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Ren L, Yu J, Chen H, Luo J, Lv F, Min S. Alteration of hyperpolarization-activated cation current-mediated metaplasticity contributes to electroconvulsive shock-induced learning and memory impairment in depressed rats. Front Psychiatry 2024; 15:1365119. [PMID: 38911706 PMCID: PMC11190359 DOI: 10.3389/fpsyt.2024.1365119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
Background Accompanied by a rapid and effective antidepressant effect, electroconvulsive shock (ECS) can also induce learning and memory impairment. Our previous research reported that metaplasticity is involved in this process. However, the mechanisms still remain unclear. This study investigated the role of I h current in the metaplastic changes and learning and memory impairment induced by ECS in depressive rats. Methods Depressive rats received ECS after modelling using chronic unpredictable. ZD7288, a type of I h current inhibitor was used to verify the effect of I h current. The sucrose preference test and Morris water maze were used for behavior testing. Changes in metaplasticity was assessed with the LTD/LTP threshold by stimulation at different frequencies. Spontaneous and evoked action potentials (APs) were measured to confirm difference of neuronal excitability. Additionally, the amplitude of I h current was analyzed. Results ECS exerts antidepressant effect, but also induce spatial learning and memory dysfunction. ECS up-regulates the LTD/LTP threshold. In rats treated with ECS, the frequency of spontaneous and evoked APs is significantly reduced. In addition, ECS induces changes in the intrinsic properties of AP, including a decrease of AP-half width and peak amplitude, and an increase in AP time to peak and post-hyperpolarization potential amplitude. In particular, ECS increases both instantaneous and steady-state I h currents. However, Inhibition of I h current with ZD7288 results in a relief of learning and memory impairment and a decrease in threshold, as well as a significant reversal of whole-cell electrophysiological changes. Conclusion ECS-induced learning and memory impairment is caused by neuronal hypoexcitability mediated metaplasticity, and upregulation of LTD/LTP threshold by an increase in I h current.
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Affiliation(s)
- Li Ren
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yu
- Department of Psychiatry, Shanghai 10th People’s Hospital, Anesthesia and Brain Research Institute, Tongji University, Shanghai, China
| | - Hengsheng Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jie Luo
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Lv
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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2
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Kim J, He MJ, Widmann AK, Lee FS. The role of neurotrophic factors in novel, rapid psychiatric treatments. Neuropsychopharmacology 2024; 49:227-245. [PMID: 37673965 PMCID: PMC10700398 DOI: 10.1038/s41386-023-01717-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/11/2023] [Accepted: 07/26/2023] [Indexed: 09/08/2023]
Abstract
Neurotrophic factors are a family of growth factors that modulate cellular growth, survival, and differentiation. For many decades, it has been generally believed that a lack of neurotrophic support led to the decreased neuronal synaptic plasticity, death, and loss of non-neuronal supportive cells seen in neuropsychiatric disorders. Traditional psychiatric medications that lead to immediate increases in neurotransmitter levels at the synapse have been shown also to elevate synaptic neurotrophic levels over weeks, correlating with the time course of the therapeutic effects of these drugs. Recent advances in psychiatric treatments, such as ketamine and psychedelics, have shown a much faster onset of therapeutic effects (within minutes to hours). They have also been shown to lead to a rapid release of neurotrophins into the synapse. This has spurred a significant shift in understanding the role of neurotrophins and how the receptor tyrosine kinases that bind neurotrophins may work in concert with other signaling systems. In this review, this renewed understanding of synaptic receptor signaling interactions and the clinical implications of this mechanistic insight will be discussed within the larger context of the well-established roles of neurotrophic factors in psychiatric disorders and treatments.
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Affiliation(s)
- Jihye Kim
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Michelle J He
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Alina K Widmann
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Francis S Lee
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA.
- Department of Pharmacology, Weill Cornell Medicine, New York, NY, 10065, USA.
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Zhu X, Zhang F, You Y, Wang H, Yuan S, Wu B, Zhu R, Liu D, Yan F, Wang Z. S-Ketamine Exerts Antidepressant Effects by Regulating Rac1 GTPase Mediated Synaptic Plasticity in the Hippocampus of Stressed Rats. Cell Mol Neurobiol 2023; 43:299-314. [PMID: 35083636 DOI: 10.1007/s10571-021-01180-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/03/2021] [Indexed: 01/07/2023]
Abstract
Clinical studies have found that ketamine has a rapid and lasting antidepressant effect, especially in the case of patients with major depressive disorder (MDD). The molecular mechanisms, however, remain unclear. In this study, we observe the effects of S-Ketamine on the expression of Rac1, neuronal morphology, and synaptic transmission function in the hippocampus of stressed rats. Chronic unpredictable mild stress (CUMS) was used to construct stressed rats. The rats were given a different regimen of ketamine (20 mg/kg, i.p.) and Rac1 inhibitor NSC23766 (50 µg, ICV) treatment. The depression-like behavior of rats was evaluated by sucrose preference test and open-field test. The protein expression of Rac1, GluA1, synapsin1, and PSD95 in the hippocampus was detected by Western blot. Pull-down analysis was used to examine the activity of Rac1. Golgi staining and electrophysiological study were used to observe the neuronal morphology and long-term potentiation (LTP). Our results showed that ketamine can up-regulate the expression and activity of Rac1; increase the spine density and the expression of synaptic-related proteins such as GluA1, Synapsin1, and PSD95 in the hippocampus of stressed rats; reduce the CUMS-induced LTP impairments; and consequently improve depression-like behavior. However, Rac1 inhibitor NSC23766 could have effectively reversed ketamine-mediated changes in the hippocampus of rats and counteracted its antidepressant effects. The specific mechanism of S-Ketamine's antidepressant effect may be related to the up-regulation of the expression and activity of Rac1 in the hippocampus of stressed rats, thus enhancing synaptic plasticity.
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Affiliation(s)
- Xianlin Zhu
- Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi City, 445000, Hubei Province, China
| | - Fan Zhang
- Department of Anesthesiology, Bishan Hospital, Bishan, Chongqing, 402760, China
| | - Yufeng You
- Department of Radiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi City, 445000, Hubei Province, China
| | - Hongbai Wang
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100000, China
| | - Su Yuan
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100000, China
| | - Banglin Wu
- Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi City, 445000, Hubei Province, China
| | - Rongyu Zhu
- Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi City, 445000, Hubei Province, China
| | - Dawei Liu
- Department of Anesthesiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Fuxia Yan
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100000, China.
| | - Zaiping Wang
- Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi City, 445000, Hubei Province, China.
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Liu D, Lv F, Min S, Yang Y, Chen L. Inhibition of NLRP3 inflammasome-mediated neuroinflammation alleviates electroconvulsive shock-induced memory impairment via regulation of hippocampal synaptic plasticity in depressive rats. Behav Brain Res 2022; 428:113879. [PMID: 35390431 DOI: 10.1016/j.bbr.2022.113879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 04/01/2022] [Indexed: 12/27/2022]
Abstract
Electroconvulsive shock has been considered one of the most effective treatment modalities for major depressive disorder. The association of acute transitory neuroinflammation in the hippocampus following electroconvulsive therapy with transient learning and memory impairment limits its clinical application. Whereas the NLRP3 inflammatory pathway is deemed to serve a key role in neuroinflammatory regulation, we aimed to examine if NLRP3 inflammasome activation was linked to electroconvulsive shock (ECS)-induced neuroinflammation and cognitive deficits. The depressed rats were modeled with chronic unpredictable mild stress. Their depression-like behaviors and cognitive performance were evaluated via sucrose preference test, forced swim test, open field test, and Morris water maze test. The NLRP3 expression was determined by western blot. The hippocampal CA1 region was immunohistochemically and electron-microscopically examined, respectively, for the activation of Iba-1 positive microglia and the ultrastructure of synapses. In this work, we found that ECS induced microglial activation in the rat hippocampal CA1 region. Pharmacological inhibition of NLRP3 inflammasome with MCC950 (NLRP3 inhibitor) in vivo significantly alleviated ECS-induced spatial learning and memory impairment, partially reversed neuroinflammation, and synaptic structural plasticity in the damaged hippocampal CA1 region, and reduced synapse associated protein expression and microglial activation. It offers a potential new approach for the prevention and treatment of cognitive decline following electroconvulsive therapy.
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Affiliation(s)
- Di Liu
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Lv
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su Min
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - You Yang
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lihao Chen
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Maffioletti E, Carvalho Silva R, Bortolomasi M, Baune BT, Gennarelli M, Minelli A. Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future. Brain Sci 2021; 11:brainsci11091120. [PMID: 34573142 PMCID: PMC8471796 DOI: 10.3390/brainsci11091120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/28/2022] Open
Abstract
Electroconvulsive therapy (ECT) represents an effective intervention for treatment-resistant depression (TRD). One priority of this research field is the clarification of ECT response mechanisms and the identification of biomarkers predicting its outcomes. We propose an overview of the molecular studies on ECT, concerning its course and outcome prediction, including also animal studies on electroconvulsive seizures (ECS), an experimental analogue of ECT. Most of these investigations underlie biological systems related to major depressive disorder (MDD), such as the neurotrophic and inflammatory/immune ones, indicating effects of ECT on these processes. Studies about neurotrophins, like the brain-derived neurotrophic factor (BDNF) and the vascular endothelial growth factor (VEGF), have shown evidence concerning ECT neurotrophic effects. The inflammatory/immune system has also been studied, suggesting an acute stress reaction following an ECT session. However, at the end of the treatment, ECT produces a reduction in inflammatory-associated biomarkers such as cortisol, TNF-alpha and interleukin 6. Other biological systems, including the monoaminergic and the endocrine, have been sparsely investigated. Despite some promising results, limitations exist. Most of the studies are concentrated on one or few markers and many studies are relatively old, with small sample sizes and methodological biases. Expression studies on gene transcripts and microRNAs are rare and genetic studies are sparse. To date, no conclusive evidence regarding ECT molecular markers has been reached; however, the future may be just around the corner.
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Affiliation(s)
- Elisabetta Maffioletti
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
| | - Rosana Carvalho Silva
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
| | | | - Bernhard T. Baune
- Department of Psychiatry and Psychotherapy, University of Münster, 48149 Münster, Germany;
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
- Correspondence: ; Tel.: +39-030-3717255; Fax: +39-030-3701157
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Zhu Y, Zhou H, Chen D, Zhou D, Zhao N, Xiong L, Deng I, Zhou X, Zhu Z. New progress of isoflurane, sevoflurane and propofol in hypoxic-ischemic brain injury and related molecular mechanisms based on p75 neurotrophic factor receptor. IBRAIN 2021; 7:132-140. [PMID: 37786902 PMCID: PMC10528789 DOI: 10.1002/j.2769-2795.2021.tb00075.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/17/2021] [Accepted: 06/10/2021] [Indexed: 10/04/2023]
Abstract
Hypoxic ischemic brain injury (HIBI) is one of the most common clinical disorders, especially in neonates. The complex pathophysiology of HIBI is an important cause of disability and even death of patients, however, being without effective clinical treatments. Common anesthetics (such as isoflurane, propofol and sevoflurane) have an adverse impact on neuronal cells for HIBI via the regulation of p75 neurotrophic factor receptor (P75NTR). In order to protect the injured brains and study the effect of underlying treatments, it is particularly significant to understand and master the developmental mechanism of anesthetics for the occurrence of HIBI related molecular mechanisms. Therefore, this paper will mainly review the corresponding pathogenic and protective mechanisms about HIBI binding to the research progress of the role of P75NTR. In conclusion, the effects of neuroprotection and injured nerves are involved in the expression and activation of P75NTR, mainly increased P75NTR mRNA, protein levels and calpain-dependent for propofol, and inducing neuronal apoptosis for isoflurane and sevoflurane, and we look forward to that connection with P75NTR, common anaesthetic and HIBI may be a new direction of research and gain perfect outcomes in the future.
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Affiliation(s)
- Yi Zhu
- School of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Hong‐Su Zhou
- School of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Dong‐Qin Chen
- School of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Di Zhou
- School of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Nan Zhao
- Department of AnesthesiaHospital of Stomatology, Zunyi Medical UniversityZunyiGuizhouChina
| | - Liu‐Lin Xiong
- Clinical and Health Sciences, University of South AustraliaAdelaide5000South AustraliaAustralia
| | - Issac Deng
- Clinical and Health Sciences, University of South AustraliaAdelaide5000South AustraliaAustralia
| | - Xin‐Fu Zhou
- Clinical and Health Sciences, University of South AustraliaAdelaide5000South AustraliaAustralia
| | - Zhao‐Qiong Zhu
- School of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
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7
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The effect of electroconvulsive therapy on neuroinflammation, behavior and amyloid plaques in the 5xFAD mouse model of Alzheimer's disease. Sci Rep 2021; 11:4910. [PMID: 33649346 PMCID: PMC7921388 DOI: 10.1038/s41598-021-83998-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/09/2021] [Indexed: 12/17/2022] Open
Abstract
Microglial cells are affected in Alzheimer’s disease (AD) and interact with amyloid-beta (Aβ) plaques. Apart from memory loss, depression is common in patients with AD. Electroconvulsive therapy (ECT) is an anti-depressive treatment that may stimulate microglia, induce neuroinflammation and alter the levels of soluble Aβ, but the effects of ECT on microglia and Aβ aggregation in AD are not known. We investigated the short- and long-term effects of ECT on neuroinflammation and Aβ accumulation. 5xFAD mice received either electroconvulsive stimulation (ECS n = 26) or sham treatment (n = 25) for 3 weeks. Microglia and Aβ were analyzed in samples collected 24 h, 5 weeks, or 9 weeks after the last treatment. Aβ plaques and microglia were quantified using immunohistochemistry. The concentration of soluble Aβ and cytokines was quantified using ELISA and levels of Aβ aggregates were measured with Western Blot. Microglial phagocytosis of Aβ in the hippocampus was evaluated by flow cytometry in Methoxy-X04 injected mice 24 h following the last ECS treatment. Y-maze and Elevated plus maze were performed to study behavior after 5 weeks. We could not detect any significant short- or long-term effects of ECS on Aβ pathology or neuroinflammation, but ECS reduced abnormal behavior in the Elevated Plus maze.
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Giacobbe J, Pariante CM, Borsini A. The innate immune system and neurogenesis as modulating mechanisms of electroconvulsive therapy in pre-clinical studies. J Psychopharmacol 2020; 34:1086-1097. [PMID: 32648795 PMCID: PMC7672674 DOI: 10.1177/0269881120936538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is a powerful and fast-acting anti-depressant strategy, often used in treatment-resistant patients. In turn, patients with treatment-resistant depression often present an increased inflammatory response. The impact of ECT on several pathophysiological mechanisms of depression has been investigated, with a focus which has largely been on cellular and synaptic plasticity. Although changes in the immune system are known to influence neurogenesis, these processes have principally been explored independently from each other in the context of ECT. OBJECTIVE The aim of this review was to compare the time-dependent consequences of acute and chronic ECT on concomitant innate immune system and neurogenesis-related outcomes measured in the central nervous system in pre-clinical studies. RESULTS During the few hours following acute electroconvulsive shock (ECS), the expression of the astrocytic reactivity marker glial fibrillary acidic protein (GFAP) and inflammatory genes, such as cyclooxygenase-2 (COX2), were significantly increased together with the neurogenic brain-derived neurotrophic factor (BDNF) and cell proliferation. Similarly, chronic ECS caused an initial upregulation of the same astrocytic marker, immune genes, and neurogenic factors. Interestingly, over time, inflammation appeared to be dampened, while glial activation and neurogenesis were maintained, after either acute or chronic ECS. CONCLUSION Regardless of treatment duration ECS would seemingly trigger a rapid increase in inflammatory molecules, dampened over time, as well as a long-lasting activation of astrocytes and production of growth and neurotrophic factors, leading to cell proliferation. This suggests that both innate immune system response and neurogenesis might contribute to the efficacy of ECT.
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Affiliation(s)
| | | | - Alessandra Borsini
- Alessandra Borsini, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, Division of Psychological Medicine, Stress, Psychiatry and Immunology Lab & Perinatal Psychiatry, The Maurice Wohl Clinical Neuroscience Institute, Cutcombe Road, London SE5 9RT, UK.
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An X, Shi X. Effects of electroconvulsive shock on neuro-immune responses: Does neuro-damage occur? Psychiatry Res 2020; 292:113289. [PMID: 32702550 DOI: 10.1016/j.psychres.2020.113289] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/07/2023]
Abstract
Electroconvulsive therapy (ECT) is one of the most effective treatments for treatment-resistant depression. However, this treatment may produce memory impairment. The mechanisms of the cognitive adverse effects are not known. Neuroimmune response is related to the cognitive deficits. By reviewing the available animal literature, we examined the glia activation, inflammatory cytokines, neuron oxidative stress responses, and neural morphological changes following electroconvulsive shock (ECS) treatment. The studies showed that ECS activates microglia, upregulates neuro-inflammatory cytokines, and increases oxidative stress responses. But these effects are rapid and may be transient. They normalize as ECS treatment continues, suggesting endogenous neuroprotection may be mobilized. The transient changes are well in line with the clinical observations that ECT usually does not cause significant long-lasting retrograde amnesia. The longitudinal studies will be particularly important to explore the dynamic changes of neuroplasticity following ECT (Jonckheere et al., 2018). Investigating the neuroplasticity changes in animals that suffered chronic stress may also be crucial to giving support to the translation of preclinical research.
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Affiliation(s)
- Xianli An
- School of Educational Science, Yangzhou University, Yangzhou, JiangSu Province, China.
| | - Xiujian Shi
- School of Educational Science, Yangzhou University, Yangzhou, JiangSu Province, China
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Blacker CJ, Millischer V, Webb LM, Ho AM, Schalling M, Frye MA, Veldic M. EAAT2 as a Research Target in Bipolar Disorder and Unipolar Depression: A Systematic Review. MOLECULAR NEUROPSYCHIATRY 2020; 5:44-59. [PMID: 32399469 PMCID: PMC7206595 DOI: 10.1159/000501885] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022]
Abstract
Glutamate is implicated in the neuropathology of both major depressive disorder and bipolar disorder. Excitatory amino acid transporter 2 (EAAT2) is the major glutamate transporter in the mammalian brain, removing glutamate from the synaptic cleft and transporting it into glia for recycling. It is thereby the principal regulator of extracellular glutamate levels and prevents neuronal excitotoxicity. EAAT2 is a promising target for elucidating the mechanisms by which the glutamate-glutamine cycle interacts with neuronal systems in mood disorders. Forty EAAT2 studies (published January 1992-January 2018) were identified via a systematic literature search. The studies demonstrated that chronic stress/steroids were most commonly associated with decreased EAAT2. In rodents, EAAT2 inhibition worsened depressive behaviors. Human EAAT2 expression usually decreased in depression, with some regional brain differences. Fewer data have been collected regarding the roles and regulation of EAAT2 in bipolar disorder. Future directions for research include correlating EAAT2 and glutamate levels in vivo, elucidating genetic variability and epigenetic regulation, clarifying intracellular protein and pharmacologic interactions, and examining EAAT2 in different bipolar mood states. As part of a macromolecular complex within glia, EAAT2 may contribute significantly to intracellular signaling, energy regulation, and cellular homeostasis. An enhanced understanding of this system is needed.
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Affiliation(s)
- Caren J. Blacker
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, Stockholm, Sweden
- Neurogenetics Unit, Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Lauren M. Webb
- Mayo Medical School, Mayo Clinic, Rochester, Minnesota, USA
| | - Ada M.C. Ho
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Martin Schalling
- Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, Stockholm, Sweden
- Neurogenetics Unit, Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Marin Veldic
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, Minnesota, USA
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11
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Li M, Yao X, Sun L, Zhao L, Xu W, Zhao H, Zhao F, Zou X, Cheng Z, Li B, Yang W, Cui R. Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism. Front Psychol 2020; 11:80. [PMID: 32153449 PMCID: PMC7044268 DOI: 10.3389/fpsyg.2020.00080] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 01/13/2020] [Indexed: 12/20/2022] Open
Abstract
Depression is one of the most common disorders causing mortality around the world. Although electroconvulsive therapy (ECT) is, along with antidepressants and psychotherapy, one of the three major treatments of depression, it is still considered as the last resort for depressed patients. This situation is partially due to limited studies and uncertainty regarding its mechanism. However, decades of increased research have focused on the effects of ECT on depression and its potential mechanism. Furthermore, these investigations may suggest that ECT should be a first-line therapy for depression due to its profound effects in relieving desperation in certain situations. Here, we outline recent clinical and preclinical studies and summarize the advantages and disadvantages of ECT. Thus, this review may provide some hints for clinical application.
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Affiliation(s)
- Ming Li
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Xiaoxiao Yao
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Lihua Sun
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Lihong Zhao
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Wenbo Xu
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Haisheng Zhao
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Fangyi Zhao
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Xiaohan Zou
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Ziqian Cheng
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Bingjin Li
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Wei Yang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Ranji Cui
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
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12
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Yu X, Ma F, Cao X, Ma X, Hu C. Effects of the application of general anesthesia with propofol during the early stage of pregnancy on brain development and function of SD rat offspring and the intervention of DHA. Neurol Res 2019; 41:1008-1014. [PMID: 31573411 DOI: 10.1080/01616412.2019.1672381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To investigate the effects of propofol used in early pregnancy on brain development and function of offspring, and further to explore the effects of docosahexaenoic acid (DHA) intervention. Methods: Forty pregnant rats were randomly divided into four groups: control group (C), propofol group (P), DHA intervention group (D), and propofol + DHA group (P + D). The DHA treatment was before propofol was administered. Morris water maze test was performed 30 days after delivery. The levels of amyloid beta (Aβ), IL-1β and reactive oxygen species (ROS) in hippocampus were detected by enzyme-linked immunosorbent assay (ELISA). The expression of brain-derived neurotrophic factor (BDNF) and tyrosine kinase-B (Trk-B), protein kinase B (Akt), p-Akt and cAMP response element-binding protein (CREB) in hippocampus were detected by western blot. Results: The learning and memory abilities of the rats in P group were reduced. The levels of Aβ, IL-1β and ROS were increased, while the levels of BDNF, Trk-B and CREB, and p-Akt/Akt ratio were reduced. In addition, compared with P group, DHA in P + D group reversed or alleviated adverse changes caused by propofol. Conclusions: Application of general anesthesia with propofol during the early stage of pregnancy can negatively affect the brain development of the offspring to reduce the learning and memory ability, while DHA can reverse it.
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Affiliation(s)
- Xiangming Yu
- Department of Neurology, 970th Hospital of the PLA , Yantai , China
| | - Fei Ma
- Department of Neurology, 404th Hospital of the PLA , Weihai , China
| | - Xingnian Cao
- Department of Neurology, 404th Hospital of the PLA , Weihai , China
| | - Xiaodi Ma
- Department of Neurology, 404th Hospital of the PLA , Weihai , China
| | - Chenhu Hu
- Department of Intensive Care Unit, 970th Hospital of the PLA , Yantai , China
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Antoniuk S, Bijata M, Ponimaskin E, Wlodarczyk J. Chronic unpredictable mild stress for modeling depression in rodents: Meta-analysis of model reliability. Neurosci Biobehav Rev 2019; 99:101-116. [DOI: 10.1016/j.neubiorev.2018.12.002] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 01/01/2023]
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Zhang F, Huang G, Zhu X. Effect of different charges of modified electroconvulsive seizure on the cognitive behavior in stressed rats: Effects of GluR1 phosphorylation and CaMKIIα activity. Exp Ther Med 2019; 17:748-758. [PMID: 30651859 PMCID: PMC6307485 DOI: 10.3892/etm.2018.7022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 09/13/2018] [Indexed: 01/02/2023] Open
Abstract
Electroconvulsive therapy (ECT) is an efficient therapy for major depression and modern ECT requires anesthesia to enhance safety. However, the commonly used anesthetic, propofol, may weaken the treatment efficacy. A recent study confirmed that ketamine rapidly reduced the symptoms of depression in affected patients. A previous study found that electroconvulsive seizure (ECS), the animal model for ECT, under anesthesia of low-dose ketamine combined with propofol could enhance the antidepressant efficacy and improve the cognitive performance. The present study aimed to investigate the responses to different charges (0, 60, 120, 180 or 240 mC) of ECS under compound anesthetics, ketamine combined with propofol, in stressed rats and the underlying mechanisms to aid in optimization of treatment regimens. The results indicated that ECS exhibited an improved antidepressant effects at 120 mC compared with 60 mC, however, no significant differences in antidepressant effects were identified among the 120, 180 and 240 mC groups. Furthermore, rats subjected to ECS at 120 mC exhibited the best cognitive performance. The phosphorylation levels of calcium/calmodulin-dependent protein kinase IIα (CaMKIIα) at Thr286, glutamate receptor 1 (GluR1) at Ser831 and cAMP-response element-binding protein (CREB) at the Ser133 were higher in the 120-mC group compared with all other groups. These results indicated that the ECS at medium intensity (120 mC) with administration of compound anesthetics may exert an improved therapeutic effect on depression compared with other intensities (0, 60, 180 and 240 mC). The results also suggested that the improvement in cognitive function in stressed rats may be attributed to the phosphorylation of CaMKIIα (Thr286), GluR1 (Ser831) and CREB (Ser133).
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Affiliation(s)
- Fan Zhang
- Department of Anesthesiology, The People's Hospital of Jianyang City, Chengdu, Sichuan 610000, P.R. China
| | - Guihua Huang
- Department of Anesthesiology, The First People's Hospital of Zunyi, Zunyi, Guizhou 563000, P.R. China
| | - Xianlin Zhu
- Department of Anesthesiology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei 445000, P.R. China
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The abuse of anesthetic propofol: associated with cognitive impairment. SCIENCE CHINA-LIFE SCIENCES 2018; 61:1428-1431. [PMID: 30367344 DOI: 10.1007/s11427-018-9401-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022]
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Zhang WL, Chi YL, Wang LZ, Liu H, Zhao LX, Su F. Administrations of Preoperative Shenmai Injection and Postoperative Shenfu Injection, Two Ginseng Containing TCM Formulas, Improve Cognitive Dysfunction in Aged Rats. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2018; 46:1065-1078. [PMID: 30001643 DOI: 10.1142/s0192415x18500556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Postoperative cognitive dysfunction (POCD) is one of the major complications in patients who have undergone surgeries. Reduction of surgery-induced inflammation and perioperative stress responses may prevent the development of POCD. As recent experimental data have suggested, Shenmai and Shenfu injections, two ginseng containing formulations, may improve cognition. We designed this study using aged rats as an experimental model to determine the effect of combined perioperative Shenmai injection and Shenfu injection in preventing the development of POCD and exploring the underlying mechanism of this intervention. Aged rats were randomized into one of the two groups. Rats in the experiment group received preoperative Shenmai injection and postoperative Shenfu injection while those of the control group did not receive this treatment. Study results indicate that the memory and cognitive ability of rats in the experiment group were significantly better than those of the control group at postoperative day 1 as well as at day 3. Plasma levels of neuron-specific enolase (NSE), S-100 [Formula: see text] protein, interleukin-6 (IL-6), tumor necrosis factor-[Formula: see text] (TNF-[Formula: see text]), cortisol (COR), aldosterone (ALD), and adenocorticotropic hormone (ACTH) were significantly lower in the experiment group than in those of the control group (day 1 postoperatively). The plasma level of NSE on postoperative day 3 remained lower in the experimental group than in those of the control group. Our experimental results indicate that preoperative Shenmai and postoperative Shenfu injections facilitate conscious recovery and prevent postoperative cognitive decline. This anti-POCD effect may be a result of minimizing surgery-induced inflammation and reduction of perioperative stress responses by these injections.
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Affiliation(s)
- Wei-Liang Zhang
- * Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, P. R. China
| | - Yong-Liang Chi
- † Department of Anesthesiology, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, Shandong 250014, P. R. China
| | - Lian-Zhu Wang
- † Department of Anesthesiology, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, Shandong 250014, P. R. China
| | - Hui Liu
- ‡ Department of General Surgery, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, Shandong 250014, P. R. China
| | - Lu-Xi Zhao
- † Department of Anesthesiology, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, Shandong 250014, P. R. China
| | - Fan Su
- † Department of Anesthesiology, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, Shandong 250014, P. R. China
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Chen Q, Ren L, Min S, Hao X, Chen H, Deng J. Changes in synaptic plasticity are associated with electroconvulsive shock-induced learning and memory impairment in rats with depression-like behavior. Neuropsychiatr Dis Treat 2018; 14:1737-1746. [PMID: 29997435 PMCID: PMC6033087 DOI: 10.2147/ndt.s163756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Accompanied with the effective antidepressant effect, electroconvulsive shock (ECS) can induce cognitive impairment, but the mechanism is unclear. Synaptic plasticity is the fundamental mechanism of learning and memory. This study aimed to investigate the effect of ECS on synaptic plasticity changes in rats with depression-like behavior. METHODS Chronic unpredictable mild stress procedure was conducted to establish a model of depression-like behavior. Rats were randomly divided into the following three groups: control group with healthy rats (group C), rats with depression-like behavior (group D), and rats with depression-like behavior undergoing ECS (group DE). Depression-like behavior and spatial learning and memory function were assessed by sucrose preference test and Morris water test, respectively. Synaptic plasticity changes in long-term potentiation (LTP), long-term depression (LTD), depotentiation, and post-tetanic potentiation (PTP) were tested by electrophysiological experiment. RESULTS ECS could exert antidepressant effect and also induced spatial learning and memory impairment in rats with depression-like behavior. And, data on electrophysiological experiment showed that ECS induced lower magnitude of LTP, higher magnitude of LTD, higher magnitude of depotentiation, and lower magnitude of PTP. CONCLUSION ECS-induced learning and memory impairment may be attributed to postsynaptic mechanism of LTP impairment, LTD and depotentiation enhancement, and presynaptic mechanism of PTP impairment.
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Affiliation(s)
- Qibin Chen
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing,
| | - Li Ren
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing,
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing,
| | - Xuechao Hao
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan
| | - Hengsheng Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China
| | - Jie Deng
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing,
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Yrondi A, Sporer M, Péran P, Schmitt L, Arbus C, Sauvaget A. Electroconvulsive therapy, depression, the immune system and inflammation: A systematic review. Brain Stimul 2017; 11:29-51. [PMID: 29111078 DOI: 10.1016/j.brs.2017.10.013] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/13/2017] [Accepted: 10/15/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The management and treatment of major depressive disorder are major public health challenges, the lifetime prevalence of this illness being 4.4%-20% in the general population. Major depressive disorder and treatment resistant depression appear to be, in part, related to a dysfunction of the immune response. Among the treatments for depression ECT occupies an important place. The underlying cerebral mechanisms of ECT remain unclear. OBJECTIVES/HYPOTHESIS The aim of this review is to survey the potential actions of ECT on the immuno-inflammatory cascade activated during depression. METHODS A systematic search of the literature was carried out, using the bibliographic search engines PubMed and Embase. The search covered articles published up until october 2017. The following MESH terms were used: Electroconvulsive therapy AND (inflammation OR immune OR immunology). RESULTS Our review shows that there is an acute immuno-inflammatory response immediately following an ECT session. There is an acute stress reaction. Studies show an increase in the plasma levels of cortisol and of interleukins 1 and 6. However, at the end of the course of treatment, ECT produces, in the long term, a fall in the plasma level of cortisol, a reduction in the levels of TNF alpha and interleukin 6. LIMITATIONS One of the limitations of this review is that a large number of studies are relatively old, with small sample sizes and methodological bias. CONCLUSION Advances in knowledge of the immuno-inflammatory component of depression seem to be paving the way towards models to explain the mechanism of action of ECT.
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Affiliation(s)
- Antoine Yrondi
- Psychiatric Department, CHU Toulouse-Purpan, 330 Avenue de Grande Bretagne, 31059 Toulouse, France; Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, France.
| | - Marie Sporer
- Psychiatric Department, CHU Toulouse-Purpan, 330 Avenue de Grande Bretagne, 31059 Toulouse, France
| | - Patrice Péran
- Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, France
| | - Laurent Schmitt
- Psychiatric Department, CHU Toulouse-Purpan, 330 Avenue de Grande Bretagne, 31059 Toulouse, France
| | - Christophe Arbus
- Psychiatric Department, CHU Toulouse-Purpan, 330 Avenue de Grande Bretagne, 31059 Toulouse, France; Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, France
| | - Anne Sauvaget
- CHU Nantes, Addictology and Liaison Psychiatry Department, Neuromodulation Unit in Psychiatry, Nantes, France
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Effect of Low Dose of Ketamine on Learning Memory Function in Patients Undergoing Electroconvulsive Therapy-A Randomized, Double-Blind, Controlled Clinical Study. J ECT 2017; 33:89-95. [PMID: 27828927 DOI: 10.1097/yct.0000000000000365] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Converging evidence suggests that low doses of ketamine have antidepressant effects. The feasibility and safety of administering low doses of ketamine as adjunctive medication during electroconvulsive therapy (ECT) to enhance ECT efficacy and mitigate cognitive impairment has attracted much attention. This study investigated the effects of low doses of ketamine on learning and memory in patients undergoing ECT under propofol anesthesia. METHODS This randomized, placebo-controlled, double-blind study recruited patients with moderate to severe depressive disorders who failed to respond to antidepressants and were scheduled to receive ECT. Participants were randomly assigned to a study group, which received an intravenous administration of 0.3 mg/kg ketamine and then underwent ECT under propofol anesthesia, and a control group, which received isovolumetric placebo (normal saline) and then underwent ECT under propofol anesthesia. The Hamilton Depression Rating Scale was used to assess the severity of depression after ECT. Before and after the ECT course, the Mini-mental State Examination and the Wechsler Memory Scale-Chinese-Revision were used to assess global cognitive and learning and memory functions, respectively. Psychotropic effects were assessed using the Brief Psychiatric Rating Scale. Vital signs and other adverse events were recorded for each ECT procedure. RESULTS Of 132 patients recruited, 66 were assigned to each group; 63 patients in study groups and 64 patients in the control group completed the ECT course during the study. Afterward, the incidence of global cognitive impairment in the control group was higher than it was in the study group. In addition, the decline in the Wechsler Memory Scale-Chinese-Revision scale was greater in the control group than in the study group. The necessary ECT treatment times were shorter in the study group than in the control group (8 [7, 9] vs 9 [8, 10]). No significant escalations of the positive Brief Psychiatric Rating Scale scores or adverse events were observed in the study group when compared with the control group. CONCLUSIONS As adjunctive medication, ketamine can attenuate learning and memory impairment, especially for short-term memory, caused by ECT performed under propofol anesthesia. Ketamine can also reduce ECT treatment times during the therapy course without inducing significant adverse effects.
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Li DJ, Wang FC, Chu CS, Chen TY, Tang CH, Yang WC, Chow PCK, Wu CK, Tseng PT, Lin PY. Significant treatment effect of add-on ketamine anesthesia in electroconvulsive therapy in depressive patients: A meta-analysis. Eur Neuropsychopharmacol 2017; 27:29-41. [PMID: 27908572 DOI: 10.1016/j.euroneuro.2016.11.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 11/06/2016] [Accepted: 11/11/2016] [Indexed: 12/12/2022]
Abstract
Add-on ketamine anesthesia in electroconvulsive therapy (ECT) has been studied in depressive patients in several clinical trials with inconclusive findings. Two most recent meta-analyses reported insignificant findings with regards to the treatment effect of add-on ketamine anesthesia in ECT in depressive patients. The aim of this study is to update the current evidence and investigate the role of add-on ketamine anesthesia in ECT in depressive patients via a systematic review and meta-analysis. We performed a thorough literature search of the PubMed and ScienceDirect databases, and extracted all relevant clinical variables to compare the antidepressive outcomes between add-on ketamine anesthesia and other anesthetics in ECT. Total 16 articles with 346 patients receiving add-on ketamine anesthesia in ECT and 329 controls were recruited. We found that the antidepressive treatment effect of add-on ketamine anesthesia in ECT in depressive patients was significantly higher than that of other anesthetics (p<0.001). This significance persisted in both short-term (1-2 weeks) and moderate-term (3-4 weeks) treatment courses (all p<0.05). However, the side effect profiles and recovery time profiles were significantly worse in add-on ketamine anesthesia group than in control group. Our meta-analysis highlights the significantly higher antidepressive treatment effect of add-on ketamine in depressive patients receiving ECT compared to other anesthetics. However, clinicians need to take undesirable side effects into consideration when using add-on ketamine anesthesia in ECT in depressive patients.
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Affiliation(s)
- Dian-Jeng Li
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Fu-Chiang Wang
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Puli Branch, Taichung Veterans General Hospital, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Hung Tang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Taiwan
| | - Wei-Cheng Yang
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Philip Chik-Keung Chow
- Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Ching-Kuan Wu
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai׳s Home, Taiwan
| | - Ping-Tao Tseng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai׳s Home, Taiwan.
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
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Cascella M, Bimonte S. The role of general anesthetics and the mechanisms of hippocampal and extra-hippocampal dysfunctions in the genesis of postoperative cognitive dysfunction. Neural Regen Res 2017; 12:1780-1785. [PMID: 29239315 PMCID: PMC5745823 DOI: 10.4103/1673-5374.219032] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Postoperative cognitive dysfunction (POCD) is a multifactorial process with a huge number of predisposing, causal, and precipitating factors. In this scenario, the neuroinflammation and the microglial activation play a pivotal role by triggering and amplifying a complex cascade involving the immuno-hormonal activation, the micro circle alterations, the hippocampal oxidative stress activation and, finally, an increased blood-brain barrier's permeability. While the role of anesthetics in the POCD's genesis in humans is debated, a huge number of preclinical studies have been conducted on the topic and many mechanisms have been proposed to explain the potential neurodegenerative effects of general anesthetics. Probably, the problem concerns on what we are searching for and how we are searching and, surprisingly, preclinical studies showed that anesthetics may also manifest neuroprotective properties. The aim of this paper is to offer an overview on the potential impact of general anesthetics on POCD. Mechanisms of hippocampal and extra-hippocampal dysfunction due to neuroinflammation are discussed, whereas further research perspectives are also given.
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Affiliation(s)
- Marco Cascella
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Via Mariano Semmola, Naples, Italy
| | - Sabrina Bimonte
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Via Mariano Semmola, Naples, Italy
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Sub-anesthetic doses of ketamine exert antidepressant-like effects and upregulate the expression of glutamate transporters in the hippocampus of rats. Neurosci Lett 2016; 639:132-137. [PMID: 28043834 DOI: 10.1016/j.neulet.2016.12.070] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 12/19/2016] [Accepted: 12/29/2016] [Indexed: 12/23/2022]
Abstract
Clinical studies on the role of the glutamatergic system in the pathogenesis of depression found that ketamine induces an antidepressant response, but the molecular mechanisms remain unclear. The present study investigated the effects of sub-anesthetic doses of ketamine on the glutamate reuptake function in the rat hippocampus. Chronic unpredictable mild stress (CUMS) was applied to construct animal models of depression. Sixty adult male Sprague-Dawley rats were randomly assigned to 5 groups and received a different regimen of CUMS and ketamine (10, 25, and 50mg/kg) treatment. The sucrose preference test and open-field test were used to assess behavioral changes. The expression levels of excitatory amino acid transporters (EAATs) were measured by western blot. Microdialysis and high-performance liquid chromatography (HPLC) were used to detect hippocampal glutamate concentrations. We found that the expression of EAAT2 and EAAT3 were obviously downregulated, and extracellular concentrations of glutamate were significantly increased in the hippocampi of depressive-like rats. Ketamine (10, 25, and 50mg/kg) upregulated the expression of EAAT2 and EAAT3, decreased the hippocampal concentration of extracellular glutamate, and alleviated the rats' depressive-like behavior. The antidepressant effect of ketamine may be linked to the regulation of EAAT expression and the enhancement of glutamate uptake in the hippocampus of depressive-like rats.
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Influence of General Anesthesia on Impulsivity and Learning Ability-Experimental Study. ACTA MEDICA MARISIENSIS 2016. [DOI: 10.1515/amma-2016-0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective: To investigate the effect of anesthesia on rats’ ability of learning and over their impulsivity.
Material and Methods: We studied eight Wistar adult male rats, test and drug naive subjects. Animals were separated in two groups, group A and B with four members each. Group A included the anesthetized animals. The combination of ketamine, xylazine and piplophen in 2ml/kg body weight dosage was used and testing was done 24 hours after anesthesia. Group B was taken as control. The study was conducted using the ”Delay discounting” apparatus. Experiments assessing impulsive behavior were conducted using automated operant chambers, equipped with two nose-poke holes (holes where pellets of food were released). Rat’s answer was considered touching the nose-poke hole. One answer was rewarded with pellets of food of 45 mg each (small reward), while another hole released five pellets of 45 mg each (high reward). Both types of rewards were presented immediately after rat’s answer and were followed for a period of 25 seconds timeout. During the training phase, rats were placed in operant chambers 30 minutes per day, 5 consecutive days. The growing percent of preference for greater reward indicates learning. For the testing phase the procedure was similar, but a delay was introduced before the release of the big reward. During this phase, the preference for higher reward was indicative for non-impulsive behaviour.
Results: The results didn’t show significant statistically differences between the two groups.
Conclusions: Anesthesia had no effect on learning ability nor on impulsivity.
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Gao X, Zhuang FZ, Qin SJ, Zhou L, Wang Y, Shen QF, Li M, Villarreal M, Benefield L, Gu SL, Ma TF. Dexmedetomidine protects against learning and memory impairments caused by electroconvulsive shock in depressed rats: Involvement of the NMDA receptor subunit 2B (NR2B)-ERK signaling pathway. Psychiatry Res 2016; 243:446-52. [PMID: 27455425 DOI: 10.1016/j.psychres.2016.07.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/25/2016] [Accepted: 07/10/2016] [Indexed: 01/09/2023]
Abstract
Cognitive impairment is a common adverse effect of electroconvulsive therapy (ECT) during treatment for severe depression. Dexmedetomidine (DEX), a sedative-anesthetic drug, is used to treat post-ECT agitation. However, it is not known if DEX can protect against ECT-induced cognitive impairments. To address this, we used chronic unpredictable mild stress (CUMS) to establish a model of depression for ECT treatment. Our Morris water maze and sucrose preference test results suggest that DEX alleviates ECT-induced learning and memory impairments without altering the antidepressant efficacy of ECT. To further investigate the underlying mechanisms of DEX, hippocampal expression of NR2B, p-ERK/ERK, p-CREB/CREB, and BDNF were quantified by western blotting. These results show that DEX suppresses over-activation of NR2B and enhances phosphorylation of ERK1/2 in the hippocampus of ECT-treated depressed rats. Furthermore, DEX had no significant effect on ECT-induced increases in p-CREB and BDNF. Overall, our findings suggest that DEX ameliorates ECT-induced learning and memory impairments in depressed rats via the NR2B-ERK signaling cascade. Moreover, CREB/BDNF seems not appear to participate in the cognitive protective mechanisms of DEX during ECT treatment.
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Affiliation(s)
- Xin Gao
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Fu-Zhi Zhuang
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Shou-Jun Qin
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Li Zhou
- Department of Anaesthesiology, The Affiliated Hospital of Xuzhou Medical University, Key Laboratory for Anesthesiology of Jiangsu Province, Xuzhou 221004, Jiangsu, China
| | - Yun Wang
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Qing-Feng Shen
- Department of Geriatric Psychiatry, The East People's Hospital of Xuzhou, Xuzhou 221004, Jiangsu, China
| | - Mei Li
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | | | - Lauren Benefield
- Texas A&M University'16, College Station 77841, TX, United States
| | - Shu-Ling Gu
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Teng-Fei Ma
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China.
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Gong HY, Zheng F, Zhang C, Chen XY, Liu JJ, Yue XQ. Propofol protects hippocampal neurons from apoptosis in ischemic brain injury by increasing GLT-1 expression and inhibiting the activation of NMDAR via the JNK/Akt signaling pathway. Int J Mol Med 2016; 38:943-50. [DOI: 10.3892/ijmm.2016.2663] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 06/21/2016] [Indexed: 11/06/2022] Open
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Ren L, Zhang F, Min S, Hao X, Qin P, Zhu X. Propofol ameliorates electroconvulsive shock-induced learning and memory impairment by regulation of synaptic metaplasticity via autophosphorylation of CaMKIIa at Thr 305 in stressed rats. Psychiatry Res 2016; 240:123-130. [PMID: 27104927 DOI: 10.1016/j.psychres.2016.03.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 02/15/2016] [Accepted: 03/16/2016] [Indexed: 01/19/2023]
Abstract
Electroconvulsive therapy (ECT) is an effective treatment for depression, but it can induce learning and memory impairment. Our previous study found propofol (γ-aminobutyric acid (GABA) receptor agonist) could ameliorate electroconvulsive shock (ECS, an analog of ECT to animals)-induced cognitive impairment, however, the underlying molecular mechanisms remain unclear. This study aimed to investigate the effects of propofol on metaplasticity and autophosphorylation of CaMKIIa in stressed rats receiving ECS. Depressive-like behavior and learning and memory function were assessed by sucrose preference test and Morris water test respectively. LTP were tested by electrophysiological experiment, the expression of CaMKIIa, p-T305-CaMKII in hippocampus and CaMKIIα in hippocampal PSD fraction were evaluated by western blot. Results suggested ECS raised the baseline fEPSP and impaired the subsequent LTP, increased the expression of p-T305-CaMKII and decreased the expression of CaMKIIα in hippocampal PSD fraction, leading to cognitive dysfunction in stressed rats. Propofol could down-regulate the baseline fEPSP and reversed the impairment of LTP partly, decreased the expression of p-T305-CaMKII and increased the expression of CaMKIIα in hippocampal PSD fraction and alleviated ECS-induced learning and memory impairment. In conclusion, propofol ameliorates ECS-induced learning and memory impairment, possibly by regulation of synaptic metaplasticity via p-T305-CaMKII.
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Affiliation(s)
- Li Ren
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Fan Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Xuechao Hao
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Peipei Qin
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xianlin Zhu
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Hao X, Zhu X, Li P, Lv F, Min S. NMDA receptor antagonist enhances antidepressant efficacy and alleviates learning-memory function impairment induced by electroconvulsive shock with regulating glutamate receptors expression in hippocampus. J Affect Disord 2016; 190:819-827. [PMID: 26625094 DOI: 10.1016/j.jad.2015.11.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/31/2015] [Accepted: 11/15/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Xuechao Hao
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Xianlin Zhu
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Ping Li
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Feng Lv
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Su Min
- Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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Vainshtein A, Veenman L, Shterenberg A, Singh S, Masarwa A, Dutta B, Island B, Tsoglin E, Levin E, Leschiner S, Maniv I, Pe’er L, Otradnov I, Zubedat S, Aga-Mizrachi S, Weizman A, Avital A, Marek I, Gavish M. Quinazoline-based tricyclic compounds that regulate programmed cell death, induce neuronal differentiation, and are curative in animal models for excitotoxicity and hereditary brain disease. Cell Death Discov 2015; 1:15027. [PMID: 27551459 PMCID: PMC4979516 DOI: 10.1038/cddiscovery.2015.27] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 07/16/2015] [Indexed: 12/21/2022] Open
Abstract
Expanding on a quinazoline scaffold, we developed tricyclic compounds with biological activity. These compounds bind to the 18 kDa translocator protein (TSPO) and protect U118MG (glioblastoma cell line of glial origin) cells from glutamate-induced cell death. Fascinating, they can induce neuronal differentiation of PC12 cells (cell line of pheochromocytoma origin with neuronal characteristics) known to display neuronal characteristics, including outgrowth of neurites, tubulin expression, and NeuN (antigen known as 'neuronal nuclei', also known as Rbfox3) expression. As part of the neurodifferentiation process, they can amplify cell death induced by glutamate. Interestingly, the compound 2-phenylquinazolin-4-yl dimethylcarbamate (MGV-1) can induce expansive neurite sprouting on its own and also in synergy with nerve growth factor and with glutamate. Glycine is not required, indicating that N-methyl-D-aspartate receptors are not involved in this activity. These diverse effects on cells of glial origin and on cells with neuronal characteristics induced in culture by this one compound, MGV-1, as reported in this article, mimic the diverse events that take place during embryonic development of the brain (maintenance of glial integrity, differentiation of progenitor cells to mature neurons, and weeding out of non-differentiating progenitor cells). Such mechanisms are also important for protective, curative, and restorative processes that occur during and after brain injury and brain disease. Indeed, we found in a rat model of systemic kainic acid injection that MGV-1 can prevent seizures, counteract the process of ongoing brain damage, including edema, and restore behavior defects to normal patterns. Furthermore, in the R6-2 (transgenic mouse model for Huntington disease; Strain name: B6CBA-Tg(HDexon1)62Gpb/3J) transgenic mouse model for Huntington disease, derivatives of MGV-1 can increase lifespan by >20% and reduce incidence of abnormal movements. Also in vitro, these derivatives were more effective than MGV-1.
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Affiliation(s)
- A Vainshtein
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
| | - L Veenman
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
| | - A Shterenberg
- Technion – Israel Institute of Technology, Schulich Faculty of Chemistry, The Mallat Family Laboratory of Organic Chemistry, Haifa, Israel
| | - S Singh
- Technion – Israel Institute of Technology, Schulich Faculty of Chemistry, The Mallat Family Laboratory of Organic Chemistry, Haifa, Israel
| | - A Masarwa
- Technion – Israel Institute of Technology, Schulich Faculty of Chemistry, The Mallat Family Laboratory of Organic Chemistry, Haifa, Israel
| | - B Dutta
- Technion – Israel Institute of Technology, Schulich Faculty of Chemistry, The Mallat Family Laboratory of Organic Chemistry, Haifa, Israel
| | - B Island
- Technion – Israel Institute of Technology, Schulich Faculty of Chemistry, The Mallat Family Laboratory of Organic Chemistry, Haifa, Israel
| | - E Tsoglin
- Technion – Israel Institute of Technology, Schulich Faculty of Chemistry, The Mallat Family Laboratory of Organic Chemistry, Haifa, Israel
| | - E Levin
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
| | - S Leschiner
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
| | - I Maniv
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
| | - L Pe’er
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
| | - I Otradnov
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
| | - S Zubedat
- Department of Physiology, Technion – Israel Institute of Technology, The Behavioral Neuroscience Laboratory, Faculty of Medicine and Emek Medical Center, Haifa, Israel
| | - S Aga-Mizrachi
- Department of Physiology, Technion – Israel Institute of Technology, The Behavioral Neuroscience Laboratory, Faculty of Medicine and Emek Medical Center, Haifa, Israel
| | - A Weizman
- Tel Aviv University, Sackler Faculty of Medicine, The Felsenstein Medical Research Center, Geha Mental Health Center, Tel Aviv, Israel
| | - A Avital
- Department of Physiology, Technion – Israel Institute of Technology, The Behavioral Neuroscience Laboratory, Faculty of Medicine and Emek Medical Center, Haifa, Israel
| | - I Marek
- Technion – Israel Institute of Technology, Schulich Faculty of Chemistry, The Mallat Family Laboratory of Organic Chemistry, Haifa, Israel
| | - M Gavish
- Department of Neuroscience, Technion – Israel Institute of Technology, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Haifa, Israel
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Quan X, Ye TH, Lin SF, Zou L, Tian SY. Propofol Affects Different Human Brain Regions Depending on Depth of Sedation(△). ACTA ACUST UNITED AC 2015; 30:135-42. [PMID: 26564411 DOI: 10.1016/s1001-9294(15)30037-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the effect of propofol on brain regions at different sedation levels and the association between changes in brain region activity and loss of consciousness using blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) and bispectral index (BIS) monitoring. METHODS Forty-eight participants were enrolled at Peking Union Medical College Hospital from October 2011 to March 2012 and randomly assigned to a mild or a deep sedation group using computer- generated random numbers. Preliminary tests were performed a week prior to scanning to determine target effect site concentrations based on BIS and concomitant Observer's Assessment of Alertness/Sedation scores while under propofol. Within one week of the preliminary tests where propofol dose-response was established, BOLD-fMRI was conducted to examine brain activation with the subject awake, and with propofol infusion at the sedation level. RESULTS Mild propofol sedation inhibited left inferior parietal lobe activation. Deep sedation inhibited activation of the left insula, left superior temporal gyrus, and right middle temporal gyrus. Compared with mild sedation, deep propofol sedation inhibited activation of the left thalamus, precentral gyrus, anterior cingulate, and right basal nuclei. CONCLUSION Mild and deep propofol sedation are associated with inhibition of different brain regions, possibly explaining differences in the respective loss of consciousness processes.
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Liu G, Liu C, Zhang XN. Comparison of the neuropsychological mechanisms of 2,6-diisopropylphenol and N-methyl-D-aspartate receptor antagonist against electroconvulsive therapy-induced learning and memory impairment in depressed rats. Mol Med Rep 2015; 12:3297-3308. [PMID: 25998151 PMCID: PMC4526078 DOI: 10.3892/mmr.2015.3803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 04/14/2015] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to examine the neurophysiological mechanisms of the 2,6-diisopropylphenol and N-methyl-D-aspartate (NMDA) receptor antagonist against learning and memory impairment, induced by electroconvulsive therapy (ECT). A total of 48 adult depressed rats without olfactory bulbs were randomly divided into six experimental groups: i) saline; ii) 10 mg/kg MK‑801; iii) 10 mg/kg MK‑801 and a course of ECT; iv) 200 mg/kg 2,6‑diisopropylphenol; v) 200 mg/kg 2,6‑diisopropylphenol and a course of ECT; and vi) saline and a course of ECT. The learning and memory abilities of the rats were assessed using a Morris water maze 1 day after a course of ECT. The hippocampus was removed 1 day after assessment using the Morris water maze assessment. The content of glutamate in the hippocampus was detected using high‑performance liquid chromatography. The expression levels of p‑AT8Ser202 and GSK‑3β1H8 in the hippocampus were determined using immunohistochemical staining and western blot analysis. The results demonstrated that the 2,6‑diisopropylphenol NMDA receptor antagonist, MK‑801 and ECT induced learning and memory impairment in the depressed rats. The glutamate content was significantly upregulated by ECT, reduced by 2,6‑diisopropylphenol, and was unaffected by the NMDA receptor antagonist in the hippocampus of the depressed rats. Tau protein hyperphosphorylation in the hippocampus was upregulated by ECT, but was reduced by 2,6‑diisopropylphenol and the MK‑801 NMDA receptor antagonist. It was also demonstrated that 2,6‑diisopropylphenol prevented learning and memory impairment and reduced the hyperphosphorylation of the Tau protein, which was induced by eECT. GSK‑3β was found to be the key protein involved in this signaling pathway. The ECT reduced the learning and memory impairment, caused by hyperphosphorylation of the Tau protein, in the depressed rats by upregulating the glutamate content.
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Affiliation(s)
- Gang Liu
- Department of Anesthesiology, General Hospital of Beijing Military Area of PLA, Beijing 100700, P.R. China
| | - Chao Liu
- Department of Anesthesiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Xue-Ning Zhang
- Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
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Zhu X, Li P, Hao X, Wei K, Min S, Luo J, Xie F, Jin J. Ketamine-mediated alleviation of electroconvulsive shock-induced memory impairment is associated with the regulation of neuroinflammation and soluble amyloid-beta peptide in depressive-like rats. Neurosci Lett 2015; 599:32-7. [PMID: 25980993 DOI: 10.1016/j.neulet.2015.05.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/18/2015] [Accepted: 05/12/2015] [Indexed: 11/16/2022]
Abstract
Electroconvulsive therapy (ECT) is an effective treatment for depression, but can result in memory deficits. This study aimed to determine whether ketamine could alleviate electroconvulsive shock (ECS, an analog of ECT in animals)-induced memory impairment and the potential molecular mechanism. Chronic unpredictable mild stress was used to generate animal models of depressive-like symptoms. Sixty adult male Sprague-Dawley rats were randomly divided into the following five groups: control group (group C); depressive-like model group (group D); ECS group (group DE); ketamine+ECS group (group DKE); and ketamine group (group DK). The sucrose preference test and Morris water maze were used to assess behavioral changes. The expression levels of Iba-1, IL-1β and TNF-α were measured by immunohistochemistry and real-time PCR. Enzyme-linked immunosorbent assays were used to detect the levels of soluble Aβ. We found that ECS up-regulated the expression of Iba-1, promoted the release of IL-1β and TNF-α, increased the levels of Aβ1-40 and Aβ1-42 in the hippocampus, and aggravated memory impairment of the depressive-like rats. However, ketamine reversed these ECS-induced molecular changes and effectively attenuated ECS-induced memory impairment. This cognitive protective effect of ketamine may be attributed to its suppression of ECS-induced neuroinflammation and reduction of the levels of soluble Aβ.
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Affiliation(s)
- Xianlin Zhu
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Ping Li
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xuechao Hao
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ke Wei
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Jie Luo
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Fei Xie
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Juying Jin
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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