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Sgambato V. The Serotonin 4 Receptor Subtype: A Target of Particular Interest, Especially for Brain Disorders. Int J Mol Sci 2024; 25:5245. [PMID: 38791281 PMCID: PMC11121119 DOI: 10.3390/ijms25105245] [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: 03/15/2024] [Revised: 04/22/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
In recent years, particular attention has been paid to the serotonin 4 receptor, which is well expressed in the brain, but also peripherally in various organs. The cerebral distribution of this receptor is well conserved across species, with high densities in the basal ganglia, where they are expressed by GABAergic neurons. The 5-HT4 receptor is also present in the cerebral cortex, hippocampus, and amygdala, where they are carried by glutamatergic or cholinergic neurons. Outside the central nervous system, the 5-HT4 receptor is notably expressed in the gastrointestinal tract. The wide distribution of the 5-HT4 receptor undoubtedly contributes to its involvement in a plethora of functions. In addition, the modulation of this receptor influences the release of serotonin, but also the release of other neurotransmitters such as acetylcholine and dopamine. This is a considerable asset, as the modulation of the 5-HT4 receptor can therefore play a direct or indirect beneficial role in various disorders. One of the main advantages of this receptor is that it mediates a much faster antidepressant and anxiolytic action than classical selective serotonin reuptake inhibitors. Another major benefit of the 5-HT4 receptor is that its activation enhances cognitive performance, probably via the release of acetylcholine. The expression of the 5-HT4 receptor is also altered in various eating disorders, and its activation by the 5-HT4 agonist negatively regulates food intake. Additionally, although the cerebral expression of this receptor is modified in certain movement-related disorders, it is still yet to be determined whether this receptor plays a key role in their pathophysiology. Finally, there is no longer any need to demonstrate the value of 5-HT4 receptor agonists in the pharmacological management of gastrointestinal disorders.
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Affiliation(s)
- Véronique Sgambato
- Institut des Sciences Cognitives Marc Jeannerod (ISCMJ), Unité Mixte de Recherche 5229 du Centre National de la Recherche Scientifique (CNRS), 69675 Bron, France; ; Tel.: +33-4379-11249
- UFR Biosciences, Université de Lyon 1, 69100 Villeurbanne, France
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Bruzzone SEP, Nasser A, Aripaka SS, Spies M, Ozenne B, Jensen PS, Knudsen GM, Frokjaer VG, Fisher PM. Genetic contributions to brain serotonin transporter levels in healthy adults. Sci Rep 2023; 13:16426. [PMID: 37777558 PMCID: PMC10542378 DOI: 10.1038/s41598-023-43690-x] [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: 03/28/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023] Open
Abstract
The serotonin transporter (5-HTT) critically shapes serotonin neurotransmission by regulating extracellular brain serotonin levels; it remains unclear to what extent 5-HTT levels in the human brain are genetically determined. Here we applied [11C]DASB positron emission tomography to image brain 5-HTT levels and evaluated associations with five common serotonin-related genetic variants that might indirectly regulate 5-HTT levels (BDNF rs6265, SLC6A4 5-HTTLPR, HTR1A rs6295, HTR2A rs7333412, and MAOA rs1137070) in 140 healthy volunteers. In addition, we explored whether these variants could predict in vivo 5-HTT levels using a five-fold cross-validation random forest framework. MAOA rs1137070 T-carriers showed significantly higher brain 5-HTT levels compared to C-homozygotes (2-11% across caudate, putamen, midbrain, thalamus, hippocampus, amygdala and neocortex). We did not observe significant associations for the HTR1A rs6295 and HTR2A rs7333412 genotypes. Our previously observed lower subcortical 5-HTT availability for rs6265 met-carriers remained in the presence of these additional variants. Despite this significant association, our prediction models showed that genotype moderately improved prediction of 5-HTT in caudate, but effects were not statistically significant after adjustment for multiple comparisons. Our observations provide additional evidence that serotonin-related genetic variants modulate adult human brain serotonin neurotransmission.
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Affiliation(s)
- Silvia Elisabetta Portis Bruzzone
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sagar Sanjay Aripaka
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marie Spies
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Peter Steen Jensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe Gedsoe Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Patrick MacDonald Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
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3
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Vulpius GM, Köhler-Forsberg K, Ozenne B, Larsen SV, Nasser A, Svarer C, Gillings N, Keller SH, Jørgensen MB, Knudsen GM, Frokjaer VG. Stress Hormone Dynamics Are Coupled to Brain Serotonin 4 Receptor Availability in Unmedicated Patients With Major Depressive Disorder: A NeuroPharm Study. Int J Neuropsychopharmacol 2023; 26:639-648. [PMID: 37542733 PMCID: PMC10519814 DOI: 10.1093/ijnp/pyad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND A prominent finding in major depressive disorder (MDD) is distorted stress hormone dynamics, which is regulated by serotonergic brain signaling. An interesting feature of the cerebral serotonin system is the serotonin 4 receptor (5-HT4R), which is lower in depressed relative to healthy individuals and also has been highlighted as a promising novel antidepressant target. Here, we test the novel hypothesis that brain 5-HT4R availability in untreated patients with MDD is correlated with cortisol dynamics, indexed by the cortisol awakening response (CAR). Further, we evaluate if CAR changes with antidepressant treatment, including a selective serotonin reuptake inhibitor, and if pretreatment CAR can predict treatment outcome. METHODS Sixty-six patients (76% women) with a moderate to severe depressive episode underwent positron emission tomography imaging with [11C]SB207145 for quantification of brain 5-HT4R binding using BPND as outcome. Serial home sampling of saliva in the first hour from awakening was performed to assess CAR before and after 8 weeks of antidepressant treatment. Treatment outcome was measured by change in Hamilton Depression Rating Scale 6 items. RESULTS In the unmedicated depressed state, prefrontal and anterior cingulate cortices 5-HT4R binding was positively associated with CAR. CAR remained unaltered after 8 weeks of antidepressant treatment, and pretreatment CAR did not significantly predict treatment outcome. CONCLUSIONS Our findings highlight a link between serotonergic disturbances in MDD and cortisol dynamics, which likely is involved in disease and treatment mechanisms. Further, our data support 5-HT4R agonism as a promising precision target in patients with MDD and disturbed stress hormone dynamics.
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Affiliation(s)
- Gunild M Vulpius
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
| | - Kristin Köhler-Forsberg
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Denmark
| | - Søren V Larsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Nic Gillings
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Sune H Keller
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Martin B Jørgensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
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4
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da Cunha-Bang S, Frokjaer VG, Mc Mahon B, Jensen PS, Svarer C, Knudsen GM. The association between brain serotonin transporter binding and impulsivity and aggression in healthy individuals. J Psychiatr Res 2023; 165:1-6. [PMID: 37441926 DOI: 10.1016/j.jpsychires.2023.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/22/2023] [Accepted: 06/18/2023] [Indexed: 07/15/2023]
Abstract
The serotonin system plays a critical role in the modulation of impulsive aggression. Although serotonin transporters (SERT) are key in modulating synaptic serotonin levels, few studies have investigated the role of SERT levels in human impulsive aggression. The aim of this study was to investigate whether brain SERT levels are associated with trait impulsive aggression. We included 148 healthy individuals (mean age 29.3 ± 13.0, range 18-80 years, 91 females) who had undergone positron emission positron (PET) examinations with the SERT tracer [11C]DASB and filled in self-report questionnaires of trait aggression, trait impulsivity and state aggression. We evaluated the association between cerebral SERT binding (BPND) and trait impulsive aggression in a latent variable model, with one latent variable (LVSERT) modelled from SERT BPND in frontostriatal and frontolimbic networks implicated in impulsive aggression, and another latent variable (LVIA) modelled from various trait measures of impulsivity and aggression. The LVSERT was not significantly associated with the LVIA (p = 0.8). Post-hoc univariate analyses did not reveal any significant associations between regional SERT levels and trait aggression, trait impulsivity or state aggression, but we found that state aggression at the day of PET scan was significantly lower in LA/LA homozygotes vs S-carriers of the 5-HTTLPR gene (p = 0.008). We conclude that brain SERT binding was not related to variations in trait impulsive aggression or state aggression. Our findings do not support that SERT is involved in mediating the serotonergic effects on aggression and impulsivity, at least not in individuals with non-pathological levels of impulsive aggression.
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Affiliation(s)
- Sofi da Cunha-Bang
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark; Mental Health Services in the Capital Region of Denmark, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Mental Health Services in the Capital Region of Denmark, Denmark
| | - Brenda Mc Mahon
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Peter Steen Jensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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5
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Rasmussen AL, Larsen SV, Ozenne B, Köhler-Forsberg K, Stenbæk DS, Jørgensen MB, Giraldi A, Frokjaer VG. Sexual health and serotonin 4 receptor brain binding in unmedicated patients with depression-a NeuroPharm study. Transl Psychiatry 2023; 13:247. [PMID: 37414758 DOI: 10.1038/s41398-023-02551-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023] Open
Abstract
Sexual dysfunction is prominent in Major Depressive Disorder (MDD) and affects women with depression more than men. Patients with MDD relative to healthy controls have lower brain levels of the serotonin 4 receptor (5-HT4R), which is expressed with high density in the striatum, i.e. a key hub of the reward system. Reduced sexual desire is putatively related to disturbed reward processing and may index anhedonia in MDD. Here, we aim to illuminate plausible underlying neurobiology of sexual dysfunction in unmedicated patients with MDD. We map associations between 5-HT4R binding, as imaged with [11C]SB207145 PET, in the striatum, and self-reported sexual function. We also evaluate if pre-treatment sexual desire score predicts 8-week treatment outcome in women. From the NeuroPharm study, we include 85 untreated MDD patients (71% women) who underwent eight weeks of antidepressant drug treatment. In the mixed sex group, we find no difference in 5-HT4R binding between patients with sexual dysfunction vs normal sexual function. However, in women we find lower 5-HT4R binding in the sexual dysfunctional group compared to women with normal sexual function (β = -0.36, 95%CI[-0.62:-0.09], p = 0.009) as well as a positive association between sexual desire and 5-HT4R binding (β = 0.07, 95%CI [0.02:0.13], p = 0.012). Sexual desire at baseline do not predict treatment outcome (ROC curve AUC = 52%[36%:67%]) in women. Taken together, we find evidence for a positive association between sexual desire and striatal 5-HT4R availability in women with depression. Interestingly, this raises the question if direct 5-HT4R agonism can target reduced sexual desire or anhedonia in MDD.
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Affiliation(s)
| | - Søren Vinther Larsen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Kristin Köhler-Forsberg
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
- Psychiatric Centre Copenhagen, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Martin Balslev Jørgensen
- Psychiatric Centre Copenhagen, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Annamaria Giraldi
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Sexological Clinic, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Psychiatric Centre Copenhagen, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark.
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6
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Sankar A, Ozenne B, Dam VH, Svarer C, Jørgensen MB, Miskowiak KW, Frokjaer VG, Knudsen GM, Fisher PM. Association between brain serotonin 4 receptor binding and reactivity to emotional faces in depressed and healthy individuals. Transl Psychiatry 2023; 13:165. [PMID: 37169780 PMCID: PMC10175268 DOI: 10.1038/s41398-023-02440-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/13/2023] Open
Abstract
Brain serotonergic (5-HT) signaling is posited to modulate neural responses to emotional stimuli. Dysfunction in 5-HT signaling is implicated in major depressive disorder (MDD), a disorder associated with significant disturbances in emotion processing. In MDD, recent evidence points to altered 5-HT4 receptor (5-HT4R) levels, a promising target for antidepressant treatment. However, how these alterations influence neural processing of emotions in MDD remains poorly understood. This is the first study to examine the association between 5-HT4R binding and neural responses to emotions in patients with MDD and healthy controls. The study included one hundred and thirty-eight participants, comprising 88 outpatients with MDD from the NeuroPharm clinical trial (ClinicalTrials.gov identifier: NCT02869035) and 50 healthy controls. Participants underwent an [11C]SB207145 positron emission tomography (PET) scan to quantify 5-HT4R binding (BPND) and a functional magnetic resonance imaging (fMRI) scan during which they performed an emotional face matching task. We examined the association between regional 5-HT4R binding and corticolimbic responses to emotional faces using a linear latent variable model, including whether this association was moderated by depression status. We observed a positive correlation between 5-HT4R BPND and the corticolimbic response to emotional faces across participants (r = 0.20, p = 0.03). This association did not differ between groups (parameter estimate difference = 0.002, 95% CI = -0.008: 0.013, p = 0.72). Thus, in the largest PET/fMRI study of associations between serotonergic signaling and brain function, we found a positive association between 5-HT4R binding and neural responses to emotions that appear unaltered in MDD. Future clinical trials with novel pharmacological agents targeting 5-HT4R are needed to confirm whether they ameliorate emotion processing biases in MDD.
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Affiliation(s)
- Anjali Sankar
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke H Dam
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Martin B Jørgensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
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Ip CT, Ganz M, Ozenne B, Olbrich S, Beliveau V, Dam VH, Köhler-Forsberg K, Jørgensen MB, Frøkjær VG, Knudsen GM. Association between the loudness dependence of auditory evoked potential, serotonergic neurotransmission and treatment outcome in patients with depression. Eur Neuropsychopharmacol 2023; 70:32-44. [PMID: 36863106 DOI: 10.1016/j.euroneuro.2023.02.008] [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: 08/08/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 03/04/2023]
Abstract
Previous studies have suggested that the loudness dependence of auditory evoked potential (LDAEP) is associated with the effectiveness of antidepressant treatment in patients with major depressive disorders (MDD). Furthermore, both LDAEP and the cerebral serotonin 4 receptor (5-HT4R) density is inversely related to brain serotonin levels. We included 84 patients with MDD and 22 healthy controls to examined the association between LDAEP and treatment response and its association with cerebral 5-HT4R density. Participants underwent both EEG and 5-HT4R neuroimaging with [11C]SB207145 PET. Thirty-nine patients with MDD were re-examined after 8 weeks of treatment with selective serotonin reuptake inhibitors/serotonin noradrenaline reuptake inhibitor (SSRI/SNRI). We found that the cortical source of LDAEP was higher in untreated patients with MDD compared to healthy controls (p=0.03). Prior to SSRI/SNRI treatment, subsequent treatment responders had a negative association between LDAEP and depressive symptoms and a positive association between scalp LDAEP and symptom improvement at week 8. This was not found in source LDAEP. In healthy controls, we found a positive correlation between both scalp and source LDAEP and cerebral 5-HT4R binding but that was not observed in patients with MDD. We did not see any changes in scalp and source LDAEP in response to SSRI/SNRI treatment. These results support a theoretical framework where both LDAEP and cerebral 5-HT4R are indices of cerebral 5-HT levels in healthy individuals while this association seems to be disrupted in MDD. The combination of the two biomarkers may be useful for stratifying patients with MDD. Clinical Trials Registration:https://clinicaltrials.gov/ct2/show/NCT02869035?draw=1Registration number: NCT0286903.
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Affiliation(s)
- Cheng-Teng Ip
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macau SAR, China
| | - Melanie Ganz
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Public Health, Section of Biostatistics, University of Copenhagen, Denmark
| | - Sebastian Olbrich
- Department for Psychiatry, Psychotherapy and Psychosomatic, University Zurich, Switzerland
| | - Vincent Beliveau
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Vibeke H Dam
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kristin Köhler-Forsberg
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Martin B Jørgensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Vibe G Frøkjær
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Nasser A, Ozenne B, Høgsted ES, Jensen PS, Frokjaer VG. Reliability of three versus five saliva sampling times for assessing the cortisol awakening response. Psychoneuroendocrinology 2023; 147:105950. [PMID: 36272363 DOI: 10.1016/j.psyneuen.2022.105950] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
Abstract
The cortisol awakening response (CAR) describes the sharp increase in cortisol secretion within 60 min after awakening. A summary of the CAR, the area under the cortisol curve above the awakening cortisol value (AUCi) is a widely used biomarker in health research. Estimation of the AUCi rely on a number of collected salivary samples at fixed time intervals (i.e., 5 samples in 15 min intervals) starting from awakening. Little empirical work has been executed to investigate the impact of reducing sampling times on AUCi estimation, which could potentially improve participant compliance and reduce operational costs. This study aimed to assess the reliability and validity of using 3-sample AUCi versus 5-sample AUCi, i.e., systematic and random fluctuations based on a large dataset from healthy and case individuals (total n = 537). We showed that the ideal timing of 3-sampling times was 0-30-60 min with a median difference in AUCi of - 8 nmol*h/L and interquartile range of 65 nmol*h/L among healthy individuals, and - 12 nmol*h/L and 78 nmol*h/L among case individuals. We subsequently validated the 3-sample AUCi by re-analyzing three published association studies. Overall, we obtained similar p-values with 3-sample AUCi when compared to 5-sample AUCi, while smaller effect sizes and standard errors were observed. In conclusion, despite a less precise estimation of the AUCi itself, our data support that the AUC measure of the CAR, based on three samples collected at 0-30-60 min from awakening, provides reliable results in association studies.
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Affiliation(s)
- Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark.
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark; Department of Public Health, Section of Biostatistics, University of Copenhagen, 5 Øster Farimagsgade, Copenhagen 1014, Denmark.
| | - Emma Sofie Høgsted
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark.
| | - Peter Steen Jensen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark.
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark; Mental Health Services Capital Region Denmark, Psychiatric Center Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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9
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Fu H, Rong J, Chen Z, Zhou J, Collier T, Liang SH. Positron Emission Tomography (PET) Imaging Tracers for Serotonin Receptors. J Med Chem 2022; 65:10755-10808. [PMID: 35939391 DOI: 10.1021/acs.jmedchem.2c00633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Serotonin (5-hydroxytryptamine, 5-HT) and 5-HT receptors (5-HTRs) have crucial roles in various neuropsychiatric disorders and neurodegenerative diseases, making them attractive diagnostic and therapeutic targets. Positron emission tomography (PET) is a noninvasive nuclear molecular imaging technique and is an essential tool in clinical diagnosis and drug discovery. In this context, numerous PET ligands have been developed for "visualizing" 5-HTRs in the brain and translated into human use to study disease mechanisms and/or support drug development. Herein, we present a comprehensive repertoire of 5-HTR PET ligands by focusing on their chemotypes and performance in PET imaging studies. Furthermore, this Perspective summarizes recent 5-HTR-focused drug discovery, including biased agonists and allosteric modulators, which would stimulate the development of more potent and subtype-selective 5-HTR PET ligands and thus further our understanding of 5-HTR biology.
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Affiliation(s)
- Hualong Fu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Jian Rong
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114, United States.,Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Zhen Chen
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, International Innovation Center for Forest Chemicals and Materials, College of Chemical Engineering, Nanjing Forestry University, Nanjing, Jiangsu 210037, China
| | - Jingyin Zhou
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Thomas Collier
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114, United States.,Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Steven H Liang
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114, United States.,Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115, United States
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10
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Köhler-Forsberg K, Ozenne B, Larsen SV, Poulsen AS, Landman EB, Dam VH, Ip CT, Jørgensen A, Svarer C, Knudsen GM, Frokjaer VG, Jørgensen MB. Concurrent anxiety in patients with major depression and cerebral serotonin 4 receptor binding. A NeuroPharm-1 study. Transl Psychiatry 2022; 12:273. [PMID: 35821015 PMCID: PMC9276803 DOI: 10.1038/s41398-022-02034-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/13/2022] [Accepted: 06/23/2022] [Indexed: 11/09/2022] Open
Abstract
Concurrent anxiety is frequent in major depressive disorder and a shared pathophysiological mechanism between anxiety and other depressive symptoms is plausible. The serotonin 4 receptor (5-HT4R) has been implicated in both depression and anxiety. This is the first study to investigate the association between the cerebral 5-HT4R binding and anxiety in patients with depression before and after antidepressant treatment and the association to treatment response. Ninety-one drug-free patients with depression were positron emission tomography scanned with the 5-HT4R ligand [11C]-SB207145. Depression severity and concurrent anxiety was measured at baseline and throughout 8 weeks of antidepressant treatment. Anxiety measures included four domains: anxiety/somatization factor score; Generalized Anxiety Disorder 10-items (GAD-10) score; anxiety/somatization factor score ≥7 (anxious depression) and syndromal anxious depression. Forty patients were rescanned at week 8. At baseline, we found a negative association between global 5-HT4R binding and both GAD-10 score (p < 0.01) and anxiety/somatization factor score (p = 0.06). Further, remitters had a higher baseline anxiety/somatization factor score compared with non-responders (p = 0.04). At rescan, patients with syndromal anxious depression had a greater change in binding relative to patients with non-syndromal depression (p = 0.04). Concurrent anxiety in patients with depression measured by GAD-10 score and anxiety/somatization factor score is negatively associated with cerebral 5-HT4R binding. A lower binding may represent a subtype with reduced natural resilience against anxiety in a depressed state, and concurrent anxiety may influence the effect on the 5-HT4R from serotonergic antidepressants. The 5-HT4R is a promising neuroreceptor for further understanding the underpinnings of concurrent anxiety in patients with depression.
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Affiliation(s)
- Kristin Köhler-Forsberg
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,grid.475435.4Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Søren V. Larsen
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Asbjørn S. Poulsen
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Elizabeth B. Landman
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Vibeke H. Dam
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Cheng-Teng Ip
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,grid.424580.f0000 0004 0476 7612Department of Clinical Pharmacology, H. Lundbeck A/S, Valby, Denmark
| | - Anders Jørgensen
- grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,grid.475435.4Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Claus Svarer
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte M. Knudsen
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G. Frokjaer
- grid.475435.4Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,grid.475435.4Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Martin B. Jørgensen
- grid.5254.60000 0001 0674 042XInstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,grid.475435.4Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen, Denmark
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11
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Spiros A, Geerts H. Toward Predicting Impact of Common Genetic Variants on Schizophrenia Clinical Responses With Antipsychotics: A Quantitative System Pharmacology Study. Front Neurosci 2021; 15:738903. [PMID: 34658776 PMCID: PMC8511786 DOI: 10.3389/fnins.2021.738903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
CNS disorders are lagging behind other indications in implementing genotype-dependent treatment algorithms for personalized medicine. This report uses a biophysically realistic computer model of an associative and dorsal motor cortico-striatal-thalamo-cortical loop and a working memory cortical model to investigate the pharmacodynamic effects of COMTVal158Met rs4680, 5-HTTLPR rs 25531 s/L and D2DRTaq1A1 genotypes on the clinical response of 7 antipsychotics. The effect of the genotypes on dopamine and serotonin dynamics and the level of target exposure for the drugs was calibrated from PET displacement studies. The simulations suggest strong gene-gene pharmacodynamic interactions unique to each antipsychotic. For PANSS Total, the D2DRTaq1 allele has the biggest impact, followed by the 5-HTTLPR rs25531. The A2A2 genotype improved efficacy for all drugs, with a more complex outcome for the 5-HTTLPR rs25531 genotype. Maximal range in PANSS Total for all 27 individual combinations is 3 (aripiprazole) to 5 points (clozapine). The 5-HTTLPR L/L with aripiprazole and risperidone and the D2DRTaq1A2A2 allele with haloperidol, clozapine and quetiapine reduce the motor side-effects with opposite effects for the s/s genotype. The COMT genotype has a limited effect on antipsychotic effect and EPS. For cognition, the COMT MM 5-HTTLPR L/L genotype combination has the best performance for all antipsychotics, except clozapine. Maximal difference is 25% of the total dynamic range in a 2-back working memory task. Aripiprazole is the medication that is best suited for the largest number of genotype combinations (10) followed by Clozapine and risperidone (6), haloperidol and olanzapine (3) and quetiapine and paliperidone for one genotype. In principle, the platform could identify the best antipsychotic treatment balancing efficacy and side-effects for a specific individual genotype. Once the predictions of this platform are validated in a clinical setting the platform has potential to support rational personalized treatment guidance in clinical practice.
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Affiliation(s)
- Athan Spiros
- In Silico Biosciences, Berwyn, PA, United States
| | - Hugo Geerts
- In Silico Biosciences, Berwyn, PA, United States.,Certara QSP, Canterbury, United Kingdom
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12
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The Modulatory Role of Serotonin on Human Impulsive Aggression. Biol Psychiatry 2021; 90:447-457. [PMID: 34266672 DOI: 10.1016/j.biopsych.2021.05.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/29/2021] [Accepted: 05/16/2021] [Indexed: 12/15/2022]
Abstract
The hypothesis of chronically low brain serotonin levels as pathophysiologically linked to impulsive aggression has been around for several decades. Whereas the theory was initially based on indirect methods to probe serotonin function, our understanding of the neural mechanisms involved in impulsive aggression has progressed with recent advances in neuroimaging. The review integrates evidence based on data from several neuroimaging domains in humans. In vivo molecular neuroimaging findings demonstrate associations between impulsive aggression and high serotonin 1B and serotonin 4 receptor binding, high serotonin transporter levels, and low monoamine oxidase A levels, suggesting that low interstitial serotonin levels are a neurobiological risk factor for impulsive aggressive behavior. Imaging genetics suggests that serotonergic-related genetic polymorphisms associate with antisocial behavior, and some evidence indicates that the low-expressing monoamine oxidase A genotype specifically predisposes to impulsive aggression, which may be mediated by effects on corticolimbic function. Interventions that (presumably) alter serotonin levels have effects on brain activity within brain regions involved in impulsive aggression, notably the amygdala, dorsal striatum, anterior cingulate, insula, and prefrontal cortex. Based on these findings, we propose a model for the modulatory role of serotonin in impulsive aggression. Future studies should ensure that clinical features unique for impulsive aggression are appropriately assessed, and we propose investigations of knowledge gaps that can help confirm, refute, or modify our proposed model of impulsive aggression.
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13
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Schoenfeld EM, Gupta NK, Syed SA, Rozenboym AV, Fulton SL, Jackowski AP, Perera TD, Coplan JD. Developmental Antecedents of Adult Macaque Neurogenesis: Early-Life Adversity, 5-HTTLPR Polymorphisms, and Adolescent Hippocampal Volume. J Affect Disord 2021; 286:204-212. [PMID: 33740637 DOI: 10.1016/j.jad.2021.02.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/16/2021] [Accepted: 02/19/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Attenuated adult hippocampal neurogenesis may manifest in affective symptomatology and/or resistance to antidepressant treatment. While early-life adversity and the short variant ('s') of the serotonin transporter gene's long polymorphic region (5-HTTLPR) are suggested as interacting risk factors for affective disorders, no studies have examined whether their superposed risk effectuates neurogenic changes into adulthood. Similarly, it is not established whether reduced hippocampal volume in adolescence, variously identified as a marker and antecedent of affective disorders, anticipates diminished adult neurogenesis. We investigate these potential developmental precursors of neurogenic alterations using a bonnet macaque model. METHODS Twenty-five male infant bonnet macaques were randomized to stressed [variable foraging demand (VFD)] or normative [low foraging demand (LFD)] rearing protocols and genotyped for 5-HTTLPR polymorphisms. Adolescent MRI brain scans (mean age 4.2y) were available for 14 subjects. Adult-born neurons were detected post-mortem (mean age 8.6y) via immunohistochemistry targeting the microtubule protein doublecortin (DCX). Models were adjusted for age and weight. RESULTS A putative vulnerability group (VG) of VFD-reared 's'-carriers (all 's/l') exhibited reduced neurogenesis compared to non-VG subjects. Neurogenesis levels were positively predicted by ipsilateral hippocampal volume normalized for total brain volume, but not by contralateral or raw hippocampal volume. LIMITATIONS No 's'-carriers were identified in LFD-reared subjects, precluding a 2×2 factorial analysis. CONCLUSION The 's' allele (with adverse rearing) and low adolescent hippocampal volume portend a neurogenic deficit in adult macaques, suggesting persistent alterations in hippocampal plasticity may contribute to these developmental factors' affective risk in humans.
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Affiliation(s)
- Eric M Schoenfeld
- Department of Psychiatry and Behavioral Sciences, State University of New York-Downstate Medical Center, Brooklyn, NY.
| | - Nishant K Gupta
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Shariful A Syed
- Department of Psychiatry and Behavioral Sciences, Stony Brook, NY
| | - Anna V Rozenboym
- Department of Biological Sciences, Kingsborough Community College, Brooklyn, NY
| | | | - Andrea P Jackowski
- UNIFESP Departamento de Psiquiatria, Universidade Federal de Sao Paulo, SP, Brazil
| | | | - Jeremy D Coplan
- Department of Psychiatry and Behavioral Sciences, State University of New York-Downstate Medical Center, Brooklyn, NY.
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14
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Geerts H, van der Graaf P. A modeling informed quantitative approach to salvage clinical trials interrupted due to COVID-19. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12053. [PMID: 33163611 PMCID: PMC7606183 DOI: 10.1002/trc2.12053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/01/2020] [Indexed: 11/29/2022]
Abstract
Many ongoing Alzheimer's disease central nervous system clinical trials are being disrupted and halted due to the COVID-19 pandemic. They are often of a long duration' are very complex; and involve many stakeholders, not only the scientists and regulators but also the patients and their family members. It is mandatory for us as a community to explore all possibilities to avoid losing all the knowledge we have gained from these ongoing trials. Some of these trials will need to completely restart, but a substantial number can restart after a hiatus with the proper protocol amendments. To salvage the information gathered so far, we need out-of-the-box thinking for addressing these missingness problems and to combine information from the completers with those subjects undergoing complex protocols deviations and amendments after restart in a rational, scientific way. Physiology-based pharmacokinetic (PBPK) modeling has been a cornerstone of model-informed drug development with regard to drug exposure at the site of action, taking into account individual patient characteristics. Quantitative systems pharmacology (QSP), based on biology-informed and mechanistic modeling of the interaction between a drug and neuronal circuits, is an emerging technology to simulate the pharmacodynamic effects of a drug in combination with patient-specific comedications, genotypes, and disease states on functional clinical scales. We propose to combine these two approaches into the concept of computer modeling-based virtual twin patients as a possible solution to harmonize the readouts from these complex clinical datasets in a biologically and therapeutically relevant way.
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15
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Geerts H, Spiros A. Simulating the Effects of Common Comedications and Genotypes on Alzheimer's Cognitive Trajectory Using a Quantitative Systems Pharmacology Approach. J Alzheimers Dis 2020; 78:413-424. [PMID: 33016912 DOI: 10.3233/jad-200688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Many Alzheimer's disease patients in clinical practice are on polypharmacy for treatment of comorbidities. OBJECTIVE While pharmacokinetic interactions between drugs have been relatively well established with corresponding treatment guidelines, many medications and common genotype variants also affect central brain circuits involved in cognitive trajectory, leading to complex pharmacodynamic interactions and a large variability in clinical trials. METHODS We applied a mechanism-based and ADAS-Cog calibrated Quantitative Systems Pharmacology biophysical model of neuronal circuits relevant for cognition in Alzheimer's disease, to standard-of-care cholinergic therapy with COMTVal158Met, 5-HTTLPR rs25531, and APOE genotypes and with benzodiazepines, antidepressants, and antipsychotics, all together 9,585 combinations. RESULTS The model predicts a variability of up to 14 points on ADAS-Cog at baseline (COMTVV 5-HTTLPRss APOE 4/4 combination is worst) and a four-fold range for the rate of progression. The progression rate is inversely proportional to baseline ADAS-Cog. Antidepressants, benzodiazepines, first-generation more than second generation, and most antipsychotics with the exception of aripiprazole worsen the outcome when added to standard-of-care in mild cases. Low dose second-generation benzodiazepines revert the negative effects of risperidone and olanzapine, but only in mild stages. Non APOE4 carriers with a COMTMM and 5HTTLPRLL are predicted to have the best cognitive performance at baseline but deteriorate somewhat faster over time. However, this effect is significantly modulated by comedications. CONCLUSION Once these simulations are validated, the platform can in principle provide optimal treatment guidance in clinical practice at an individual patient level, identify negative pharmacodynamic interactions with novel targets and address protocol amendments in clinical trials.
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16
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Spies M, Nasser A, Ozenne B, Jensen PS, Knudsen GM, Fisher PM. Common HTR2A variants and 5-HTTLPR are not associated with human in vivo serotonin 2A receptor levels. Hum Brain Mapp 2020; 41:4518-4528. [PMID: 32697408 PMCID: PMC7555071 DOI: 10.1002/hbm.25138] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/08/2020] [Accepted: 06/16/2020] [Indexed: 12/22/2022] Open
Abstract
The serotonin 2A receptor (5‐HT2AR) is implicated in the pathophysiology and treatment of various psychiatric disorders. [18F]altanserin and [11C]Cimbi‐36 positron emission tomography (PET) allow for high‐resolution imaging of 5‐HT2AR in the living human brain. Cerebral 5‐HT2AR binding is strongly genetically determined, though the impact of specific variants is poorly understood. Candidate gene studies suggest that HTR2A single nucleotide polymorphisms including rs6311/rs6313, rs6314, and rs7997012 may influence risk for psychiatric disorders and mediate treatment response. Although known to impact in vitro expression of 5‐HT2AR or other serotonin (5‐HT) proteins, their effect on human in vivo brain 5‐HT2AR binding has as of yet been insufficiently studied. We thus assessed the extent to which these variants and the commonly studied 5‐HTTLPR predict neocortex in vivo 5‐HT2AR binding in healthy adult humans. We used linear regression analyses and likelihood ratio tests in 197 subjects scanned with [18F]altanserin or [11C]Cimbi‐36 PET. Although we observed genotype group differences in 5‐HT2AR binding of up to ~10%, no genetic variants were statistically significantly predictive of 5‐HT2AR binding in what is the largest human in vivo 5‐HT2AR imaging genetics study to date. Thus, in vitro and post mortem results suggesting effects on 5‐HT2AR expression did not carry over to the in vivo setting. To any extent these variants might affect clinical risk, our findings do not support that 5‐HT2AR binding mediates such effects. Our observations indicate that these individual variants do not significantly contribute to genetic load on human in vivo 5‐HT2AR binding.
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Affiliation(s)
- Marie Spies
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark.,Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Arafat Nasser
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Peter S Jensen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
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17
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Geerts H, van der Graaf PH. Salvaging CNS Clinical Trials Halted Due to COVID-19. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2020; 9:367-370. [PMID: 32468710 PMCID: PMC7283764 DOI: 10.1002/psp4.12535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/22/2020] [Indexed: 01/06/2023]
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18
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Sun X, Li C, Zhong X, Dong D, Ming Q, Gao Y, Xiong G, Cheng C, Zhao H, Wang X, Yao S. Influence of psychosocial stress on activation in human brain regions: moderation by the 5-HTTLPR genetic locus. Physiol Behav 2020; 220:112876. [PMID: 32194071 DOI: 10.1016/j.physbeh.2020.112876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 02/29/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Abstract
Variants of the serotonin transporter linked polymorphic region (5-HTTLPR) of the serotonin transporter gene SLC6A4 have been related with the onset of depression, anxiety, and other mental disorders. Homozygotes for the short 5-HTTLPR variant, referred to as the SS genotype, have greater cortisol responses to experimentally induced psychosocial stress. In the current study, we used functional magnetic resonance imaging (fMRI) to compare regional brain activations across 5-HTTLPR genotypes in subjects performing the Montreal Imaging Stress Task (MIST). Subjects with an SS genotype had significant greater increases in cortisol concentrations after the task than subjects with at least one long 5-HTTLPR allele. Additionally, relative to L carriers, the SS group had greater activation in the dorsomedial prefrontal cortex(dmPFC), dorsal anterior cingulate cortex, anterior insula.
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Affiliation(s)
- Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Chuting Li
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Qingsen Ming
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Department of Psychiatry, The First Affiliated Hospital of Sochoow University, Suzhou, Jiangsu, China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Ge Xiong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Chang Cheng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Haofei Zhao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders.
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19
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Geerts H, Spiros A. Learning from amyloid trials in Alzheimer's disease. A virtual patient analysis using a quantitative systems pharmacology approach. Alzheimers Dement 2020; 16:862-872. [PMID: 32255562 PMCID: PMC7983876 DOI: 10.1002/alz.12082] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/12/2020] [Accepted: 02/17/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Many trials of amyloid-modulating agents fail to improve cognitive outcome in Alzheimer's disease despite substantial reduction of amyloid β levels. METHODS We applied a mechanism-based Quantitative Systems Pharmacology model exploring the pharmacodynamic interactions of apolipoprotein E (APOE), Catechol -O -methyl Transferase (COMTVal158Met), and 5-HT transporter (5-HTTLPR) rs25531 genotypes and aducanumab. RESULTS The model predicts large clinical variability. Anticipated placebo differences on Alzheimer's Disease Assessment Scale (ADAS)-COG in the aducanumab ENGAGE and EMERGE ranged from 0.77 worsening to 1.56 points improvement, depending on the genotype-comedication combination. 5-HTTLPR L/L subjects are found to be the most resilient. Virtual patient simulations suggest improvements over placebo between 4% and 20% at the 10 mg/kg dose, depending on the imbalance of the 5-HTTLPR genotype and exposure. In the Phase II PRIME trial, maximal anticipated placebo difference at 10 mg/kg ranges from 0.3 worsening to 5.3 points improvement. DISCUSSION These virtual patient simulations, once validated against clinical data, could lead to better informed future clinical trial designs.
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Affiliation(s)
- Hugo Geerts
- In-Silico Biosciences, Certara-QSP, Berwyn, Pennsylvania, USA
| | - Athan Spiros
- In-Silico Biosciences, Certara-QSP, Berwyn, Pennsylvania, USA
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20
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Köhler-Forsberg K, Jorgensen A, Dam VH, Stenbæk DS, Fisher PM, Ip CT, Ganz M, Poulsen HE, Giraldi A, Ozenne B, Jørgensen MB, Knudsen GM, Frokjaer VG. Predicting Treatment Outcome in Major Depressive Disorder Using Serotonin 4 Receptor PET Brain Imaging, Functional MRI, Cognitive-, EEG-Based, and Peripheral Biomarkers: A NeuroPharm Open Label Clinical Trial Protocol. Front Psychiatry 2020; 11:641. [PMID: 32792991 PMCID: PMC7391965 DOI: 10.3389/fpsyt.2020.00641] [Citation(s) in RCA: 21] [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: 11/27/2019] [Accepted: 06/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Between 30 and 50% of patients with major depressive disorder (MDD) do not respond sufficiently to antidepressant regimens. The conventional pharmacological treatments predominantly target serotonergic brain signaling but better tools to predict treatment response and identify relevant subgroups of MDD are needed to support individualized and mechanistically targeted treatment strategies. The aim of this study is to investigate antidepressant-free patients with MDD using neuroimaging, electrophysiological, molecular, cognitive, and clinical examinations and evaluate their ability to predict clinical response to SSRI treatment as individual or combined predictors. METHODS We will include 100 untreated patients with moderate to severe depression (>17 on the Hamilton Depression Rating Scale 17) in a non-randomized open clinical trial. We will collect data from serotonin 4 receptor positron emission tomography (PET) brain scans, functional magnetic resonance imaging (fMRI), electroencephalogram (EEG), cognitive tests, psychometry, and peripheral biomarkers, before (at baseline), during, and after 12 weeks of standard antidepressant treatment. Patients will be treated with escitalopram, and in case of non-response at week 4 or intolerable side effects, offered to switch to a second line treatment with duloxetine. Our primary outcome (treatment response) is assessed using the Hamilton depression rating subscale 6-item scores at week 8, compared to baseline. In a subset of the patients (n = ~40), we will re-assess the neurobiological response (using PET, fMRI, and EEG) 8 weeks after initiated pharmacological antidepressant treatment, to map neurobiological signatures of treatment responses. Data from matched controls will either be collected or is already available from other cohorts. DISCUSSION The extensive investigational program with follow-up in this large cohort of participants provides a unique possibility to (a) uncover potential biomarkers for antidepressant treatment response, (b) apply the findings for future stratification of MDD, (c) advance the understanding of pathophysiological underpinnings of MDD, and (d) uncover how putative biomarkers change in response to 8 weeks of pharmacological antidepressant treatment. Our data can pave the way for a precision medicine approach for optimized treatment of MDD and also provides a resource for future research and data sharing. CLINICAL TRIAL REGISTRATION The study was registered at clinicaltrials.gov prior to initiation (NCT02869035; 08.16.2016, URL: https://clinicaltrials.gov/ct2/results?cond=&term=NCT02869035&cntry=&state=&city=&dist=).
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Affiliation(s)
- Kristin Köhler-Forsberg
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Anders Jorgensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Vibeke H Dam
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Cheng-Teng Ip
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Pharmacology, H. Lundbeck A/S, Valby, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Center Copenhagen, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Martin Balslev Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe Gedsoe Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
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Geerts H, Wikswo J, van der Graaf PH, Bai JPF, Gaiteri C, Bennett D, Swalley SE, Schuck E, Kaddurah-Daouk R, Tsaioun K, Pelleymounter M. Quantitative Systems Pharmacology for Neuroscience Drug Discovery and Development: Current Status, Opportunities, and Challenges. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2019; 9:5-20. [PMID: 31674729 PMCID: PMC6966183 DOI: 10.1002/psp4.12478] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
The substantial progress made in the basic sciences of the brain has yet to be adequately translated to successful clinical therapeutics to treat central nervous system (CNS) diseases. Possible explanations include the lack of quantitative and validated biomarkers, the subjective nature of many clinical endpoints, and complex pharmacokinetic/pharmacodynamic relationships, but also the possibility that highly selective drugs in the CNS do not reflect the complex interactions of different brain circuits. Although computational systems pharmacology modeling designed to capture essential components of complex biological systems has been increasingly accepted in pharmaceutical research and development for oncology, inflammation, and metabolic disorders, the uptake in the CNS field has been very modest. In this article, a cross-disciplinary group with representatives from academia, pharma, regulatory, and funding agencies make the case that the identification and exploitation of CNS therapeutic targets for drug discovery and development can benefit greatly from a system and network approach that can span the gap between molecular pathways and the neuronal circuits that ultimately regulate brain activity and behavior. The National Institute of Neurological Disorders and Stroke (NINDS), in collaboration with the National Institute on Aging (NIA), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), and National Center for Advancing Translational Sciences (NCATS), convened a workshop to explore and evaluate the potential of a quantitative systems pharmacology (QSP) approach to CNS drug discovery and development. The objective of the workshop was to identify the challenges and opportunities of QSP as an approach to accelerate drug discovery and development in the field of CNS disorders. In particular, the workshop examined the potential for computational neuroscience to perform QSP-based interrogation of the mechanism of action for CNS diseases, along with a more accurate and comprehensive method for evaluating drug effects and optimizing the design of clinical trials. Following up on an earlier white paper on the use of QSP in general disease mechanism of action and drug discovery, this report focuses on new applications, opportunities, and the accompanying limitations of QSP as an approach to drug development in the CNS therapeutic area based on the discussions in the workshop with various stakeholders.
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Affiliation(s)
- Hugo Geerts
- In Silico Biosciences, Berwyn, Pennsylvania, USA
| | - John Wikswo
- Vanderbilt Institute for Integrative Biosystems Research and Education, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Jane P F Bai
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Chris Gaiteri
- Rush Alzheimer's Disease Center, Rush University, Chicago, Illinois, USA
| | - David Bennett
- Rush Alzheimer's Disease Center, Rush University, Chicago, Illinois, USA
| | | | | | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Katya Tsaioun
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mary Pelleymounter
- Division of Translational Research, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
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22
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Geerts H, Barrett JE. Neuronal Circuit-Based Computer Modeling as a Phenotypic Strategy for CNS R&D. Front Neurosci 2019; 13:723. [PMID: 31379482 PMCID: PMC6646593 DOI: 10.3389/fnins.2019.00723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/28/2019] [Indexed: 12/13/2022] Open
Abstract
With the success rate of drugs for CNS indications at an all-time low, new approaches are needed to turn the tide of failed clinical trials. This paper reviews the history of CNS drug Discovery over the last 60 years and proposes a new paradigm based on the lessons learned. The initial wave of successful therapeutics discovered using careful clinical observations was followed by an emphasis on a phenotypic target-agnostic approach, often leading to successful drugs with a rich pharmacology. The subsequent introduction of molecular biology and the focus on a target-driven strategy has largely dominated drug discovery efforts over the last 30 years, but has not increased the probability of success, because these highly selective molecules are unlikely to address the complex pathological phenotypes of most CNS disorders. In many cases, reliance on preclinical animal models has lacked robust translational power. We argue that Quantitative Systems Pharmacology (QSP), a mechanism-based computer model of biological processes informed by preclinical knowledge and enhanced by neuroimaging and clinical data could be a new powerful knowledge generator engine and paradigm for rational polypharmacy. Progress in the academic discipline of computational neurosciences, allows one to model the effect of pathology and therapeutic interventions on neuronal circuit firing activity that can relate to clinical phenotypes, driven by complex properties of specific brain region activation states. The model is validated by optimizing the correlation between relevant emergent properties of these neuronal circuits and historical clinical and imaging datasets. A rationally designed polypharmacy target profile will be discovered using reverse engineering and sensitivity analysis. Small molecules will be identified using a combination of Artificial Intelligence methods and computational modeling, tested subsequently in heterologous cellular systems with human targets. Animal models will be used to establish target engagement and for ADME-Tox, with the QSP approach complemented by in vivo preclinical models that can be further refined to increase predictive validity. The QSP platform can also mitigate the variability in clinical trials with the concept of virtual patients. Because the QSP platform integrates knowledge from a wide variety of sources in an actionable simulation, it offers the possibility of substantially improving the success rate of CNS R&D programs while, at the same time, reducing both cost and the number of animals.
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Affiliation(s)
- Hugo Geerts
- In Silico Biosciences, Inc., Berwyn, IL, United States
| | - James E Barrett
- Center for Substance Abuse Research, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
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Influence of Serotonin Transporter SLC6A4 Genotype on the Effect of Psychosocial Stress on Cognitive Performance: An Exploratory Pilot Study. Cogn Behav Neurol 2019; 31:79-85. [PMID: 29927798 DOI: 10.1097/wnn.0000000000000153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Previous research has shown an effect of various psychosocial stressors on unconstrained cognitive flexibility, such as searching through a large set of potential solutions in the lexical-semantic network during verbal problem-solving. Functional magnetic resonance imaging has shown that the presence of the short (S) allele (lacking a 43-base pair repeat) of the promoter region of the gene (SLC6A4) encoding the serotonin transporter (5-HTT) protein is associated with a greater amygdalar response to emotional stimuli and a greater response to stressors. Therefore, we hypothesized that the presence of the S-allele is associated with greater stress-associated impairment in performance on an unconstrained cognitive flexibility task, anagrams. METHODS In this exploratory pilot study, 28 healthy young adults were genotyped for long (L)-allele versus S-allele promoter region polymorphism of the 5-HTT gene, SLC6A4. Participants solved anagrams during the Trier Social Stress Test, which included public speaking and mental arithmetic stressors. We compared the participants' cognitive response to stress across genotypes. RESULTS A Gene×Stress interaction effect was observed in this small sample. Comparisons revealed that participants with at least one S-allele performed worse during the Stress condition. CONCLUSIONS Genetic susceptibility to stress conferred by SLC6A4 appeared to modulate unconstrained cognitive flexibility during psychosocial stress in this exploratory sample. If confirmed, this finding may have implications for conditions associated with increased stress response, including performance anxiety and cocaine withdrawal. Future work is needed both to confirm our findings with a larger sample and to explore the mechanisms of this proposed effect.
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Deen M, Hougaard A, Hansen HD, Svarer C, Eiberg H, Lehel S, Knudsen GM, Ashina M. Migraine is associated with high brain 5-HT levels as indexed by 5-HT 4 receptor binding. Cephalalgia 2018; 39:526-532. [PMID: 30089402 DOI: 10.1177/0333102418793642] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Serotonin (5-HT) plays a role in migraine pathophysiology, but whether brain 5-HT is involved in the conversion from episodic to chronic migraine is unknown. Here, we investigated brain 5-HT levels, as indexed by 5-HT4 receptor binding, in chronic migraine patients and evaluated whether these were associated with migraine frequency. METHODS Sixteen chronic migraine patients underwent a dynamic PET scan after injection of [11C]SB207145, a specific 5-HT4 receptor radioligand. Data from 15 episodic migraine patients and 16 controls were included for comparison. Quantification of 5-HT4 receptor binding was used as a proxy for brain 5-HT levels, since 5-HT4 receptor binding is inversely related to brain 5-HT levels. RESULTS Chronic migraine patients had 9.1% (95% CI: [-17%; -1.0%]) lower 5-HT4 receptor binding compared to controls ( p = 0.039). There was no difference in 5-HT4 receptor binding between chronic and episodic migraine patients ( p = 0.48) and no association between number of monthly migraine days and 5-HT4 receptor binding (slope estimate 0.003, 95% CI: [-0.004; 0.715], p = 0.39). CONCLUSION The finding of low 5-HT4 receptor binding suggests that cerebral levels of 5-HT are elevated in chronic migraine patients. This is in line with observations made in patients with episodic migraine. Elevated brain 5-HT levels may thus be an inherent trait of the migraine brain rather than a risk factor for conversion from episodic to chronic migraine.
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Affiliation(s)
- Marie Deen
- 1 Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark.,2 Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, Copenhagen, Denmark.,3 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Hougaard
- 1 Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Hanne D Hansen
- 2 Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Claus Svarer
- 2 Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Hans Eiberg
- 4 Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Szabolcs Lehel
- 5 PET and Cyclotron Unit, Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- 2 Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, Copenhagen, Denmark.,3 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Messoud Ashina
- 1 Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark.,3 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Geerts H, Gieschke R, Peck R. Use of quantitative clinical pharmacology to improve early clinical development success in neurodegenerative diseases. Expert Rev Clin Pharmacol 2018; 11:789-795. [PMID: 30019953 DOI: 10.1080/17512433.2018.1501555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The success rate of pharmaceutical Research & Development (R&D) is much lower compared to other industries such as micro-electronics or aeronautics with the probability of a successful clinical development to approval in central nervous system (CNS) disorders hovering in the single digits (7%). Areas covered: Inspired by adjacent engineering-based industries, we argue that quantitative modeling in CNS R&D might improve success rates. We will focus on quantitative techniques in early clinical development, such as PharmacoKinetic-PharmacoDynamic modeling, clinical trial simulation, model-based meta-analysis and the mechanism-based physiology-based pharmacokinetic modeling, and quantitative systems pharmacology. Expert commentary: Mechanism-based computer modeling rely less on existing clinical datasets, therefore can better generalize than Big Data analytics, including prospectively and quantitatively predicting the clinical outcome of new drugs. More specifically, exhaustive post-hoc analysis of failed trials using individual virtual human trial simulation could illuminate underlying causes such as lack of sufficient functional target engagement, negative pharmacodynamic interactions with comedications and genotypes, and mismatched patient population. These insights are beyond the capacity of artificial intelligence (AI) methods as they are many more possible combinations than subjects. Unlike 'black box' approaches in AI, mechanism-based platforms are transparent and based on biologically sound assumptions that can be interrogated.
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Affiliation(s)
- Hugo Geerts
- a In Silico Biosciences, Computational Neuropharmacology , Berwyn , PA , USA
| | - Ronald Gieschke
- b Early Development , Clinical Pharmacology, Roche Innovation Center , Basel , Switzerland
| | - Richard Peck
- b Early Development , Clinical Pharmacology, Roche Innovation Center , Basel , Switzerland
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26
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Borgsted C, Ozenne B, Mc Mahon B, Madsen MK, Hjordt LV, Hageman I, Baaré WFC, Knudsen GM, Fisher PM. Amygdala response to emotional faces in seasonal affective disorder. J Affect Disord 2018; 229:288-295. [PMID: 29329062 DOI: 10.1016/j.jad.2017.12.097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 11/29/2017] [Accepted: 12/31/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Seasonal affective disorder (SAD) is characterized by seasonally recurring depression. Heightened amygdala activation to aversive stimuli is associated with major depressive disorder but its relation to SAD is unclear. We evaluated seasonal variation in amygdala activation in SAD and healthy controls (HC) using a longitudinal design targeting the asymptomatic/symptomatic phases of SAD. We hypothesized increased amygdala activation to aversive stimuli in the winter in SAD individuals (season-by-group interaction). METHODS Seventeen SAD individuals and 15 HCs completed an implicit emotional faces BOLD-fMRI paradigm during summer and winter. We computed amygdala activation (SPM5) to an aversive contrast (angry & fearful minus neutral) and angry, fearful and neutral faces, separately. Season-by-group and main effects were evaluated using Generalized Least Squares. In SAD individuals, we correlated change in symptom severity, assessed with The Hamilton Rating Scale for Depression - Seasonal Affective Disorder version (SIGH-SAD), with change in amygdala activation. RESULTS We found no season-by-group, season or group effect on our aversive contrast. Independent of season, SAD individuals showed significantly lower amygdala activation to all faces compared to healthy controls, with no evidence for a season-by-group interaction. Seasonal change in amygdala activation was unrelated to change in SIGH-SAD. LIMITATIONS Small sample size, lack of positive valence stimuli. CONCLUSIONS Amygdala activation to aversive faces is not increased in symptomatic SAD individuals. Instead, we observed decreased amygdala activation across faces, independent of season. Our findings suggest that amygdala activation to angry, fearful and neutral faces is altered in SAD individuals, independent of the presence of depressive symptoms.
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Affiliation(s)
- Camilla Borgsted
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark
| | - Brenda Mc Mahon
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Martin K Madsen
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Liv V Hjordt
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ida Hageman
- Psychiatric Centre Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, 2650 Hvidovre, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark.
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Deen M, Hansen HD, Hougaard A, Nørgaard M, Eiberg H, Lehel S, Ashina M, Knudsen GM. High brain serotonin levels in migraine between attacks: A 5-HT 4 receptor binding PET study. Neuroimage Clin 2018; 18:97-102. [PMID: 29387527 PMCID: PMC5790018 DOI: 10.1016/j.nicl.2018.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/19/2017] [Accepted: 01/15/2018] [Indexed: 01/03/2023]
Abstract
Migraine has been hypothesized to be a syndrome of chronic low serotonin (5-HT) levels, but investigations of brain 5-HT levels have given equivocal results. Here, we used positron emission tomography (PET) imaging of the 5-HT4 receptor as a proxy for brain 5-HT levels. Given that the 5-HT4 receptor is inversely related to brain 5-HT levels, we hypothesized that between attacks migraine patients would have higher 5-HT4 receptor binding compared to controls. Eighteen migraine patients without aura (migraine free >48 h), and 16 age- and sex-matched controls underwent PET scans after injection of [11C]SB207145, a specific 5-HT4 receptor radioligand. An investigator blinded to group calculated a neocortical mean [11C]SB207145 binding potential (BPND). Three migraine patients reported a migraine attack within 48 h after the scan and were excluded from the primary analysis. Comparing 15 migraine patients and 16 controls, we found that migraine patients have significantly lower neocortical 5-HT4 receptor binding than controls (0.60 ± 0.09 vs. 0.67 ± 0.05, p = .024), corrected for 5-HTTLPR genotype, sex and age. We found no association between 5-HT4 receptor binding and attack frequency, years with migraine or time since last migraine attack. Our finding of lower 5-HT4 receptor binding in migraine patients is suggestive of higher brain 5-HT levels. This is in contrast with the current belief that migraine is associated with low brain 5-HT levels. High brain 5-HT levels may represent a trait of the migraine brain or it could be a consequence of migraine attacks.
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Affiliation(s)
- Marie Deen
- Danish Headache Center, Department of Neurology, Rigshospitalet, DK-2600 Glostrup, Denmark; Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark; Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark; Center for Experimental Medicine Neuropharmacology, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Hanne D Hansen
- Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark; Center for Experimental Medicine Neuropharmacology, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Anders Hougaard
- Danish Headache Center, Department of Neurology, Rigshospitalet, DK-2600 Glostrup, Denmark; Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Martin Nørgaard
- Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark; Center for Experimental Medicine Neuropharmacology, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Hans Eiberg
- Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Szabolcs Lehel
- PET- and Cyclotron Unit, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet, DK-2600 Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark; Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and NeuroPharm, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark; Center for Experimental Medicine Neuropharmacology, Department of Neurology, Rigshospitalet, DK-2100 Copenhagen, Denmark.
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Geerts H, Hofmann-Apitius M, Anastasio TJ. Knowledge-driven computational modeling in Alzheimer's disease research: Current state and future trends. Alzheimers Dement 2017; 13:1292-1302. [PMID: 28917669 DOI: 10.1016/j.jalz.2017.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/05/2017] [Accepted: 08/01/2017] [Indexed: 11/24/2022]
Abstract
Neurodegenerative diseases such as Alzheimer's disease (AD) follow a slowly progressing dysfunctional trajectory, with a large presymptomatic component and many comorbidities. Using preclinical models and large-scale omics studies ranging from genetics to imaging, a large number of processes that might be involved in AD pathology at different stages and levels have been identified. The sheer number of putative hypotheses makes it almost impossible to estimate their contribution to the clinical outcome and to develop a comprehensive view on the pathological processes driving the clinical phenotype. Traditionally, bioinformatics approaches have provided correlations and associations between processes and phenotypes. Focusing on causality, a new breed of advanced and more quantitative modeling approaches that use formalized domain expertise offer new opportunities to integrate these different modalities and outline possible paths toward new therapeutic interventions. This article reviews three different computational approaches and their possible complementarities. Process algebras, implemented using declarative programming languages such as Maude, facilitate simulation and analysis of complicated biological processes on a comprehensive but coarse-grained level. A model-driven Integration of Data and Knowledge, based on the OpenBEL platform and using reverse causative reasoning and network jump analysis, can generate mechanistic knowledge and a new, mechanism-based taxonomy of disease. Finally, Quantitative Systems Pharmacology is based on formalized implementation of domain expertise in a more fine-grained, mechanism-driven, quantitative, and predictive humanized computer model. We propose a strategy to combine the strengths of these individual approaches for developing powerful modeling methodologies that can provide actionable knowledge for rational development of preventive and therapeutic interventions. Development of these computational approaches is likely to be required for further progress in understanding and treating AD.
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Affiliation(s)
- Hugo Geerts
- In Silico Biosciences, Berwyn, PA, USA; Perelman School of Medicine, Univ. of Pennsylvania.
| | - Martin Hofmann-Apitius
- Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
| | - Thomas J Anastasio
- Department of Molecular and Integrative Physiology, and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Testosterone levels in healthy men correlate negatively with serotonin 4 receptor binding. Psychoneuroendocrinology 2017; 81:22-28. [PMID: 28426945 DOI: 10.1016/j.psyneuen.2017.03.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/14/2017] [Indexed: 12/20/2022]
Abstract
The serotonergic system integrates sex steroid information and plays a central role in mood and stress regulation, cognition, appetite and sleep. This interplay may be critical for likelihood of developing depressive episodes, at least in a subgroup of sensitive individuals. The serotonin 4 receptor (5-HT4R) indexes central serotonergic tonus, which may be related to endogenous sex-steroid levels in the mentally healthy state even though this remains elusive. Here we evaluate if peripheral levels of estradiol and testosterone are associated with 5-HT4R binding as imaged by [11C]SB207145 positron emission tomography in a group of 41 healthy men. We estimated global 5-HT4R binding using a latent variable model framework, which models shared correlation between 5-HT4R across multiple brain regions (hippocampus, amygdala, posterior and anterior cingulate, thalamus, pallidostriatum and neocortex). We tested whether testosterone and estradiol predict global 5-HT4R, adjusting for age. We found that testosterone, but not estradiol, correlated negatively with global 5-HT4R levels (p=0.02) suggesting that men with high levels of testosterone have higher cerebral serotonergic tonus. Our findings corroborate the link between sex hormone levels and serotonin signalling. Future longitudinal studies in clinical relevant populations are needed to elucidate the potential importance of testosterone in the pathophysiology of e.g. major depression and its treatment.
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Stenbæk DS, Fisher PM, Ozenne B, Andersen E, Hjordt LV, McMahon B, Hasselbalch SG, Frokjaer VG, Knudsen GM. Brain serotonin 4 receptor binding is inversely associated with verbal memory recall. Brain Behav 2017; 7:e00674. [PMID: 28413715 PMCID: PMC5390847 DOI: 10.1002/brb3.674] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 01/12/2017] [Accepted: 02/04/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND We have previously identified an inverse relationship between cerebral serotonin 4 receptor (5-HT 4R) binding and nonaffective episodic memory in healthy individuals. Here, we investigate in a novel sample if the association is related to affective components of memory, by examining the association between cerebral 5-HT 4R binding and affective verbal memory recall. METHODS Twenty-four healthy volunteers were scanned with the 5-HT 4R radioligand [11C]SB207145 and positron emission tomography, and were tested with the Verbal Affective Memory Test-24. The association between 5-HT 4R binding and affective verbal memory was evaluated using a linear latent variable structural equation model. RESULTS We observed a significant inverse association across all regions between 5-HT 4R binding and affective verbal memory performances for positive (p = 5.5 × 10-4) and neutral (p = .004) word recall, and an inverse but nonsignificant association for negative (p = .07) word recall. Differences in the associations with 5-HT 4R binding between word categories (i.e., positive, negative, and neutral) did not reach statistical significance. CONCLUSION Our findings replicate our previous observation of a negative association between 5-HT 4R binding and memory performance in an independent cohort and provide novel evidence linking 5-HT 4R binding, as a biomarker for synaptic 5-HT levels, to the mnestic processing of positive and neutral word stimuli in healthy humans.
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Affiliation(s)
- Dea S Stenbæk
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Brice Ozenne
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark.,Department of Biostatistics University of Copenhagen Copenhagen Denmark
| | - Emil Andersen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Liv V Hjordt
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Brenda McMahon
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Steen G Hasselbalch
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark.,Department of Neurology The Neuroscience Centre Danish Dementia Research Centre Rigshospitalet, University of Copenhagen Copenhagen Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
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Jakobsen GR, Fisher PM, Dyssegaard A, McMahon B, Holst KK, Lehel S, Svarer C, Jensen PS, Knudsen GM, Frokjaer VG. Brain serotonin 4 receptor binding is associated with the cortisol awakening response. Psychoneuroendocrinology 2016; 67:124-32. [PMID: 26894483 DOI: 10.1016/j.psyneuen.2016.01.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/30/2016] [Accepted: 01/30/2016] [Indexed: 12/13/2022]
Abstract
Serotonin signalling is considered critical for an appropriate and dynamic adaptation to stress. Previously, we have shown that prefrontal serotonin transporter (SERT) binding is positively associated with the cortisol awakening response (CAR) (Frokjaer et al., 2013), which is an index of hypothalamic-pituitary-adrenal (HPA)-axis output dynamics. Here, we investigated in healthy individuals if cerebral serotonin 4 receptor (5-HT4r) binding, reported to be a proxy for serotonin levels, is associated with CAR. Thirty healthy volunteers (25 males, age range 20-56 years) underwent 5-HT4r PET imaging with [(11)C]-SB207145, genotyping of the SERT-linked polymorphic region (5-HTTLPR), and performed serial home sampling of saliva (5 time points from 0 to 60min from awakening) to assess CAR. The association between 5-HT4r binding in 4 regions of interest (prefrontal cortex, anterior cingulate cortex, pallidostriatum, and hippocampus) and CAR was tested using multiple linear regression with adjustment for age and 5-HTTLPR genotype. Finally, an exploratory voxel-based analysis of the association was performed. CAR was negatively associated with 5-HT4r binding in pallidostriatum (p=0.01), prefrontal cortex (p=0.03), and anterior cingulate cortex (p=0.002), respectively, but showed no association in hippocampus. The results remained significant when taking into account other potentially relevant covariates. In conclusion, our finding reinforces an association between HPA-axis function and serotonin signaling in vivo in humans. We suggest that higher synaptic serotonin concentration, here indexed by lower 5-HT4r binding, supports HPA-axis dynamics, which in healthy volunteers is reflected by a robust CAR.
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Affiliation(s)
- Gustav R Jakobsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Agnete Dyssegaard
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Brenda McMahon
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Klaus K Holst
- Department of Biostatistics, University of Copenhagen, DK-1014 Copenhagen, Denmark
| | | | - Claus Svarer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Peter S Jensen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark.
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Developmental psychopathology in an era of molecular genetics and neuroimaging: A developmental neurogenetics approach. Dev Psychopathol 2016; 27:587-613. [PMID: 25997774 DOI: 10.1017/s0954579415000188] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The emerging field of neurogenetics seeks to model the complex pathways from gene to brain to behavior. This field has focused on imaging genetics techniques that examine how variability in common genetic polymorphisms predict differences in brain structure and function. These studies are informed by other complimentary techniques (e.g., animal models and multimodal imaging) and have recently begun to incorporate the environment through examination of Imaging Gene × Environment interactions. Though neurogenetics has the potential to inform our understanding of the development of psychopathology, there has been little integration between principles of neurogenetics and developmental psychopathology. The paper describes a neurogenetics and Imaging Gene × Environment approach and how these approaches have been usefully applied to the study of psychopathology. Six tenets of developmental psychopathology (the structure of phenotypes, the importance of exploring mechanisms, the conditional nature of risk, the complexity of multilevel pathways, the role of development, and the importance of who is studied) are identified, and how these principles can further neurogenetics applications to understanding the development of psychopathology is discussed. A major issue of this piece is how neurogenetics and current imaging and molecular genetics approaches can be incorporated into developmental psychopathology perspectives with a goal of providing models for better understanding pathways from among genes, environments, the brain, and behavior.
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da Cunha-Bang S, Mc Mahon B, Fisher PM, Jensen PS, Svarer C, Knudsen GM. High trait aggression in men is associated with low 5-HT levels, as indexed by 5-HT4 receptor binding. Soc Cogn Affect Neurosci 2016; 11:548-55. [PMID: 26772668 DOI: 10.1093/scan/nsv140] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/12/2015] [Indexed: 02/04/2023] Open
Abstract
Impulsive aggression has commonly been associated with a dysfunction of the serotonin (5-HT) system: many, but not all, studies point to an inverse relationship between 5-HT and aggression. As cerebral 5-HT4 receptor (5-HT4R) binding has recently been recognized as a proxy for stable brain levels of 5-HT, we here test the hypothesis in healthy men and women that brain 5-HT levels, as indexed by cerebral 5-HT4R, are inversely correlated with trait aggression and impulsivity. Sixty-one individuals (47 men) underwent positron emission tomography scanning with the radioligand [(11)C]SB207145 for quantification of brain 5-HT4R binding. The Buss-Perry Aggression Questionnaire (BPAQ) and the Barratt Impulsiveness Scale were used for assessment of trait aggression and trait impulsivity. Among male subjects, there was a positive correlation between global 5-HT4R and BPAQ total score (P = 0.037) as well as BPAQ physical aggression (P = 0.025). No main effect of global 5-HT4R on trait aggression or impulsivity was found in the mixed gender sample, but there was evidence for sex interaction effects in the relationship between global 5-HT4R and BPAQ physical aggression. In conclusion we found that low cerebral 5-HT levels, as indexed by 5-HT4R binding were associated with high trait aggression in males, but not in females.
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Affiliation(s)
- Sofi da Cunha-Bang
- Department of Neurology, Rigshospitalet, Neurobiology Research Unit and Center for Integrated Molecular Imaging, Copenhagen, Denmark and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brenda Mc Mahon
- Department of Neurology, Rigshospitalet, Neurobiology Research Unit and Center for Integrated Molecular Imaging, Copenhagen, Denmark and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Patrick MacDonald Fisher
- Department of Neurology, Rigshospitalet, Neurobiology Research Unit and Center for Integrated Molecular Imaging, Copenhagen, Denmark and
| | - Peter Steen Jensen
- Department of Neurology, Rigshospitalet, Neurobiology Research Unit and Center for Integrated Molecular Imaging, Copenhagen, Denmark and
| | - Claus Svarer
- Department of Neurology, Rigshospitalet, Neurobiology Research Unit and Center for Integrated Molecular Imaging, Copenhagen, Denmark and
| | - Gitte Moos Knudsen
- Department of Neurology, Rigshospitalet, Neurobiology Research Unit and Center for Integrated Molecular Imaging, Copenhagen, Denmark and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Role of Serotonin Transporter Changes in Depressive Responses to Sex-Steroid Hormone Manipulation: A Positron Emission Tomography Study. Biol Psychiatry 2015; 78:534-43. [PMID: 26004162 DOI: 10.1016/j.biopsych.2015.04.015] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 03/21/2015] [Accepted: 04/17/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND An adverse response to acute and pronounced changes in sex-hormone levels during, for example, the perimenopausal or postpartum period appears to heighten risk for major depression in women. The underlying risk mechanisms remain elusive but may include transiently compromised serotonergic brain signaling. Here, we modeled a biphasic ovarian sex hormone fluctuation using a gonadotropin-releasing hormone agonist (GnRHa) and evaluated if emergence of depressive symptoms was associated with change in cerebral serotonin transporter (SERT) binding following intervention. METHODS A double-blind, randomized, placebo-controlled study included 63 healthy female volunteers (mean age 24.3 ± 4.9 years) with regular menstrual cycles between 23 and 35 days. Participants were randomized to active (goserelin [GnRHa] 3.6 mg implant) or placebo intervention. Sixty women completed follow-up and entered the analyses. Primary outcome measures were changes from baseline in depressive symptoms assessed on the 17-item Hamilton Depression Rating Scale and SERT binding as imaged by [(11)C]DASB positron emission tomography. Outcome measures were acquired at baseline in the follicular phase (cycle day 6.6 ± 2.2) and at follow-up (16.2 ± 2.6 days after intervention start). RESULTS Sex hormone manipulation with GnRHa significantly triggered subclinical depressive symptoms within-group (p = .003) and relative to placebo (p = .02), which were positively associated with net decreases in estradiol levels (p = .02) from baseline within the GnRHa group. Depressive symptoms were associated with increases in neocortical SERT binding in the GnRHa group relative to placebo (p = .003). CONCLUSIONS Our data imply both serotonergic signaling and estradiol in the mechanisms by which sex-steroid hormone fluctuations provoke depressive symptoms and thus provide a rationale for future preventive strategies in high-risk groups.
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Role of the 5-HTTLPR and SNP Promoter Polymorphisms on Serotonin Transporter Gene Expression: a Closer Look at Genetic Architecture and In Vitro Functional Studies of Common and Uncommon Allelic Variants. Mol Neurobiol 2015; 53:5510-26. [DOI: 10.1007/s12035-015-9409-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 08/23/2015] [Indexed: 12/11/2022]
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Kumar JSD, Mann JJ. PET tracers for serotonin receptors and their applications. Cent Nerv Syst Agents Med Chem 2015; 14:96-112. [PMID: 25360773 DOI: 10.2174/1871524914666141030124316] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/26/2014] [Accepted: 10/28/2014] [Indexed: 11/22/2022]
Abstract
Serotonin receptors (5-HTRs) are implicated in the pathophysiology of a variety of neuropsychiatric and neurodegenerative disorders and are also targets for drug therapy. In the CNS, most of these receptors are expressed in high abundance in specific brain regions reflecting their role in brain functions. Quantifying binding to 5-HTRs in vivo may permit assessment of physiologic and pathologic conditions, and monitoring disease progression, evaluating treatment response, and for investigating new treatment modalities. Positron emission tomography (PET) molecular imaging has the sensitivity to quantify binding of 5-HTRs in CNS disorders and to measure drug occupancy as part of a process of new drug development. Although research on PET imaging of 5-HTRs have been performed more than two decades, the successful radiotracers so far developed for human studies are limited to 5-HT₁AR, 5-HT₁BR, 5-HT₂AR, 5-HT₄R and 5-HT₆R. Herein we review the development and application of radioligands for PET imaging of 5-HTRs in living brain.
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Affiliation(s)
| | - J John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric institute, 1051 Riverside Drive, Box: 42, New York, NY, 10032, USA.
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Fluctuations in [¹¹C]SB207145 PET binding associated with change in threat-related amygdala reactivity in humans. Neuropsychopharmacology 2015; 40:1510-8. [PMID: 25560201 PMCID: PMC4397409 DOI: 10.1038/npp.2014.339] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 11/27/2014] [Accepted: 12/11/2014] [Indexed: 12/17/2022]
Abstract
Serotonin critically affects the neural processing of emotionally salient stimuli, including indices of threat; however, how alterations in serotonin signaling contribute to changes in brain function is not well understood. Recently, we showed in a placebo-controlled study of 32 healthy males that brain serotonin 4 receptor (5-HT4) binding, assessed with [(11)C]SB207145 PET, was sensitive to a 3-week intervention with the selective serotonin reuptake inhibitor fluoxetine, supporting it as an in vivo model for fluctuations in central serotonin levels. Participants also underwent functional magnetic resonance imaging while performing a gender discrimination task of fearful, angry, and neutral faces. This offered a unique opportunity to evaluate whether individual fluctuations in central serotonin levels, indexed by change in [(11)C]SB207145 binding, predicted changes in threat-related reactivity (ie, fear and angry vs neutral faces) within a corticolimbic circuit including the amygdala and medial prefrontal and anterior cingulate cortex. We observed a significant association such that decreased brain-wide [(11)C]SB207145 binding (ie, increased brain serotonin levels) was associated with lower threat-related amygdala reactivity, whereas intervention group status did not predict change in corticolimbic reactivity. This suggests that in the healthy brain, interindividual responses to pharmacologically induced and spontaneously occurring fluctuations in [(11)C]SB207145 binding, a putative marker of brain serotonin levels, affect amygdala reactivity to threat. Our finding also supports that change in brain [(11)C]SB207145 binding may be a relevant marker for evaluating neurobiological mechanisms underlying sensitivity to threat and serotonin signaling.
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38
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Knudsen GM, Jensen PS, Erritzoe D, Baaré WFC, Ettrup A, Fisher PM, Gillings N, Hansen HD, Hansen LK, Hasselbalch SG, Henningsson S, Herth MM, Holst KK, Iversen P, Kessing LV, Macoveanu J, Madsen KS, Mortensen EL, Nielsen FÅ, Paulson OB, Siebner HR, Stenbæk DS, Svarer C, Jernigan TL, Strother SC, Frokjaer VG. The Center for Integrated Molecular Brain Imaging (Cimbi) database. Neuroimage 2015; 124:1213-1219. [PMID: 25891375 DOI: 10.1016/j.neuroimage.2015.04.025] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 04/08/2015] [Accepted: 04/09/2015] [Indexed: 01/07/2023] Open
Abstract
We here describe a multimodality neuroimaging containing data from healthy volunteers and patients, acquired within the Lundbeck Foundation Center for Integrated Molecular Brain Imaging (Cimbi) in Copenhagen, Denmark. The data is of particular relevance for neurobiological research questions related to the serotonergic transmitter system with its normative data on the serotonergic subtype receptors 5-HT1A, 5-HT1B, 5-HT2A, and 5-HT4 and the 5-HT transporter (5-HTT), but can easily serve other purposes. The Cimbi database and Cimbi biobank were formally established in 2008 with the purpose to store the wealth of Cimbi-acquired data in a highly structured and standardized manner in accordance with the regulations issued by the Danish Data Protection Agency as well as to provide a quality-controlled resource for future hypothesis-generating and hypothesis-driven studies. The Cimbi database currently comprises a total of 1100 PET and 1000 structural and functional MRI scans and it holds a multitude of additional data, such as genetic and biochemical data, and scores from 17 self-reported questionnaires and from 11 neuropsychological paper/computer tests. The database associated Cimbi biobank currently contains blood and in some instances saliva samples from about 500 healthy volunteers and 300 patients with e.g., major depression, dementia, substance abuse, obesity, and impulsive aggression. Data continue to be added to the Cimbi database and biobank.
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Affiliation(s)
- Gitte M Knudsen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark.
| | - Peter S Jensen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - David Erritzoe
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - William F C Baaré
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark
| | - Anders Ettrup
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Patrick M Fisher
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Nic Gillings
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; PET and Cyclotron Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Hanne D Hansen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Lars Kai Hansen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; DTU Compute, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark
| | - Steen G Hasselbalch
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Susanne Henningsson
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark
| | - Matthias M Herth
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; PET and Cyclotron Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Klaus K Holst
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, DK-1014 Copenhagen, Denmark
| | - Pernille Iversen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark
| | - Lars V Kessing
- Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Julian Macoveanu
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kathrine Skak Madsen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark
| | - Erik L Mortensen
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, DK-2200 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Finn Årup Nielsen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; DTU Compute, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark
| | - Olaf B Paulson
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Hartwig R Siebner
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, DK-2400 Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, DK-2400 Copenhagen, Denmark
| | - Dea S Stenbæk
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Claus Svarer
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Terry L Jernigan
- Center for Human Development, University of California, San Diego, La Jolla, CA 92093, USA
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Vibe G Frokjaer
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Fresneau N, Dumas N, Tournier BB, Fossey C, Ballandonne C, Lesnard A, Millet P, Charnay Y, Cailly T, Bouillon JP, Fabis F. Design of a serotonin 4 receptor radiotracer with decreased lipophilicity for single photon emission computed tomography. Eur J Med Chem 2015; 94:386-96. [PMID: 25778994 DOI: 10.1016/j.ejmech.2015.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 10/23/2022]
Abstract
With the aim to develop a suitable radiotracer for the brain imaging of the serotonin 4 receptor subtype (5-HT4R) using single photon emission computed tomography (SPECT), we synthesized and evaluated a library of di- and triazaphenanthridines with lipophilicity values which were in the range expected to favour brain penetration, and which demonstrated specific binding to the target of interest. Adding additional nitrogen atoms to previously described phenanthridine ligands exhibiting a high unspecific binding, we were able to design a radioiodinated compound [(125)I]14. This compound exhibited a binding affinity value of 0.094 nM toward human 5-HT4R and a high selectivity over other serotonin receptor subtypes (5-HTR). In vivo SPECT imaging studies and competition experiments demonstrated that the decreased lipophilicity (in comparison with our previously reported compounds 4 and 5) allowed a more specific labelling of the 5-HT4R brain-containing regions.
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Affiliation(s)
- Nathalie Fresneau
- Normandie Univ., COBRA, UMR 6014 et FR 3038, Univ. Rouen, INSA Rouen, CNRS, 1 Rue Tesnière, F-76821 Mont-Saint-Aignan Cedex, France
| | - Noé Dumas
- Hôpitaux Universitaires de Genève, Département de Santé Mentale et de Psychiatrie, Service de Psychiatrie Générale, Unité des Biomarqueurs de Vulnérabilité, Chemin du Petit-Bel-Air, 2, CH-1225 Genève, Switzerland
| | - Benjamin B Tournier
- Hôpitaux Universitaires de Genève, Département de Santé Mentale et de Psychiatrie, Service de Psychiatrie Générale, Unité des Biomarqueurs de Vulnérabilité, Chemin du Petit-Bel-Air, 2, CH-1225 Genève, Switzerland
| | - Christine Fossey
- Normandie Univ., Université de Caen Basse-Normandie, CERMN (EA 4258, FR CNRS 3038 INC3M, SF 4206 ICORE), UFR des Sciences Pharmaceutiques, Bd Becquerel, F-14032 Caen, France
| | - Céline Ballandonne
- Normandie Univ., Université de Caen Basse-Normandie, CERMN (EA 4258, FR CNRS 3038 INC3M, SF 4206 ICORE), UFR des Sciences Pharmaceutiques, Bd Becquerel, F-14032 Caen, France
| | - Aurélien Lesnard
- Normandie Univ., Université de Caen Basse-Normandie, CERMN (EA 4258, FR CNRS 3038 INC3M, SF 4206 ICORE), UFR des Sciences Pharmaceutiques, Bd Becquerel, F-14032 Caen, France
| | - Philippe Millet
- Hôpitaux Universitaires de Genève, Département de Santé Mentale et de Psychiatrie, Service de Psychiatrie Générale, Unité des Biomarqueurs de Vulnérabilité, Chemin du Petit-Bel-Air, 2, CH-1225 Genève, Switzerland
| | - Yves Charnay
- Hôpitaux Universitaires de Genève, Département de Santé Mentale et de Psychiatrie, Service de Psychiatrie Générale, Unité des Biomarqueurs de Vulnérabilité, Chemin du Petit-Bel-Air, 2, CH-1225 Genève, Switzerland
| | - Thomas Cailly
- Normandie Univ., Université de Caen Basse-Normandie, CERMN (EA 4258, FR CNRS 3038 INC3M, SF 4206 ICORE), UFR des Sciences Pharmaceutiques, Bd Becquerel, F-14032 Caen, France
| | - Jean-Philippe Bouillon
- Normandie Univ., COBRA, UMR 6014 et FR 3038, Univ. Rouen, INSA Rouen, CNRS, 1 Rue Tesnière, F-76821 Mont-Saint-Aignan Cedex, France.
| | - Frédéric Fabis
- Normandie Univ., Université de Caen Basse-Normandie, CERMN (EA 4258, FR CNRS 3038 INC3M, SF 4206 ICORE), UFR des Sciences Pharmaceutiques, Bd Becquerel, F-14032 Caen, France.
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Madsen K, Torstensen E, Holst KK, Haahr ME, Knorr U, Frokjaer VG, Brandt-Larsen M, Iversen P, Fisher PM, Knudsen GM. Familial risk for major depression is associated with lower striatal 5-HT₄ receptor binding. Int J Neuropsychopharmacol 2014; 18:pyu034. [PMID: 25522384 PMCID: PMC4368872 DOI: 10.1093/ijnp/pyu034] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The 5-HT4 receptor provides a novel potential target for antidepressant treatment. No studies exist to elucidate the 5-HT4 receptor's in vivo distribution in the depressed state or in populations that may display trait markers for major depression disorder (MDD). The aim of this study was to determine whether familial risk for MDD is associated with cerebral 5-HT4 receptor binding as measured with [(11)C]SB207145 brain PET imaging. Familial risk is the most potent risk factor of MDD. METHODS We studied 57 healthy individuals (mean age 36 yrs, range 20-86; 21 women), 26 of which had first-degree relatives treated for MDD. RESULTS We found that having a family history of MDD was associated with lower striatal 5-HT4 receptor binding (p = 0.038; in individuals below 40 years, p = 0.013). Further, we found evidence for a "risk-dose effect" on 5-HT4 receptor binding, since the number of first-degree relatives with a history of MDD binding correlated negatively with 5-HT4 receptor binding in both the striatum (p = 0.001) and limbic regions (p = 0.012). CONCLUSIONS Our data suggest that the 5-HT4 receptor is involved in the neurobiological mechanism underlying familial risk for depression, and that lower striatal 5-HT4 receptor binding is associated with increased risk for developing MDD. The finding is intriguing considering that the 5-HT4 receptor has been suggested to be an effective target for antidepressant treatment.
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Affiliation(s)
- Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Eva Torstensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Klaus K Holst
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Mette E Haahr
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Ulla Knorr
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Malene Brandt-Larsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Pernille Iversen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen).
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41
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Abstract
Hippocampal volume loss has been related to chronic stress as well as genetic factors. Although genetic and environmental variables affecting hippocampal volume have extensively been studied and related to mental illness, limited evidence is available with respect to G × E interactions on hippocampal volume. The present MRI study investigated interaction effects on hippocampal volume between three well-studied functional genetic variants (COMT Val158Met, BDNF Val66Met, 5-HTTLPR) associated with hippocampal volume and a measure of environmental adversity (life events questionnaire) in a large sample of healthy humans (n = 153). All three variants showed significant interactions with environmental adversity with respect to hippocampal volume. Observed effects were additive by nature and driven by both recent as well as early life events. A consecutive analysis of hippocampal subfields revealed a spatially distinct profile for each genetic variant suggesting a specific role of 5-HTTLPR for the subiculum, BDNF Val66Met for CA4/dentate gyrus, and COMT Val158Met for CA2/3 volume changes. The present study underscores the importance of G × E interactions as determinants of hippocampal volume, which is crucial for the neurobiological understanding of stress-related conditions, such as mood disorders or post-traumatic stress disorder (PTSD).
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Fisher PM, Holst KK, Adamsen D, Klein AB, Frokjaer VG, Jensen PS, Svarer C, Gillings N, Baare WFC, Mikkelsen JD, Knudsen GM. BDNF Val66met and 5-HTTLPR polymorphisms predict a human in vivo marker for brain serotonin levels. Hum Brain Mapp 2014; 36:313-23. [PMID: 25220079 DOI: 10.1002/hbm.22630] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/29/2014] [Accepted: 08/29/2014] [Indexed: 11/12/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) has been implicated in multiple aspects of brain function including regulation of serotonin signaling. The BDNF val66met polymorphism (rs6265) has been linked to aspects of serotonin signaling in humans but its effects are not well understood. To address this, we evaluated whether BDNF val66met was predictive of a putative marker of brain serotonin levels, serotonin 4 receptor (5-HT4 ) binding assessed with [11C]SB207145 positron emission tomography, which has also been associated with the serotonin-transporter-linked polymorphic region (5-HTTLPR) polymorphism. We applied a linear latent variable model (LVM) using regional 5-HT4 binding values (neocortex, amygdala, caudate, hippocampus, and putamen) from 68 healthy humans, allowing us to explicitly model brain-wide and region-specific genotype effects on 5-HT4 binding. Our data supported an LVM wherein BDNF val66met significantly predicted a LV reflecting [11C]SB207145 binding across regions (P = 0.005). BDNF val66met met-carriers showed 2-9% higher binding relative to val/val homozygotes. In contrast, 5-HTTLPR did not predict the LV but S-carriers showed 7% lower neocortical binding relative to LL homozygotes (P = 7.3 × 10(-6)). We observed no evidence for genetic interaction. Our findings indicate that BDNF val66met significantly predicts a common regulator of brain [11C]SB207145 binding, which we hypothesize reflects brain serotonin levels. In contrast, our data indicate that 5-HTTLPR specifically affects 5-HT4 binding in the neocortex. These findings implicate serotonin signaling as an important molecular mediator underlying the effects of BDNF val66met and 5-HTTLPR on behavior and related risk for neuropsychiatric illness in humans.
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Affiliation(s)
- Patrick M Fisher
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark; Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark
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43
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Central 5-HT4 receptor binding as biomarker of serotonergic tonus in humans: a [11C]SB207145 PET study. Mol Psychiatry 2014; 19:427-32. [PMID: 24189342 DOI: 10.1038/mp.2013.147] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 08/10/2013] [Accepted: 09/09/2013] [Indexed: 01/22/2023]
Abstract
Identification of a biomarker that can inform on extracellular serotonin (5-HT) levels in the brains of living humans would enable greater understanding of the way brain circuits are modulated by serotonergic neurotransmission. Substantial evidence from studies in animals and humans indicates an inverse relationship between central 5-HT tonus and 5-HT type 4 receptor (5-HT4R) density, suggesting that 5-HT4R receptor density may be a biomarker marker for 5-HT tonus. Here, we investigated whether a 3-week administration of a selective serotonin reuptake inhibitor, expected to increase brain 5-HT levels, is associated with a decline in brain 5-HT4R binding. A total of 35 healthy men were studied in a placebo-controlled, randomized, double-blind study. Participants were assigned to receive 3 weeks of oral dosing with placebo or fluoxetine, 40 mg per day. Brain 5-HT4R binding was quantified at baseline and at follow-up with [(11)C]SB207145 positron emission tomography (PET). Three weeks of intervention with fluoxetine was associated with a 5.2% reduction in brain 5-HT4R binding (P=0.017), whereas placebo intervention did not change 5-HT4R binding (P=0.52). Our findings are consistent with a model, wherein the 5-HT4R density adjusts to changes in the extracellular 5-HT tonus. Our data demonstrate for the first time in humans that the imaging of central 5-HT4R binding may be used as an in vivo biomarker of the central 5-HT tonus.
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44
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PET Neuroimaging: The White Elephant Packs His Trunk? Neuroimage 2014; 84:1094-100. [DOI: 10.1016/j.neuroimage.2013.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/07/2013] [Accepted: 08/11/2013] [Indexed: 01/30/2023] Open
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45
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Greve DN, Svarer C, Fisher PM, Feng L, Hansen AE, Baare W, Rosen B, Fischl B, Knudsen GM. Cortical surface-based analysis reduces bias and variance in kinetic modeling of brain PET data. Neuroimage 2013; 92:225-36. [PMID: 24361666 DOI: 10.1016/j.neuroimage.2013.12.021] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 11/08/2013] [Accepted: 12/07/2013] [Indexed: 01/30/2023] Open
Abstract
Exploratory (i.e., voxelwise) spatial methods are commonly used in neuroimaging to identify areas that show an effect when a region-of-interest (ROI) analysis cannot be performed because no strong a priori anatomical hypothesis exists. However, noise at a single voxel is much higher than noise in a ROI making noise management critical to successful exploratory analysis. This work explores how preprocessing choices affect the bias and variability of voxelwise kinetic modeling analysis of brain positron emission tomography (PET) data. These choices include the use of volume- or cortical surface-based smoothing, level of smoothing, use of voxelwise partial volume correction (PVC), and PVC masking threshold. PVC was implemented using the Muller-Gartner method with the masking out of voxels with low gray matter (GM) partial volume fraction. Dynamic PET scans of an antagonist serotonin-4 receptor radioligand ([(11)C]SB207145) were collected on sixteen healthy subjects using a Siemens HRRT PET scanner. Kinetic modeling was used to compute maps of non-displaceable binding potential (BPND) after preprocessing. The results showed a complicated interaction between smoothing, PVC, and masking on BPND estimates. Volume-based smoothing resulted in large bias and intersubject variance because it smears signal across tissue types. In some cases, PVC with volume smoothing paradoxically caused the estimated BPND to be less than when no PVC was used at all. When applied in the absence of PVC, cortical surface-based smoothing resulted in dramatically less bias and the least variance of the methods tested for smoothing levels 5mm and higher. When used in combination with PVC, surface-based smoothing minimized the bias without significantly increasing the variance. Surface-based smoothing resulted in 2-4 times less intersubject variance than when volume smoothing was used. This translates into more than 4 times fewer subjects needed in a group analysis to achieve similarly powered statistical tests. Surface-based smoothing has less bias and variance because it respects cortical geometry by smoothing the PET data only along the cortical ribbon and so does not contaminate the GM signal with that of white matter and cerebrospinal fluid. The use of surface-based analysis in PET should result in substantial improvements in the reliability and detectability of effects in exploratory PET analysis, with or without PVC.
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Affiliation(s)
- Douglas N Greve
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Claus Svarer
- Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark
| | - Patrick M Fisher
- Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark
| | - Ling Feng
- Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark
| | - Adam E Hansen
- PET and Cyclotron Unit, Rigshospitalet, Copenhagen, Denmark
| | - William Baare
- Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark; University of Copenhagen, Copenhagen, Denmark
| | - Bruce Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Bruce Fischl
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Computer Science and Artificial Intelligence Laboratory, MIT, USA
| | - Gitte M Knudsen
- Center for Integrated Molecular Brain Imaging, Rigshospitalet, Copenhagen, Denmark; Danish Research Center for Magnetic Resonance, Hvidovre Hospital, Copenhagen, Denmark
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46
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Geerts H, Roberts P, Spiros A. A quantitative system pharmacology computer model for cognitive deficits in schizophrenia. CPT Pharmacometrics Syst Pharmacol 2013; 2:e36. [PMID: 23887686 PMCID: PMC3636495 DOI: 10.1038/psp.2013.12] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 02/08/2013] [Indexed: 01/29/2023] Open
Abstract
Although the positive symptoms of schizophrenia are reasonably well-controlled by current antipsychotics, cognitive impairment remains largely unaddressed. The Matrics initiative lays out a regulatory path forward and a number of targets have been tested in the clinic, so far without much success. To address this translational disconnect, we have developed a mechanism-based humanized computer model of a relevant key cortical brain network with schizophrenia pathology involved with the maintenance aspect of working memory (WM). The model is calibrated using published clinical experiments on N-back WM tests. We further simulate the opposite effect of γ-aminobutyric acid (GABA) modulators lorazepam and flumazenil and of a published augmentation trial of clozapine with risperidone, illustrating the introduction of new targets and the capacity of predicting the effects of polypharmacy. This humanized approach allows for early prospective and quantitative assessment of cognitive outcome in a central nervous system (CNS) research and development project, thereby hopefully increasing the success rate of clinical trials.CPT: Pharmacometrics & Systems Pharmacology (2013) 2, e36; doi:10.1038/psp.2013.12; advance online publication 3 April 2013.
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Affiliation(s)
- H Geerts
- In Silico Biosciences, Berwyn, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - P Roberts
- In Silico Biosciences, Berwyn, Pennsylvania, USA
- OHSUPortland, Oregon, USA
| | - A Spiros
- In Silico Biosciences, Berwyn, Pennsylvania, USA
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