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Ganapathiraju MK, Triptish B, Deshpande S, Wesesky M, Wood J, Nimgaonkar VL. Schizophrenia interactome derived repurposable drugs and randomized control trials of two candidates. Biol Psychiatry 2024:S0006-3223(24)01426-4. [PMID: 38950808 DOI: 10.1016/j.biopsych.2024.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/29/2024] [Accepted: 06/09/2024] [Indexed: 07/03/2024]
Abstract
There is a substantial unmet need for effective and patient-acceptable drugs to treat severe mental illnesses like schizophrenia. Computational analysis of genomic, transcriptomic, and pharmacologic data generated in the past two decades enables repurposing of drugs or compounds with acceptable safety profiles, namely those that are FDA-approved or reached late stages in clinical trials. We developed a rational approach to achieve this computationally for schizophrenia by studying drugs that target the proteins in its protein interaction network ('interactome'). This involved contrasting the transcriptomic modulations observed in the disorder and the drug; our analyses resulted in 12 candidate drugs, 9 of which had additional supportive evidence: their target networks were enriched for pathways relevant to schizophrenia etiology or for genes that had an association with diseases pathogenically similar to schizophrenia. To translate these computational results to the clinic, these shortlisted drugs must be tested empirically through randomized controlled trials (RCT), where their prior safety approvals obviate the need for time-consuming phase I and II studies. We selected two among the shortlisted candidates based on likely adherence and side effect profiles. We are testing them through adjunctive RCTs for patients with schizophrenia or schizoaffective disorder who experienced incomplete resolution of psychotic features with conventional treatment. The integrated computational analysis for identifying and ranking drugs for clinical trials can be iterated as additional data are obtained. Our approach could be expanded to enable disease subtype-specific drug discovery in future and should also be exploited for other psychiatric disorders.
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Affiliation(s)
- Madhavi K Ganapathiraju
- Department of Biomedical Informatics and Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, USA; Carnegie Mellon University in Qatar, Doha, Qatar.
| | - Bhatia Triptish
- Dept. of Psychiatry, Centre of Excellence in Mental Health, ABVIMS- Dr Ram Manohar Lohia Hospital, New Delhi 110001, India
| | - Smita Deshpande
- Department of Psychiatry, St John's Medical College Hospital, Koramangala, Bengaluru, Karnataka 560034, India
| | - Maribeth Wesesky
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joel Wood
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vishwajit L Nimgaonkar
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Veterans Administration Pittsburgh Healthcare System, Pittsburgh, PA, USA.
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2
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Dhoundiyal S, Srivastava S, Kumar S, Singh G, Ashique S, Pal R, Mishra N, Taghizadeh-Hesary F. Radiopharmaceuticals: navigating the frontier of precision medicine and therapeutic innovation. Eur J Med Res 2024; 29:26. [PMID: 38183131 PMCID: PMC10768149 DOI: 10.1186/s40001-023-01627-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/26/2023] [Indexed: 01/07/2024] Open
Abstract
This review article explores the dynamic field of radiopharmaceuticals, where innovative developments arise from combining radioisotopes and pharmaceuticals, opening up exciting therapeutic possibilities. The in-depth exploration covers targeted drug delivery, delving into passive targeting through enhanced permeability and retention, as well as active targeting using ligand-receptor strategies. The article also discusses stimulus-responsive release systems, which orchestrate controlled release, enhancing precision and therapeutic effectiveness. A significant focus is placed on the crucial role of radiopharmaceuticals in medical imaging and theranostics, highlighting their contribution to diagnostic accuracy and image-guided curative interventions. The review emphasizes safety considerations and strategies for mitigating side effects, providing valuable insights into addressing challenges and achieving precise drug delivery. Looking ahead, the article discusses nanoparticle formulations as cutting-edge innovations in next-generation radiopharmaceuticals, showcasing their potential applications. Real-world examples are presented through case studies, including the use of radiolabelled antibodies for solid tumors, peptide receptor radionuclide therapy for neuroendocrine tumors, and the intricate management of bone metastases. The concluding perspective envisions the future trajectory of radiopharmaceuticals, anticipating a harmonious integration of precision medicine and artificial intelligence. This vision foresees an era where therapeutic precision aligns seamlessly with scientific advancements, ushering in a new epoch marked by the fusion of therapeutic resonance and visionary progress.
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Affiliation(s)
- Shivang Dhoundiyal
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, 203201, India
| | - Shriyansh Srivastava
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, 203201, India.
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University (DPSRU), Sector 3 Pushp Vihar, New Delhi, 110017, India.
| | - Sachin Kumar
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University (DPSRU), Sector 3 Pushp Vihar, New Delhi, 110017, India
| | - Gaaminepreet Singh
- Department of Physiology and Biophysics, Case Western Reserve University (CWRU), Cleveland, OH, USA
| | - Sumel Ashique
- Department of Pharmaceutical Sciences, Bengal College of Pharmaceutical Sciences & Research, Durgapur, 713212, West Bengal, India
| | - Radheshyam Pal
- Department of Pharmacology, Pandaveswar School of Pharmacy, Pandaveswar, 713346, West Bengal, India
| | - Neeraj Mishra
- Amity Institute of Pharmacy, Amity University Madhya Pradesh, Gwalior, 474005, MP, India
| | - Farzad Taghizadeh-Hesary
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Department of Clinical Oncology, Iran University of Medical Sciences, Tehran, Iran.
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3
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Bowen ER, DiGiacomo P, Fraser HP, Guttenplan K, Smith BAH, Heberling ML, Vidano L, Shah N, Shamloo M, Wilson JL, Grimes KV. Beta-2 adrenergic receptor agonism alters astrocyte phagocytic activity and has potential applications to psychiatric disease. DISCOVER MENTAL HEALTH 2023; 3:27. [PMID: 38036718 PMCID: PMC10689618 DOI: 10.1007/s44192-023-00050-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023]
Abstract
Schizophrenia is a debilitating condition necessitating more efficacious therapies. Previous studies suggested that schizophrenia development is associated with aberrant synaptic pruning by glial cells. We pursued an interdisciplinary approach to understand whether therapeutic reduction in glial cell-specifically astrocytic-phagocytosis might benefit neuropsychiatric patients. We discovered that beta-2 adrenergic receptor (ADRB2) agonists reduced phagocytosis using a high-throughput, phenotypic screen of over 3200 compounds in primary human fetal astrocytes. We used protein interaction pathways analysis to associate ADRB2, to schizophrenia and endocytosis. We demonstrated that patients with a pediatric exposure to salmeterol, an ADRB2 agonist, had reduced in-patient psychiatry visits using a novel observational study in the electronic health record. We used a mouse model of inflammatory neurodegenerative disease and measured changes in proteins associated with endocytosis and vesicle-mediated transport after ADRB2 agonism. These results provide substantial rationale for clinical consideration of ADRB2 agonists as possible therapies for patients with schizophrenia.
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Affiliation(s)
- Ellen R Bowen
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA
- Weill Cornell Medicine, New York, NY, USA
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Phillip DiGiacomo
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Hannah P Fraser
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Kevin Guttenplan
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA
- Vollum Institute, Oregon Health & Science University, Portland, OR, USA
| | - Benjamin A H Smith
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Marlene L Heberling
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Laura Vidano
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Nigam Shah
- Center for Biomedical Informatics Research, Stanford School of Medicine, Stanford, CA, USA
| | - Mehrdad Shamloo
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Jennifer L Wilson
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA.
| | - Kevin V Grimes
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA.
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4
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Kandi V, Vundecode A, Godalwar TR, Dasari S, Vadakedath S, Godishala V. The Current Perspectives in Clinical Research: Computer-Assisted Drug Designing, Ethics, and Good Clinical Practice. BORNEO JOURNAL OF PHARMACY 2022. [DOI: 10.33084/bjop.v5i2.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In the era of emerging microbial and non-communicable diseases and re-emerging microbial infections, the medical fraternity and the public are plagued by under-preparedness. It is evident by the severity of the Coronavirus disease (COVID-19) pandemic that novel microbial diseases are a challenge and are challenging to control. This is mainly attributed to the lack of complete knowledge of the novel microbe’s biology and pathogenesis and the unavailability of therapeutic drugs and vaccines to treat and control the disease. Clinical research is the only answer utilizing which can handle most of these circumstances. In this review, we highlight the importance of computer-assisted drug designing (CADD) and the aspects of molecular docking, molecular superimposition, 3D-pharmacophore technology, ethics, and good clinical practice (GCP) for the development of therapeutic drugs, devices, and vaccines.
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5
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Jalal B, Chamberlain SR, Robbins TW, Sahakian BJ. Obsessive-compulsive disorder-contamination fears, features, and treatment: novel smartphone therapies in light of global mental health and pandemics (COVID-19). CNS Spectr 2022; 27:136-144. [PMID: 33081864 PMCID: PMC7691644 DOI: 10.1017/s1092852920001947] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 10/04/2020] [Indexed: 02/06/2023]
Abstract
This review aims to shed light on the symptoms of obsessive-compulsive disorder (OCD) with a focus on contamination fears. In addition, we will briefly review the current therapies for OCD and detail what their limitations are. A key focus will be on discussing how smartphone solutions may provide approaches to novel treatments, especially when considering global mental health and the challenges imposed by rural environments and limited resources; as well as restrictions imposed by world-wide pandemics such as COVID-19. In brief, research that questions this review will seek to address include: (1) What are the symptoms of contamination-related OCD? (2) How effective are current OCD therapies and what are their limitations? (3) How can novel technologies help mitigate challenges imposed by global mental health and pandemics/COVID-19.
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Affiliation(s)
- Baland Jalal
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Department of Psychiatry, Faculty of Medicine, University of Southampton; and Southern Health NHS Foundation Trust, Cambridgeshire & Peterborough NHS Foundation Trust, United Kingdom
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J. Sahakian
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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6
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Costi S, Han MH, Murrough JW. The Potential of KCNQ Potassium Channel Openers as Novel Antidepressants. CNS Drugs 2022; 36:207-216. [PMID: 35258812 DOI: 10.1007/s40263-021-00885-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 12/12/2022]
Abstract
Major depressive disorder (MDD) is a leading cause of disability worldwide and less than one-third of patients with MDD achieve stable remission of symptoms, despite currently available treatments. Although MDD represents a serious health problem, a complete understanding of the neurobiological mechanisms underlying this condition continues to be elusive. Accumulating evidence from preclinical and animal studies provides support for the antidepressant potential of modulators of KCNQ voltage-gated potassium (K+) channels. KCNQ K+ channels, through regulation of neuronal excitability and activity, contribute to neurophysiological mechanisms underlying stress resilience, and represent potential targets of drug discovery for depression. The present article focuses on the pharmacology and efficacy of KCNQ2/3 K+ channel openers as novel therapeutic agents for depressive disorders from initial studies conducted on animal models showing depressive-like behaviors to recent work in humans that examines the potential for KCNQ2/3 channel modulators as novel antidepressants. Data from preclinical work suggest that KCNQ-type K+ channels are an active mediator of stress resilience and KCNQ2/3 K+ channel openers show antidepressant efficacy. Similarly, evidence from clinical trials conducted in patients with MDD using the KCNQ2/3 channel opener ezogabine (retigabine) showed significant improvements in depressive symptoms and anhedonia. Overall, KCNQ channel openers appear a promising target for the development of novel therapeutics for the treatment of psychiatric disorders and specifically for MDD.
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Affiliation(s)
- Sara Costi
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Ming-Hu Han
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Affective Neuroscience, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Mental Health and Public Health, Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - James W Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA. .,Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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7
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Phillips AG. Placing old wine into new bottles: successful repurposing of bumetanide for treatment of autism spectrum disorder. Sci Bull (Beijing) 2021; 66:1491-1492. [PMID: 36654274 DOI: 10.1016/j.scib.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Anthony G Phillips
- Department of Psychiatry, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z4, Canada.
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8
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Sotiropoulos MG, Poulogiannopoulou E, Delis F, Dalla C, Antoniou K, Kokras N. Innovative screening models for the discovery of new schizophrenia drug therapies: an integrated approach. Expert Opin Drug Discov 2021; 16:791-806. [PMID: 33467920 DOI: 10.1080/17460441.2021.1877657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: Schizophrenia is a severe psychiatric disorder affecting millions worldwide. However, available treatment options do not fully address the disease. Whereas current antipsychotics may control psychotic symptoms, they seem notoriously ineffective in improving negative and cognitive symptoms or in preventing functional decline. As the etiology of schizophrenia eludes us, the development of valid animal models for screening new drug targets appears to be a strenuous task.Areas covered: In this review, the authors present the key concepts that validate animal models of schizophrenia, as well as the different screening approaches for novel schizophrenia treatments. The models covered are either based on major neurotransmitter systems or neurodevelopmental, immune, and genetic approaches.Expert opinion: Sadly, due to inertia, research focuses on developing 'anti-psychotics', instead of 'anti-schizophrenia' drugs that would tackle the entire syndrome of schizophrenia. Whereas no perfect model may ever exist, combining different experimental designs may enhance validity, as the over-reliance on a single model is inappropriate. Multi-model approaches incorporating vulnerability, the 'two-hit' hypothesis, and endophenotypes offer a promise for developing new strategies for schizophrenia treatment. Forward and reverse translation between preclinical and clinical research will increase the probability of success and limit failures in drug development.
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Affiliation(s)
- Marinos G Sotiropoulos
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Poulogiannopoulou
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Delis
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christina Dalla
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Antoniou
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Nikolaos Kokras
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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9
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Tricklebank MD, Robbins TW, Simmons C, Wong EHF. Time to re-engage psychiatric drug discovery by strengthening confidence in preclinical psychopharmacology. Psychopharmacology (Berl) 2021; 238:1417-1436. [PMID: 33694032 PMCID: PMC7945970 DOI: 10.1007/s00213-021-05787-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is urgent need for new medications for psychiatric disorders. Mental illness is expected to become the leading cause of disability worldwide by 2030. Yet, the last two decades have seen the pharmaceutical industry withdraw from psychiatric drug discovery after costly late-stage trial failures in which clinical efficacy predicted pre-clinically has not materialised, leading to a crisis in confidence in preclinical psychopharmacology. METHODS Based on a review of the relevant literature, we formulated some principles for improving investment in translational neuroscience aimed at psychiatric drug discovery. RESULTS We propose the following 8 principles that could be used, in various combinations, to enhance CNS drug discovery: (1) consider incorporating the NIMH Research Domain Criteria (RDoC) approach; (2) engage the power of translational and systems neuroscience approaches; (3) use disease-relevant experimental perturbations; (4) identify molecular targets via genomic analysis and patient-derived pluripotent stem cells; (5) embrace holistic neuroscience: a partnership with psychoneuroimmunology; (6) use translational measures of neuronal activation; (7) validate the reproducibility of findings by independent collaboration; and (8) learn and reflect. We provide recent examples of promising animal-to-human translation of drug discovery projects and highlight some that present re-purposing opportunities. CONCLUSIONS We hope that this review will re-awaken the pharma industry and mental health advocates to the opportunities for improving psychiatric pharmacotherapy and so restore confidence and justify re-investment in the field.
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Affiliation(s)
- Mark David Tricklebank
- Centre for Neuroimaging Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College, London, UK.
| | - Trevor W. Robbins
- Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB23EB, Cambridge, UK
| | - Camilla Simmons
- Centre for Neuroimaging Sciences, Institute of Psychiatry Psychology and Neuroscience, King’s College, London, UK
| | - Erik H. F. Wong
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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10
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Bourdon JL, Davies RA, Long EC. Four Actionable Bottlenecks and Potential Solutions to Translating Psychiatric Genetics Research: An Expert Review. Public Health Genomics 2020; 23:171-183. [PMID: 33147585 PMCID: PMC7854816 DOI: 10.1159/000510832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/27/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psychiatric genetics has had limited success in translational efforts. A thorough understanding of the present state of translation in this field will be useful in the facilitation and assessment of future translational progress. PURPOSE A narrative literature review was conducted. Combinations of 3 groups of terms were searched in EBSCOhost, Google Scholar, and PubMed. The review occurred in multiple steps, including abstract collection, inclusion/exclusion criteria review, coding, and analysis of included papers. RESULTS One hundred and fourteen articles were analyzed for the narrative review. Across those, 4 bottlenecks were noted that, if addressed, may provide insights and help improve and increase translation in the field of psychiatric genetics. These 4 bottlenecks are emphasizing linear translational frameworks, relying on molecular genomic findings, prioritizing certain psychiatric disorders, and publishing more reviews than experiments. CONCLUSIONS These entwined bottlenecks are examined with one another. Awareness of these bottlenecks can inform stakeholders who work to translate and/or utilize psychiatric genetic information. Potential solutions include utilizing nonlinear translational frameworks as well as a wider array of psychiatric genetic information (e.g., family history and gene-environment interplay) in this area of research, expanding which psychiatric disorders are considered for translation, and when possible, conducting original research. Researchers are urged to consider how their research is translational in the context of the frameworks, genetic information, and psychiatric disorders discussed in this review. At a broader level, these efforts should be supported with translational efforts in funding and policy shifts.
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Affiliation(s)
- Jessica L Bourdon
- Department of Psychiatry, Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA,
| | - Rachel A Davies
- Yerkes National Primate Research Center, Division of Behavioral Neuroscience and Psychiatric Disorders, Emory University, Atlanta, Georgia, USA
| | - Elizabeth C Long
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania, USA
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11
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Jiménez-Garrido DF, Gómez-Sousa M, Ona G, Dos Santos RG, Hallak JEC, Alcázar-Córcoles MÁ, Bouso JC. Effects of ayahuasca on mental health and quality of life in naïve users: A longitudinal and cross-sectional study combination. Sci Rep 2020; 10:4075. [PMID: 32139811 PMCID: PMC7057990 DOI: 10.1038/s41598-020-61169-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 02/20/2020] [Indexed: 11/09/2022] Open
Abstract
Ayahuasca is a hallucinogenic decoction used as a traditional medicine in several Amazonian regions. The ritualistic use of ayahuasca has spread throughout many countries, making it necessary to study its risks and benefits. Two sub-studies were designed for this investigation. In sub-study 1, a psychiatric interview and a battery of questionnaires were administered to subjects (n = 40) before their first ayahuasca use. Two follow-ups were conducted at 1 and 6 months. In sub-study 2, the same interview and battery of questionnaires were administered to long-term ayahuasca users (n = 23) and their scores were compared with those of the ayahuasca-naïve group. In the first assessment, nearly half (45%) of the naïve users were found to meet the diagnostic criteria for a psychiatric disorder. After the ayahuasca use, more than 80% of those subjects showed clinical improvements that persisted at 6 months. The questionnaires showed significant reductions in depression and psychopathology. Regarding sub-study 2, long-term users showed lower depression scores, and higher scores for self-transcendence and quality of life, as compared to their peers in sub-study 1. Further controlled and observational naturalistic studies assessing the eventual risks and potential benefits of ayahuasca are warranted.
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Affiliation(s)
- Daniel F Jiménez-Garrido
- ICEERS - International Center for Ethnobotanical Education, Research, and Services, Barcelona, Spain
| | - María Gómez-Sousa
- ICEERS - International Center for Ethnobotanical Education, Research, and Services, Barcelona, Spain
| | - Genís Ona
- ICEERS - International Center for Ethnobotanical Education, Research, and Services, Barcelona, Spain.,Universitat Rovira i Virgili, Department of Anthropology, Philosophy and Social Work, Tarragona, Spain
| | - Rafael G Dos Santos
- ICEERS - International Center for Ethnobotanical Education, Research, and Services, Barcelona, Spain.,Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.,National Institute for Translational Medicine (INCT-TM), CNPq, São Paulo, Brazil
| | - Miguel Ángel Alcázar-Córcoles
- Department of Biological & Health Psychology, School of Psychology, Madrid Autonomous University, 28049, Madrid, Spain
| | - José Carlos Bouso
- ICEERS - International Center for Ethnobotanical Education, Research, and Services, Barcelona, Spain.
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12
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Adams T, Wesley M, Rippey C. Transcranial Electric Stimulation and the Extinction of Fear. THE CLINICAL PSYCHOLOGIST 2020; 73:5-14. [PMID: 35153300 PMCID: PMC8830604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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13
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Abstract
In neuroimaging research, averaging data at the level of the group results in blurring of potentially meaningful individual differences. A more widespread use of an individual-specific approach is advocated for, which involves a more thorough investigation of each individual in a group, and characterization of idiosyncrasies at the level of behavior, cognition, and symptoms, as well as at the level of brain organization. It is hoped that such an approach, focused on individuals, will provide convergent findings that will help identify the underlying pathologic condition in various psychiatric disorders and help in the development of treatments individualized for each patient.
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Affiliation(s)
- Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Suite 2301, Charlestown, MA 02129, USA.
| | - William J Liu
- Department of Neuroscience, Grossman Institute of Neurobiology, The College, University of Chicago, 5812 South Ellis Avenue, MC 0912, Suite P-400, Chicago, IL 60637, USA
| | - Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Suite 2301, Charlestown, MA 02129, USA
| | - Louisa Dahmani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Suite 2301, Charlestown, MA 02129, USA
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14
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Gulinello M, Mitchell HA, Chang Q, Timothy O'Brien W, Zhou Z, Abel T, Wang L, Corbin JG, Veeraragavan S, Samaco RC, Andrews NA, Fagiolini M, Cole TB, Burbacher TM, Crawley JN. Rigor and reproducibility in rodent behavioral research. Neurobiol Learn Mem 2019; 165:106780. [PMID: 29307548 PMCID: PMC6034984 DOI: 10.1016/j.nlm.2018.01.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 12/22/2017] [Accepted: 01/03/2018] [Indexed: 01/08/2023]
Abstract
Behavioral neuroscience research incorporates the identical high level of meticulous methodologies and exacting attention to detail as all other scientific disciplines. To achieve maximal rigor and reproducibility of findings, well-trained investigators employ a variety of established best practices. Here we explicate some of the requirements for rigorous experimental design and accurate data analysis in conducting mouse and rat behavioral tests. Novel object recognition is used as an example of a cognitive assay which has been conducted successfully with a range of methods, all based on common principles of appropriate procedures, controls, and statistics. Directors of Rodent Core facilities within Intellectual and Developmental Disabilities Research Centers contribute key aspects of their own novel object recognition protocols, offering insights into essential similarities and less-critical differences. Literature cited in this review article will lead the interested reader to source papers that provide step-by-step protocols which illustrate optimized methods for many standard rodent behavioral assays. Adhering to best practices in behavioral neuroscience will enhance the value of animal models for the multiple goals of understanding biological mechanisms, evaluating consequences of genetic mutations, and discovering efficacious therapeutics.
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Affiliation(s)
- Maria Gulinello
- IDDRC Behavioral Core Facility, Neuroscience Department, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Heather A Mitchell
- IDD Models Core, Waisman Center, University of Wisconsin Madison, Madison, WI 53705, USA
| | - Qiang Chang
- IDD Models Core, Waisman Center, University of Wisconsin Madison, Madison, WI 53705, USA
| | - W Timothy O'Brien
- IDDRC Preclinical Models Core, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Zhaolan Zhou
- IDDRC Preclinical Models Core, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Ted Abel
- IDDRC Preclinical Models Core, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA; Current affiliation: Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, USA
| | - Li Wang
- IDDRC Neurobehavioral Core, Center for Neuroscience Research, Children's National Health System, Washington, DC 20010, USA
| | - Joshua G Corbin
- IDDRC Neurobehavioral Core, Center for Neuroscience Research, Children's National Health System, Washington, DC 20010, USA
| | - Surabi Veeraragavan
- IDDRC Neurobehavioral Core, Baylor College of Medicine, Houston, TX 77030, USA
| | - Rodney C Samaco
- IDDRC Neurobehavioral Core, Baylor College of Medicine, Houston, TX 77030, USA
| | - Nick A Andrews
- IDDRC Neurodevelopmental Behavior Core, Boston Children's Hospital, Boston, MA 02115, USA
| | - Michela Fagiolini
- IDDRC Neurodevelopmental Behavior Core, Boston Children's Hospital, Boston, MA 02115, USA
| | - Toby B Cole
- IDDRC Rodent Behavior Laboratory, Center on Human Development and Disability, University of Washington, Seattle, WA 98195, USA
| | - Thomas M Burbacher
- IDDRC Rodent Behavior Laboratory, Center on Human Development and Disability, University of Washington, Seattle, WA 98195, USA
| | - Jacqueline N Crawley
- IDDRC Rodent Behavior Core, MIND Institute, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
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15
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Mofsen AM, Rodebaugh TL, Nicol GE, Depp CA, Miller JP, Lenze EJ. When All Else Fails, Listen to the Patient: A Viewpoint on the Use of Ecological Momentary Assessment in Clinical Trials. JMIR Ment Health 2019; 6:e11845. [PMID: 31066701 PMCID: PMC6524455 DOI: 10.2196/11845] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/05/2019] [Accepted: 04/03/2019] [Indexed: 01/09/2023] Open
Abstract
A major problem in mental health clinical trials, such as depression, is low assay sensitivity in primary outcome measures. This has contributed to clinical trial failures, resulting in the exodus of the pharmaceutical industry from the Central Nervous System space. This reduced assay sensitivity in psychiatry outcome measures stems from inappropriately broad measures, recall bias, and poor interrater reliability. Limitations in the ability of traditional measures to differentiate between the trait versus state-like nature of individual depressive symptoms also contributes to measurement error in clinical trials. In this viewpoint, we argue that ecological momentary assessment (EMA)-frequent, real time, in-the-moment assessments of outcomes, delivered via smartphone-can both overcome these psychometric challenges and reduce clinical trial failures by increasing assay sensitivity and minimizing recall and rater bias. Used in this manner, EMA has the potential to further our understanding of treatment response by allowing for the assessment of dynamic interactions between treatment and distinct symptom response.
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Affiliation(s)
- Aaron M Mofsen
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, MO, United States
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, MO, United States
| | - Ginger E Nicol
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, MO, United States
| | - Colin A Depp
- Department of Psychiatry, University of California - San Diego, San Diego, CA, United States
| | - J Philip Miller
- Division of Biostatistics, School of Medicine, Washington University in St Louis, St Louis, MO, United States
| | - Eric J Lenze
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, MO, United States
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Abstract
The biological mechanisms underlying psychiatric diagnoses are not well defined. Clinical diagnosis based on categorical systems exhibit high levels of heterogeneity and co-morbidity. The Research Domain Criteria (RDoC) attempts to reconceptualize psychiatric disorders into transdiagnostic functional dimensional constructs based on neurobiological measures and observable behaviour. By understanding the underlying neurobiology and pathophysiology of the relevant processes, the RDoC aims to advance biomarker development for disease prediction and treatment response. This important evolving dimensional framework must also consider environmental factors. Emerging evidence suggests that gut microbes (microbiome) play a physiological role in brain diseases by modulating neuroimmune, neuroendocrine and neural signalling pathways between the gut and the brain. The integration of the gut microbiome signature as an additional dimensional component of the RDoC may enhance precision psychiatry.
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17
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Rich K, Summers P, Westreich AM. Genetics Is Forging New Frontiers in Mental Health Care: A Patient-Centered Collaborative Approach Will Smooth the Journey. Genet Test Mol Biomarkers 2019; 23:153-155. [PMID: 30875253 DOI: 10.1089/gtmb.2019.29043.sjt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Kelly Rich
- 1 Genetic Alliance, Washington, District of Columbia.,2 Division of Human Genetics, The Ohio State University, Columbus, Ohio
| | - Perry Summers
- 1 Genetic Alliance, Washington, District of Columbia
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18
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Ona G, Kohek M, Massaguer T, Gomariz A, Jiménez DF, Dos Santos RG, Hallak JEC, Alcázar-Córcoles MÁ, Bouso JC. Ayahuasca and Public Health: Health Status, Psychosocial Well-Being, Lifestyle, and Coping Strategies in a Large Sample of Ritual Ayahuasca Users. J Psychoactive Drugs 2019; 51:135-145. [DOI: 10.1080/02791072.2019.1567961] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Genís Ona
- International Center for Ethnobotanical Education, Research, and Services (ICEERS), Barcelona, Spain
- Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Tarragona, Spain
| | - Maja Kohek
- International Center for Ethnobotanical Education, Research, and Services (ICEERS), Barcelona, Spain
- Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Tarragona, Spain
| | - Tomàs Massaguer
- International Center for Ethnobotanical Education, Research, and Services (ICEERS), Barcelona, Spain
| | - Alfred Gomariz
- International Center for Ethnobotanical Education, Research, and Services (ICEERS), Barcelona, Spain
| | - Daniel F. Jiménez
- International Center for Ethnobotanical Education, Research, and Services (ICEERS), Barcelona, Spain
| | - Rafael G. Dos Santos
- International Center for Ethnobotanical Education, Research, and Services (ICEERS), Barcelona, Spain
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jaime E. C. Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- National Institute for Translational Medicine (INCT-TM), CNPq, Riberão Preto (SP), Brazil
| | - Miguel Ángel Alcázar-Córcoles
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research, and Services (ICEERS), Barcelona, Spain
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19
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Jalal B, Brühl A, O'Callaghan C, Piercy T, Cardinal RN, Ramachandran VS, Sahakian BJ. Novel Smartphone Interventions Improve Cognitive Flexibility and Obsessive-Compulsive Disorder Symptoms in Individuals with Contamination Fears. Sci Rep 2018; 8:14923. [PMID: 30353111 PMCID: PMC6199277 DOI: 10.1038/s41598-018-33142-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 09/14/2018] [Indexed: 11/09/2022] Open
Abstract
One type of obsessive-compulsive disorder (OCD) is characterized by contamination fears and compulsive cleansing. Few effective treatments are available for this debilitating condition. Compulsive symptoms, such as excessive washing, are believed to be mediated by cognitive inflexibility-arguably the most striking cognitive impairment in OCD. In this study, we investigated the effects of two novel smartphone interventions on cognitive flexibility and OCD symptoms in healthy individuals with OCD-like contamination fears. In the first intervention, participants watched a brief video recording of themselves engaging in handwashing on a smartphone, four times a day, for a total of one week (N = 31). The second intervention was similar except that participants watched themselves repeatedly touching a disgust-inducing object (N = 31). In a third (control) "intervention", participants watched themselves performing sequential hand movements (N = 31). As hypothesized, the two smartphone interventions, unlike the control, improved cognitive flexibility; as assessed on the Intradimensional-Extradimensional Set Shifting task (a sensitive marker of cognitive flexibility). The two interventions, unlike the control, also improved OCD symptoms (measured with the Obsessive-Compulsive Inventory-Revised and Yale-Brown Obsessive-Compulsive Scale). Finally, we found high levels of adherence to the interventions. These findings have significant clinical implications for OCD.
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Affiliation(s)
- Baland Jalal
- University of Cambridge School of Clinical Medicine, Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, Herchel Smith Building for Brain and Mind Sciences, Cambridge, CB2 0QQ, Cambridge Biomedical Campus, UK.
| | - Annette Brühl
- University of Cambridge School of Clinical Medicine, Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, Herchel Smith Building for Brain and Mind Sciences, Cambridge, CB2 0QQ, Cambridge Biomedical Campus, UK
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich,, Zurich, Switzerland
| | - Claire O'Callaghan
- University of Cambridge School of Clinical Medicine, Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, Herchel Smith Building for Brain and Mind Sciences, Cambridge, CB2 0QQ, Cambridge Biomedical Campus, UK
| | - Thomas Piercy
- University of Cambridge School of Clinical Medicine, Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, Herchel Smith Building for Brain and Mind Sciences, Cambridge, CB2 0QQ, Cambridge Biomedical Campus, UK
| | - Rudolf N Cardinal
- University of Cambridge School of Clinical Medicine, Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, Herchel Smith Building for Brain and Mind Sciences, Cambridge, CB2 0QQ, Cambridge Biomedical Campus, UK
- Liaison Psychiatry Service, Cambridgeshire & Peterborough NHS Foundation Trust/Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | | | - Barbara J Sahakian
- University of Cambridge School of Clinical Medicine, Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, Herchel Smith Building for Brain and Mind Sciences, Cambridge, CB2 0QQ, Cambridge Biomedical Campus, UK
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20
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Najafi H, Hosseini SM, Tavallaie M, Soltani BM. A Predicted Molecular Model for Development of Human Intelligence. NEUROCHEM J+ 2018. [DOI: 10.1134/s1819712418030091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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21
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Dos Santos RG, Bouso JC, Alcázar-Córcoles MÁ, Hallak JEC. Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews. Expert Rev Clin Pharmacol 2018; 11:889-902. [PMID: 30102078 DOI: 10.1080/17512433.2018.1511424] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Mood, anxiety, and substance-use disorders are among the most prevalent psychiatric disorders in the population. Although several pharmacological treatments are available, they are not effective for a significant proportion of patients and are associated with several adverse reactions. Therefore, new treatments should be explored. Recent studies suggest that serotonergic hallucinogens/psychedelics including ayahuasca, psilocybin, and lysergic acid diethylamide (LSD) have anxiolytic, antidepressive, and antiaddictive effects. Areas Covered: A systematic review of systematic reviews assessing the efficacy, safety, and tolerability of serotonergic hallucinogens/psychedelic was performed using the PubMed data base until 11 April 2018. Systematic reviews with or without meta-analysis were analyzed, but only reviews that described at least one randomized controlled trial (RCT) were included. Expert Commentary: Psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence, and ayahuasca reduced depression symptoms in treatment-resistant depression. Although the results are promising, several studies were open label, and only few were RCTs, and most had small sample sizes and a short duration. Single or few doses of these drugs seem to be well tolerated, but long-term studies are lacking. New RCTs with bigger samples and longer duration are needed to replicate these findings.
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Affiliation(s)
- Rafael G Dos Santos
- a ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services) , Barcelona , Spain.,b Department of Neurosciences and Behavior, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil.,c Translational Medicine , National Institute of Science and Technology , Ribeirão Preto , Brazil
| | - José Carlos Bouso
- a ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services) , Barcelona , Spain
| | - Miguel Ángel Alcázar-Córcoles
- d Departamento de Psicología Biológica y de la Salud. Facultad de Psicología , Universidad Autónoma de Madrid , Madrid , Spain
| | - Jaime E C Hallak
- b Department of Neurosciences and Behavior, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil.,c Translational Medicine , National Institute of Science and Technology , Ribeirão Preto , Brazil
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22
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Benvenutti R, Marcon M, Reis CG, Nery LR, Miguel C, Herrmann AP, Vianna MRM, Piato A. N-acetylcysteine protects against motor, optomotor and morphological deficits induced by 6-OHDA in zebrafish larvae. PeerJ 2018; 6:e4957. [PMID: 29868300 PMCID: PMC5985760 DOI: 10.7717/peerj.4957] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/22/2018] [Indexed: 12/13/2022] Open
Abstract
Background Parkinson's disease (PD) is the second most common neurodegenerative disorder. In addition to its highly debilitating motor symptoms, non-motor symptoms may precede their motor counterparts by many years, which may characterize a prodromal phase of PD. A potential pharmacological strategy is to introduce neuroprotective agents at an earlier stage in order to prevent further neuronal death. N-acetylcysteine (NAC) has been used against paracetamol overdose hepatotoxicity by restoring hepatic concentrations of glutathione (GSH), and as a mucolytic in chronic obstructive pulmonary disease by reducing disulfide bonds in mucoproteins. It has been shown to be safe for humans at high doses. More recently, several studies have evidenced that NAC has a multifaceted mechanism of action, presenting indirect antioxidant effect by acting as a GSH precursor, besides its anti-inflammatory and neurotrophic effects. Moreover, NAC modulates glutamate release through activation of the cystine-glutamate antiporter in extra-synaptic astrocytes. Its therapeutic benefits have been demonstrated in clinical trials for several neuropsychiatric conditions but has not been tested in PD models yet. Methods In this study, we evaluated the potential of NAC to prevent the damage induced by 6-hydroxydopamine (6-OHDA) on motor, optomotor and morphological parameters in a PD model in larval zebrafish. Results NAC was able to prevent the motor deficits (total distance, mean speed, maximum acceleration, absolute turn angle and immobility time), optomotor response impairment and morphological alterations (total length and head length) caused by exposure to 6-OHDA, which reinforce and broaden the relevance of its neuroprotective effects. Discussion NAC acts in different targets relevant to PD pathophysiology. Further studies and clinical trials are needed to assess this agent as a candidate for prevention and adjunctive treatment of PD.
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Affiliation(s)
- Radharani Benvenutti
- Programa de Pós-graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Matheus Marcon
- Programa de Pós-graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carlos G Reis
- Programa de Pós-graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Laura R Nery
- Programa de Pós-graduação em Biologia Celular e Molecular, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Camila Miguel
- Programa de Pós-graduação em Zoologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana P Herrmann
- Programa de Pós-graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Monica R M Vianna
- Programa de Pós-graduação em Biologia Celular e Molecular, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Programa de Pós-graduação em Zoologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Angelo Piato
- Programa de Pós-graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Programa de Pós-graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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23
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Phillips AG, Geyer MA, Robbins TW. Effective Use of Animal Models for Therapeutic Development in Psychiatric and Substance Use Disorders. Biol Psychiatry 2018; 83:915-923. [PMID: 29478700 DOI: 10.1016/j.biopsych.2018.01.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/13/2017] [Accepted: 01/12/2018] [Indexed: 12/28/2022]
Abstract
Athina Markou and others argue forcefully for the adoption of a "translational-back translational strategy" for central nervous system drug discovery involving novel application of drugs with established safety profiles in proof-of-principle studies in humans, which in turn encourage parallel studies using experimental animals to provide vital data on the neural systems and neuropharmacological mechanisms related to the actions of the candidate drugs. Encouraged by the increasing adoption of drug-development strategies involving reciprocal information exchange between preclinical animal studies and related clinical research programs, this review presents additional compelling examples related to the following: 1) the treatment of cognitive deficits that define attention-deficit/hyperactivity disorder; 2) the development of fast-acting antidepressants based on promising clinical effects with low doses of the anesthetic ketamine; and 3) new and effective medications for the treatment of substance misuse. In the context of addressing the unmet medical need for new and effective drugs for treatment of mental ill health, now may be the time to launch major new academic-industry consortia committed to open access of all preclinical and clinical data generated by this research.
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Affiliation(s)
- Anthony G Phillips
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Mark A Geyer
- Department of Psychiatry, University of California-San Diego, La Jolla, California
| | - Trevor W Robbins
- Department of Psychology and Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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24
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Hvoslef-Eide M, Nilsson SR, Hailwood JM, Robbins TW, Saksida LM, Mar AC, Bussey TJ. Effects of anterior cingulate cortex lesions on a continuous performance task for mice. Brain Neurosci Adv 2018; 2. [PMID: 31168482 PMCID: PMC6546594 DOI: 10.1177/2398212818772962] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Important tools in the study of prefrontal cortical-dependent executive functions are cross-species behavioural tasks with translational validity. A widely used test of executive function and attention in humans is the continuous performance task (CPT). Optimal performance in variations of this task is associated with activity along the medial wall of the prefrontal cortex, including the anterior cingulate cortex (ACC), for its essential components such as response control, target detection and processing of false alarm errors. We assess the validity of a recently developed rodent touchscreen continuous performance task (rCPT) that is analogous to typical human CPT procedures. Here we evaluate the performance of mice with quinolinic acid-induced lesions centred on the ACC in the rCPT following a range of task parameter manipulations designed to challenge attention and impulse control. Lesioned mice showed a disinhibited response profile expressed as a decreased response criterion and increased false alarm rates. ACC lesions also resulted in a milder increase in inter-trial interval responses ('ITI touches') and hit rate. Lesions did not affect discriminative sensitivity d'. The disinhibited behaviour of ACC lesioned animals was stable and not affected by the manipulation of variable task parameter manipulations designed to increase task difficulty. The results are in general agreement with human studies implicating the ACC in the processing of inappropriate responses. We conclude that the rCPT may be useful for studying prefrontal cortex function in mice and has the capability of providing meaningful links between animal and human cognitive tasks.
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Affiliation(s)
- Martha Hvoslef-Eide
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.,Department of Biosciences, University of Oslo, PO Box 1066, Blindern, 0371 Oslo, Norway
| | - Simon Ro Nilsson
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.,Neuroscience Institute, New York University Medical Center, New York, NY, USA.,Department of Neuroscience and Physiology, New York University Medical Center, New York, NY, USA
| | - Jonathan M Hailwood
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Lisa M Saksida
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.,Molecular Medicine Research Group, Robarts Research Institute & Department of Physiology, Western University, London, ON, Canada.,Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,The Brain and Mind Institute, Western University, London, ON, Canada
| | - Adam C Mar
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.,Neuroscience Institute, New York University Medical Center, New York, NY, USA.,Department of Neuroscience and Physiology, New York University Medical Center, New York, NY, USA
| | - Timothy J Bussey
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.,Molecular Medicine Research Group, Robarts Research Institute & Department of Physiology, Western University, London, ON, Canada.,Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,The Brain and Mind Institute, Western University, London, ON, Canada
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25
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Wylie KP, Smucny J, Legget KT, Tregellas JR. Targeting Functional Biomarkers in Schizophrenia with Neuroimaging. Curr Pharm Des 2017; 22:2117-23. [PMID: 26818860 DOI: 10.2174/1381612822666160127113912] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/26/2016] [Indexed: 01/09/2023]
Abstract
Many of the most debilitating symptoms for psychiatric disorders such as schizophrenia remain poorly treated. As such, the development of novel treatments is urgently needed. Unfortunately, the costs associated with high failure rates for investigational compounds as they enter clinical trials has led to pharmaceutical companies downsizing or eliminating research programs needed to develop these drugs. One way of increasing the probability of success for investigational compounds is to incorporate alternative methods of identifying biological targets in order to more effectively screen new drugs. A promising method of accomplishing this goal for psychiatric drugs is to use functional magnetic resonance imaging (fMRI). fMRI investigates neural circuits, shedding light on the biology that generates symptoms such as hallucinations. Once identified, relevant neural circuits can be targeted with pharmacologic interventions and the response to these drugs measured with fMRI. This review describes the early use of fMRI in this context, and discusses the alpha7 nicotinic receptor agonist 3-(2,4-dimethoxybenzylidene) anabaseine (DMXB-A), as an example of the potential value of fMRI for psychiatric drug development.
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Affiliation(s)
- Korey P Wylie
- Department of Psychiatry, Anschutz Medical Campus, Bldg. 500, Mail Stop F546, 13001 East 17th Place, Aurora, CO, 80045, USA.
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26
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Savulich G, Piercy T, Fox C, Suckling J, Rowe JB, O’Brien JT, Sahakian BJ. Cognitive Training Using a Novel Memory Game on an iPad in Patients with Amnestic Mild Cognitive Impairment (aMCI). Int J Neuropsychopharmacol 2017; 20:624-633. [PMID: 28898959 PMCID: PMC5569993 DOI: 10.1093/ijnp/pyx040] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/19/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cognitive training is effective in patients with mild cognitive impairment but does not typically address the motivational deficits associated with older populations with memory difficulties. METHODS We conducted a randomized controlled trial of cognitive training using a novel memory game on an iPad in 42 patients with a diagnosis of amnestic mild cognitive impairment assigned to either the cognitive training (n=21; 8 hours of gameplay over 4 weeks) or control (n=21; clinic visits as usual) groups. RESULTS Significant time-by-pattern-by-group interactions were found for cognitive performance in terms of the number of errors made and trials needed on the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning task (P=.044; P=.027). Significant time-by-group interactions were also found for the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning first trial memory score (P=.002), Mini-Mental State Examination (P=.036), the Brief Visuospatial Memory Test (P=.032), and the Apathy Evaluation Scale (P=.026). Within-group comparisons revealed highly specific effects of cognitive training on episodic memory. The cognitive training group maintained high levels of enjoyment and motivation to continue after each hour of gameplay, with self-confidence and self-rated memory ability improving over time. CONCLUSIONS Episodic memory robustly improved in the cognitive training group. "Gamified" cognitive training may also enhance visuospatial abilities in patients with amnestic mild cognitive impairment. Gamification maximizes engagement with cognitive training by increasing motivation and could complement pharmacological treatments for amnestic mild cognitive impairment and mild Alzheimer's disease. Larger, more controlled trials are needed to replicate and extend these findings.
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Affiliation(s)
- George Savulich
- Department of Psychiatry (Dr Savulich, Mr Piercy, and Profs Suckling, O’Brien, and Sahakian), and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (Dr Savulich, Mr Piercy, and Profs Suckling, Rowe, and Sahakian) University of Cambridge, Cambridge, United Kingdom; Department of Psychological Sciences, University of East Anglia, Norwich, United Kingdom (Prof Fox); Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom (Prof Rowe)
| | - Thomas Piercy
- Department of Psychiatry (Dr Savulich, Mr Piercy, and Profs Suckling, O’Brien, and Sahakian), and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (Dr Savulich, Mr Piercy, and Profs Suckling, Rowe, and Sahakian) University of Cambridge, Cambridge, United Kingdom; Department of Psychological Sciences, University of East Anglia, Norwich, United Kingdom (Prof Fox); Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom (Prof Rowe)
| | - Chris Fox
- Department of Psychiatry (Dr Savulich, Mr Piercy, and Profs Suckling, O’Brien, and Sahakian), and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (Dr Savulich, Mr Piercy, and Profs Suckling, Rowe, and Sahakian) University of Cambridge, Cambridge, United Kingdom; Department of Psychological Sciences, University of East Anglia, Norwich, United Kingdom (Prof Fox); Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom (Prof Rowe)
| | - John Suckling
- Department of Psychiatry (Dr Savulich, Mr Piercy, and Profs Suckling, O’Brien, and Sahakian), and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (Dr Savulich, Mr Piercy, and Profs Suckling, Rowe, and Sahakian) University of Cambridge, Cambridge, United Kingdom; Department of Psychological Sciences, University of East Anglia, Norwich, United Kingdom (Prof Fox); Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom (Prof Rowe)
| | - James B Rowe
- Department of Psychiatry (Dr Savulich, Mr Piercy, and Profs Suckling, O’Brien, and Sahakian), and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (Dr Savulich, Mr Piercy, and Profs Suckling, Rowe, and Sahakian) University of Cambridge, Cambridge, United Kingdom; Department of Psychological Sciences, University of East Anglia, Norwich, United Kingdom (Prof Fox); Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom (Prof Rowe)
| | - John T O’Brien
- Department of Psychiatry (Dr Savulich, Mr Piercy, and Profs Suckling, O’Brien, and Sahakian), and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (Dr Savulich, Mr Piercy, and Profs Suckling, Rowe, and Sahakian) University of Cambridge, Cambridge, United Kingdom; Department of Psychological Sciences, University of East Anglia, Norwich, United Kingdom (Prof Fox); Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom (Prof Rowe)
| | - Barbara J Sahakian
- Department of Psychiatry (Dr Savulich, Mr Piercy, and Profs Suckling, O’Brien, and Sahakian), and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (Dr Savulich, Mr Piercy, and Profs Suckling, Rowe, and Sahakian) University of Cambridge, Cambridge, United Kingdom; Department of Psychological Sciences, University of East Anglia, Norwich, United Kingdom (Prof Fox); Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom (Prof Rowe)
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Khan KM, Collier AD, Meshalkina DA, Kysil EV, Khatsko SL, Kolesnikova T, Morzherin YY, Warnick JE, Kalueff AV, Echevarria DJ. Zebrafish models in neuropsychopharmacology and CNS drug discovery. Br J Pharmacol 2017; 174:1925-1944. [PMID: 28217866 PMCID: PMC5466539 DOI: 10.1111/bph.13754] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/11/2017] [Accepted: 02/14/2017] [Indexed: 12/12/2022] Open
Abstract
Despite the high prevalence of neuropsychiatric disorders, their aetiology and molecular mechanisms remain poorly understood. The zebrafish (Danio rerio) is increasingly utilized as a powerful animal model in neuropharmacology research and in vivo drug screening. Collectively, this makes zebrafish a useful tool for drug discovery and the identification of disordered molecular pathways. Here, we discuss zebrafish models of selected human neuropsychiatric disorders and drug-induced phenotypes. As well as covering a broad range of brain disorders (from anxiety and psychoses to neurodegeneration), we also summarize recent developments in zebrafish genetics and small molecule screening, which markedly enhance the disease modelling and the discovery of novel drug targets.
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Affiliation(s)
- Kanza M Khan
- Department of PsychologyUniversity of Southern MississippiHattiesburgMSUSA
| | - Adam D Collier
- Department of PsychologyUniversity of Southern MississippiHattiesburgMSUSA
- The International Zebrafish Neuroscience Research Consortium (ZNRC)SlidellLAUSA
| | - Darya A Meshalkina
- The International Zebrafish Neuroscience Research Consortium (ZNRC)SlidellLAUSA
- Institute of Translational BiomedicineSt. Petersburg State UniversitySt. PetersburgRussia
| | - Elana V Kysil
- Institute of Translational BiomedicineSt. Petersburg State UniversitySt. PetersburgRussia
| | | | | | | | - Jason E Warnick
- The International Zebrafish Neuroscience Research Consortium (ZNRC)SlidellLAUSA
- Department of Behavioral SciencesArkansas Tech UniversityRussellvilleARUSA
| | - Allan V Kalueff
- The International Zebrafish Neuroscience Research Consortium (ZNRC)SlidellLAUSA
- Institute of Translational BiomedicineSt. Petersburg State UniversitySt. PetersburgRussia
- Ural Federal UniversityEkaterinburgRussia
- Research Institute of Marine Drugs and Nutrition, College of Food Science and TechnologyGuangdong Ocean UniversityZhanjiangGuangdongChina
| | - David J Echevarria
- Department of PsychologyUniversity of Southern MississippiHattiesburgMSUSA
- The International Zebrafish Neuroscience Research Consortium (ZNRC)SlidellLAUSA
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Brühl AB, Sahakian BJ. Neuroscience-based Nomenclature: improving clinical and scientific terminology in research and clinical psychopharmacology. Psychol Med 2017; 47:1339-1341. [PMID: 28095940 DOI: 10.1017/s0033291716003603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- A B Brühl
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute,University of Cambridge,Cambridge,UK
| | - B J Sahakian
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute,University of Cambridge,Cambridge,UK
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Baldwin DS, Hou R, Gordon R, Huneke NTM, Garner M. Pharmacotherapy in Generalized Anxiety Disorder: Novel Experimental Medicine Models and Emerging Drug Targets. CNS Drugs 2017; 31:307-317. [PMID: 28303465 DOI: 10.1007/s40263-017-0423-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Many pharmacological and psychological approaches have been found efficacious in patients with generalized anxiety disorder (GAD), but many treatment-seeking patients will not respond and others will relapse despite continuing with interventions that initially had beneficial effects. Other patients will respond but then stop treatment early because of untoward effects such as sexual dysfunction, drowsiness, and weight gain. There is much scope for the development of novel approaches that could have greater overall effectiveness or acceptability than currently available interventions or that have particular effectiveness in specific clinical subgroups. 'Experimental medicine' studies in healthy volunteers model disease states and represent a proof-of-concept approach for the development of novel therapeutic interventions: they determine whether to proceed to pivotal efficacy studies and so can reduce delays in translating innovations into clinical practice. Investigations in healthy volunteers challenged with the inhalation of air 'enriched' with 7.5% carbon dioxide (CO2) indicate this technique provides a validated and robust experimental medicine model, mirroring the subjective, autonomic, and cognitive features of GAD. The anxiety response during CO2 challenge probably involves both central noradrenergic neurotransmission and effects on acid-base sensitive receptors and so may stimulate development of novel agents targeted at central chemosensors. Increasing awareness of the potential role of altered cytokine balance in anxiety and the interplay of cytokines with monoaminergic mechanisms may also encourage the investigation of novel agents with modulating effects on immunological profiles. Although seemingly disparate, these two approaches to treatment development may pivot on a shared mechanism in exerting anxiolytic-like effects through pharmacological effects on acid-sensing ion channels.
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Affiliation(s)
- David S Baldwin
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK. .,University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. .,University Department of Psychiatry, Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton, SO14 3DT, UK.
| | - Ruihua Hou
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Robert Gordon
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nathan T M Huneke
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Matthew Garner
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,Academic Unit of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, UK
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Ahfeldt T, Litterman NK, Rubin LL. Studying human disease using human neurons. Brain Res 2017; 1656:40-48. [PMID: 27060768 PMCID: PMC5053850 DOI: 10.1016/j.brainres.2016.03.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 03/08/2016] [Accepted: 03/31/2016] [Indexed: 01/25/2023]
Abstract
Utilizing patient derived cells has enormous promise for discovering new drugs for diseases of the nervous system, a goal that has been historically quite challenging. In this review, we will outline the potential of human stem cell derived neuron models for assessing therapeutics and high-throughput screening and compare to more traditional drug discovery strategies. We summarize recent successes of the approach and discuss special considerations for developing human stem cell based assays. New technologies, such as genome editing, offer improvements to help overcome the challenges that remain. Finally, human neurons derived from patient cells have advantages for translational research beyond drug screening as they can also be used to identify individual efficacy and safety prior to clinical testing and for dissecting disease mechanisms. This article is part of a Special Issue entitled SI: Exploiting human neurons.
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Affiliation(s)
- Tim Ahfeldt
- Department of Stem Cells and Regenerative Biology, Harvard University, Cambridge MA , USA, , Fax: 617-495-3961
| | - Nadia K. Litterman
- Department of Stem Cells and Regenerative Biology, Harvard University, Cambridge MA , USA, , Fax: 617-495-3961
| | - Lee L. Rubin
- Department of Stem Cells and Regenerative Biology, Harvard University, Cambridge MA , USA, , Fax: 617-495-3961
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31
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Toumi M, Rémuzat C. Value added medicines: what value repurposed medicines might bring to society? JOURNAL OF MARKET ACCESS & HEALTH POLICY 2016; 5:1264717. [PMID: 28265347 PMCID: PMC5328340 DOI: 10.1080/20016689.2017.1264717] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 06/06/2023]
Abstract
Background & objectives: Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations. Methods: A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature. Following completion of the literature review, a primary research was conducted to get perspective of various stakeholders across EU member states on drug repurposing (healthcare professionals, regulatory authorities and Health Technology Assessment (HTA) bodies/payers, patients, and representatives of the pharmaceutical industry developing medicines in this field). Ad hoc literature review was performed to illustrate, when appropriate, statements of the various stakeholders. Results: Various nomenclatures have been used to describe the concept of drug repurposing in the literature, with more or less broad definitions either based on outcomes, processes, or being a mix of both. In this context, Medicines for Europe (http://www.medicinesforeurope.com/value-added-medicines/) established one single terminology for these medicines, known as value added medicines, defined as 'medicines based on known molecules that address healthcare needs and deliver relevant improvements for patients, healthcare professionals and/or payers'. Stakeholder interviews highlighted three main potential benefits for value added medicines: (1) to address a number of medicine-related healthcare inefficiencies related to irrational use of medicines, non-availability of appropriate treatment options, shortage of mature products, geographical inequity in medicine access; (2) to improve healthcare system efficiency; and (3) to contribute to sustainability of healthcare systems through economic advantages. Current HTA framework, generic stigma, and pricing rules, such as internal reference pricing or tendering processes in place in some countries, were reported as the current key hurdles preventing the full recognition of value added medicines' benefits, discouraging manufacturers from bringing such products to the market. Discussion & conclusions: There is currently a gap between increasing regulatory authority interest in capturing value added medicines' benefits and the resistance of HTA bodies/payers, who tend to ignore this important segment of the pharmaceutical field. This situation calls for policy changes to foster appropriate incentives to enhance value recognition of value added medicines and deliver the expected benefit to society. Policy changes from HTA perspective should include: absence of any legislative barriers preventing companies from pursuing HTA; HTA requirements proportionate to potential reward; HTA decision-making framework taking into account the specific characteristics of value added medicines; eligibility for early HTA dialogues; Policy changes from pricing perspective should encompass: tenders/procurement policies allowing differentiation from generic medicines; eligibility for early entry agreement; non-systematic implementation of external and internal reference pricing policies; recognition of indication-specific pricing. At the same time, the pharmaceutical industry should engage all the stakeholders (patients, healthcare providers, HTA bodies/payers) in early dialogues to identify their expectations and to ensure the developed value added medicines address their needs.
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Affiliation(s)
- Mondher Toumi
- Faculté de Médecine, Laboratoire de Santé Publique, Aix-Marseille Université, Université de la Méditerranée, Marseille Cedex, France
| | - Cécile Rémuzat
- Pricing & Market Access Department, Creativ-Ceutical, Paris, France
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Pandria N, Kovatsi L, Vivas AB, Bamidis PD. Resting-state Abnormalities in Heroin-dependent Individuals. Neuroscience 2016; 378:113-145. [PMID: 27884551 DOI: 10.1016/j.neuroscience.2016.11.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 07/19/2016] [Accepted: 11/14/2016] [Indexed: 11/30/2022]
Abstract
Drug addiction is a major health problem worldwide. Recent neuroimaging studies have shed light into the underlying mechanisms of drug addiction as well as its consequences to the human brain. The most vulnerable, to heroin addiction, brain regions have been reported to be specific prefrontal, parietal, occipital, and temporal regions, as well as, some subcortical regions. The brain regions involved are usually linked with reward, motivation/drive, memory/learning, inhibition as well as emotional control and seem to form circuits that interact with each other. So, along with neuroimaging studies, recent advances in resting-state dynamics might allow further assessments upon the multilayer complexity of addiction. In the current manuscript, we comprehensively review and discuss existing resting-state neuroimaging findings classified into three overlapping and interconnected groups: functional connectivity alterations, structural deficits and abnormal topological properties. Moreover, behavioral traits of heroin-addicted individuals as well as the limitations of the currently available studies are also reviewed. Finally, in need of a contemporary therapy a multimodal therapeutic approach is suggested using classical treatment practices along with current neurotechonologies, such as neurofeedback and goal-oriented video-games.
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Affiliation(s)
- Niki Pandria
- Neuroscience of Cognition and Affection Group, Laboratory of Medical Physics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Leda Kovatsi
- Laboratory of Forensic Medicine and Toxicology, Medical School, Thessaloniki, Greece.
| | - Ana B Vivas
- Cognitive Psychology and Neuropsychology Lab, Department of Psychology, City College, The University of Sheffield International Faculty, Thessaloniki, Greece.
| | - Panagiotis D Bamidis
- Neuroscience of Cognition and Affection Group, Laboratory of Medical Physics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Jacobsen JPR, Krystal AD, Krishnan KRR, Caron MG. Adjunctive 5-Hydroxytryptophan Slow-Release for Treatment-Resistant Depression: Clinical and Preclinical Rationale. Trends Pharmacol Sci 2016; 37:933-944. [PMID: 27692695 DOI: 10.1016/j.tips.2016.09.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/04/2016] [Accepted: 09/06/2016] [Indexed: 01/09/2023]
Abstract
Serotonin transporter (SERT) inhibitors treat depression by elevating brain extracellular 5-hydroxytryptamine (5-HTExt). However, only one-third of patients respond adequately. Treatment-resistant depression (TRD) is a major unmet need. Interestingly, elevating 5-HTExt beyond what is achieved by a SERT inhibitor appears to treat TRD. Adjunctive administration of 5-hydroxytryptophan (5-HTP) safely elevates 5-HTExt beyond the SERT inhibitor effect in humans; however, 5-HTP cannot be a clinically viable drug because of its poor pharmacokinetics. A slow-release (SR) delivery mode would be predicted to overcome the pharmacokinetic limitations of 5-HTP, substantially enhancing the pharmacological action and transforming 5-HTP into a clinically viable drug. Animal studies bear out this prediction. Thus, adjunct 5-HTP SR could be an important new treatment for TRD. Here, we review the clinical and preclinical evidence for this treatment.
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Affiliation(s)
| | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27710, USA
| | | | - Marc G Caron
- Department of Cell Biology, Duke University, Durham, NC 27710, USA; Department of Medicine, Duke University, Durham, NC 27710, USA; Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA.
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Fisher PA. Translational Neuroscience as a Tool for Intervention Development in the Context of High-Adversity Families. New Dir Child Adolesc Dev 2016; 2016:111-25. [PMID: 27589501 PMCID: PMC5338687 DOI: 10.1002/cad.20165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The use of theory-driven models to develop and evaluate family-based intervention programs has a long history in psychology. Some of the first evidence-based parenting programs to address child problem behavior, developed in the 1970s, were grounded in causal models derived from longitudinal developmental research. The same translational strategies can also be applied to designing programs that leverage emerging scientific knowledge about the effects of early adverse experiences on neurobiological systems to reduce risk and promote well-being. By specifying not only behavioral targets but also affected underlying neural systems, interventions can become more precise and efficient. This chapter describes the development of a program of research focusing on an intervention for young children in foster care. The intervention emerged from social learning theory research and employs a translational neuroscience approach. The conceptual model guiding the research, which incorporates behavioral domains as well as stress-regulatory neural systems, is described. Finally, future directions for translational neuroscience in family-based intervention research are considered.
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Johnson AR, Banks ML, Blough BE, Lile JA, Nicholson KL, Negus SS. Development of a translational model to screen medications for cocaine use disorder I: Choice between cocaine and food in rhesus monkeys. Drug Alcohol Depend 2016; 165:103-10. [PMID: 27264165 PMCID: PMC4939093 DOI: 10.1016/j.drugalcdep.2016.05.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/09/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Homologous cocaine self-administration procedures in laboratory animals and humans may facilitate translational research for medications development to treat cocaine dependence. This study, therefore, sought to establish choice between cocaine and an alternative reinforcer in rhesus monkeys responding under a procedure back-translated from previous human studies and homologous to a human laboratory procedure described in a companion paper. METHODS Four rhesus monkeys with chronic indwelling intravenous catheters had access to cocaine injections (0, 0.043, 0.14, or 0.43mg/kg/injection) and food (0, 1, 3, or 10 1g banana-flavored food pellets). During daily 5h sessions, a single cocaine dose and a single food-reinforcer magnitude were available in 10 30-min trials. During the initial "sample" trial, the available cocaine and food reinforcer were delivered non-contingently. During each of the subsequent nine "choice" trials, responding could produce either the cocaine or food reinforcer under an independent concurrent progressive-ratio schedule. RESULTS Preference was governed by the cocaine dose and food-reinforcer magnitude, and increasing cocaine doses produced dose-dependent increases in cocaine choice at all food-reinforcer magnitudes. Effects of the candidate medication lisdexamfetamine (0.32-3.2mg/kg/day) were then examined on choice between 0.14mg/kg/injection cocaine and 10 pellets. Under baseline conditions, this reinforcer pair maintained an average of approximately 6 cocaine and 3 food choices. Lisdexamfetamine dose-dependently decreased cocaine choice in all monkeys, but food choice was not significantly altered. CONCLUSIONS These results support utility of this procedure in rhesus monkeys as one component of a platform for translational research on medications development to treat cocaine use disorder.
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Affiliation(s)
- Amy R. Johnson
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA
| | - Matthew L. Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA
| | - Bruce E. Blough
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, NC
| | - Joshua A. Lile
- Departments of Behavioral Science, Psychiatry, and Psychology, University of Kentucky, Lexington, KY
| | - Katherine L. Nicholson
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA
| | - S. Stevens Negus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA
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Bortolato B, Carvalho AF, Soczynska JK, Perini GI, McIntyre RS. The Involvement of TNF-α in Cognitive Dysfunction Associated with Major Depressive Disorder: An Opportunity for Domain Specific Treatments. Curr Neuropharmacol 2016; 13:558-76. [PMID: 26467407 PMCID: PMC4761629 DOI: 10.2174/1570159x13666150630171433] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/05/2014] [Accepted: 12/08/2014] [Indexed: 12/31/2022] Open
Abstract
Major depressive disorder is a highly prevalent, chronic and recurring disorder, associated
with substantial impairment in cognitive and interpersonal functions. Accumulating evidence suggests
that inflammatory processes play an important role in the etio-pathogenesis, phenomenology,
comorbidity and treatment of MDD. Suboptimal remission rates and the persistence of cognitive
deficits contribute to functional impairment in MDD inviting the need for the development of mechanistically novel and
domain specific treatment approaches. The MEDLINE/ Pubmed database was searched from inception to February, 9th,
2014 with combinations of the following search terms: ‘TNF-alpha’, ‘depression’, ‘infliximab’, ‘etanercept’, ‘adalimumab’, ‘golimumab’and ‘certolizumab’. Preclinical and clinical evidence linking TNF-α to MDD pathophysiology were
reviewed as well as the current status of TNF-α modulators as novel agents for the treatment of MDD. Experimental
models and clinical studies provide encouraging preliminary evidence for the efficacy of TNF-α antagonists in mitigating
depressive symptoms and improving cognitive deficits. Further studies are warranted to confirm these data in larger
randomized controlled trials in primary psychiatric populations. Translational research provides a promising perspective
that may aid the development and/or repurposing of mechanism-based treatments for depressive symptoms and cognitive
impairment in MDD.
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Affiliation(s)
| | | | | | | | - Roger S McIntyre
- Department of Psychiatry and Pharmacology, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON, Canada M5T2S8
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Banik A, Brown RE, Bamburg J, Lahiri DK, Khurana D, Friedland RP, Chen W, Ding Y, Mudher A, Padjen AL, Mukaetova-Ladinska E, Ihara M, Srivastava S, Padma Srivastava MV, Masters CL, Kalaria RN, Anand A. Translation of Pre-Clinical Studies into Successful Clinical Trials for Alzheimer's Disease: What are the Roadblocks and How Can They Be Overcome? J Alzheimers Dis 2016; 47:815-43. [PMID: 26401762 DOI: 10.3233/jad-150136] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Preclinical studies are essential for translation to disease treatments and effective use in clinical practice. An undue emphasis on single approaches to Alzheimer's disease (AD) appears to have retarded the pace of translation in the field, and there is much frustration in the public about the lack of an effective treatment. We critically reviewed past literature (1990-2014), analyzed numerous data, and discussed key issues at a consensus conference on Brain Ageing and Dementia to identify and overcome roadblocks in studies intended for translation. We highlight various factors that influence the translation of preclinical research and highlight specific preclinical strategies that have failed to demonstrate efficacy in clinical trials. The field has been hindered by the domination of the amyloid hypothesis in AD pathogenesis while the causative pathways in disease pathology are widely considered to be multifactorial. Understanding the causative events and mechanisms in the pathogenesis are equally important for translation. Greater efforts are necessary to fill in the gaps and overcome a variety of confounds in the generation, study design, testing, and evaluation of animal models and the application to future novel anti-dementia drug trials. A greater variety of potential disease mechanisms must be entertained to enhance progress.
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Affiliation(s)
- Avijit Banik
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Richard E Brown
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - James Bamburg
- Department of Biochemistry and Molecular Biology, Colorado State University, Fort Collins, CO, USA
| | - Debomoy K Lahiri
- Departments of Psychiatry and of Medical & Molecular Genetics, Indiana University School of Medicine, Neuroscience Research Center, Indianapolis, IN, USA
| | - Dheeraj Khurana
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Robert P Friedland
- Department of Neurology, University of Louisville, School of Medicine, Louisville, KY, USA
| | - Wei Chen
- Division of Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ying Ding
- Department of Biostatistics, University of Pittsburgh, 318C Parran Hall, Pittsburgh, PA, USA
| | - Amritpal Mudher
- Southampton Neurosciences Group, University of Southampton, Southampton, UK
| | - Ante L Padjen
- Department of Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
| | - Elizabeta Mukaetova-Ladinska
- Institute of Neuroscience, Newcastle University, NIHR Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Masafumi Ihara
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Sudhir Srivastava
- Division of Toxicology, Central Drug Research Institute, Lucknow, India
| | - M V Padma Srivastava
- Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Colin L Masters
- Mental Health Research Institute, University of Melbourne, Royal Parade, The VIC, Australia
| | - Raj N Kalaria
- Institute of Neuroscience, Newcastle University, NIHR Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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38
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Sahin M, Henske EP, Manning BD, Ess KC, Bissler JJ, Klann E, Kwiatkowski DJ, Roberds SL, Silva AJ, Hillaire-Clarke CS, Young LR, Zervas M, Mamounas LA. Advances and Future Directions for Tuberous Sclerosis Complex Research: Recommendations From the 2015 Strategic Planning Conference. Pediatr Neurol 2016; 60:1-12. [PMID: 27267556 PMCID: PMC4921275 DOI: 10.1016/j.pediatrneurol.2016.03.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 03/24/2016] [Indexed: 11/17/2022]
Abstract
On March 10 to March 12, 2015, the National Institute of Neurological Disorders and Stroke and the Tuberous Sclerosis Alliance sponsored a workshop in Bethesda, Maryland, to assess progress and new opportunities for research in tuberous sclerosis complex with the goal of updating the 2003 Research Plan for Tuberous Sclerosis (http://www.ninds.nih.gov/about_ninds/plans/tscler_research_plan.htm). In addition to the National Institute of Neurological Disorders and Stroke and Tuberous Sclerosis Alliance, participants in the strategic planning effort and workshop included representatives from six other Institutes of the National Institutes of Health, the Department of Defense Tuberous Sclerosis Complex Research Program, and a broad cross-section of basic scientists and clinicians with expertise in tuberous sclerosis complex along with representatives from the pharmaceutical industry. Here we summarize the outcomes from the extensive premeeting deliberations and final workshop recommendations, including (1) progress in the field since publication of the initial 2003 research plan for tuberous sclerosis complex, (2) the key gaps, needs, and challenges that hinder progress in tuberous sclerosis complex research, and (3) a new set of research priorities along with specific recommendations for addressing the major challenges in each priority area. The new research plan is organized around both short-term and long-term goals with the expectation that progress toward specific objectives can be achieved within a five to ten year time frame.
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Affiliation(s)
- Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Elizabeth P Henske
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Brendan D Manning
- Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kevin C Ess
- Vanderbilt Kennedy Center for Research on Human Development, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - John J Bissler
- University of Tennessee Health Science Center, Le Bonheur Children's Hospital and St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Eric Klann
- Center for Neural Science, New York University, New York, New York
| | - David J Kwiatkowski
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Alcino J Silva
- Departments of Neurobiology, Psychiatry and Psychology, Integrative Center for Learning and Memory, Brain Research Institute, University of California at Los Angeles, Los Angeles, California
| | - Coryse St Hillaire-Clarke
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Lisa R Young
- Division of Pulmonary Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Mark Zervas
- Department of Neuroscience, Amgen Inc, Cambridge, Massachusetts
| | - Laura A Mamounas
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
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39
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Bhui K. Invited commentary on … Rethinking funding priorities in mental health research. Br J Psychiatry 2016; 208:510-1. [PMID: 27251689 DOI: 10.1192/bjp.bp.116.185991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 04/18/2016] [Indexed: 11/23/2022]
Abstract
This commentary takes up the notion proposed by Lewis-Fernández and colleagues that we need more balance in research priorities. Specifically, our reliance on neurobiology may be misplaced and likely to be unrewarding unless we ensure that: (a) research with better return for patients and the public is also pursued; (b) research findings are put into practice; and (c) we retain a focus on proportionate investment in service provision. Patient, public and economic perspectives should drive the decision making for better investment, and behaviour change might be better targeted at commissioners and policy makers rather than patients and providers.
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Affiliation(s)
- Kamaldeep Bhui
- Kamaldeep Bhui, MD, Wolfson Institute of Preventive Medicine, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK.
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40
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The cost and impact of compulsivity: A research perspective. Eur Neuropsychopharmacol 2016; 26:800-9. [PMID: 27235690 DOI: 10.1016/j.euroneuro.2016.02.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 12/13/2015] [Accepted: 02/05/2016] [Indexed: 11/20/2022]
Abstract
Compulsivity is the defining feature of various psychiatric disorders including Obsessive Compulsive Related Disorders (OCRDs), and other compulsive, impulsive, and addictive disorders. These disorders are disabling, chronic conditions with an early onset and high rates of comorbidity, misdiagnoses, and delay in treatment onset. Disorders of compulsivity are responsible for considerable socioeconomic burden to society. We review the costs and impacts of compulsivity. In order to facilitate earlier diagnosis and targeted treatments, we examine the overlapping mechanisms that underlie compulsivity. We reconceptualize psychiatric disorders based on core features of compulsivity, highlight challenges in harmonizing research in children and adults, describe newer research methodologies, and point to future directions that can impact the costs and impact of disorders of compulsivity.
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41
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Gillan CM, Robbins TW, Sahakian BJ, van den Heuvel OA, van Wingen G. The role of habit in compulsivity. Eur Neuropsychopharmacol 2016; 26:828-40. [PMID: 26774661 PMCID: PMC4894125 DOI: 10.1016/j.euroneuro.2015.12.033] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 12/17/2015] [Accepted: 12/20/2015] [Indexed: 11/22/2022]
Abstract
Compulsivity has been recently characterized as a manifestation of an imbalance between the brain׳s goal-directed and habit-learning systems. Habits are perhaps the most fundamental building block of animal learning, and it is therefore unsurprising that there are multiple ways in which the development and execution of habits can be promoted/discouraged. Delineating these neurocognitive routes may be critical to understanding if and how habits contribute to the many faces of compulsivity observed across a range of psychiatric disorders. In this review, we distinguish the contribution of excessive stimulus-response habit learning from that of deficient goal-directed control over action and response inhibition, and discuss the role of stress and anxiety as likely contributors to the transition from goal-directed action to habit. To this end, behavioural, pharmacological, neurobiological and clinical evidence are synthesised and a hypothesis is formulated to capture how habits fit into a model of compulsivity as a trans-diagnostic psychiatric trait.
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Affiliation(s)
- Claire M Gillan
- Department of Psychology, New York University, 6 Washington Place, New York, NY 10003, USA; Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom.
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J Sahakian
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Odile A van den Heuvel
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands; The OCD Team, Haukeland University Hospital, Bergen, Norway
| | - Guido van Wingen
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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42
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Argyelan M, Lencz T, Kaliora S, Sarpal DK, Weissman N, Kingsley PB, Malhotra AK, Petrides G. Subgenual cingulate cortical activity predicts the efficacy of electroconvulsive therapy. Transl Psychiatry 2016; 6:e789. [PMID: 27115120 PMCID: PMC4872412 DOI: 10.1038/tp.2016.54] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 01/25/2016] [Accepted: 02/28/2016] [Indexed: 12/12/2022] Open
Abstract
Electroconvulsive therapy (ECT) is the most effective treatment for depression, yet its mechanism of action is unknown. Our goal was to investigate the neurobiological underpinnings of ECT response using longitudinally collected resting-state functional magnetic resonance imaging (rs-fMRI) in 16 patients with treatment-resistant depression and 10 healthy controls. Patients received bifrontal ECT 3 times a week under general anesthesia. We acquired rs-fMRI at three time points: at baseline, after the 1st ECT administration and after the course of the ECT treatment; depression was assessed with the Hamilton Depression Rating Scale (HAM-D). The primary measure derived from rs-fMRI was fractional amplitude of low frequency fluctuation (fALFF), which provides an unbiased voxel-wise estimation of brain activity. We also conducted seed-based functional connectivity analysis based on our primary findings. We compared treatment-related changes in HAM-D scores with pre- and post-treatment fALFF and connectivity measures. Subcallosal cingulate cortex (SCC) demonstrated higher BOLD signal fluctuations (fALFF) at baseline in depressed patients, and SCC fALFF decreased over the course of treatment. The baseline level of fALFF of SCC predicted response to ECT. In addition, connectivity of SCC with bilateral hippocampus, bilateral temporal pole, and ventromedial prefrontal cortex was significantly reduced over the course of treatment. These results suggest that the antidepressant effect of ECT may be mediated by downregulation of SCC activity and connectivity. SCC function may serve as an important biomarker of target engagement in the development of novel therapies for depression that is resistant to treatment with standard medications.
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Affiliation(s)
- M Argyelan
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, 75-59 263rd Street, Glen Oaks, NY 11004, USA. E-mail:
| | - T Lencz
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA,Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - S Kaliora
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - D K Sarpal
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - N Weissman
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - P B Kingsley
- Department of Radiology, North Shore University Hospital, Northwell Health, Manhasset, NY, USA
| | - A K Malhotra
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA,Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - G Petrides
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA,Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, USA
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43
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Vatansever D, Manktelow AE, Sahakian BJ, Menon DK, Stamatakis EA. Cognitive Flexibility: A Default Network and Basal Ganglia Connectivity Perspective. Brain Connect 2016; 6:201-7. [PMID: 26652748 DOI: 10.1089/brain.2015.0388] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The intra/extradimensional set-shifting task (IED) provides a reliable assessment of cognitive flexibility, the shifting of attention to select behaviorally relevant stimuli in a given context. Impairments in this domain were previously reported in patients with altered neurotransmitter systems such as schizophrenia and Parkinson's disease. Consequently, corticostriatal connections were implicated in the mediation of this function. In addition, parts of the default mode network (DMN), namely the medial prefrontal and posterior cingulate/precuneus cortices, are also being progressively described in association with set-shifting paradigms. Nevertheless, a definitive link between cognitive flexibility and DMN connectivity remains to be established. To this end, we related resting state functional magnetic resonance imaging (fMRI)-based functional connectivity of DMN with IED task performance in a healthy population, measured outside the scanner. The results demonstrated that greater posterior cingulate cortex/precuneus (DMN) connectivity with the ventromedial striatopallidum at rest correlated with fewer total adjusted errors on the IED task. This finding points to a relationship between DMN and basal ganglia connectivity for cognitive flexibility, further highlighting this network's potential role in adaptive human cognition.
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Affiliation(s)
- Deniz Vatansever
- 1 Division of Anaesthesia, Department of Medicine, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom .,2 Wolfson Brain Imaging Centre, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Anne E Manktelow
- 1 Division of Anaesthesia, Department of Medicine, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom .,2 Wolfson Brain Imaging Centre, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Barbara J Sahakian
- 3 Department of Psychiatry, University of Cambridge , Cambridge, United Kingdom
| | - David K Menon
- 1 Division of Anaesthesia, Department of Medicine, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom .,2 Wolfson Brain Imaging Centre, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Emmanuel A Stamatakis
- 1 Division of Anaesthesia, Department of Medicine, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom .,2 Wolfson Brain Imaging Centre, University of Cambridge , Cambridge Biomedical Campus, Cambridge, United Kingdom
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44
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The National Institute of Mental Health Research Domain Criteria and Clinical Research in Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry 2016; 55:93-8. [PMID: 26802775 PMCID: PMC4724376 DOI: 10.1016/j.jaac.2015.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 10/05/2015] [Accepted: 11/16/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This review discusses the relevance of the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) to clinical research in child and adolescent psychiatry. METHOD We summarize the characteristics of the NIMH RDoC project and then provide examples of RDoC designs that are of relevance to clinical investigators in child and adolescent psychiatry. The final section addresses questions regarding the impact of RDoC on clinical care. RESULTS RDoC encourages investigators to investigate psychopathology dimensionally: greater or lesser degrees of healthy/adapted functioning of neurobiological, cognitive, and behavioral processes (constructs) that cut across current diagnostic categories. Elucidation of the developmental components of RDoC constructs is needed to ensure they are fully validated. Integrating RDoC approaches into clinical research of child and adolescent psychopathology is contributing to our understanding of development as an aspect of the heterogeneity within DSM disorders and commonalities across seemingly disparate disorders. Continued efforts promise to also explain the processes that lead to mental illness in at-risk populations. CONCLUSION Incorporating an RDoC approach in clinical research in child and adolescent psychiatry promises to be a fruitful avenue of research into the root causes and manifestations of mental illness, which will eventually lead to more precise treatments. Although the long-term aspiration of RDoC is to help reduce the burden of suffering for those with mental illnesses, it is not intended to be used for practical clinical purposes at this early stage.
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45
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Animal models of major depression and their clinical implications. Prog Neuropsychopharmacol Biol Psychiatry 2016; 64:293-310. [PMID: 25891248 DOI: 10.1016/j.pnpbp.2015.04.004] [Citation(s) in RCA: 241] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/09/2015] [Accepted: 04/12/2015] [Indexed: 12/12/2022]
Abstract
Major depressive disorder is a common, complex, and potentially life-threatening mental disorder that imposes a severe social and economic burden worldwide. Over the years, numerous animal models have been established to elucidate pathophysiology that underlies depression and to test novel antidepressant treatment strategies. Despite these substantial efforts, the animal models available currently are of limited utility for these purposes, probably because none of the models mimics this complex disorder fully. It is presumable that psychiatric illnesses, such as affective disorders, are related to the complexity of the human brain. Here, we summarize the animal models that are used most commonly for depression, and discuss their advantages and limitations. We discuss genetic models, including the recently developed optogenetic tools and the stress models, such as the social stress, chronic mild stress, learned helplessness, and early-life stress paradigms. Moreover, we summarize briefly the olfactory bulbectomy model, as well as models that are based on pharmacological manipulations and disruption of the circadian rhythm. Finally, we highlight common misinterpretations and often-neglected important issues in this field.
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46
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Hvoslef-Eide M, Nilsson SRO, Saksida LM, Bussey TJ. Cognitive Translation Using the Rodent Touchscreen Testing Approach. Curr Top Behav Neurosci 2016; 28:423-447. [PMID: 27305921 DOI: 10.1007/7854_2015_5007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The development of novel therapeutic avenues for the treatment of cognitive deficits in psychiatric and neurodegenerative disease is of high importance, yet progress in this field has been slow. One reason for this lack of success may lie in discrepancies between how cognitive functions are assessed in experimental animals and humans. In an attempt to bridge this translational gap, the rodent touchscreen testing platform is suggested as a translational tool. Specific examples of successful cross-species translation are discussed focusing on paired associate learning (PAL), the 5-choice serial reaction time task (5-CSRTT), the rodent continuous performance task (rCPT) and reversal learning. With ongoing research assessing the neurocognitive validity of tasks, the touchscreen approach is likely to become increasingly prevalent in translational cognitive research.
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Affiliation(s)
- M Hvoslef-Eide
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.
| | - S R O Nilsson
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
| | - L M Saksida
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
| | - T J Bussey
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
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47
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van Amelsvoort T, Hernaus D. Effect of Pharmacological Interventions on the Fronto-Cingulo-Parietal Cognitive Control Network in Psychiatric Disorders: A Transdiagnostic Systematic Review of fMRI Studies. Front Psychiatry 2016; 7:82. [PMID: 27242552 PMCID: PMC4870274 DOI: 10.3389/fpsyt.2016.00082] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/26/2016] [Indexed: 01/10/2023] Open
Abstract
Executive function deficits, such as working memory, decision-making, and attention problems, are a common feature of several psychiatric disorders for which no satisfactory treatment exists. Here, we transdiagnostically investigate the effects of pharmacological interventions (other than methylphenidate) on the fronto-cingulo-parietal cognitive control network, in order to identify functional brain markers for future procognitive pharmacological interventions. Twenty-nine manuscripts investigated the effect of pharmacological treatment on executive function-related brain correlates in psychotic disorders (n = 11), depression (n = 4), bipolar disorder (n = 4), ADHD (n = 4), OCD (n = 2), smoking dependence (n = 2), alcohol dependence (n = 1), and pathological gambling (n = 1). In terms of impact on the fronto-cingulo-parietal network, the preliminary evidence for catechol-O-methyl-transferase inhibitors, nicotinic receptor agonists, and atomoxetine was relatively consistent, the data for atypical antipsychotics and anticonvulsants moderate, and interpretation of the data for antidepressants was hampered by the employed study designs. Increased activity in task-relevant areas and decreased activity in task-irrelevant areas were the most common transdiagnostic effects of pharmacological treatment. These markers showed good positive and moderate negative predictive value. It is concluded that fronto-cingulo-parietal activity changes can serve as a marker for future procognitive interventions. Future recommendations include the use of randomized double-blind designs and selective cholinergic and glutamatergic compounds.
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Affiliation(s)
- Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, School for Mental Health and NeuroScience MHeNS Maastricht University , Maastricht , Netherlands
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, School for Mental Health and NeuroScience MHeNS Maastricht University , Maastricht , Netherlands
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48
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Quintana DS, Guastella AJ, Westlye LT, Andreassen OA. The promise and pitfalls of intranasally administering psychopharmacological agents for the treatment of psychiatric disorders. Mol Psychiatry 2016; 21:29-38. [PMID: 26552590 DOI: 10.1038/mp.2015.166] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/27/2015] [Accepted: 09/29/2015] [Indexed: 01/29/2023]
Abstract
Accumulating research demonstrates the potential of intranasal delivery of psychopharmacological agents to treat a range of psychiatric disorders and symptoms. It is believed that intranasal administration offers both direct and indirect pathways to deliver psychopharmacological agents to the central nervous system. This administration route provides a unique opportunity to repurpose both old drugs for new uses and improve currently approved drugs that are indicated for other administration routes. Despite this promise, however, the physiology of intranasal delivery and related assumptions behind the bypassing of the blood brain barrier is seldom considered in detail in clinical trials and translational research. In this review, we describe the current state of the art in intranasal psychopharmacological agent delivery research and current challenges using this administration route, and discuss important aspects of nose-to-brain delivery that may improve the efficacy of these new therapies in future research. We also highlight current gaps in the literature and suggest how research can directly examine the assumptions of nose-to-brain delivery of psychopharmacological agents in humans.
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Affiliation(s)
- D S Quintana
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - A J Guastella
- Brain and Mind Center, Central Clinical School, University of Sydney, Sydney, NSW, Australia
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - O A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Oslo, Norway
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49
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Mocelin R, Herrmann AP, Marcon M, Rambo CL, Rohden A, Bevilaqua F, de Abreu MS, Zanatta L, Elisabetsky E, Barcellos LJ, Lara DR, Piato AL. N-acetylcysteine prevents stress-induced anxiety behavior in zebrafish. Pharmacol Biochem Behav 2015; 139 Pt B:121-6. [DOI: 10.1016/j.pbb.2015.08.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 05/28/2015] [Accepted: 08/04/2015] [Indexed: 12/23/2022]
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50
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Abstract
Binge eating disorder (BED) is the most common of eating disorders and is characterized by excessive, out-of-control, rapid food intake. This review focuses on cognitive impairments in BED, which represent an endophenotype that mediates brain function and behavior. Here we focus on reviewing impulsivity, compulsivity, attentional biases to food cues, and executive function. Behavioral regulation in BED appears to be influenced by the context of motivationally salient food cues and the degree of obesity. Deficits in delay discounting and risk taking under ambiguity are impaired in obesity irrespective of BED status. However, in BED subjects with milder obesity, greater risk seeking under explicit probabilistic risk is observed to monetary rewards, whereas this shifts to risk aversion and enhanced delay discounting in more severe obesity. Relative to non-BED obese subjects, BED is characterized by enhanced behavioral inflexibility or compulsivity across multiple domains, with subjects selecting the same choices despite change in relevance (set shifting), being no longer rewarding (habit formation), or irrespective of outcome (perseveration). The context of food cues was associated with multiple attentional and early and late inhibitory impairments and enhanced memory bias, although BED patients also have generalized cognitive interference in working memory. These findings may help explain the phenotype of binge eating. Motivationally salient food cues provoke attentional and memory biases along with impairing response inhibitory processes. Those with BED are also more susceptible to cognitive interference and have impaired decisional impulsivity, with the tendency to inflexibly stick with the same choices irrespective of changes in context. These findings suggest critical cognitive domains that may guide therapeutic interventions.
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