Holmes
- Section on Behavioral Science and Genetics, Laboratory for Integrative Neuroscience, National Institute on Alcoholism and Alcohol Abuse, NIH, 5625 Fishers Lane Room 2N09, Rockville, MD 20852-9411, USA.
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Townsend MH, Conrad EJ. The therapeutic potential of escitalopram in the treatment of panic disorder. Neuropsychiatr Dis Treat 2007; 3:835-8. [PMID: 19300618 PMCID: PMC2656325 DOI: 10.2147/ndt.s965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Panic disorder is a chronic and disabling condition that is often accompanied by other psychiatric and medical conditions. The serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been used effectively with panic disorder (PD) and conditions in which panic attacks frequently occur. Escitalopram is the most selective SSRI and a variety of evidence suggests it is of great value in the treatment of panic disorder. In this paper, we review the theoretical and practical implications of its use.
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Affiliation(s)
- Mark H Townsend
- Department of Psychiatry, Louisiana State University Health Sciences Center New Orleans, New Orleans, Louisiana, USA
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Smolin B, Klein E, Levy Y, Ben-Shachar D. Major depression as a disorder of serotonin resistance: inference from diabetes mellitus type II. Int J Neuropsychopharmacol 2007; 10:839-50. [PMID: 17250776 DOI: 10.1017/s1461145707007559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The multifactorial nature of depression resembles that of other complex disorders such as diabetes mellitus or coronary artery disease. However, while for the latter disorders predisposing and risk factors have been identified, such knowledge is still scarce in depression. In this review we propose to use diabetes mellitus, for which characteristic milestones have been condensed to obesity-hyperinsulinaemia-insulin resistance-diabetes mellitus, as a conceptual analogical model. Based on this model we hypothesize that depression develops according to a similar pattern: prolonged psychological stress-hyperserotonism-serotonin resistance-major depression. We review extensive supporting evidence from human studies and animal models of depression, including stress involvement in the aetiology of depression, evidence for increased synaptic serotonin and decreased 5-HT1A receptor activity. Conceptualizing the pathogenesis of depression as a multi-step process may inspire new concepts, which will eventually lead to delineation of additional preventive and therapeutic interventions similar to those currently practised in diabetes.
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Affiliation(s)
- Bella Smolin
- Department of Internal Medicine Rambam Medical Center, B. Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Abstract
The serotonin 5-HT(1A) receptor is implicated in the pathophysiology of major neuropsychiatric disorders, including depression, suicidal behavior, panic disorder, epilepsy, bulimia, schizophrenia, Parkinson's disease, and Alzheimer's disease and is, therefore, an important target for drug therapy. 5-HT(1A) receptors are expressed as somatodendritic autoreceptors in serotonin neurons of the raphé nuclei (presynaptic) and as postsynaptic receptors in cortical and subcortical serotonin terminal fields in the brain. Due to the higher concentration and heterogeneous distribution of this receptor, it is an attractive target for quantification in vivo using positron emission tomography (PET) and single photon emission tomography (SPECT). Here, we review the PET radioligands employed for imaging 5-HT(1A) receptors in living brain.
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Affiliation(s)
- J S Dileep Kumar
- Department of Psychiatry, Columbia University College of Physicians and Surgeons & New York State Psychiatric Institute, New York, NY 10032, United States.
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