Excitotoxic lesion of the medial prefrontal cortex in Wistar rats: Effects on trait and state anxiety

Clinical validation of the nursing diagnosis "Fall risk in adults (00303)" in elderly people in the community-dwelling

PURPOSE

To identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling.

METHOD

This is a methodological study, with a quantitative approach, carried out with elderly people living in the city of Ribeirão Preto, SP, Brazil, from February to December 2018. For data collection, the demographic profile, Mini-Mental State Examination, diseases self-reported, functional independence measure, Lawton and Brody scale, geriatric depression scale, and self-perception of gait instruments were used. Tests of accuracy and association of risk factors with p ≤ 0.05 were performed.

FINDINGS

A total of 262 elderly people, aged over 80 years (55.7%), 71% of which were female and 42.7% were widowed, were included in the sample. A total of 82.1% had vascular diseases, 72.1% had diabetes, and 20.6% had depression. The predominant risk factors were difficulty performing instrumental activities of daily living (58.8%), cognitive dysfunction (43.5%), and depressive symptoms (26.3%). Difficulty performing instrumental activities of daily living had a sensitivity greater than 60%. The positive and negative predictive values were mostly greater than 50%. In the regression analysis, it was found that the elderly have a higher risk of suffering a fall if they present anxiety (p = 0.05), impaired physical mobility (p = 0.02), and difficulty to perform instrumental activities of daily living as risk factors (p = 0.03).

CONCLUSION

It was possible to identify the presence of risk factors for the diagnosis fall risk in adults (00303) in the clinical context of the elderly in home settings and contribute to the clinical validation of the taxonomy, increase the evidence and importance of the diagnosis, and generate new knowledge for gerontological nursing.

IMPLICATIONS FOR NURSING PRACTICE

To help nurses identify risk factors that lead elderly people to suffer falls at home and to implement preventive actions in their community with the support of their families.

Corticotropin-releasing factor signaling and its potential role in the prefrontal cortex-dependent regulation of anxiety

A large body of literature has highlighted the significance of the corticotropin-releasing factor (CRF) system in the regulation of neuropsychiatric diseases. Anxiety disorders are among the most common neuropsychiatric disorders. An increasing number of studies have demonstrated that the CRF family mediates and regulates the development and maintenance of anxiety. Thus, the CRF family is considered to be a potential target for the treatment of anxiety disorders. The prefrontal cortex (PFC) plays a role in the occurrence and development of anxiety, and both CRF and CRF-R1 are widely expressed in the PFC. This paper begins by reviewing CRF-related signaling pathways and their different roles in anxiety and related processes. Then, the role of the CRF system in other neuropsychiatric diseases is reviewed and the potential role of PFC CRF signaling in the regulation of anxiety disorders is discussed. Although other signaling pathways are potentially involved in the process of anxiety, CRF in the PFC primarily modulates anxiety disorders through the activation of corticotropin-releasing factor type1 receptors (CRF-R1) and the excitation of the cAMP/PKA signaling pathway. Moreover, the main signaling pathways of CRF involved in sex differentiation in the PFC appear to be different. In summary, this review suggests that the CRF system in the PFC plays a critical role in the occurrence of anxiety. Thus, CRF signaling is of great significance as a potential target for the treatment of stress-related disorders in the future.

Hippocampus: Molecular, Cellular, and Circuit Features in Anxiety

Anxiety disorders are currently a major psychiatric and social problem, the mechanisms of which have been only partially elucidated. The hippocampus serves as a major target of stress mediators and is closely related to anxiety modulation. Yet so far, its complex anatomy has been a challenge for research on the mechanisms of anxiety regulation. Recent advances in imaging, virus tracking, and optogenetics/chemogenetics have permitted elucidation of the activity, connectivity, and function of specific cell types within the hippocampus and its connected brain regions, providing mechanistic insights into the elaborate organization of the hippocampal circuitry underlying anxiety. Studies of hippocampal neurotransmitter systems, including glutamatergic, GABAergic, cholinergic, dopaminergic, and serotonergic systems, have contributed to the interpretation of the underlying neural mechanisms of anxiety. Neuropeptides and neuroinflammatory factors are also involved in anxiety modulation. This review comprehensively summarizes the hippocampal mechanisms associated with anxiety modulation, based on molecular, cellular, and circuit properties, to provide tailored targets for future anxiety treatment.

Factors Affecting the Relationship Between Stress and Anxiety in Critically Ill Patients: A Partial Least Squares Structural Equation Modeling Approach

This study aimed to examine the factors affecting the relationship between stress and anxiety in critically ill patients. A cross-sectional research paradigm was employed to enroll patients admitted to the medical intensive care unit (ICU) of a medical university hospital. Partial least squares structural equation modeling (PLS-SEM) was used to examine the data. A total of 90 ICU patients were included in this study; 56 were men and 34 were women. The patients' mean age was 65.3 years. Only the emotional responses dimension of illness was significantly positively correlated with stress. However, the emotional responses dimension of illness representation, acute physiology and chronic health evaluation system (APACHE) score, age, and education level were significantly positively correlated with anxiety. Nevertheless, treatment control was significantly negatively correlated with anxiety. Overall, illness representations (emotional responses and treatment control), APACHE score, age, and education were important predictors of anxiety, with an explanatory power of 37.9%. We recommend that for clinically relevant practice, besides focusing on ICU patients' illness representation, attention should also be paid to their individual characteristics, such as differences in age and education levels.

Effects of Quinolinate-Induced Lesion of the Medial Prefrontal Cortex on Prefrontal and Striatal Concentrations of D-Serine in the Rat

D-Serine has been shown to play an important role in the expression and control of a variety of brain functions by acting as the endogenous coagonist for the N-methyl-D-aspartate type glutamate receptor (NMDAR), at least, in the forebrain. To obtain further insight into the still debatable cellular localization of the D-amino acid, we have examined the effects of the selective destruction of the neuronal cell bodies by quinolinate on the tissue or extracellular D-serine concentrations in the medial prefrontal cortex of the rat. A local quinolinate infusion into the bilateral medial prefrontal cortex produced a cortical lesion with a marked (- 65%) and non-significant alteration (- 5%) in the cortical and striatal tissue D-serine concentrations, respectively, 7 days post-infusion. In vivo microdialysis experiments in the right prefrontal lesion site 9 days after the quinolinate application revealed that the basal extracellular D-serine levels were also dramatically reduced (- 64%). A prominent reduction in the tissue levels of GABA in the interneurons of the prefrontal cortex (- 78%) without significant changes in those in the striatum (+ 12%) verified that a major lesion part was confined to the cortical portion. The lack of a significant influence of the prefrontal quinolinate lesion on its dopamine concentrations in the mesocortical dopamine projections suggests that the nerve terminals and axons in the lesion site may be spared. These findings are consistent with the perikarya-selective nature of the present quinolinate-induced lesion and further support the view that neuronal cell bodies of intrinsic neurons in the prefrontal cortical region contain substantial amounts of D-serine, which may sustain the basal extracellular concentrations of D-serine.

The Hole-Board Test in Mutant Mice

First described by Boissier and Simon in (Ther Recreat J 17:1225-1232, 1962), the hole-board has become a recognized test of anxiety and spatial memory. Benzodiazepines acting at the GABA_A-BZD site increase hole-pokes in rats and mice, indicating a loss in behavioral inhibition concordant with the behavior of mutant mice deficient in the GABA transporter. Hole-poking also depends on arousal mechanisms dependent on dopaminergic transmission, as indicated by drug and null mutant studies. In addition, the behavior is modified in natural and null mutants affecting the cerebellum as well as null mutants affecting neuropeptides, growth factors, cell adhesion, and inflammation. Further research is required to determine convergences between genetic and pharmacological effects.

Prefrontal Cortical Control of Anxiety: Recent Advances

Dysfunction in the prefrontal cortex is commonly implicated in anxiety disorders, but the mechanisms remain unclear. Approach-avoidance conflict tasks have been extensively used in animal research to better understand how changes in neural activity within the prefrontal cortex contribute to avoidance behaviors, which are believed to play a major role in the maintenance of anxiety disorders. In this article, we first review studies utilizing in vivo electrophysiology to reveal the relationship between changes in neural activity and avoidance behavior in rodents. We then review recent studies that take advantage of optical and genetic techniques to test the unique contribution of specific prefrontal cortex circuits and cell types to the control of anxiety-related avoidance behaviors. This new body of work reveals that behavior during approach-avoidance conflict is dynamically modulated by individual cell types, distinct neural pathways, and specific oscillatory frequencies. The integration of these different pathways, particularly as mediated by interactions between excitatory and inhibitory neurons, represents an exciting opportunity for the future of understanding anxiety.

Psychoactive properties of BNN27, a novel neurosteroid derivate, in male and female rats

RATIONALE

Νeurosteroids, like dehydroepiandrosterone (DHEA), play an important role in neurodegeneration and neural protection, but they are metabolized in androgens, estrogens, or other active metabolites. A newly developed synthetic DHEA analog, BNN27 ((20R)-3β,21-dihydroxy-17R,20-epoxy-5-pregnene), exerts neurotrophic and neuroprotective actions without estrogenic or androgenic effects.

OBJECTIVES

This study aimed to investigate potential anxiolytic or antidepressant properties of BNN27.

METHODS

Male and female adult Wistar rats were treated with BNN27 (10, 30, or 90 mg/kg, i.p.) and subjected to behavioral tests measuring locomotion, exploration, and "depressive-like" behavior (open field, light/dark box, hole-board, and forced swim tests). The hippocampus and prefrontal cortex were collected for glutamate and GABA measurements, and trunk blood was collected for gonadal hormone analysis.

RESULTS

Acute high-dose BNN27 reduced locomotion and exploratory behavior in both sexes. Intermediate acute doses (30 mg/kg) of BNN27 reduced exploration and testosterone levels only in males, and enhanced progesterone levels in both sexes. Notably, with the present design, BNN27 had neither anxiolytic nor antidepressant effects and did not affect estrogen levels. Interestingly, acute administration of a low BNN27 dose (10 mg/kg) increased glutamate turnover, GABA, and glutamine levels in the hippocampus. The same dose also enhanced glutamate levels in the prefrontal cortex of males only. Sex differences were apparent in the basal levels of behavioral, hormonal, and neurochemical parameters, as expected.

CONCLUSIONS

BNN27 affects locomotion, progesterone, and testosterone levels, as well as the glutamatergic and GABAergic systems of the hippocampus and prefrontal cortex in a sex-dependent way.

Neurobiological links between stress and anxiety

Stress and anxiety have intertwined behavioral and neural underpinnings. These commonalities are critical for understanding each state, as well as their mutual interactions. Grasping the mechanisms underlying this bidirectional relationship will have major clinical implications for managing a wide range of psychopathologies. After briefly defining key concepts for the study of stress and anxiety in pre-clinical models, we present circuit, as well as cellular and molecular mechanisms involved in either or both stress and anxiety. First, we review studies on divergent circuits of the basolateral amygdala (BLA) underlying emotional valence processing and anxiety-like behaviors, and how norepinephrine inputs from the locus coeruleus (LC) to the BLA are responsible for acute-stress induced anxiety. We then describe recent studies revealing a new role for mitochondrial function within the nucleus accumbens (NAc), defining individual trait anxiety in rodents, and participating in the link between stress and anxiety. Next, we report findings on the impact of anxiety on reward encoding through alteration of circuit dynamic synchronicity. Finally, we present work unravelling a new role for hypothalamic corticotropin-releasing hormone (CRH) neurons in controlling anxiety-like and stress-induce behaviors. Altogether, the research reviewed here reveals circuits sharing subcortical nodes and underlying the processing of both stress and anxiety. Understanding the neural overlap between these two psychobiological states, might provide alternative strategies to manage disorders such as post-traumatic stress disorder (PTSD).