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Abstract
The study and use of resilience is of the utmost importance to psychodynamic psychiatry. It is deeply ingrained in ideas about well-being and the treatment and care of patients. However, its neurobiology is incompletely understood, its terminology and relation to trauma and coping not well defined, and its efficacy underutilized in clinical practice. This article reviews the scientific literature on resilience, especially as it relates to trauma and coping. It also attempts to point the way for its greater application in psychiatry and mental health by utilizing resilience in more informed and individualized approaches.
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Affiliation(s)
- Ahron Friedberg
- Clinical Professor of Psychiatry at Mount Sinai in New York City
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Paiva T, Canas-Simião H. Sleep and violence perpetration: A review of biological and environmental substrates. J Sleep Res 2022; 31:e13547. [PMID: 35037316 DOI: 10.1111/jsr.13547] [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: 10/03/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/27/2022]
Abstract
Violence is a worldwide societal burden that negatively impacts individual health, wellbeing and economic development. Evidence suggests a bidirectional relationship between sleep changes and violence. This review details, evaluates and discusses the biological and demographic substrates linking sleep and violence perpetration, and summarizes the overlap of brain areas, functional neuronal systems and genetic features involved, not including violent behaviours during sleep. Knowledge on the biological variables that affect the individual's susceptibility to violent behaviour may have implications for criminology, management of detentions and rehabilitation strategies.
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Affiliation(s)
- Teresa Paiva
- Sleep and Medicine Center (CENC), Comprehensive Health Research Center (CHRC), Instituto de Saúde Ambiental - Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Hugo Canas-Simião
- Psychiatry and Mental Health Department, Centro Hospitalar de Lisboa Ocidental (CHLO); Comprehensive Health Research Center (CHRC); Sleep and Medicine Center (CENC), Lisbon, Portugal
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Williamson JB, Jaffee MS, Jorge RE. Posttraumatic Stress Disorder and Anxiety-Related Conditions. Continuum (Minneap Minn) 2021; 27:1738-1763. [PMID: 34881734 DOI: 10.1212/con.0000000000001054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article provides a synopsis of current assessment and treatment considerations for posttraumatic stress disorder (PTSD) and related anxiety disorder characteristics. Epidemiologic and neurobiological data are reviewed as well as common associated symptoms, including sleep disruption, and treatment approaches to these conditions. RECENT FINDINGS PTSD is no longer considered an anxiety-related disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition classification and instead is associated with trauma/stressor-related disorders. PTSD symptoms are clustered into four domains including intrusive experiences, avoidance, mood, and arousal symptoms. Despite this reclassification, similarities exist in consideration of diagnosis, treatment, and comorbidities with anxiety disorders. PTSD and anxiety-related disorders are heterogeneous, which is reflected by the neural circuits involved in the genesis of symptoms that may vary across symptom domains. Treatment is likely to benefit from consideration of this heterogeneity.Research in animal models of fear and anxiety, as well as in humans, suggests that patients with PTSD and generalized anxiety disorder have difficulty accurately determining safety from danger and struggle to suppress fear in the presence of safety cues.Empirically supported psychotherapies commonly involved exposure (fear extinction learning) and are recommended for PTSD. Cognitive-behavioral therapy has been shown to be effective in other anxiety-related disorders. Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are commonly used in the treatment of PTSD and anxiety disorders in which pharmacologic intervention is supported. Treating sleep disruption including sleep apnea (continuous positive airway pressure [CPAP]), nightmares, and insomnia (preferably via psychotherapy) may improve symptoms of PTSD, as well as improve mood in anxiety disorders. SUMMARY PTSD has a lifetime prevalence that is close to 10% and shares neurobiological features with anxiety disorders. Anxiety disorders are the most common class of mental conditions and are highly comorbid with other disorders; treatment considerations typically include cognitive-behavioral therapy and pharmacologic intervention. Developing technologies show some promise as treatment alternatives in the future.
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Translational Studies in the Complex Role of Neurotransmitter Systems in Anxiety and Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:121-140. [PMID: 32002926 DOI: 10.1007/978-981-32-9705-0_8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Discovery of innovative anxiolytics is severely hampering. Existing anxiolytics are developed decades ago and are still the therapeutics of choice. Moreover, lack of new drug targets forecasts a severe jeopardy in the future treatment of the huge population of CNS-diseased patients. We simply lack the knowledge on what is wrong in brains of anxious people (normal and diseased). Translational research, based on interacting clinical and preclinical research, is extremely urgent. In this endeavor, genetic and genomic approaches are part of the spectrum of contributing factors. We focus on three druggable targets: serotonin transporter, 5-HT1A, and GABAA receptors. It is still uncertain whether and how these targets are involved in normal and diseased anxiety processes. For serotonergic anxiolytics, the slow onset of action points to indirect effects leading to plasticity changes in brain systems leading to reduced anxiety. For GABAA benzodiazepine drugs, acute anxiolytic effects are found indicating primary mechanisms directly influencing anxiety processes. Close translational collaboration between fundamental academic and discovery research will lead to badly needed breakthroughs in the search for new anxiolytics.
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Abstract
The study and use of resilience is of the utmost importance to psychodynamic psychiatry. It is deeply ingrained in ideas about well-being and the treatment and care of patients. However, its neurobiology is incompletely understood, its terminology and relation to trauma and coping not well defined, and its efficacy underutilized in clinical practice. This article reviews the scientific literature on resilience, especially as it relates to trauma and coping. It also attempts to point the way for its greater application in psychiatry and mental health by utilizing resilience in more informed and individualized approaches.
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Affiliation(s)
- Ahron Friedberg
- Clinical Professor of Psychiatry at Mount Sinai in New York City
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Morozova A, Zubkov E, Strekalova T, Kekelidze Z, Storozeva Z, Schroeter CA, Bazhenova N, Lesch KP, Cline BH, Chekhonin V. Ultrasound of alternating frequencies and variable emotional impact evokes depressive syndrome in mice and rats. Prog Neuropsychopharmacol Biol Psychiatry 2016; 68:52-63. [PMID: 27036099 DOI: 10.1016/j.pnpbp.2016.03.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 02/29/2016] [Accepted: 03/11/2016] [Indexed: 01/06/2023]
Abstract
Emotional stress is primarily triggered by the cognitive processing of negative input; it is regarded as a serious pathogenetic factor of depression that is challenging to model in animals. While available stress paradigms achieve considerable face and construct validity in modelling depressive disorders, broader use of naturalistic stressors instead of the more prevalent models with artificial challenges inducing physical discomfort or pain may substantially contribute to the development of novel antidepressants. Here, we investigated whether a 3-week exposure of Wistar rats and Balb/c mice to unpredictably alternating frequencies of ultrasound between the ranges of 20-25 and 25-45kHz, which are known to correspond with an emotionally negative and with a neutral emotional state, respectively, for small rodents in nature, can induce behavioural and molecular depressive-like changes. Both rats and mice displayed decreased sucrose preference, elevated "despair" behaviour in a swim test, reduced locomotion and social exploration. Rats showed an increased expression of SERT and 5-HT2A receptor, a decreased expression of 5-HT1A receptor in the prefrontal cortex and hippocampus, diminished BDNF on gene and protein levels in the hippocampus. Fluoxetine, administered to rats at the dose of 10mg/kg, largely precluded behavioural depressive-like changes. Thus, the here applied paradigm of emotional stress is generating an experimental depressive state in rodents, which is not related to any physical stressors or pain. In essence, this ultrasound stress model, besides enhancing animal welfare, is likely to provide improved validity in the modelling of clinical depression and may help advance translational research and drug discovery for this disorder.
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Affiliation(s)
- Anna Morozova
- Department of Basic and Applied Neurobiology, V.P. Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia; Department of Medical Nanobiotechnology, Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - Eugene Zubkov
- Department of Basic and Applied Neurobiology, V.P. Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia; Department of Medical Nanobiotechnology, Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - Tatyana Strekalova
- Department of Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Zurab Kekelidze
- Department of Basic and Applied Neurobiology, V.P. Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | - Zinaida Storozeva
- Department of Basic and Applied Neurobiology, V.P. Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | | | - Nataliia Bazhenova
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Brandon H Cline
- INSERM U1119, FMTS, Université de Strasbourg, Faculté de Médecine, Strasbourg, France.
| | - Vladimir Chekhonin
- Department of Basic and Applied Neurobiology, V.P. Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia; Department of Medical Nanobiotechnology, Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia.
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Lee JC, Wang LP, Tsien JZ. Dopamine Rebound-Excitation Theory: Putting Brakes on PTSD. Front Psychiatry 2016; 7:163. [PMID: 27729874 PMCID: PMC5037223 DOI: 10.3389/fpsyt.2016.00163] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/14/2016] [Indexed: 01/19/2023] Open
Abstract
It is not uncommon for humans or animals to experience traumatic events in their lifetimes. However, the majority of individuals are resilient to long-term detrimental changes turning into anxiety and depression, such as post-traumatic stress disorder (PTSD). What underlying neural mechanism accounts for individual variability in stress resilience? Hyperactivity in fear circuits, such as the amygdalar system, is well-known to be the major pathophysiological basis for PTSD, much like a "stuck accelerator." Interestingly, increasing evidence demonstrates that dopamine (DA) - traditionally known for its role in motivation, reward prediction, and addiction - is also crucial in regulating fear learning and anxiety. Yet, how dopaminergic (DAergic) neurons control stress resilience is unclear, especially given that DAergic neurons have multiple subtypes with distinct temporal dynamics. Here, we propose the Rebound-Excitation Theory, which posits that DAergic neurons' rebound-excitation at the termination of fearful experiences serves as an important "brake" by providing intrinsic safety-signals to fear-processing neural circuits in a spatially and temporally controlled manner. We discuss how DAergic neuron rebound-excitation may be regulated by genetics and experiences, and how such physiological properties may be used as a brain-activity biomarker to predict and confer individual resilience to stress and anxiety.
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Affiliation(s)
- Jason C Lee
- Department of Neurology, Brain and Behavior Discovery Institute, Medical College of Georgia, Augusta University , Augusta, GA , USA
| | - Lei Philip Wang
- Department of Neurology, Brain and Behavior Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA; Department of Psychiatry, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Joe Z Tsien
- Department of Neurology, Brain and Behavior Discovery Institute, Medical College of Georgia, Augusta University , Augusta, GA , USA
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Hawn SE, Overstreet C, Stewart KE, Amstadter AB. Recent advances in the genetics of emotion regulation: a review. Curr Opin Psychol 2015; 3:108-116. [PMID: 27588302 PMCID: PMC5004926 DOI: 10.1016/j.copsyc.2014.12.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent attention has been given to the role of emotion regulation in the development and maintenance of psychopathology, and the psychosocial literature on emotion regulation has been growing rapidly over the past decade. However, knowledge about the genetic etiology of emotion regulation facets has been slower to develop. The present paper aims to briefly introduce the various constructs that fall under the umbrella of emotion regulation; provide an overview of behavioral genetic methods; summarize the empirical studies of emotion regulation twin studies; introduce molecular genetic methods; review the recent molecular genetic studies on emotion regulation; and provide future directions for research.
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Affiliation(s)
- Sage E Hawn
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Cassie Overstreet
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Karen E Stewart
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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Strekalova T, Evans M, Chernopiatko A, Couch Y, Costa-Nunes J, Cespuglio R, Chesson L, Vignisse J, Steinbusch HW, Anthony DC, Pomytkin I, Lesch KP. Deuterium content of water increases depression susceptibility: the potential role of a serotonin-related mechanism. Behav Brain Res 2014; 277:237-44. [PMID: 25092571 DOI: 10.1016/j.bbr.2014.07.039] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 07/22/2014] [Accepted: 07/23/2014] [Indexed: 12/17/2022]
Abstract
Environmental factors can significantly affect disease prevalence, including neuropsychiatric disorders such as depression. The ratio of deuterium to protium in water shows substantial geographical variation, which could affect disease susceptibility. Thus the link between deuterium content of water and depression was investigated, both epidemiologically, and in a mouse model of chronic mild stress. We performed a correlation analysis between deuterium content of tap water and rates of depression in regions of the USA. Next, we used a 10-day chronic stress paradigm to test whether 2-week deuterium-depleted water treatment (91 ppm) affects depressive-like behavior and hippocampal SERT. The effect of deuterium-depletion on sleep electrophysiology was also evaluated in naïve mice. There was a geographic correlation between a content of deuterium and the prevalence of depression across the USA. In the chronic stress model, depressive-like features were reduced in mice fed with deuterium-depleted water, and SERT expression was decreased in mice treated with deuterium-treated water compared with regular water. Five days of predator stress also suppressed proliferation in the dentate gyrus; this effect was attenuated in mice fed with deuterium-depleted water. Finally, in naïve mice, deuterium-depleted water treatment increased EEG indices of wakefulness, and decreased duration of REM sleep, phenomena that have been shown to result from the administration of selective serotonin reuptake inhibitors (SSRI). Our data suggest that the deuterium content of water may influence the incidence of affective disorder-related pathophysiology and major depression, which might be mediated by the serotoninergic mechanisms.
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Affiliation(s)
- Tatyana Strekalova
- Department of Pharmacology, Oxford University, Oxford, UK; Institute for Hygiene and Tropical Medicine, New University of Lisbon, Portugal; School for Mental Health and Neuroscience, Department of Neuroscience, Maastricht University, Maastricht, Netherlands.
| | - Matthew Evans
- Department of Pharmacology, Oxford University, Oxford, UK
| | - Anton Chernopiatko
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia; Timantti AB, Stockholm, Sweden
| | - Yvonne Couch
- Department of Pharmacology, Oxford University, Oxford, UK
| | - João Costa-Nunes
- Institute for Hygiene and Tropical Medicine, New University of Lisbon, Portugal
| | - Raymond Cespuglio
- Claude Bernard University, Faculty of Medicine, EA 4170 Lyon, France
| | | | | | - Harry W Steinbusch
- School for Mental Health and Neuroscience, Department of Neuroscience, Maastricht University, Maastricht, Netherlands
| | | | - Igor Pomytkin
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia; Timantti AB, Stockholm, Sweden
| | - Klaus-Peter Lesch
- School for Mental Health and Neuroscience, Department of Neuroscience, Maastricht University, Maastricht, Netherlands; Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany.
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11
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Olivier JDA, Vinkers CH, Olivier B. The role of the serotonergic and GABA system in translational approaches in drug discovery for anxiety disorders. Front Pharmacol 2013; 4:74. [PMID: 23781201 PMCID: PMC3677985 DOI: 10.3389/fphar.2013.00074] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/21/2013] [Indexed: 12/13/2022] Open
Abstract
There is ample evidence that genetic factors play an important role in anxiety disorders. In support, human genome-wide association studies have implicated several novel candidate genes. However, illumination of such genetic factors involved in anxiety disorders has not resulted in novel drugs over the past decades. A complicating factor is the heterogeneous classification of anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and diverging operationalization of anxiety used in preclinical and clinical studies. Currently, there is an increasing focus on the gene × environment (G × E) interaction in anxiety as genes do not operate in isolation and environmental factors have been found to significantly contribute to the development of anxiety disorders in at-risk individuals. Nevertheless, extensive research on G × E mechanisms in anxiety has not resulted in major breakthroughs in drug discovery. Modification of individual genes in rodent models has enabled the specific study of anxiety in preclinical studies. In this context, two extensively studied neurotransmitters involved in anxiety are the gamma-aminobutyric acid (GABA) and 5-HT (5-hydroxytryptamine) system. In this review, we illustrate the complex interplay between genes and environment in anxiety processes by reviewing preclinical and clinical studies on the serotonin transporter (5-HTT), 5-HT1A receptor, 5-HT2 receptor, and GABAA receptor. Even though targets from the serotonin and GABA system have yielded drugs with known anxiolytic efficacy, the relation between the genetic background of these targets and anxiety symptoms and development of anxiety disorders is largely unknown. The aim of this review is to show the vast complexity of genetic and environmental factors in anxiety disorders. In light of the difficulty with which common genetic variants are identified in anxiety disorders, animal models with translational validity may aid in elucidating the neurobiological background of these genes and their possible role in anxiety. We argue that, in addition to human genetic studies, translational models are essential to map anxiety-related genes and to enhance our understanding of anxiety disorders in order to develop potentially novel treatment strategies.
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Affiliation(s)
- Jocelien D A Olivier
- Department of, Women's and Children's Health, Uppsala University Uppsala, Sweden ; Center for Gender Medicine, Karolinska Institutet Stockholm, Sweden
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Couch Y, Anthony DC, Dolgov O, Revischin A, Festoff B, Santos AI, Steinbusch HW, Strekalova T. Microglial activation, increased TNF and SERT expression in the prefrontal cortex define stress-altered behaviour in mice susceptible to anhedonia. Brain Behav Immun 2013; 29:136-146. [PMID: 23305936 DOI: 10.1016/j.bbi.2012.12.017] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/14/2012] [Accepted: 12/21/2012] [Indexed: 01/03/2023] Open
Abstract
A chronic stress paradigm comprising exposure to predation, tail suspension and restraint induces a depressive syndrome in C57BL/6J mice that occurs in some, but not all, animals. Here, we sought to extend our behavioural studies to investigate how susceptibility (sucrose preference<65%) or resilience (sucrose preference>65%) to stress-induced anhedonia affects the 5HT system and the expression of inflammation-related genes. All chronically stressed animals, displayed increased level of anxiety, but susceptible mice exhibited an increased propensity to float in the forced swim test and demonstrate hyperactivity under stressful lighting conditions. These changes were not present in resilient or acutely stressed animals. Compared to resilient animals, susceptible mice showed elevated expression of tumour necrosis factor alpha (TNF) and the 5-HT transporter (SERT) in the pre-frontal area. Enhanced expression of 5HT(2A) and COX-1 in the pre-frontal area was observed in all stressed animals. In turn, indoleamine-2,3-dioxygenase (IDO) was significantly unregulated in the raphe of susceptible animals. At the cellular level, increased numbers of Iba-1-positive microglial cells were also present in the prefrontal area of susceptible animals compared to resilient animals. Consequently, the susceptible animals display a unique molecular profile when compared to resilient, but anxious, animals. Unexpectedly, this altered profile provides a rationale for exploring anti-inflammatory, and possibly, TNF-targeted therapy for major depression.
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Affiliation(s)
- Yvonne Couch
- Department of Pharmacology, Oxford University, Mansfield Road, Oxford, UK
| | - Daniel C Anthony
- Department of Pharmacology, Oxford University, Mansfield Road, Oxford, UK.
| | - Oleg Dolgov
- Department of Molecular Cell Biology, Max-Planck Institute of Biophysical Chemistry, Göttingen, Germany; Institute of Normal Physiology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russia
| | - Alexander Revischin
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russia
| | | | - Ana Isabel Santos
- Department of Physiology, Medical Faculty, New University of Lisbon, Campo Martires da Patria, Lisbon, Portugal
| | - Harry W Steinbusch
- Department of Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Tatyana Strekalova
- Department of Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
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Russo SJ, Murrough JW, Han MH, Charney DS, Nestler EJ. Neurobiology of resilience. Nat Neurosci 2012; 15:1475-84. [PMID: 23064380 PMCID: PMC3580862 DOI: 10.1038/nn.3234] [Citation(s) in RCA: 677] [Impact Index Per Article: 56.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 09/11/2012] [Indexed: 02/07/2023]
Abstract
Humans exhibit a remarkable degree of resilience in the face of extreme stress, with most resisting the development of neuropsychiatric disorders. Over the past 5 years, there has been increasing interest in the active, adaptive coping mechanisms of resilience; however, in humans, most published work focuses on correlative neuroendocrine markers that are associated with a resilient phenotype. In this review, we highlight a growing literature in rodents that is starting to complement the human work by identifying the active behavioral, neural, molecular and hormonal basis of resilience. The therapeutic implications of these findings are important and can pave the way for an innovative approach to drug development for a range of stress-related syndromes.
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Affiliation(s)
- Scott J Russo
- Department of Neuroscience, Friedman Brain Institute, Mount Sinai School of Medicine, New York, New York, USA.
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Klucken T, Wehrum S, Schweckendiek J, Merz CJ, Hennig J, Vaitl D, Stark R. The 5-HTTLPR polymorphism is associated with altered hemodynamic responses during appetitive conditioning. Hum Brain Mapp 2012; 34:2549-60. [PMID: 22505321 DOI: 10.1002/hbm.22085] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2011] [Revised: 02/20/2012] [Accepted: 02/28/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Current models suggest that a variation in the promoter region of the serotonin transporter gene (5-HTTLPR) is associated with altered amygdala reactivity not only towards negative but also towards positive stimuli, which has been neglected in the past. This association may possibly convey an elevated vulnerability for psychopathology like abuse, craving, and relapses. Since appetitive conditioning is a crucial mechanism in the pathogenesis of these psychiatric disorders, the identification of specific factors contributing to interindividual variation is important. METHODS In the present study (N = 86), an appetitive conditioning paradigm was conducted, in which a neutral stimulus (CS+) was associated with appetitive stimuli, while a second stimulus (CS-) predicted their absence. Subjects were genotyped according to the 5-HTTLPR genotype. RESULTS As the main result, we report a significant association between the 5-HTTLPR genotype and hemodynamic responses. Individuals with the s-allele displayed elevated conditioned bilateral amygdala activity in contrast to l/l-allele carriers. Further, increased hemodynamic responses in s-allele carriers were also found in the extended emotional network including the orbitofrontal cortex, the thalamus, and the ventral striatum. CONCLUSION The present findings indicate an association of the 5-HTTLPR and altered conditioned responses in appetitive conditioning. Further, the findings contribute to the ongoing debate on 5-HTTLPR dependent hemodynamic response patterns by emphasizing that s-allele carriers are not exclusively biased towards fearful, but also towards positive stimuli. In conclusion, our results imply that s-allele carriers might be better described as hyper-reactive towards salient stimuli, which may convey vulnerability for the development of psychiatric disorders.
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Affiliation(s)
- Tim Klucken
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany
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Pergamin-Hight L, Bakermans-Kranenburg MJ, van Ijzendoorn MH, Bar-Haim Y. Variations in the promoter region of the serotonin transporter gene and biased attention for emotional information: a meta-analysis. Biol Psychiatry 2012; 71:373-9. [PMID: 22138391 DOI: 10.1016/j.biopsych.2011.10.030] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 10/20/2011] [Accepted: 10/21/2011] [Indexed: 12/16/2022]
Abstract
BACKGROUND Selective attention to negative information has been strongly implicated in the etiology and maintenance of anxiety and offered as a potential intermediate phenotype for anxiety disorders. Attention biases have been studied in relation to a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) offering equivocal findings. The present meta-analysis tested whether the extant published data support the notion that variation in the 5-HTTLPR genotype modulates selective attention to negative information. METHODS Eleven relevant samples from 10 published articles were identified through a systematic literature search (total n = 807). Relevant attention bias and 5-HTTLPR data were extracted based on specific coding rules, and Cohen's d effect size index was used to calculate all outcome measures. Publication bias was assessed using various methods. RESULTS Carriers of the low (SS, SL(G), L(G)L(G)) transmission efficacy genotype display attentional vigilance toward negatively valenced stimuli, a pattern not found in the intermediate (SL(A), L(A)L(G)) and high (L(A)L(A)) efficacy genotypes. This phenomenon emerges as of medium effect size. CONCLUSIONS The meta-analysis supports the notion that allele variants of the 5-HTTLPR are associated with selective attention to negative stimuli. More studies are needed to fully establish the consistency of this effect. Future studies applying systematic attention bias modification may shed further light on the role of 5-HTTLPR in the development of anxiety disorders and in the prediction of clinical response to attention bias modification treatments.
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Affiliation(s)
- Lee Pergamin-Hight
- The Adler Center for Child Development and Psychopathology, Department of Psychology, Tel Aviv University, Tel Aviv, Israel
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Derakshan N, Koster EHW. Information processing, affect, and psychopathology: A Festschrift for Michael W. Eysenck. JOURNAL OF COGNITIVE PSYCHOLOGY 2012. [DOI: 10.1080/20445911.2011.637489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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17
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Margoob MA, Mushtaq D. Serotonin transporter gene polymorphism and psychiatric disorders: is there a link? Indian J Psychiatry 2011; 53:289-99. [PMID: 22303036 PMCID: PMC3267339 DOI: 10.4103/0019-5545.91901] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Though still in infancy, the field of psychiatric genetics holds great potential to contribute to the development of new diagnostic and therapeutic options to treat these disorders. Among a large number of existing neurotransmitter systems, the serotonin system dysfunction has been implicated in many psychiatric disorders and therapeutic efficacy of many drugs is also thought to be based on modulation of serotonin. Serotonin transporter gene polymorphism is one of the most extensively studied polymorphisms in psychiatric behavioral genetics. In this article, we review the status of evidence for association between the serotonin gene polymorphism and some common mental disorders like affective disorders, post-traumatic stress disorder, obsessive-compulsive disorder, suicide, autism, and other anxiety and personality disorders. Going beyond traditional association studies, gene-environment interaction, currently gaining momentum, is also discussed in the review. While the existing information of psychiatric genetics is inadequate for putting into practice genetic testing in the diagnostic work-up of the psychiatric patient, if consistent in future research attempts, such results can be of great help to improve the clinical care of a vast majority of patients suffering from such disorders.
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Affiliation(s)
- Mushtaq A Margoob
- Department of Psychiatry, Institute of Mental Health and Neurosciences-Kashmir, Kashmir, India.
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