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Present and future antipsychotic drugs: a systematic review of the putative mechanisms of action for efficacy and a critical appraisal under a translational perspective. Pharmacol Res 2022; 176:106078. [PMID: 35026403 DOI: 10.1016/j.phrs.2022.106078] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/23/2021] [Accepted: 01/07/2022] [Indexed: 01/10/2023]
Abstract
Antipsychotics represent the mainstay of schizophrenia pharmacological therapy, and their role has been expanded in the last years to mood disorders treatment. Although introduced in 1952, many years of research were required before an accurate picture of how antipsychotics work began to emerge. Despite the well-recognized characterization of antipsychotics in typical and atypical based on their liability to induce motor adverse events, their main action at dopamine D2R to elicit the "anti-psychotic" effect, as well as the multimodal action at other classes of receptors, their effects on intracellular mechanisms starting with receptor occupancy is still not completely understood. Significant lines of evidence converge on the impact of these compounds on multiple molecular signaling pathways implicated in the regulation of early genes and growth factors, dendritic spine shape, brain inflammation, and immune response, tuning overall the function and architecture of the synapse. Here we present, based on PRISMA approach, a comprehensive and systematic review of the above mechanisms under a translational perspective to disentangle those intracellular actions and signaling that may underline clinically relevant effects and represent potential targets for further innovative strategies in antipsychotic therapy.
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Serum kynurenine metabolites might not be associated with risk factors of treatment-resistant schizophrenia. J Psychiatr Res 2022; 145:339-346. [PMID: 34776248 DOI: 10.1016/j.jpsychires.2021.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 10/11/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND About a third of patients with schizophrenia do not respond adequately to currently available antipsychotics and thus experiences symptoms of greater severity, known as treatment-resistant schizophrenia (TRS). Some evidence suggests that the tryptophan (TRP) pathway (comprising 5-HT and kynurenine sub-pathways) has an important influence on response to antipsychotics. We therefore hypothesized that TRS is linked to metabolites of TRP pathway. METHODS We measured TRP metabolites in 54 patients with TRS and compared them to 49 age- and sex-matched patients who responded to antipsychotics (NTRS), and 62 healthy controls using liquid chromatography-tandem mass spectrometry. Psychopathology and clinical symptoms were assessed by means of schizophrenia positive and negative scales. Working memory abilities, cortical thickness and white matter diffusion tensor imaging fractional anisotropy were appraised in enrolled subjects by neurophysiological tests, as spatial span and digital sequencing tests, and 3T magnetic resonance imaging. RESULTS Patients with TRS had a significantly higher 5-HT/TRP ratio (p = 0.009) than patients with NTRS. However, the two groups did not differ in kynurenine-pathway metabolites or ratios. Additionally, 5-HT/TRP was positively correlated with disorganized symptoms in TRS (r = 0.59, p < 0.001), and negatively correlated with digit-sequencing test scores (r = -0.34, p = 0.02). These correlations were insignificant among patients with NTRS and healthy controls. In patients with TRS, 5-HT/TRP was strongly linked to the right supramarginal cortex (t = -3.2, p = 0.003), and in healthy controls, to the right transverse temporal (t = 3.40, p = 0.001), but significance disappeared after FDR correction. CONCLUSIONS Present results indicate that an upregulated 5-HT biosynthetic pathway can be associated to TRS, suggesting that targeting mechanisms of 5-HT conversion from tryptophan could shed light on the development of new pharmacological approaches of TRS.
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Baqapuri HI, Roes LD, Zvyagintsev M, Ramadan S, Keller M, Roecher E, Zweerings J, Klasen M, Gur RC, Mathiak K. A Novel Brain-Computer Interface Virtual Environment for Neurofeedback During Functional MRI. Front Neurosci 2021; 14:593854. [PMID: 33505237 PMCID: PMC7830095 DOI: 10.3389/fnins.2020.593854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022] Open
Abstract
Virtual environments (VEs), in the recent years, have become more prevalent in neuroscience. These VEs can offer great flexibility, replicability, and control over the presented stimuli in an immersive setting. With recent developments, it has become feasible to achieve higher-quality visuals and VEs at a reasonable investment. Our aim in this project was to develop and implement a novel real-time functional magnetic resonance imaging (rt-fMRI)-based neurofeedback (NF) training paradigm, taking into account new technological advances that allow us to integrate complex stimuli into a visually updated and engaging VE. We built upon and developed a first-person shooter in which the dynamic change of the VE was the feedback variable in the brain-computer interface (BCI). We designed a study to assess the feasibility of the BCI in creating an immersive VE for NF training. In a randomized single-blinded fMRI-based NF-training session, 24 participants were randomly allocated into one of two groups: active and reduced contingency NF. All participants completed three runs of the shooter-game VE lasting 10 min each. Brain activity in a supplementary motor area region of interest regulated the possible movement speed of the player's avatar and thus increased the reward probability. The gaming performance revealed that the participants were able to actively engage in game tasks and improve across sessions. All 24 participants reported being able to successfully employ NF strategies during the training while performing in-game tasks with significantly higher perceived NF control ratings in the NF group. Spectral analysis showed significant differential effects on brain activity between the groups. Connectivity analysis revealed significant differences, showing a lowered connectivity in the NF group compared to the reduced contingency-NF group. The self-assessment manikin ratings showed an increase in arousal in both groups but failed significance. Arousal has been linked to presence, or feelings of immersion, supporting the VE's objective. Long paradigms, such as NF in MRI settings, can lead to mental fatigue; therefore, VEs can help overcome such limitations. The rewarding achievements from gaming targets can lead to implicit learning of self-regulation and may broaden the scope of NF applications.
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Affiliation(s)
- Halim I. Baqapuri
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Linda D. Roes
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Souad Ramadan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Micha Keller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Erik Roecher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Martin Klasen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
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Klasen M, Mathiak KA, Zvyagintsev M, Sarkheil P, Weber R, Mathiak K. Selective reward responses to violent success events during video games. Brain Struct Funct 2020; 225:57-69. [DOI: 10.1007/s00429-019-01986-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 11/14/2019] [Indexed: 01/10/2023]
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Klasen M, Wolf D, Eisner PD, Eggermann T, Zerres K, Zepf FD, Weber R, Mathiak K. Serotonergic Contributions to Human Brain Aggression Networks. Front Neurosci 2019; 13:42. [PMID: 30853880 PMCID: PMC6395384 DOI: 10.3389/fnins.2019.00042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/16/2019] [Indexed: 12/28/2022] Open
Abstract
Aggressive behavior is associated with dysfunctional frontolimbic emotion regulation circuits. Recent findings suggest serotonin as a primary transmitter for prefrontal amygdala control. However, the association between serotonin levels, amygdala regulation, and aggression is still a matter of debate. Neurobehavioral models furthermore suggest a possible mediating influence of the monoamine oxidase A gene (MAOA) on this brain-behavior relationship, with carriers of low expressing allele varieties being a risk group for aggression. In the present study, we investigated the influence of brain serotonin modulation and MAOA genotype on functional amygdala connectivity during aggressive behavior. Modulation of serotonergic neurotransmission with acute tryptophan depletion (ATD) and placebo were administered in a double-blind, cross-over design in 38 healthy male participants. Aggressive behavior was modeled in a violent video game during simultaneous assessment of brain activation with functional magnetic resonance imaging (fMRI). Trait aggression was measured with the Buss-Perry Aggression Questionnaire (BP-AQ), and MAOA genotypes were assessed from blood samples. Voxel-wise functional connectivity with anatomically defined amygdala was calculated from the functional data. Tryptophan depletion with ATD reduced aggression-specific amygdala connectivity with bilateral supramarginal gyrus. Moreover, ATD impact was associated with trait aggression and MAOA genotype in prefrontal cortex regions. In summary, serotonergic corticolimbic projections contribute to aggressive behavior. Genotype-specific vulnerability of frontolimbic projections may underlie the elevated risk in low expressing allele carriers.
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Affiliation(s)
- Martin Klasen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
- JARA – Translational Brain Medicine, Aachen, Germany
| | - Dhana Wolf
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
- JARA – Translational Brain Medicine, Aachen, Germany
| | - Patrick D. Eisner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
- JARA – Translational Brain Medicine, Aachen, Germany
| | - Thomas Eggermann
- Institute of Human Genetics, Medical School, RWTH Aachen University, Aachen, Germany
| | - Klaus Zerres
- Institute of Human Genetics, Medical School, RWTH Aachen University, Aachen, Germany
| | - Florian D. Zepf
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Jena, Germany
- Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - René Weber
- Media Neuroscience Lab, Department of Communication, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
- JARA – Translational Brain Medicine, Aachen, Germany
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Molero-Chamizo A, Martín Riquel R, Moriana JA, Nitsche MA, Rivera-Urbina GN. Bilateral Prefrontal Cortex Anodal tDCS Effects on Self-reported Aggressiveness in Imprisoned Violent Offenders. Neuroscience 2019; 397:31-40. [DOI: 10.1016/j.neuroscience.2018.11.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 09/19/2018] [Accepted: 11/13/2018] [Indexed: 12/13/2022]
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Wolf D, Klasen M, Eisner P, Zepf FD, Zvyagintsev M, Palomero-Gallagher N, Weber R, Eisert A, Mathiak K. Central serotonin modulates neural responses to virtual violent actions in emotion regulation networks. Brain Struct Funct 2018; 223:3327-3345. [PMID: 29948188 PMCID: PMC6698268 DOI: 10.1007/s00429-018-1693-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 06/03/2018] [Indexed: 12/31/2022]
Abstract
Disruptions in the cortico-limbic emotion regulation networks have been linked to depression, anxiety, impulsivity, and aggression. Altered transmission of the central nervous serotonin (5-HT) contributes to dysfunctions in the cognitive control of emotions. To date, studies relating to pharmaco-fMRI challenging of the 5-HT system have focused on emotion processing for facial expressions. We investigated effects of a single-dose selective 5-HT reuptake inhibitor (escitalopram) on emotion regulation during virtual violence. For this purpose, 38 male participants played a violent video game during fMRI scanning. The SSRI reduced neural responses to violent actions in right-hemispheric inferior frontal gyrus and medial prefrontal cortex encompassing the anterior cingulate cortex (ACC), but not to non-violent actions. Within the ACC, the drug effect differentiated areas with high inhibitory 5-HT1A receptor density (subgenual s25) from those with a lower density (pregenual p32, p24). This finding links functional responses during virtual violent actions with 5-HT neurotransmission in emotion regulation networks, underpinning the ecological validity of the 5-HT model in aggressive behavior. Available 5-HT receptor density data suggest that this SSRI effect is only observable when inhibitory and excitatory 5-HT receptors are balanced. The observed early functional changes may impact patient groups receiving SSRI treatment.
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Affiliation(s)
- Dhana Wolf
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Martin Klasen
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Patrick Eisner
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Florian D Zepf
- Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, The University of Western Australia, Perth, Australia
- Specialised Child and Adolescent Mental Health Services, Department of Health in Western Australia, Perth, Australia
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Nicola Palomero-Gallagher
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - René Weber
- Media Neuroscience Lab, Department of Communication, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Albrecht Eisert
- Department of Pharmacy, RWTH Aachen, Aachen, Germany
- Department of Pharmacology and Toxicology, RWTH Aachen, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, Aachen, Germany
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Klasen M, Wolf D, Eisner PD, Habel U, Repple J, Vernaleken I, Schlüter T, Eggermann T, Zerres K, Zepf FD, Mathiak K. Neural networks underlying trait aggression depend on MAOA gene alleles. Brain Struct Funct 2017; 223:873-881. [PMID: 29019036 DOI: 10.1007/s00429-017-1528-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 09/20/2017] [Indexed: 12/29/2022]
Abstract
Low expressing alleles of the MAOA gene (MAOA-L) have been associated with an increased risk for developing an aggressive personality. This suggests an MAOA-L-specific neurobiological vulnerability associated with trait aggression. The neural networks underlying this vulnerability are unknown. The present study investigated genotype-specific associations between resting state brain networks and trait aggression (Buss-Perry Aggression Questionnaire) in 82 healthy Caucasian males. Genotype influences on aggression-related networks were studied for intrinsic and seed-based brain connectivity. Intrinsic connectivity was higher in the ventromedial prefrontal cortex (VMPFC) of MAOA-L compared to high expressing allele (MAOA-H) carriers. Seed-based connectivity analyses revealed genotype differences in the functional involvement of this region. MAOA genotype modulated the relationship between trait aggression and VMPFC connectivity with supramarginal gyrus (SMG) and areas of the default mode network (DMN). Separate analyses for the two groups were performed to better understand how the genotype modulated the relationship between aggression and brain networks. They revealed a positive correlation between VMPFC connectivity and aggression in right angular gyrus (AG) and a negative correlation in right SMG in the MAOA-L group. No such effect emerged in the MAOA-H carriers. The results indicate a particular relevance of VMPFC for aggression in MAOA-L carriers; in specific, a detachment from the DMN along with a strengthened coupling to the AG seems to go along with lower trait aggression. MAOA-L carriers may thus depend on a synchronization of emotion regulation systems (VMPFC) with core areas of empathy (SMG) to prevent aggression.
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Affiliation(s)
- Martin Klasen
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany.
| | - Dhana Wolf
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Patrick D Eisner
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Jonathan Repple
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
- Department of Psychiatry and Psychotherapy, University of Muenster, 48149, Münster, Germany
| | - Ingo Vernaleken
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Thorben Schlüter
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Thomas Eggermann
- Institute of Human Genetics, Medical School, RWTH Aachen University, 52074, Aachen, Germany
| | - Klaus Zerres
- Institute of Human Genetics, Medical School, RWTH Aachen University, 52074, Aachen, Germany
| | - Florian D Zepf
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; School of Medicine, Division of Paediatrics and Child Health & Division of Psychiatry and Clinical Neurosciences, The University of Western Australia, Perth, Australia
- Specialised Child and Adolescent Mental Health Services, Department of Health in Western Australia, Perth, Australia
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
- JARA-Translational Brain Medicine, RWTH Aachen University, 52074, Aachen, Germany
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Eisner P, Klasen M, Wolf D, Zerres K, Eggermann T, Eisert A, Zvyagintsev M, Sarkheil P, Mathiak KA, Zepf F, Mathiak K. Cortico-limbic connectivity in MAOA-L carriers is vulnerable to acute tryptophan depletion. Hum Brain Mapp 2016; 38:1622-1635. [PMID: 27935229 DOI: 10.1002/hbm.23475] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/09/2016] [Accepted: 11/14/2016] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION A gene-environment interaction between expression genotypes of the monoamine oxidase A (MAOA) and adverse childhood experience increases the risk of antisocial behavior. However, the neural underpinnings of this interaction remain uninvestigated. A cortico-limbic circuit involving the prefrontal cortex (PFC) and the amygdala is central to the suppression of aggressive impulses and is modulated by serotonin (5-HT). MAOA genotypes may modulate the vulnerability of this circuit and increase the risk for emotion regulation deficits after specific life events. Acute tryptophan depletion (ATD) challenges 5-HT regulation and may identify vulnerable neuronal circuits, contributing to the gene-environment interaction. METHODS Functional magnetic resonance imaging measured the resting-state state activity in 64 healthy males in a double-blind, placebo-controlled study. Cortical maps of amygdala correlation identified the impact of ATD and its interaction with low- (MAOA-L) and high-expression variants (MAOA-H) of MAOA on cortico-limbic connectivity. RESULTS Across all Regions of Interest (ROIs) exhibiting an ATD effect on cortico-limbic connectivity, MAOA-L carriers were more susceptible to ATD than MAOA-H carriers. In particular, the MAOA-L group exhibited a larger reduction of amygdala connectivity with the right prefrontal cortex and a larger increase of amygdala connectivity with the insula and dorsal PCC. CONCLUSION MAOA-L carriers were more susceptable to a central 5-HT challenge in cortico-limbic networks. Such vulnerability of the cortical serotonergic system may contribute to the emergence of antisocial behavior after systemic challenges, observed as gene-environment interaction. Hum Brain Mapp 38:1622-1635, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Patrick Eisner
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.,JARA-Translational Brain Medicine, Aachen, Germany
| | - Martin Klasen
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.,JARA-Translational Brain Medicine, Aachen, Germany
| | - Dhana Wolf
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.,JARA-Translational Brain Medicine, Aachen, Germany
| | - Klaus Zerres
- Department of Human Genetics, Medical School, RWTH Aachen University, Aachen, Germany
| | - Thomas Eggermann
- Department of Human Genetics, Medical School, RWTH Aachen University, Aachen, Germany
| | - Albrecht Eisert
- Department of Pharmacy, RWTH Aachen University, Aachen, Germany
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.,JARA-Translational Brain Medicine, Aachen, Germany
| | - Pegah Sarkheil
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.,JARA-Translational Brain Medicine, Aachen, Germany
| | - Krystyna A Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.,JARA-Translational Brain Medicine, Aachen, Germany
| | - Florian Zepf
- Department of Child and Adolescent Psychiatry, School of Psychiatry and Clinical Neurosciences and School of Pediatrics and Child Health; Faculty of Medicine, Dentistry and Health Sciences; The University of Western Australia (M561), Perth, Australia.,Department of Health in Western Australia, Specialized Child and Adolescent Mental Health Services (CAMHS), Perth, Australia
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany.,JARA-Translational Brain Medicine, Aachen, Germany
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Abstract
Violence is a serious public health issue across the world. This article assists clinicians in understanding the most up-to-date literature regarding structural and functional brain theories related to risk of violence. In this article, we review anatomic regions of the brain that have been implicated in violence and associated personality constructs associated with violence. We discuss different imaging techniques that have been used to uncover abnormal brain volume, associations, and functions throughout the brain in samples with violence history or risk. Finally, we discuss implications of these findings both for treatment considerations and future research directions.
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Affiliation(s)
- Delaney Smith
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Suite 130, Columbus, OH 43214, USA; Twin Valley Behavioral Healthcare, 2200 West Broad Street, Columbus, OH 43223, USA.
| | - Riley Smith
- Department of Physical Medicine and Rehabilitation, Wayne State University/Beaumont, 18181 Oakwood Boulevard, Suite 411, Dearborn, MI 48124, USA
| | - Douglas Misquitta
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Suite 130, Columbus, OH 43214, USA
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Michels L, Scherpiet S, Stämpfli P, Herwig U, Brühl AB. Baseline Perfusion Alterations Due to Acute Application of Quetiapine and Pramipexole in Healthy Adults. Int J Neuropsychopharmacol 2016; 19:pyw067. [PMID: 27466220 PMCID: PMC5137281 DOI: 10.1093/ijnp/pyw067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 07/01/2016] [Accepted: 07/22/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The dopaminergic system is implicated in many mental processes and neuropsychiatric disorders. Pharmacologically, drugs with dopamine receptor antagonistic and agonistic effects are used, but their effects on functional brain metabolism are not well known. METHODS In this randomized crossover, placebo-controlled, and rater-blinded study, 25 healthy adults received an acute dose placebo substance (starch), quetiapine (dopamine receptor antagonist), or pramipexole (dopamine agonist of the nonergoline class) 1 hour before the experiment. Background-suppressed 2D pseudo-continuous arterial spin labeling was used to examine whole-brain baseline cerebral blood flow differences induced by the 3 substances. RESULTS We found that quetiapine reduced perfusion in the occipital (early visual areas) and bilateral cerebellar cortex relative to placebo. In contrast, quetiapine enhanced cerebral blood flow (relative to placebo) in the striatal system (putamen and caudate nucleus) but also in the supplementary motor area, insular-, prefrontal- as well as in the pre- and postcentral cortex. Pramipexole increased cerebral blood flow compared with placebo in the caudate nucleus, putamen, middle frontal, supplementary motor area, and brainstem (substantia nigra), but reduced cerebral blood flow in the posterior thalamus, cerebellum, and visual areas. Pramipexole administration resulted in stronger cerebral blood flow relative to quetiapine in the hypothalamus, cerebellum, and substantia nigra. CONCLUSIONS Our results indicate that quetiapine and pramipexole differentially modulate regional baseline cerebral blood flow. Both substances act on the dopaminergic system, although they affect distinct regions. Quetiapine altered dopaminergic function in frontal, striatal, and motor regions. In contrast, pramipexole affected cerebral blood flow of the nigrostriatal (striatum and substantia nigra) dopaminergic, but less the fronto-insular system.
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Affiliation(s)
- Lars Michels
- Institute of Neuroradiology, University Hospital Zurich, Zurich, Switzerland (Dr Michels); MR-Center, University Children's Hospital Zurich, Zurich, Switzerland (Dr Michels); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland (Drs Scherpiet, Stämpfli, Herwig, and Brühl); Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK (Dr Brühl). .,L.M. and S.S. are shared first authors.
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Zvyagintsev M, Klasen M, Weber R, Sarkheil P, Esposito F, Mathiak KA, Schwenzer M, Mathiak K. Violence-related content in video game may lead to functional connectivity changes in brain networks as revealed by fMRI-ICA in young men. Neuroscience 2016; 320:247-58. [PMID: 26855192 DOI: 10.1016/j.neuroscience.2016.01.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
Abstract
In violent video games, players engage in virtual aggressive behaviors. Exposure to virtual aggressive behavior induces short-term changes in players' behavior. In a previous study, a violence-related version of the racing game "Carmageddon TDR2000" increased aggressive affects, cognitions, and behaviors compared to its non-violence-related version. This study investigates the differences in neural network activity during the playing of both versions of the video game. Functional magnetic resonance imaging (fMRI) recorded ongoing brain activity of 18 young men playing the violence-related and the non-violence-related version of the video game Carmageddon. Image time series were decomposed into functional connectivity (FC) patterns using independent component analysis (ICA) and template-matching yielded a mapping to established functional brain networks. The FC patterns revealed a decrease in connectivity within 6 brain networks during the violence-related compared to the non-violence-related condition: three sensory-motor networks, the reward network, the default mode network (DMN), and the right-lateralized frontoparietal network. Playing violent racing games may change functional brain connectivity, in particular and even after controlling for event frequency, in the reward network and the DMN. These changes may underlie the short-term increase of aggressive affects, cognitions, and behaviors as observed after playing violent video games.
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Affiliation(s)
- M Zvyagintsev
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Germany; JARA-Translational Brain Medicine, RWTH Aachen University, Germany; IZKF Aachen, RWTH Aachen University, Germany.
| | - M Klasen
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Germany; JARA-Translational Brain Medicine, RWTH Aachen University, Germany
| | - R Weber
- Department of Communication, Media Neuroscience Lab, University of California, Santa Barbara, CA, United States
| | - P Sarkheil
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Germany; JARA-Translational Brain Medicine, RWTH Aachen University, Germany
| | - F Esposito
- Department of Medicine and Surgery, University of Salerno, Baronissi (Salerno), Italy
| | - K A Mathiak
- JARA-Translational Brain Medicine, RWTH Aachen University, Germany; Department of Child and Adolescent Psychiatry, RWTH Aachen University, Germany
| | - M Schwenzer
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Germany; JARA-Translational Brain Medicine, RWTH Aachen University, Germany
| | - K Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Germany; JARA-Translational Brain Medicine, RWTH Aachen University, Germany
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Cordes JS, Mathiak KA, Dyck M, Alawi EM, Gaber TJ, Zepf FD, Klasen M, Zvyagintsev M, Gur RC, Mathiak K. Cognitive and neural strategies during control of the anterior cingulate cortex by fMRI neurofeedback in patients with schizophrenia. Front Behav Neurosci 2015; 9:169. [PMID: 26161073 PMCID: PMC4480149 DOI: 10.3389/fnbeh.2015.00169] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 06/15/2015] [Indexed: 11/13/2022] Open
Abstract
Cognitive functioning is impaired in patients with schizophrenia, leading to significant disabilities in everyday functioning. Its improvement is an important treatment target. Neurofeedback (NF) seems a promising method to address the neural dysfunctions underlying those cognitive impairments. The anterior cingulate cortex (ACC), a central hub for cognitive processing, is one of the brain regions known to be dysfunctional in schizophrenia. Here we conducted NF training based on real-time functional magnetic resonance imaging (fMRI) in patients with schizophrenia to enable them to control their ACC activity. Training was performed over 3 days in a group of 11 patients with schizophrenia and 11 healthy controls. Social feedback was provided in accordance with the evoked activity in the selected region of interest (ROI). Neural and cognitive strategies were examined off-line. Both groups learned to control the activity of their ACC but used different neural strategies: patients activated the dorsal and healthy controls the rostral subdivision. Patients mainly used imagination of music to elicit activity and the control group imagination of sports. In a stepwise regression analysis, the difference in neural control did not result from the differences in cognitive strategies but from diagnosis alone. Based on social reinforcers, patients with schizophrenia can learn to regulate localized brain activity. However, cognitive strategies and neural network location differ from healthy controls. These data emphasize that for therapeutic interventions in patients with schizophrenia compensatory strategies may emerge. Specific cognitive skills or specific dysfunctional networks should be addressed to train impaired skills. Social NF based on fMRI may be one method to accomplish precise learning targets.
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Affiliation(s)
- Julia S Cordes
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany
| | - Krystyna A Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany ; Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University Aachen, Germany
| | - Miriam Dyck
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany
| | - Eliza M Alawi
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany
| | - Tilman J Gaber
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University Aachen, Germany
| | - Florian D Zepf
- JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany ; Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University Aachen, Germany ; Department of Child and Adolescent Psychiatry, School of Psychiatry and Clinical Neurosciences and School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (M561) Perth, WA, Australia ; Specialised Child and Adolescent Mental Health Services (CAMHS), Department of Health in Western Australia Perth, WA, Australia
| | - Martin Klasen
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania Philadelphia, PA, USA
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; JARA-Translational Brain Medicine, RWTH Aachen University Aachen, Germany ; Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
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Anderson JS, Treiman SM, Ferguson MA, Nielsen JA, Edgin JO, Dai L, Gerig G, Korenberg JR. Violence: heightened brain attentional network response is selectively muted in Down syndrome. J Neurodev Disord 2015; 7:15. [PMID: 26131023 PMCID: PMC4486123 DOI: 10.1186/s11689-015-9112-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 05/26/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The ability to recognize and respond appropriately to threat is critical to survival, and the neural substrates subserving attention to threat may be probed using depictions of media violence. Whether neural responses to potential threat differ in Down syndrome is not known. METHODS We performed functional MRI scans of 15 adolescent and adult Down syndrome and 14 typically developing individuals, group matched by age and gender, during 50 min of passive cartoon viewing. Brain activation to auditory and visual features, violence, and presence of the protagonist and antagonist were compared across cartoon segments. fMRI signal from the brain's dorsal attention network was compared to thematic and violent events within the cartoons between Down syndrome and control samples. RESULTS We found that in typical development, the brain's dorsal attention network was most active during violent scenes in the cartoons and that this was significantly and specifically reduced in Down syndrome. When the antagonist was on screen, there was significantly less activation in the left medial temporal lobe of individuals with Down syndrome. As scenes represented greater relative threat, the disparity between attentional brain activation in Down syndrome and control individuals increased. There was a reduction in the temporal autocorrelation of the dorsal attention network, consistent with a shortened attention span in Down syndrome. Individuals with Down syndrome exhibited significantly reduced activation in primary sensory cortices, and such perceptual impairments may constrain their ability to respond to more complex social cues such as violence. CONCLUSIONS These findings may indicate a relative deficit in emotive perception of violence in Down syndrome, possibly mediated by impaired sensory perception and hypoactivation of medial temporal structures in response to threats, with relative preservation of activity in pro-social brain regions. These findings indicate that specific genetic differences associated with Down syndrome can modulate the brain's response to violence and other complex emotive ideas.
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Affiliation(s)
- Jeffrey S Anderson
- Department of Radiology, 1A71 School of Medicine, University of Utah, Salt Lake City, UT 84132 USA ; Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, USA ; The Brain Institute at the University of Utah, Salt Lake City, USA ; Department of Bioengineering, University of Utah, Salt Lake City, USA
| | - Scott M Treiman
- The Brain Institute at the University of Utah, Salt Lake City, USA
| | | | - Jared A Nielsen
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, USA
| | - Jamie O Edgin
- Department of Psychology, University of Arizona, Tucson, USA
| | - Li Dai
- Department of Pediatrics, University of Utah, Salt Lake City, USA
| | - Guido Gerig
- The Brain Institute at the University of Utah, Salt Lake City, USA ; Department of Bioengineering, University of Utah, Salt Lake City, USA ; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, USA
| | - Julie R Korenberg
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, USA ; The Brain Institute at the University of Utah, Salt Lake City, USA ; Department of Pediatrics, University of Utah, Salt Lake City, USA
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Abstract
The atypical antipsychotic quetiapine has been used in different psychotic and non-psychotic disorders in children and adolescents in randomized clinical trials, open-label studies and chart reviews. Most of these studies suggest that quetiapine may be a promising agent with a potential for use in young patients. The aim of this paper is to critically review available literature on quetiapine in the treatment of children and adolescents with a variety of psychiatric disorders, including psychotic disorders, bipolar disorders (manic and depressive episodes), conduct disorder, autism spectrum disorder, Tourette's syndrome and personality disorders. Furthermore, we report on possible neurochemical pathways involved during treatment with quetiapine, and discuss some issues that are clinically relevant in daily practice, such as titration strategies, safety and tolerability, and monitoring possible side effects. Controlled studies support the short-term efficacy for treating psychosis, mania, and aggression within certain diagnostic categories. However, although quetiapine seems well tolerated in various pediatric populations during acute and intermediate treatments, and hyper-prolactinemia and extra-pyramidal side effects are consistently low among studies, weight gain and alterations in lipid profile need to be closely monitored. Furthermore, the distal benefit/risk ratio during long-term treatment remains to be determined.
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Klasen M, Kreifelts B, Chen YH, Seubert J, Mathiak K. Neural processing of emotion in multimodal settings. Front Hum Neurosci 2014; 8:822. [PMID: 25374523 PMCID: PMC4204532 DOI: 10.3389/fnhum.2014.00822] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 09/26/2014] [Indexed: 02/04/2023] Open
Affiliation(s)
- Martin Klasen
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University Aachen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, University of Tuebingen Tuebingen, Germany
| | - Yu-Han Chen
- Department of Psychiatry, The University of New Mexico School of Medicine Albuquerque, NM, USA
| | - Janina Seubert
- Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University Aachen, Germany ; Jülich Aachen Research Alliance-Translational Brain Medicine, RWTH Aachen University Aachen, Germany
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