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Hoge EA, Armstrong CH, Mete M, Oliva I, Lazar SW, Lago TR, Grillon C. Attenuation of Anxiety-Potentiated Startle After Treatment With Escitalopram or Mindfulness Meditation in Anxiety Disorders. Biol Psychiatry 2024; 95:85-92. [PMID: 37331547 DOI: 10.1016/j.biopsych.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Biological markers for anxiety disorders may further understanding of disorder pathophysiology and suggest potential targeted treatments. The fear-potentiated startle (FPS) (a measure of startle to predictable threat) and anxiety-potentiated startle (APS) (startle to unpredictable threat) laboratory paradigm has been used to detect physiological differences in individuals with anxiety disorders compared with nonanxious control individuals, and in pharmacological challenge studies in healthy adults. However, little is known about how startle may change with treatment for anxiety disorders, and no data are available regarding alterations due to mindfulness meditation training. METHODS Ninety-three individuals with anxiety disorders and 66 healthy individuals completed 2 sessions of the neutral, predictable, and unpredictable threat task, which employs a startle probe and the threat of shock to assess moment-by-moment fear and anxiety. Between the two testing sessions, patients received randomized 8-week treatment with either escitalopram or mindfulness-based stress reduction. RESULTS APS, but not FPS, was higher in participants with anxiety disorders compared with healthy control individuals at baseline. Further, there was a significantly greater decrease in APS for both treatment groups compared with the control group, with the patient groups showing reductions bringing them into the range of control individuals at the end of the treatment. CONCLUSIONS Both anxiety treatments (escitalopram and mindfulness-based stress reduction) reduced startle potentiation during unpredictable (APS) but not predictable (FPS) threat. These findings further validate APS as a biological correlate of pathological anxiety and provide physiological evidence for the impact of mindfulness-based stress reduction on anxiety disorders, suggesting that there may be comparable effects of the two treatments on anxiety neurocircuitry.
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Affiliation(s)
- Elizabeth A Hoge
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC.
| | | | - Mihriye Mete
- Center of Biostatistics, Informatics and Data Science, Medstar Health Research Institute, Hyattsville, Maryland
| | - Isabelle Oliva
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tiffany R Lago
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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Gil-Paterna P, Furmark T. Imaging the cerebellum in post-traumatic stress and anxiety disorders: a mini-review. Front Syst Neurosci 2023; 17:1197350. [PMID: 37645454 PMCID: PMC10460913 DOI: 10.3389/fnsys.2023.1197350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) and anxiety disorders are among the most prevalent psychiatric conditions worldwide sharing many clinical manifestations and, most likely, neural mechanisms as suggested by neuroimaging research. While the so-called fear circuitry and traditional limbic structures of the brain, particularly the amygdala, have been extensively studied in sufferers of these disorders, the cerebellum has been relatively underexplored. The aim of this paper was to present a mini-review of functional (task-activity or resting-state connectivity) and structural (gray matter volume) results on the cerebellum as reported in magnetic resonance imaging studies of patients with PTSD or anxiety disorders (49 selected studies in 1,494 patients). While mixed results were noted overall, e.g., regarding the direction of effects and anatomical localization, cerebellar structures like the vermis seem to be highly involved. Still, the neurofunctional and structural alterations reported for the cerebellum in excessive anxiety and trauma are complex, and in need of further evaluation.
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Bresin K, Mekawi Y, McDonald JB, Bozzay ML, Heller W, Verona E. Threat effects on attention networks in individuals with a history of externalizing behaviors. Int J Psychophysiol 2023; 183:9-18. [PMID: 36375628 PMCID: PMC10440126 DOI: 10.1016/j.ijpsycho.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022]
Abstract
Research identifying the biobehavioral processes that link threat exposure to cognitive alterations can inform treatments designed to reduce perpetration of stress-induced aggression. The present study attempted to specify the effects of relatively predictable versus unpredictable threat on two attention networks, attentional alerting and executive control. In a sample of adults (n = 74, 35 % identifying as women, Mage = 32.85) with high rates of externalizing behaviors (e.g., substance use, criminal/legal system involvement, aggressivity), we measured event-related brain activity during an attention network test that manipulated cognitive systems activation under relatively unpredictable and predictable threat conditions. Results showed that threat exposure alters attentional alerting and executive control. The predictable threat condition, relative to unpredictable threat, increased visual alerting (N1 amplitude to alert vs. no alert cue conditions) and decreased attention to the task (P3 amplitude to subsequent task-relevant flankers, but these effects did not survive adjusting for multiple tests. In contrast, overall threat and unpredictable threat conditions were associated with faster response time to alert cue (versus no cue) and poorer conflict processing, operationalized as flanker N2 reductions and slower response time to incongruent (versus congruent) flanker trials. These results expand what is known about threat-related modulation of cognition in a sample of individuals with histories of externalizing behaviors.
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Affiliation(s)
- Konrad Bresin
- University of Louisville, Department of Counseling and Human Development, USA; University of Louisville, Department of Psychological and Brain Sciences, USA.
| | - Yara Mekawi
- University of Louisville, Department of Psychological and Brain Sciences, USA
| | | | - Melanie L Bozzay
- Alpert Medical School of Brown University, USA; Providence VA Medical Center, USA
| | - Wendy Heller
- Department of Psychology, University of Illinois at Urbana-Champaign, USA
| | - Edelyn Verona
- Department of Psychology, University of South Florida, USA; Center for Justice Research & Policy, University of South Florida, USA
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Hantsoo L, Duffy KA, Sammel M, Johnson RL, Kim D, Grillon C, Epperson CN. Enduring impact of childhood adversity: Affective modulation of acoustic startle response during pregnancy and postpartum. Physiol Behav 2023; 258:114031. [PMID: 36402424 PMCID: PMC9762518 DOI: 10.1016/j.physbeh.2022.114031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 10/09/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Women with a history of adverse childhood experiences (ACEs) enter pregnancy and the postpartum with a physiologic system programmed by early life stress, potentially reflected in psychophysiologic reactivity. METHODS We enrolled pregnant, psychiatrically healthy women ≥18 years old. Using the ACE Questionnaire, women were categorized as high (≥2 ACEs; n = 77) or low ACE (<2 ACEs; n = 72). Participants completed an affective modulation of acoustic startle response (ASR) task during pregnancy and postpartum, in which ASR magnitude was measured while participants viewed pleasant, unpleasant, and neutral pictures. Two types of control trials were included (habituation trials presented at baseline and intertrial interval trials presented when no picture was present). RESULTS Among high ACE women, ASR was significantly higher postpartum compared with pregnancy in the unpleasant (p = 0.002, β = 0.46, 95% CI [0.18, 0.74], χ2 = 10.12, z = 3.18) and intertrial interval trials (p = 0.002, β = 0.44, 95% CI [0.16, 0.73], χ2 = 9.25, z = 3.04), accounting for multiple comparisons using a Bonferroni correction at p < 0.005. Among low ACE women, ASR was similar in pregnancy and postpartum. CONCLUSIONS Physiological reactivity increased in high ACE women from pregnancy to postpartum, but no change was observed in low ACE women.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, 550 N. Broadway Street, Baltimore, MD, United States.
| | - Korrina A Duffy
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, United States
| | - Mary Sammel
- Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17(th) Place, Mail Stop B119, Aurora, CO, 80045, United States
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17(th) Place, Mail Stop B119, Aurora, CO, 80045, United States
| | - Deborah Kim
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA, 19104, United States
| | - Christian Grillon
- National Institute of Mental Health, 15K North Drive, Bethesda, MD, 20892, United States
| | - C Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, United States; Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, United States
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Guo W, Fan S, Xiao D, He C, Guan M, Xiong W. A midbrain-reticulotegmental circuit underlies exaggerated startle under fear emotions. Mol Psychiatry 2022; 27:4881-4892. [PMID: 36117214 DOI: 10.1038/s41380-022-01782-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 01/19/2023]
Abstract
Exaggerated startle has been recognized as a core hyperarousal symptom of multiple fear-related anxiety disorders, such as post-traumatic stress disorder (PTSD) and panic disorder. However, the mechanisms driving this symptom are poorly understood. Here we reveal a neural projection from dorsal raphe nucleus (DRN) to a startle-controlling center reticulotegmental nucleus (RtTg) that mediates enhanced startle response under fear condition. Within RtTg, we identify an inhibitory microcircuit comprising GABAergic neurons in pericentral RtTg (RtTgP) and glutamatergic neurons in central RtTg (RtTgC). Inhibition of this RtTgP-RtTgC microcircuit leads to elevated startle amplitudes. Furthermore, we demonstrate that the conditioned fear-activated DRN 5-HTergic neurons send inhibitory projections to RtTgP GABAergic neurons, which in turn upregulate neuronal activities of RtTgC glutamatergic neurons. Chemogenetic activation of the DRN-RtTgP projections mimics the increased startle response under fear emotions. Moreover, conditional deletion of 5-HT1B receptor from RtTgP GABAergic neurons largely reverses the exaggeration of startle during conditioned fear. Thus, our study establishes the disinhibitory DRN-RtTgP-RtTgC circuit as a critical mechanism underlying exaggerated startle under fear emotions, and provides 5-HT1B receptor as a potential therapeutic target for treating hyperarousal symptom in fear-associated psychiatric disorders.
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Affiliation(s)
- Weiwei Guo
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Sijia Fan
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Dan Xiao
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Chen He
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Mengyuan Guan
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Wei Xiong
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China. .,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China. .,Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China.
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Ramakrishnan N, Lijffijt M, Green CE, Balderston NL, Murphy N, Grillon C, Iqbal T, Vo-Le B, O’Brien B, Murrough JW, Swann AC, Mathew SJ. Neurophysiological and clinical effects of the NMDA receptor antagonist lanicemine (BHV-5500) in PTSD: A randomized, double-blind, placebo-controlled trial. Depress Anxiety 2021; 38:1108-1119. [PMID: 34254405 PMCID: PMC8560553 DOI: 10.1002/da.23194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with hyperarousal and stress reactivity, features consistent with behavioral sensitization. In this Phase 1b, parallel-arm, randomized, double-blind, placebo-controlled trial, we tested whether the selective low-trapping N-methyl-D-aspartate receptor (NMDAR) antagonist [Lanicemine (BHV-5500)] blocks expression of behavioral sensitization. METHODS Twenty-four participants with elevated anxiety potentiated startle (APS) and moderate-to-severe PTSD symptoms received three infusions of lanicemine 1.0 mg/ml (100 mg) or matching placebo (0.9% saline) (1:1 ratio), over a 5-day period. The primary outcome was change in APS from baseline to end of third infusion. We also examined changes in EEG gamma-band oscillatory activity as measures of NMDAR target engagement and explored Clinician-Administered PTSD Scale (CAPS-5) hyperarousal scores. RESULTS Lanicemine was safe and well-tolerated with no serious adverse events. Using Bayesian statistical inference, the posterior probability that lanicemine outperformed placebo on APS T-score after three infusions was 38%. However, after the first infusion, there was a 90% chance that lanicemine outperformed placebo in attenuating APS T-score by a standardized effect size more than 0.4. CONCLUSION We demonstrated successful occupancy of lanicemine on NMDAR using gamma-band EEG and effects on hyperarousal symptoms (Cohen's d = 0.75). While lanicemine strongly attenuated APS following a single infusion, differential changes from placebo after three infusions was likely obscured by habituation effects. To our knowledge, this is the first use of APS in the context of an experimental medicine trial of a NMDAR antagonist in PTSD. These findings support selective NMDAR antagonism as a viable pharmacological strategy for salient aspects of PTSD.
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Affiliation(s)
- Nithya Ramakrishnan
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA,Corresponding Authors: Nithya Ramakrishnan, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. , (713)798-7768; Sanjay J. Mathew, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. (713) 798-5877
| | - Marijn Lijffijt
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | | | | | - Nicholas Murphy
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA,The Menninger Clinic, Houston, TX, USA
| | | | - Tabish Iqbal
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Brittany Vo-Le
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Brittany O’Brien
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - James W. Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai; Department of Neuroscience, Icahn School of Medicine at Mount Sinai
| | - Alan C. Swann
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Sanjay J. Mathew
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA,The Menninger Clinic, Houston, TX, USA,Corresponding Authors: Nithya Ramakrishnan, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. , (713)798-7768; Sanjay J. Mathew, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX 77030, USA. (713) 798-5877
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7
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Lago TR, Brownstein MJ, Page E, Beydler E, Manbeck A, Beale A, Roberts C, Balderston N, Damiano E, Pineles SL, Simon N, Ernst M, Grillon C. The novel vasopressin receptor (V1aR) antagonist SRX246 reduces anxiety in an experimental model in humans: a randomized proof-of-concept study. Psychopharmacology (Berl) 2021; 238:2393-2403. [PMID: 33970290 PMCID: PMC8376758 DOI: 10.1007/s00213-021-05861-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 04/26/2021] [Indexed: 12/19/2022]
Abstract
RATIONALE Arginine vasopressin (AVP) is a neuropeptide that modulates both physiological and emotional responses to threat. Until recently, drugs that target vasopressin receptors (V1a) in the human central nervous system were unavailable. The development of a novel V1a receptor antagonist, SRX246, permits the experimental validation of vasopressin's role in the regulation of anxiety and fear in humans. OBJECTIVES Here, we examined the effects of SRX246 in a proof-of-concept translational paradigm of fear (phasic response to imminent threat) and anxiety (prolonged response to potential threat). METHODS Healthy volunteers received both SRX246 and placebo in a randomized, double-blind, counter-balanced order separated by a 5-7-day wash-out period. Threat consisted of unpleasant electric shocks. The "NPU" threat test probed startle reactivity during predictable threat (i.e., fear-potentiated startle) and unpredictable threat (i.e., anxiety-potentiated startle). RESULTS As predicted, SRX246 decreased anxiety-potentiated startle independent of fear-potentiated startle. CONCLUSIONS As anxiety-potentiated startle is elevated in anxiety and trauma-associated disorders and decreased by traditional anxiolytics such as SSRIs and benzodiazepines, the V1a receptor is a promising novel treatment target.
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Affiliation(s)
- Tiffany R Lago
- National Institute of Mental Health, Bethesda, MD, USA.
- VA Boston Healthcare System, Boston, MA, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | | | - Emily Page
- National Institute of Mental Health, Bethesda, MD, USA
| | - Emily Beydler
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Alexis Beale
- National Institute of Mental Health, Bethesda, MD, USA
| | | | - Nicholas Balderston
- National Institute of Mental Health, Bethesda, MD, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Eve Damiano
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
| | - Suzanne L Pineles
- Boston University School of Medicine, Boston, MA, USA
- National Center, PTSD At VA Boston Healthcare System, Boston, MA, USA
| | - Neal Simon
- Azevan Pharmaceuticals Inc, Bethlehem, PA, USA
- Lehigh University, Bethelhem, PA, USA
| | - Monique Ernst
- National Institute of Mental Health, Bethesda, MD, USA
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8
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Lijffijt M, Green CE, Balderston N, Iqbal T, Atkinson M, Vo-Le B, Vo-Le B, O’Brien B, Grillon C, Swann AC, Mathew SJ. A Proof-of-Mechanism Study to Test Effects of the NMDA Receptor Antagonist Lanicemine on Behavioral Sensitization in Individuals With Symptoms of PTSD. Front Psychiatry 2019; 10:846. [PMID: 31920733 PMCID: PMC6923195 DOI: 10.3389/fpsyt.2019.00846] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/24/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Individuals with post-traumatic stress disorder (PTSD) have a heightened sensitivity to subsequent stressors, addictive drugs, and symptom recurrence, a form of behavioral sensitization. N-methyl-D-aspartate receptors (NMDARs) are involved in the establishment and activation of sensitized behavior. Objective: We describe a protocol of a randomized placebo-controlled Phase 1b proof-of-mechanism trial to examine target engagement, safety, tolerability, and possible efficacy of the NMDAR antagonist lanicemine in individuals with symptoms of PTSD (Clinician Administered PTSD Scale [CAPS-5] score ≥ 25) and evidence of behavioral sensitization measured as enhanced anxiety-potentiated startle (APS; T-score ≥ 2.8). Methods: Subjects (n = 24; age range 21-65) receive three 60-min intravenous infusions of placebo or 100 mg lanicemine over 5 non-consecutive days. Primary endpoint is change in APS from pre-treatment baseline to after the third infusion. NMDAR engagement is probed with resting state EEG gamma band power, 40 Hz auditory steady state response, the mismatch negativity amplitude, and P50 sensory gating. Change in CAPS-5 scores is an exploratory clinical endpoint. Bayesian statistical methods will evaluate endpoints to determine suitability of this agent for further study. Conclusion: In contrast to traditional early-phase trials that use symptom severity to track treatment efficacy, this study tracks engagement of the study drug on expression of behavioral sensitization, a functional mechanism likely to cut across disorders. This experimental therapeutics design is consistent with recent NIMH-industry collaborative studies, and could serve as a template for testing novel pharmacological agents in psychiatry. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03166501.
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Affiliation(s)
- Marijn Lijffijt
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Charles E. Green
- Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
- Department of Pediatrics - Center for Evidence Based Medicine, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Nicholas Balderston
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Tabish Iqbal
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Megan Atkinson
- Department of Anesthesiology, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Department of Anesthesiology, Baylor College of Medicine, Houston, TX, United States
| | - Brittany Vo-Le
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Bylinda Vo-Le
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Brittany O’Brien
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Christian Grillon
- Department of Pediatrics - Center for Evidence Based Medicine, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Alan C. Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
| | - Sanjay J. Mathew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
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9
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Radoman M, Phan KL, Gorka SM. Neural correlates of predictable and unpredictable threat in internalizing psychopathology. Neurosci Lett 2019; 701:193-201. [PMID: 30825592 PMCID: PMC6476657 DOI: 10.1016/j.neulet.2019.02.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/08/2019] [Accepted: 02/20/2019] [Indexed: 11/19/2022]
Abstract
Converging lines of evidence suggest that heightened responding to unpredictable threat may be an important neurobiological marker of internalizing psychopathology (IP). Prior data also indicate that aversive responding to uncertainty may be mediated by hyperactivation of several brain regions within the frontolimbic circuit, namely the anterior insula (aINS) and the dorsal anterior cingulate cortex (dACC). To date, however, the majority of this research has been focused on individual diagnoses and it is unclear whether abnormal neural reactivity to unpredictable threat is observed within heterogeneous, transdiagnostic IP patient populations, as theory would suggest. The aim of the current study was to therefore examine the neural correlates of temporally unpredictable (U) and predictable (P) threat in a sample of healthy controls (n = 24) and patients with a broad range of IP diagnoses (n = 51). We also examined whether symptom severity measures of fear and distress/misery dimensions correlated with neural reactivity to U- and P-threat. All participants completed a modified version of a well-validated threat-of-shock task during functional magnetic resonance imaging (fMRI). Across all participants, U- and P-threat elicited heightened activation in the aINS and brainstem, while P-threat alone also activated the dACC. Relative to healthy controls, patients displayed greater activation in the right aINS during U-threat, and greater right brainstem activation during P-threat. In addition, we found that brainstem activity during U-threat correlated with fear, but not distress/misery, psychopathology. Taken together, these preliminary results suggest that exaggerated aINS reactivity during U-threat and brainstem reactivity during P-threat may have the potential to become important transdiagnostic biomarkers of IP; however, future research efforts are needed to corroborate and expand the present findings.
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Affiliation(s)
- Milena Radoman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States; Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Stephanie M Gorka
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States.
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How to Deal With Temporal Relationships Between Biopsychosocial Variables: A Practical Guide to Time Series Analysis. Psychosom Med 2019; 81:289-304. [PMID: 30730383 DOI: 10.1097/psy.0000000000000680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Longitudinal data allow for conclusions about the temporal order of events and interactional dynamics between several processes. The aim of this article is to provide a concise and pragmatic description of time series analyses (TSAs) of patient samples with numerous (or daily) repeated biological, behavioral, or psychological measurements. In addition, the article demonstrates how to implement the described analyses with the software R. METHODS To illustrate the concrete application of the time series method, we use two case series of patients with anorexia nervosa. Upon awakening, the patients collected salivary cortisol on a daily basis and answered several questions on a handheld computer (electronic diary) regarding psychosocial variables at the time of salivary collection. RESULTS Basic concepts of time series analysis such as stationarity, auto- and cross-correlation, Granger causality, impulse response function, and variance decomposition are presented. In addition, we demonstrate vector autoregressive analyses with three variables. For Patient 1, we demonstrate how TSA is used to detect cortisol and anxiety decreases during inpatient treatment and also how TSA can be used to show that an increase in cortisol is followed by a next-day increase in anxiety. For Patient 2, TSA was used to show higher salivary cortisol upon awakening on the days the patient was weighed compared with other days. In addition, we show how interdependencies of depressive feelings, positive anticipations, and cortisol values can be quantified using TSA. CONCLUSIONS Time series designs enable modeling of temporal relationships and bidirectional associations between biopsychosocial variables within individuals. These individual patterns cannot be derived from traditional group-based statistical analyses. This article provides accessible research tools for conducting TSA relevant to psychosomatic and biobehavioral research.
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Glucocorticoid-immune response to acute stress in women and men living with HIV. J Behav Med 2019; 42:1153-1158. [PMID: 30888591 DOI: 10.1007/s10865-019-00029-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/12/2019] [Indexed: 12/14/2022]
Abstract
Despite high risk for serious non-AIDS events (SNAEs) and accelerated age-related increases in inflammatory markers relative to HIV+ men, HIV+ women have been understudied, particularly in terms of stress impacts on immune parameters. The purpose of this study was to examine sex differences in glucocorticoid-immune stress response in mid-life HIV+ individuals, as poor glucocorticoid control of stress-induced inflammation may contribute to health risk in HIV+ women. Male and female participants completed a threat of shock laboratory stressor. Serum cortisol and cytokines [interleukin (IL)-6, IL-8, IL-10, IL-1β, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interferon (IFN)-γ] were assessed at six timepoints prior to and in response to the stressor. Participants included 8 HIV- controls (n = 5 female) and 9 HIV+ (n = 5 female) who were virally suppressed. Repeated measures mixed models revealed a significant sex by HIV status by time interaction for IL-10, IL-1β, TNF-α, and cortisol. IL-10 response, an anti-inflammatory cytokine, was larger in males than females, regardless of HIV status. TNF-α response was blunted in HIV+ individuals compared with HIV-, and specifically in HIV+ women, IL-1β and cortisol response were blunted. Individuals living with HIV may have impaired coordination between the immune system and hypothalamic pituitary adrenal (HPA) axis. HIV+ women in particular exhibited dysregulated IL-1β and cortisol response to acute stress. Future work should focus on relationships among proinflammatory cytokines, stress, and SNAEs in HIV, with attention to sex as a biological variable.
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Lago TR, Hsiung A, Leitner BP, Duckworth CJ, Chen KY, Ernst M, Grillon C. Exercise decreases defensive responses to unpredictable, but not predictable, threat. Depress Anxiety 2018; 35:868-875. [PMID: 29637654 PMCID: PMC6314494 DOI: 10.1002/da.22748] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Research supports the anxiolytic effect of exercise, but the mechanism underlying this effect is unclear. This study examines the influence of exercise in healthy controls on two distinct defensive states implicated in anxiety disorders: fear, a phasic response to a predictable threat, and anxiety, a sustained response to an unpredictable threat. METHODS Thirty-four healthy volunteers (17 male, age M = 26.18, SD = 5.6) participated in sessions of exercise (biking at 60-70% of heart rate reserve) and control (biking at 10-20% of heart rate reserve) activity for 30 min, separated by 1 week. Threat responses were measured by eyeblink startle and assessed with the "Neutral-Predictable-Unpredictable threat test," which includes a neutral (N) and two threat conditions, one with predictable (P) and one with unpredictable (U) shock. RESULTS Results show that exercise versus control activity reduces startle potentiation during unpredictable threat (P = .031), but has no effect on startle potentiation during predictable threat (P = .609). CONCLUSIONS These results suggest that exercise reduces defensive response to unpredictable, but not predictable, threat, a dissociation that may help inform clinical indications for this behavioral intervention, as well as provide clues to its underlying neurobehavioral mechanisms.
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Affiliation(s)
- Tiffany R Lago
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Abigail Hsiung
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Brooks P Leitner
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Courtney J Duckworth
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Christian Grillon
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
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Kaye JT, Bradford DE, Magruder KP, Curtin JJ. Probing for Neuroadaptations to Unpredictable Stressors in Addiction: Translational Methods and Emerging Evidence. J Stud Alcohol Drugs 2017; 78:353-371. [PMID: 28499100 DOI: 10.15288/jsad.2017.78.353] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Stressors clearly contribute to addiction etiology and relapse in humans, but our understanding of specific mechanisms remains limited. Rodent models of addiction offer the power, flexibility, and precision necessary to delineate the causal role and specific mechanisms through which stressors influence alcohol and other drug use. This review describes a program of research using startle potentiation to unpredictable stressors that is well positioned to translate between animal models and clinical research with humans on stress neuroadaptations in addiction. This research rests on a solid foundation provided by three separate pillars of evidence from (a) rodent behavioral neuroscience on stress neuroadaptations in addiction, (b) rodent affective neuroscience on startle potentiation, and (c) human addiction and affective science with startle potentiation. Rodent stress neuroadaptation models implicate adaptations in corticotropin-releasing factor and norepinephrine circuits within the central extended amygdala following chronic alcohol and other drug use that mediate anxious behaviors and stress-induced reinstatement among drug-dependent rodents. Basic affective neuroscience indicates that these same neural mechanisms are involved in startle potentiation to unpredictable stressors in particular (vs. predictable stressors). We believe that synthesis of these evidence bases should focus us on the role of unpredictable stressors in addiction etiology and relapse. Startle potentiation in unpredictable stressor tasks is proposed to provide an attractive and flexible test bed to encourage tight translation and reverse translation between animal models and human clinical research on stress neuroadaptations. Experimental therapeutics approaches focused on unpredictable stressors hold high promise to identify, repurpose, or refine pharmacological and psychosocial interventions for addiction.
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Affiliation(s)
- Jesse T Kaye
- University of Wisconsin-Madison, Madison, Wisconsin
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Gorka SM, Lieberman L, Klumpp H, Kinney KL, Kennedy AE, Ajilore O, Francis J, Duffecy J, Craske MG, Nathan J, Langenecker S, Shankman SA, Phan KL. Reactivity to unpredictable threat as a treatment target for fear-based anxiety disorders. Psychol Med 2017; 47:2450-2460. [PMID: 28436351 DOI: 10.1017/s0033291717000964] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Heightened reactivity to unpredictable threat (U-threat) is a core individual difference factor underlying fear-based psychopathology. Little is known, however, about whether reactivity to U-threat is a stable marker of fear-based psychopathology or if it is malleable to treatment. The aim of the current study was to address this question by examining differences in reactivity to U-threat within patients before and after 12-weeks of selective serotonin reuptake inhibitors (SSRIs) or cognitive-behavioral therapy (CBT). METHODS Participants included patients with principal fear (n = 22) and distress/misery disorders (n = 29), and a group of healthy controls (n = 21) assessed 12-weeks apart. A well-validated threat-of-shock task was used to probe reactivity to predictable (P-) and U-threat and startle eyeblink magnitude was recorded as an index of defensive responding. RESULTS Across both assessments, individuals with fear-based disorders displayed greater startle magnitude to U-threat relative to healthy controls and distress/misery patients (who did not differ). From pre- to post-treatment, startle magnitude during U-threat decreased only within the fear patients who received CBT. Moreover, within fear patients, the magnitude of decline in startle to U-threat correlated with the magnitude of decline in fear symptoms. For the healthy controls, startle to U-threat across the two time points was highly reliable and stable. CONCLUSIONS Together, these results indicate that startle to U-threat characterizes fear disorder patients and is malleable to treatment with CBT but not SSRIs within fear patients. Startle to U-threat may therefore reflect an objective, psychophysiological indicator of fear disorder status and CBT treatment response.
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Affiliation(s)
- S M Gorka
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - L Lieberman
- Department of Psychology,University of Illinois-Chicago,1007 West Harrison St. (M/C 285) Chicago, IL 60607,USA
| | - H Klumpp
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - K L Kinney
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - A E Kennedy
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - O Ajilore
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - J Francis
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - J Duffecy
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - M G Craske
- Department of Psychology,University of California,Los Angeles, Franz Hall - Box 95156 Los Angeles, CA 90094,USA
| | - J Nathan
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - S Langenecker
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - S A Shankman
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
| | - K L Phan
- Department of Psychiatry,University of Illinois-Chicago,1747 West Roosevelt Road Chicago, IL 60608,USA
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Gorka SM, Hee D, Lieberman L, Mittal VA, Phan KL, Shankman SA. Reactivity to uncertain threat as a familial vulnerability factor for alcohol use disorder. Psychol Med 2016; 46:3349-3358. [PMID: 27624067 DOI: 10.1017/s0033291716002415] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND When sober, problematic drinkers display exaggerated reactivity to threats that are uncertain (U-threat). Since this aversive affective state can be alleviated via acute alcohol intoxication, it has been posited that individuals who exhibit heightened reactivity to U-threat at baseline are motivated to use alcohol as a means of avoidance-based coping, setting the stage for excessive drinking. To date, however, no study has attempted to characterize the dispositional nature of exaggerated reactivity to U-threat and test whether it is a vulnerability factor or exclusively a disease marker of problematic alcohol use. METHOD The current investigation utilized a family study design to address these gaps by examining whether (1) reactivity to U-threat is associated with risk for problematic alcohol use, defined by family history of alcohol use disorder (AUD) and (2) reactivity to U-threat is correlated amongst adult biological siblings. A total of 157 families, and 458 individuals, participated in the study and two biological siblings completed a threat-of-shock task designed to probe reactivity to U-threat and predictable threat (P-threat). Startle potentiation was collected as an index of aversive responding. RESULTS Within biological siblings, startle potentiation to U-threat [intraclass correlation (ICC) = 0.35] and P-threat (ICC = 0.63) was significantly correlated. In addition, independent of an individuals' own AUD status, startle potentiation to U-threat, but not P-threat, was positively associated with risk for AUD (i.e. AUD family history). CONCLUSION This suggests that heightened reactivity to U-threat may be a familial vulnerability factor for problematic drinking and a novel prevention target for AUD.
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Affiliation(s)
- S M Gorka
- Department of Psychiatry,University of Illinois at Chicago,Chicago, IL,USA
| | - D Hee
- Department of Psychology,University of Illinois at Chicago,Chicago, IL,USA
| | - L Lieberman
- Department of Psychology,University of Illinois at Chicago,Chicago, IL,USA
| | - V A Mittal
- Department of Psychology,Northwestern University,Evanston, IL,USA
| | - K L Phan
- Department of Psychiatry,University of Illinois at Chicago,Chicago, IL,USA
| | - S A Shankman
- Department of Psychiatry,University of Illinois at Chicago,Chicago, IL,USA
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Gorka SM, Lieberman L, Phan KL, Shankman SA. Association between problematic alcohol use and reactivity to uncertain threat in two independent samples. Drug Alcohol Depend 2016; 164:89-96. [PMID: 27173662 PMCID: PMC4893928 DOI: 10.1016/j.drugalcdep.2016.04.034] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent laboratory studies have shown that acute alcohol intoxication selectively and effectively dampens aversive responding to uncertain threat. An emerging hypothesis is that individuals who exhibit heightened reactivity to uncertain threat may be especially motivated to use alcohol to dampen their distress, setting the stage for negative reinforcement processes to drive excessive alcohol use. However, no study to date has directly examined whether current problematic drinkers exhibit heightened reactivity to uncertain threat as would be expected. METHODS The present study was therefore designed to examine the association between current problematic alcohol use and reactivity to uncertain threat during sobriety in two, independent samples. In Study 1 (n=221) and Study 2 (n=74), adult participants completed the same well-validated threat-of-shock task which separately probes responses to temporally predictable and unpredictable threat. Startle potentiation was measured as an index of aversive responding. Problematic alcohol use was defined as number of binge episodes within the past 30days in Study 1 and total scores on a self-report measure of hazardous drinking in Study 2. RESULTS As hypothesized, across both studies greater levels of problematic drinking were associated with greater startle potentiation to unpredictable threat. In Study 2, hazardous drinking scores were also positively associated with startle potentiation to predictable threat. CONCLUSIONS The findings are notably consistent with the notion that heightened reactivity to uncertain threat is an important individual difference factor associated with the onset and/or maintenance of problematic drinking behaviors and may therefore be a novel prevention and intervention target.
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Affiliation(s)
- Stephanie M. Gorka
- University of Illinois-Chicago, Department of Psychiatry, 1747 West Roosevelt Road, Chicago, IL 60608, United States,Corresponding author. (S.M. Gorka)
| | - Lynne Lieberman
- University of Illinois-Chicago, Department of Psychology, 1007 West Harrison St. (M/C 285), Chicago, IL 60607, United States
| | - K. Luan Phan
- University of Illinois-Chicago, Department of Psychiatry, 1747 West Roosevelt Road, Chicago, IL 60608, United States,University of Illinois-Chicago, Department of Psychology, 1007 West Harrison St. (M/C 285), Chicago, IL 60607, United States,Jesse Brown VA Medical Center, Mental Health Service Line, 820 S. Damen Avenue, Chicago, IL 60612, United States,University of Illinois-Chicago, Department of Anatomy and Cell Biology, and The Graduate Program in Neuroscience, 808 S. Wood Street Chicago, IL 60612, United States
| | - Stewart A. Shankman
- University of Illinois-Chicago, Department of Psychiatry, 1747 West Roosevelt Road, Chicago, IL 60608, United States,University of Illinois-Chicago, Department of Psychology, 1007 West Harrison St. (M/C 285), Chicago, IL 60607, United States
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Krishnan B, Scott MT, Pollandt S, Schroeder B, Kurosky A, Shinnick-Gallagher P. Fear potentiated startle increases phospholipase D (PLD) expression/activity and PLD-linked metabotropic glutamate receptor mediated post-tetanic potentiation in rat amygdala. Neurobiol Learn Mem 2016; 128:65-79. [PMID: 26748024 PMCID: PMC4744522 DOI: 10.1016/j.nlm.2015.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/08/2015] [Accepted: 12/25/2015] [Indexed: 12/30/2022]
Abstract
Long-term memory (LTM) of fear stores activity dependent modifications that include changes in amygdala signaling. Previously, we identified an enhanced probability of release of glutamate mediated signaling to be important in rat fear potentiated startle (FPS), a well-established translational behavioral measure of fear. Here, we investigated short- and long-term synaptic plasticity in FPS involving metabotropic glutamate receptors (mGluRs) and associated downstream proteomic changes in the thalamic-lateral amygdala pathway (Th-LA). Aldolase A, an inhibitor of phospholipase D (PLD), expression was reduced, concurrent with significantly elevated PLD protein expression. Blocking the PLD-mGluR signaling significantly reduced PLD activity. While transmitter release probability increased in FPS, PLD-mGluR agonist and antagonist actions were occluded. In the unpaired group (UNP), blocking the PLD-mGluR increased while activating the receptor decreased transmitter release probability, consistent with decreased synaptic potentials during tetanic stimulation. FPS Post-tetanic potentiation (PTP) immediately following long-term potentiation (LTP) induction was significantly increased. Blocking PLD-mGluR signaling prevented PTP and reduced cumulative PTP probability but not LTP maintenance in both groups. These effects are similar to those mediated through mGluR7, which is co-immunoprecipitated with PLD in FPS. Lastly, blocking mGluR-PLD in the rat amygdala was sufficient to prevent behavioral expression of fear memory. Thus, our study in the Th-LA pathway provides the first evidence for PLD as an important target of mGluR signaling in amygdala fear-associated memory. Importantly, the PLD-mGluR provides a novel therapeutic target for treating maladaptive fear memories in posttraumatic stress and anxiety disorders.
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MESH Headings
- Amygdala/enzymology
- Amygdala/physiology
- Animals
- Conditioning, Classical/drug effects
- Conditioning, Classical/physiology
- Cyclopropanes/pharmacology
- Electric Stimulation
- Excitatory Postsynaptic Potentials/drug effects
- Fear/drug effects
- Fear/physiology
- Fructose-Bisphosphate Aldolase/metabolism
- Glycine/analogs & derivatives
- Glycine/pharmacology
- Long-Term Potentiation/drug effects
- Male
- Memory, Long-Term/drug effects
- Memory, Long-Term/physiology
- Neural Pathways/drug effects
- Neural Pathways/physiology
- Phospholipase D/antagonists & inhibitors
- Phospholipase D/metabolism
- Phospholipase D/physiology
- Rats
- Rats, Sprague-Dawley
- Receptors, Metabotropic Glutamate/agonists
- Receptors, Metabotropic Glutamate/antagonists & inhibitors
- Receptors, Metabotropic Glutamate/physiology
- Reflex, Startle/drug effects
- Reflex, Startle/physiology
- Thalamus/physiology
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Affiliation(s)
- Balaji Krishnan
- Department of Pharmacology & Toxicology, University of Texas Medical Branch, Galveston, TX, United States; UTMB Mitchell Center for Neurodegenerative Diseases, Department of Neurology, University of Texas Medical Branch, Galveston, TX, United States.
| | - Michael T Scott
- Department of Pharmacology & Toxicology, University of Texas Medical Branch, Galveston, TX, United States
| | - Sebastian Pollandt
- Department of Pharmacology & Toxicology, University of Texas Medical Branch, Galveston, TX, United States
| | - Bradley Schroeder
- Department of Pharmacology & Toxicology, University of Texas Medical Branch, Galveston, TX, United States
| | - Alexander Kurosky
- UTMB NHLBI Proteomics Center, Department of Biochemistry & Molecular Biology, University of Texas Medical Branch, Galveston, TX, United States
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Montoya ER, van Honk J, Bos PA, Terburg D. Dissociated neural effects of cortisol depending on threat escapability. Hum Brain Mapp 2015; 36:4304-16. [PMID: 26248899 PMCID: PMC6869485 DOI: 10.1002/hbm.22918] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/13/2015] [Accepted: 07/14/2015] [Indexed: 11/08/2022] Open
Abstract
Evolution has provided us with a highly flexible neuroendocrine threat system which, depending on threat imminence, switches between active escape and passive freezing. Cortisol, the "stress-hormone", is thought to play an important role in both fear behaviors, but the exact mechanisms are not understood. Using pharmacological functional magnetic resonance imaging we investigated how cortisol modulates the brain's fear systems when humans are under virtual-predator attack. We show dissociated neural effects of cortisol depending on whether escape from threat is possible. During inescapable threat cortisol reduces fear-related midbrain activity, whereas in anticipation of active escape cortisol boosts activity in the frontal salience network (insula and anterior cingulate cortex), which is involved in autonomic control, visceral perception and motivated action. Our findings suggest that cortisol adjusts the human neural threat system from passive fear to active escape, which illuminates the hormone's crucial role in the adaptive flexibility of fear behaviors.
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Affiliation(s)
- Estrella R. Montoya
- Department of Experimental PsychologyUtrecht UniversityUtrechtCS3584The Netherlands
| | - Jack van Honk
- Department of Experimental PsychologyUtrecht UniversityUtrechtCS3584The Netherlands
- Department of PsychiatryUniversity of Cape TownCape Town7925South Africa
- Institute of Infectious Diseases and Molecular Medicine, University of Cape TownCape Town7925South Africa
| | - Peter A. Bos
- Department of Experimental PsychologyUtrecht UniversityUtrechtCS3584The Netherlands
- Department of PsychiatryUniversity of Cape TownCape Town7925South Africa
| | - David Terburg
- Department of Experimental PsychologyUtrecht UniversityUtrechtCS3584The Netherlands
- Department of PsychiatryUniversity of Cape TownCape Town7925South Africa
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Agrawal A, Bogdan R. Risky Business: Pathways to Progress in Biologically Informed Studies of Psychopathology. PSYCHOLOGICAL INQUIRY 2015; 26:231-238. [PMID: 27114696 DOI: 10.1080/1047840x.2015.1039930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Arpana Agrawal
- Washington University School of Medicine, Department of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110
| | - Ryan Bogdan
- Washington University in St. Louis, Department of Psychology, CB 1125, One Brookings Drive, Saint Louis, MO 63130
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20
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Wood KH, Wheelock MD, Shumen JR, Bowen KH, Ver Hoef LW, Knight DC. Controllability modulates the neural response to predictable but not unpredictable threat in humans. Neuroimage 2015; 119:371-81. [PMID: 26149610 DOI: 10.1016/j.neuroimage.2015.06.086] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/12/2015] [Accepted: 06/14/2015] [Indexed: 01/15/2023] Open
Abstract
Stress resilience is mediated, in part, by our ability to predict and control threats within our environment. Therefore, determining the neural mechanisms that regulate the emotional response to predictable and controllable threats may provide important new insight into the processes that mediate resilience to emotional dysfunction and guide the future development of interventions for anxiety disorders. To better understand the effect of predictability and controllability on threat-related brain activity in humans, two groups of healthy volunteers participated in a yoked Pavlovian fear conditioning study during functional magnetic resonance imaging (fMRI). Threat predictability was manipulated by presenting an aversive unconditioned stimulus (UCS) that was either preceded by a conditioned stimulus (i.e., predictable) or by presenting the UCS alone (i.e., unpredictable). Similar to animal model research that has employed yoked fear conditioning procedures, one group (controllable condition; CC), but not the other group (uncontrollable condition; UC) was able to terminate the UCS. The fMRI signal response within the dorsolateral prefrontal cortex (PFC), dorsomedial PFC, ventromedial PFC, and posterior cingulate was diminished during predictable compared to unpredictable threat (i.e., UCS). In addition, threat-related activity within the ventromedial PFC and bilateral hippocampus was diminished only to threats that were both predictable and controllable. These findings provide insight into how threat predictability and controllability affects the activity of brain regions (i.e., ventromedial PFC and hippocampus) involved in emotion regulation, and may have important implications for better understanding neural processes that mediate emotional resilience to stress.
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Affiliation(s)
- Kimberly H Wood
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Muriah D Wheelock
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Joshua R Shumen
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Kenton H Bowen
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Lawrence W Ver Hoef
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; Birmingham VA Medical Center, Birmingham, AL 35294, USA
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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The CRH1 antagonist GSK561679 increases human fear but not anxiety as assessed by startle. Neuropsychopharmacology 2015; 40:1064-71. [PMID: 25430779 PMCID: PMC4367474 DOI: 10.1038/npp.2014.316] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/14/2014] [Accepted: 11/17/2014] [Indexed: 01/27/2023]
Abstract
Fear to predictable threat and anxiety to unpredictable threat reflect distinct processes mediated by different brain structures, the central nucleus of the amygdala and the bed nucleus of the stria terminalis (BNST), respectively. This study tested the hypothesis that the corticotropin-releasing factor (CRF1) antagonist GSK561679 differentially reduces anxiety but increases fear in humans. A total of 31 healthy females received each of four treatments: placebo, 50 mg GSK561679 (low-GSK), 400 mg GSK561679 (high-GSK), and 1 mg alprazolam in a crossover design. Participants were exposed to three conditions during each of the four treatments. The three conditions included one in which predictable aversive shocks were signaled by a cue, a second during which shocks were administered unpredictably, and a third condition without shock. Fear and anxiety were assessed using the acoustic startle reflex. High-GSK had no effect on startle potentiation during unpredictable threat (anxiety) but increased startle potentiation during the predictable condition (fear). Low-GSK did not affect startle potentiation across conditions. Consistent with previous findings, alprazolam reduced startle potentiation during unpredictable threat but not during predictable threat. The increased fear by high-GSK replicates animal findings and suggests a lift of the inhibitory effect of the BNST on the amygdala by the CRF1 antagonist.
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Niciu MJ, Mathews DC, Nugent AC, Ionescu DF, Furey ML, Richards EM, Machado-Vieira R, Zarate CA. Developing biomarkers in mood disorders research through the use of rapid-acting antidepressants. Depress Anxiety 2014; 31:297-307. [PMID: 24353110 PMCID: PMC3984598 DOI: 10.1002/da.22224] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 01/10/2023] Open
Abstract
An impediment to progress in mood disorders research is the lack of analytically valid and qualified diagnostic and treatment biomarkers. Consistent with the National Institute of Mental Health (NIMH)'s Research Domain Criteria (RDoC) initiative, the lack of diagnostic biomarkers has precluded us from moving away from a purely subjective (symptom-based) toward a more objective diagnostic system. In addition, treatment response biomarkers in mood disorders would facilitate drug development and move beyond trial-and-error toward more personalized treatments. As such, biomarkers identified early in the pathophysiological process are proximal biomarkers (target engagement), while those occurring later in the disease process are distal (disease pathway components). One strategy to achieve this goal in biomarker development is to increase efforts at the initial phases of biomarker development (i.e. exploration and validation) at single sites with the capability of integrating multimodal approaches across a biological systems level. Subsequently, resultant putative biomarkers could then undergo characterization and surrogacy as these latter phases require multisite collaborative efforts. We have used multimodal approaches - genetics, proteomics/metabolomics, peripheral measures, multimodal neuroimaging, neuropsychopharmacological challenge paradigms and clinical predictors - to explore potential predictor and mediator/moderator biomarkers of the rapid-acting antidepressants ketamine and scopolamine. These exploratory biomarkers may then be used for a priori stratification in larger multisite controlled studies during the validation and characterization phases with the ultimate goal of surrogacy. In sum, the combination of target engagement and well-qualified disease-related measures are crucial to improve our pathophysiological understanding, personalize treatment selection, and expand our armamentarium of novel therapeutics.
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Affiliation(s)
- Mark J. Niciu
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland
| | | | - Allison C. Nugent
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland
| | - Dawn F. Ionescu
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland
| | - Maura L. Furey
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland
| | - Erica M. Richards
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland
| | - Rodrigo Machado-Vieira
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland
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Gorka SM, Nelson BD, Shankman SA. Startle response to unpredictable threat in comorbid panic disorder and alcohol dependence. Drug Alcohol Depend 2013; 132:216-22. [PMID: 23465734 PMCID: PMC3679290 DOI: 10.1016/j.drugalcdep.2013.02.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/16/2013] [Accepted: 02/03/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Although the adverse consequences of comorbid panic disorder (PD) and alcohol dependence (AD) are well-established, relatively little is known about the mechanisms underlying their co-occurrence. Several researchers have postulated that alcohol's ability to dampen response to unpredictable threat may be an important motivational factor in comorbid PD and AD. To date, no research has examined these processes using a clinical sample and it is unclear whether individuals with PD and AD evidence different reactivity to unpredictable threat relative to individuals with PD-only. METHODS The aim of the current study was to examine differences in aversive responding during predictable and unpredictable threat-of-shock in three groups of individuals with: (1) current PD and remitted AD (PD and AD), (2) current PD but no lifetime diagnosis of AD (PD-only), and (3) no lifetime diagnoses of PD or AD (controls). Aversive responding was assessed using a well-established electromyography (EMG) startle paradigm. RESULTS Results indicated that PD and AD individuals evidenced greater startle potentiation during unpredictable (but not predictable) threat relative to controls and PD-only individuals (who did not differ). CONCLUSIONS These findings suggest that heightened reactivity to unpredictable threat may be an important process in PD and AD comorbidity and a possible key motivational factor underlying engagement in alcohol use.
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24
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Translational value of startle modulations. Cell Tissue Res 2013; 354:287-95. [DOI: 10.1007/s00441-013-1599-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 02/21/2013] [Indexed: 01/05/2023]
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25
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Gorka SM, Nelson BD, Sarapas C, Campbell M, Lewis GF, Bishop JR, Porges SW, Shankman SA. Relation between Respiratory Sinus Arrythymia and Startle Response during Predictable and Unpredictable Threat. J PSYCHOPHYSIOL 2013; 27:95-104. [PMID: 23788825 DOI: 10.1027/0269-8803/a000091] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Research suggests that lower respiratory sinus arrhythmia (RSA) is associated with greater aversive responding. One physiological indicator of aversive responding is startle potentiation. While a few studies have demonstrated an inverse association between RSA and startle potentiation, no study to date has distinguished whether this relation is similar for predictable versus unpredictable aversive stimuli. This is an important distinction, given that degree of predictability has been shown to be an important determinant of aversive responding. The present study examined whether resting RSA was associated with startle eye blink responding during predictable and unpredictable threat of electric shock. Resting RSA was collected during a 6-minute seated baseline phase at the beginning of the experimental session. Participants then completed a computerized startle task in which predictable and unpredictable shocks were administered. Results indicated that lower resting RSA was associated with greater startle potentiation during unpredictable threat, but not during predictable threat. These findings are consistent with a growing body of literature suggesting that individual differences in RSA are associated with aversive responding, and extend previous work by suggesting that RSA may be more robustly associated with a heightened sensitivity to unpredictable threat. This pattern of results may have implications for the understanding of pathological anxiety given that individuals with anxiety disorders typically exhibit low RSA and heightened responding during unpredictable threat.
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Affiliation(s)
- Stephanie M Gorka
- University of Illinois at Chicago, Department of Psychology, 1007 West Harrison St. (M/C 285), Chicago, IL60657, ; ; ; ;
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26
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van Ast VA, Vervliet B, Kindt M. Contextual control over expression of fear is affected by cortisol. Front Behav Neurosci 2012; 6:67. [PMID: 23087629 PMCID: PMC3468896 DOI: 10.3389/fnbeh.2012.00067] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 09/25/2012] [Indexed: 02/02/2023] Open
Abstract
At the core of anxiety disorders is the inability to use contextual information to modulate behavioral responses to potentially threatening events. Models of the pathogenesis of anxiety disorders incorporate stress and concomitant stress hormones as important vulnerability factors, while others emphasize sex as an important factor. However, translational basic research has not yet investigated the effects of stress hormones and sex on the ability to use contextual information to modulate responses to threat. Therefore, the purpose of the present study was threefold: first, we aimed at developing an experimental paradigm specifically capable of capturing contextual modulation of the expression of fear. Second, we tested whether cortisol would alter the contextualization of fear expression. Third, we aimed at assessing whether alterations in contextualization due to cortisol were different for men and women. Healthy participants (n = 42) received placebo or hydrocortisone (20 mg) prior to undergoing a newly developed differential contextual fear-conditioning paradigm. The results indicated that people rapidly acquire differential contextual modulation of the expression of fear, as measured by fear potentiated startle (FPS) and skin conductance responses (SCR). In addition, cortisol impaired the contextualization of fear expression leading to increased fear generalization on FPS data in women. The opposite pattern was found in men. Finally, as assessed by SCR, cortisol impaired differential conditioning in men. The results are in line with models suggesting heightened vulnerability in women for developing anxiety disorders after stressful events.
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Affiliation(s)
- Vanessa A van Ast
- Department of Clinical Psychology, University of Amsterdam Amsterdam, Netherlands
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27
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Acute tryptophan depletion increases translational indices of anxiety but not fear: serotonergic modulation of the bed nucleus of the stria terminalis? Neuropsychopharmacology 2012; 37:1963-71. [PMID: 22491355 PMCID: PMC3376328 DOI: 10.1038/npp.2012.43] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Serotonin is strongly implicated in the mammalian stress response, but surprisingly little is known about its mode of action. Recent data suggest that serotonin can inhibit aversive responding in humans, but this remains underspecified. In particular, data in rodents suggest that global serotonin depletion may specifically increase long-duration bed nucleus of the stria terminalis (BNST)-mediated aversive responses (ie, anxiety), but not short-duration BNST-independent responses (ie, fear). Here, we extend these findings to humans. In a balanced, placebo-controlled crossover design, healthy volunteers (n=20) received a controlled diet with and without the serotonin precursor tryptophan (acute tryptophan depletion; ATD). Aversive states were indexed by translational acoustic startle measures. Fear and anxiety were operationally defined as the increase in startle reactivity during short- and long-duration threat periods evoked by predictable shock (fear-potentiated startle) and by the context in which the shocks were administered (anxiety-potentiated startle), respectively. ATD significantly increased long-duration anxiety-potentiated startle but had no effect on short-duration fear-potentiated startle. These results suggest that serotonin depletion in humans selectively increases anxiety but not fear. Current translational frameworks support the proposition that ATD thus disinhibits dorsal raphé-originating serotonergic control of corticotropin-releasing hormone-mediated excitation of the BNST. This generates a candidate neuropharmacological mechanism by which depleted serotonin may increase response to sustained threats, alongside clear implications for our understanding of the manifestation and treatment of mood and anxiety disorders.
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28
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Schmitz A, Grillon C. Assessing fear and anxiety in humans using the threat of predictable and unpredictable aversive events (the NPU-threat test). Nat Protoc 2012; 7:527-32. [PMID: 22362158 PMCID: PMC3446242 DOI: 10.1038/nprot.2012.001] [Citation(s) in RCA: 248] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The threat of predictable and unpredictable aversive events was developed to assess short-duration (fear) and long-duration (anxiety) aversive states in humans. A typical experiment consists of three conditions: a safe condition (neutral (N)), during which participants are safe from aversive stimuli, and two threat conditions-one in which aversive events are administered predictably (P) (i.e., signaled by a threat cue), and one in which aversive stimuli are administered unpredictably (U). During the so-called NPU-threat test, ongoing change in aversive states is measured with the startle reflex. The NPU-threat test has been validated in pharmacological and clinical studies and can be implemented in children and adults. Similar procedures have been applied in animal models, making the NPU-threat test an ideal tool for translational research. The procedure is relatively short (35 min), simple to implement and generates consistent results with large effect sizes.
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Affiliation(s)
- Anja Schmitz
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
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29
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Krugers HJ, Zhou M, Joëls M, Kindt M. Regulation of excitatory synapses and fearful memories by stress hormones. Front Behav Neurosci 2011; 5:62. [PMID: 22013419 PMCID: PMC3190121 DOI: 10.3389/fnbeh.2011.00062] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Accepted: 09/05/2011] [Indexed: 12/18/2022] Open
Abstract
Memories for emotionally arousing and fearful events are generally well retained. From the evolutionary point of view this is a highly adaptive behavioral response aimed to remember relevant information. However, fearful memories can also be inappropriately and vividly (re)expressed, such as in posttraumatic stress disorder. The memory formation of emotionally arousing events is largely modulated by hormones, peptides, and neurotransmitters which are released during and after exposure to these conditions. One of the core reactions in response to a stressful situation is the rapid activation of the autonomic nervous system, which results in the release of norepinephrine in the brain. In addition, stressful events stimulate the hypothalamus-pituitary-adrenal axis which slowly increases the release of glucocorticoid hormones from the adrenal glands. Here we will review how glucocorticoids and norepinephrine regulate the formation of fearful memories in rodents and humans and how these hormones can facilitate the storage of information by regulating excitatory synapses.
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Affiliation(s)
- Harm J. Krugers
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of AmsterdamAmsterdam, Netherlands
| | - Ming Zhou
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of AmsterdamAmsterdam, Netherlands
| | - Marian Joëls
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of AmsterdamAmsterdam, Netherlands
- Department of Neuroscience and Pharmacology, Rudolf Magnus Institute of Neuroscience, University Medical Center UtrechtUtrecht, Netherlands
| | - Merel Kindt
- Department of Clinical Psychology, University of AmsterdamAmsterdam, Netherlands
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