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Patel RR, Wolfe SA, Borgonetti V, Gandhi PJ, Rodriguez L, Snyder AE, D'Ambrosio S, Bajo M, Domissy A, Head S, Contet C, Dayne Mayfield R, Roberts AJ, Roberto M. Ethanol withdrawal-induced adaptations in prefrontal corticotropin releasing factor receptor 1-expressing neurons regulate anxiety and conditioned rewarding effects of ethanol. Mol Psychiatry 2022; 27:3441-3451. [PMID: 35668157 PMCID: PMC9708587 DOI: 10.1038/s41380-022-01642-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 04/22/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022]
Abstract
Prefrontal circuits are thought to underlie aberrant emotion contributing to relapse in abstinence; however, the discrete cell-types and mechanisms remain largely unknown. Corticotropin-releasing factor and its cognate type-1 receptor, a prominent brain stress system, is implicated in anxiety and alcohol use disorder (AUD). Here, we tested the hypothesis that medial prefrontal cortex CRF1-expressing (mPFCCRF1+) neurons comprise a distinct population that exhibits neuroadaptations following withdrawal from chronic ethanol underlying AUD-related behavior. We found that mPFCCRF1+ neurons comprise a glutamatergic population with distinct electrophysiological properties and regulate anxiety and conditioned rewarding effects of ethanol. Notably, mPFCCRF1+ neurons undergo unique neuroadaptations compared to neighboring neurons including a remarkable decrease in excitability and glutamatergic signaling selectively in withdrawal, which is driven in part by the basolateral amygdala. To gain mechanistic insight into these electrophysiological adaptations, we sequenced the transcriptome of mPFCCRF1+ neurons and found that withdrawal leads to an increase in colony-stimulating factor 1 (CSF1) in this population. We found that selective overexpression of CSF1 in mPFCCRF1+ neurons is sufficient to decrease glutamate transmission, heighten anxiety, and abolish ethanol reinforcement, providing mechanistic insight into the observed mPFCCRF1+ synaptic adaptations in withdrawal that drive these behavioral phenotypes. Together, these findings highlight mPFCCRF1+ neurons as a critical site of enduring adaptations that may contribute to the persistent vulnerability to ethanol misuse in abstinence, and CSF1 as a novel target for therapeutic intervention for withdrawal-related negative affect.
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Affiliation(s)
- Reesha R Patel
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Sarah A Wolfe
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Vittoria Borgonetti
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
- Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino, Università degli Studi di Firenze, 50139, Firenze (FI), Italy
| | - Pauravi J Gandhi
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Larry Rodriguez
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Angela E Snyder
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Shannon D'Ambrosio
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Michal Bajo
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Alain Domissy
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Steven Head
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Candice Contet
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - R Dayne Mayfield
- Department of Neuroscience, The University of Texas at Austin, Austin, TX, 78712, USA
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Amanda J Roberts
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Marisa Roberto
- The Scripps Research Institute, 10550N. Torrey Pines Rd, La Jolla, CA, 92037, USA.
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Dalmaz C, Barth B, Pokhvisneva I, Wang Z, Patel S, Quillfeldt JA, Mendonça Filho EJ, de Lima RMS, Arcego DM, Sassi RB, Hall GBC, Kobor MS, Meaney MJ, Silveira PP. Prefrontal cortex VAMP1 gene network moderates the effect of the early environment on cognitive flexibility in children. Neurobiol Learn Mem 2021; 185:107509. [PMID: 34454100 DOI: 10.1016/j.nlm.2021.107509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 08/10/2021] [Accepted: 08/20/2021] [Indexed: 01/07/2023]
Abstract
During development, genetic and environmental factors interact to modify specific phenotypes. Both in humans and in animal models, early adversities influence cognitive flexibility, an important brain function related to behavioral adaptation to variations in the environment. Abnormalities in cognitive functions are related to changes in synaptic connectivity in the prefrontal cortex (PFC), and altered levels of synaptic proteins. We investigated if individual variations in the expression of a network of genes co-expressed with the synaptic protein VAMP1 in the prefrontal cortex moderate the effect of early environmental quality on the performance of children in cognitive flexibility tasks. Genes overexpressed in early childhood and co-expressed with the VAMP1 gene in the PFC were selected for study. SNPs from these genes (post-clumping) were compiled in an expression-based polygenic score (PFC-ePRS-VAMP1). We evaluated cognitive performance of the 4 years-old children in two cohorts using similar cognitive flexibility tasks. In the first cohort (MAVAN) we utilized two CANTAB tasks: (a) the Intra-/Extra-dimensional Set Shift (IED) task, and (b) the Spatial Working Memory (SWM) task. In the second cohort, GUSTO, we used the Dimensional Change Card Sort (DCCS) task. The results show that in 4 years-old children, the PFC-ePRS-VAMP1 network moderates responsiveness to the effects of early adversities on the performance in attentional flexibility tests. The same result was observed for a spatial working memory task. Compared to attentional flexibility, reversal learning showed opposite effects of the environment, as moderated by the ePRS. A parallel ICA analysis was performed to identify relationships between whole-brain voxel based gray matter density and SNPs that comprise the PFC-ePRS-VAMP1. The early environment predicts differences in gray matter content in regions such as prefrontal and temporal cortices, significantly associated with a genetic component related to Wnt signaling pathways. Our data suggest that a network of genes co-expressed with VAMP1 in the PFC moderates the influence of early environment on cognitive function in children.
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Affiliation(s)
- Carla Dalmaz
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Depto Bioquimica e PPG CB Bioquimica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; PPG Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Barbara Barth
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Zihan Wang
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Sachin Patel
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Jorge A Quillfeldt
- PPG Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Depto Biofisica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Euclides J Mendonça Filho
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Randriely Merscher Sobreira de Lima
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; PPG Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Danusa M Arcego
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Roberto Britto Sassi
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Geoffrey B C Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Michael S Kobor
- Centre for Molecular Medicine and Therapeutics, BC Children's Hospital Research Institute, Department of Medical Genetics, The University of British Columbia, 938 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Michael J Meaney
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Patrícia P Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; PPG Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Martis LS, Højgaard K, Holmes MC, Elfving B, Wiborg O. Vortioxetine ameliorates anhedonic-like behaviour and promotes strategic cognitive performance in a rodent touchscreen task. Sci Rep 2021; 11:9113. [PMID: 33907240 PMCID: PMC8079376 DOI: 10.1038/s41598-021-88462-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/12/2021] [Indexed: 11/08/2022] Open
Abstract
Depression-associated cognitive impairments are among the most prevalent and persistent symptoms during remission from a depressive episode and a major risk factor for relapse. Consequently, development of antidepressant drugs, which also alleviate cognitive impairments, is vital. One such potential antidepressant is vortioxetine that has been postulated to exhibit both antidepressant and pro-cognitive effects. Hence, we tested vortioxetine for combined antidepressant and pro-cognitive effects in male Long-Evans rats exposed to the chronic mild stress (CMS) paradigm. This well-established CMS paradigm evokes cognitive deficits in addition to anhedonia, a core symptom of depression. Learning and memory performance was assessed in the translational touchscreen version of the paired-associates learning task. To identify the mechanistic underpinning of the neurobehavioural results, transcriptional profiling of genes involved in the stress response, neuronal plasticity and genes of broad relevance in neuropsychiatric pathologies were assessed. Vortioxetine substantially relieved the anhedonic-like state in the CMS rats and promoted acquisition of the cognitive test independent of hedonic phenotype, potentially due to an altered cognitive strategy. Minor alterations in gene expression profiling in prefrontal cortex and hippocampus were found. In summary, our findings suggest that vortioxetine exhibits an antidepressant effect as well as behavioural changes in a translational learning task.
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Affiliation(s)
- Lena-Sophie Martis
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kristoffer Højgaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Megan C Holmes
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, UK
| | - Betina Elfving
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ove Wiborg
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
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Adolescent Stress Disrupts the Maturation of Anxiety-related Behaviors and Alters the Developmental Trajectory of the Prefrontal Cortex in a Sex- and Age-specific Manner. Neuroscience 2018; 390:265-277. [PMID: 30179643 DOI: 10.1016/j.neuroscience.2018.08.030] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/20/2018] [Accepted: 08/24/2018] [Indexed: 12/11/2022]
Abstract
Adolescence is a window of vulnerability to environmental factors such as chronic stress that can disrupt brain development and cause long-lasting behavioral dysfunction, as seen in disorders like depression, anxiety, and schizophrenia. There are also sex differences in the prevalence of these disorders across the lifespan. However, the mechanisms of how adolescent stress contributes to neuropsychiatric phenotypes are not well understood, nor are the mediating effects of sex. We hypothesize that adolescent stress disrupts the γ-aminobutyric acid (GABA) system in the prefrontal cortex (PFC) in a sex-specific manner, as this system matures during adolescence and plays an important role in cognitive and emotional functioning. We exposed male and female mice to unpredictable chronic mild stress (UCMS) during adolescence (post-natal day [PND] 28-42). One cohort underwent testing for PFC-related behavioral and molecular changes 24 h following the cessation of stress (late adolescence); a separate cohort was tested approximately 2.5 weeks after the end of UCMS (adulthood). We observed an age-related decline in anxiety-like behaviors in control mice, while mice stressed in adolescence showed elevated anxiety-like behaviors in both adolescence and adulthood. PFC-dependent cognitive functioning was also impaired in adult males stressed in adolescence. Adolescent stress disrupted expression patterns of parvalbumin (PV) and perineuronal nets (PNNs) in the PFC, as well as NMDA receptor subunit composition, in a sex- and age-specific manner. The findings presented here contribute to understanding how adolescent stress may lead to neuropsychiatric disorders such as anxiety by disrupting the development of the PFC and emotional behaviors.
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Martis LS, Brision C, Holmes MC, Wiborg O. Resilient and depressive-like rats show distinct cognitive impairments in the touchscreen paired-associates learning (PAL) task. Neurobiol Learn Mem 2018; 155:287-296. [PMID: 30138691 DOI: 10.1016/j.nlm.2018.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 08/06/2018] [Accepted: 08/18/2018] [Indexed: 01/17/2023]
Abstract
Depression-associated cognitive impairments persist after remission from affective symptoms of major depressive disorder (MDD), decreasing quality of life and increasing risk of relapse in patients. Conventional antidepressants are ineffective in restoring cognitive functions. Therefore, novel antidepressants with improved efficacy for ameliorating cognitive symptoms are required. For tailoring such antidepressants, translational animal models are in demand. The chronic mild stress (CMS) model is a well-validated preclinical model of depression and known for eliciting the MDD core symptom "anhedonia" in stress-susceptible rats. Thus, cognitive performance was assessed in rats susceptible (depressive-like) or resilient to CMS and in unchallenged controls. The rodent analogue of the human touchscreen Paired-Associates Learning (PAL) task was used for cognitive assessment. Both stress groups exhibited a lack of response inhibition compared to controls while only the depressive-like group was impaired in task acquisition. The results indicate that cognitive deficits specifically associate with the anhedonic-like state rather than being a general consequence of stress exposure. Hence, we propose that the application of a translational touchscreen task on the etiologically valid CMS model, displaying depression-associated cognitive impairments, provides a novel platform for pro-cognitive and clinically pertinent antidepressant drug screening.
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Affiliation(s)
- Lena-Sophie Martis
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark; Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Scotland, United Kingdom
| | - Claudia Brision
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark
| | - Megan C Holmes
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Scotland, United Kingdom; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Scotland, United Kingdom
| | - Ove Wiborg
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark; Department of Health Science and Technology, Aalborg University, Denmark.
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6
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Corticosterone impairs flexible adjustment of spatial navigation in an associative place–reward learning task. Behav Pharmacol 2018; 29:351-364. [DOI: 10.1097/fbp.0000000000000370] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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7
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Isherwood SN, Robbins TW, Dalley JW, Pekcec A. Bidirectional variation in glutamate efflux in the medial prefrontal cortex induced by selective positive and negative allosteric mGluR5 modulators. J Neurochem 2018; 145:111-124. [PMID: 29315577 PMCID: PMC5972455 DOI: 10.1111/jnc.14290] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/18/2017] [Accepted: 12/27/2017] [Indexed: 01/30/2023]
Abstract
Dysregulation of prefrontal cortical glutamatergic signalling via NMDA receptor hypofunction has been implicated in cognitive dysfunction and impaired inhibitory control in such neuropsychiatric disorders as schizophrenia, attention‐deficit hyperactivity disorder and drug addiction. Although NMDA receptors functionally interact with metabotropic glutamate receptor 5 (mGluR5), the consequence of this interaction for glutamate release in the prefrontal cortex (PFC) remains unknown. We therefore investigated the effects of positive and negative allosteric mGluR5 modulation on changes in extracellular glutamate efflux in the medial PFC (mPFC) induced by systemic administration of the non‐competitive NMDA receptor antagonist dizocilpine (or MK801) in rats. Extracellular glutamate efflux was measured following systemic administration of the positive allosteric mGluR5 modulator [S‐(4‐Fluoro‐phenyl)‐{3‐[3‐(4‐fluoro‐phenyl)‐[1,2,4]‐oxadiazol‐5‐yl]‐piperidin‐1‐yl}‐methanone] (ADX47273; 100 mg/kg, p.o.) and negative allosteric mGluR5 modulator [2‐chloro‐4‐{[1‐(4‐fluorophenyl)‐2,5‐dimethyl‐1H‐imidazol‐4‐yl]ethynyl}pyridine] (RO4917523; 0.3 mg/kg, p.o.), using a wireless glutamate biosensor in awake, freely moving rats. The effect of MK801 (0.03–0.06 mg/kg, s.c.) on mPFC glutamate efflux was also investigated in addition to the effects of MK801 (0.03 mg/kg, s.c.) following ADX47273 (100 mg/kg, p.o.) pre‐treatment. ADX47273 produced a sustained increase in glutamate efflux and increased the effect of NMDA receptor antagonism on glutamate efflux in the mPFC. In contrast, negative allosteric mGluR5 modulation with RO4917523 decreased glutamate efflux in the mPFC. These findings indicate that positive and negative allosteric mGluR5 modulators produce long lasting and opposing actions on extracellular glutamate efflux in the mPFC. Positive and negative allosteric modulators of mGluR5 may therefore be viable therapeutic agents to correct abnormalities in glutamatergic signalling present in a range of neuropsychiatric disorders. ![]()
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Affiliation(s)
- Sarah N Isherwood
- Boehringer Ingelheim Pharma GmbH & Co. KG, Div. Research Germany, Biberach an der Riss, Germany.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
| | - Jeffrey W Dalley
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.,Department of Psychology, University of Cambridge, Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anton Pekcec
- Boehringer Ingelheim Pharma GmbH & Co. KG, Div. Research Germany, Biberach an der Riss, Germany
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Jiang C, Rau PLP. Working memory performance impaired after exposure to acute social stress: The evidence comes from ERPs. Neurosci Lett 2017; 658:137-141. [DOI: 10.1016/j.neulet.2017.08.054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 08/12/2017] [Accepted: 08/22/2017] [Indexed: 12/25/2022]
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9
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de Araújo Costa Folha OA, Bahia CP, de Aguiar GPS, Herculano AM, Coelho NLG, de Sousa MBC, Shiramizu VKM, de Menezes Galvão AC, de Carvalho WA, Pereira A. Effect of chronic stress during adolescence in prefrontal cortex structure and function. Behav Brain Res 2017; 326:44-51. [PMID: 28238824 DOI: 10.1016/j.bbr.2017.02.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/16/2017] [Accepted: 02/21/2017] [Indexed: 01/20/2023]
Abstract
Critical periods of plasticity (CPPs) are defined by developmental intervals wherein neuronal circuits are most susceptible to environmental influences. The CPP of the prefrontal cortex (PFC), which controls executive functions, extends up to early adulthood and, like other cortical areas, reflects the maturation of perineuronal nets (PNNs) surrounding the cell bodies of specialized inhibitory interneurons. The aim of the present work was to evaluate the effect of chronic stress on both structure and function of the adolescent's rat PFC. We subjected P28 rats to stressful situations for 7, 15 and 35days and evaluated the spatial distribution of histochemically-labeled PNNs in both the Medial Prefrontal Cortex (MPFC) and the Orbitofrontal Cortex (OFC) and PFC-associated behavior as well. Chronic stress affects PFC development, slowing PNN maturation in both the (MPFC) and (OFC) while negatively affecting functions associated with these areas. We speculate upon the risks of prolonged exposure to stressful environments in human adolescents and the possibility of stunted development of executive functions.
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Affiliation(s)
- Otávio Augusto de Araújo Costa Folha
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Av. Generalíssimo Deodoro, 1, 66035-160 Belém, PA, Brazil
| | - Carlomagno Pacheco Bahia
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Av. Generalíssimo Deodoro, 1, 66035-160 Belém, PA, Brazil
| | - Gisele Priscila Soares de Aguiar
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Av. Generalíssimo Deodoro, 1, 66035-160 Belém, PA, Brazil
| | - Anderson Manoel Herculano
- Laboratory of Experimental Pharmacology, Institute of Biological Sciences, Federal University of Pará, Av. Augusto Correa, 1, 66075-110 Belém, PA, Brazil
| | - Nicole Leite Galvão Coelho
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Campus Universitário Lagoa Nova, 59078-970 Natal, RN, Brazil
| | - Maria Bernardete Cordeiro de Sousa
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Campus Universitário Lagoa Nova, 59078-970 Natal, RN, Brazil
| | - Victor Kenji Medeiros Shiramizu
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Campus Universitário Lagoa Nova, 59078-970 Natal, RN, Brazil
| | - Ana Cecília de Menezes Galvão
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Campus Universitário Lagoa Nova, 59078-970 Natal, RN, Brazil
| | - Walther Augusto de Carvalho
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Av. Generalíssimo Deodoro, 1, 66035-160 Belém, PA, Brazil
| | - Antonio Pereira
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Av. Generalíssimo Deodoro, 1, 66035-160 Belém, PA, Brazil; Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Campus Universitário Lagoa Nova, 59078-970 Natal, RN, Brazil.
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Lehner M, Wisłowska-Stanek A, Gryz M, Sobolewska A, Turzyńska D, Chmielewska N, Krząścik P, Skórzewska A, Płaźnik A. The co-expression of GluN2B subunits of the NMDA receptors and glucocorticoid receptors after chronic restraint stress in low and high anxiety rats. Behav Brain Res 2016; 319:124-134. [PMID: 27865917 DOI: 10.1016/j.bbr.2016.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/27/2016] [Accepted: 11/02/2016] [Indexed: 12/11/2022]
Abstract
The aim of this study was to assess the mechanisms underlying behavioural differences between high- (HR) and low- (LR) anxiety rats, selected according to their behaviour in the contextual fear test (i.e., the duration of the freezing response was used as a discriminating variable), after a chronic restraint procedure (21days, 3h daily). We analysed the expression of the GluN2B subunits of the NMDA and glucocorticoid receptors (GRs) in selected brain structures (immunofluorescence). Following chronic restraint stress in the HR rats, we observed a decrease in the expression of the GRs and GluN2B subunits of the NMDA receptor in the prefrontal cortical areas and the hippocampus compared to the HR-control and the LR-restraint groups. These effects coincided with an increase in passive depressive-like behaviour in the Porsolt test of the HR rats. Moreover, in the hippocampus, the HR-restraint animals demonstrated decreased glutamate levels and a decreased glutamate/glutamine ratio compared to the LR-restraint rats. Furthermore, the HR-restraint group had increased GRs/GluN2B subunits colocalisation in the basolateral amygdala (BLA) compared to the HR-control and the LR-restraint rats. The present results suggest that in HR rats exposed to chronic restraint stress, the hippocampal and cortical glutamatergic system components are changed. These effects could have a negative influence on the feedback mechanisms regulating the hypothalamic-pituitary-adrenal axis as well as on the behavioural processes expressed as depressive-like symptoms.
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Affiliation(s)
- Małgorzata Lehner
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957, Warsaw, Poland.
| | - Aleksandra Wisłowska-Stanek
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CEPT, 1B Banacha Streeet, 02-097, Warsaw, Poland
| | - Marek Gryz
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957, Warsaw, Poland
| | - Alicja Sobolewska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957, Warsaw, Poland
| | - Danuta Turzyńska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957, Warsaw, Poland
| | - Natalia Chmielewska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957, Warsaw, Poland
| | - Paweł Krząścik
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CEPT, 1B Banacha Streeet, 02-097, Warsaw, Poland
| | - Anna Skórzewska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957, Warsaw, Poland
| | - Adam Płaźnik
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957, Warsaw, Poland; Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CEPT, 1B Banacha Streeet, 02-097, Warsaw, Poland
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Onaka Y, Shintani N, Nakazawa T, Kanoh T, Ago Y, Matsuda T, Hashimoto R, Ohi K, Hirai H, Nagata KY, Nakamura M, Kasai A, Hayata-Takano A, Nagayasu K, Takuma K, Ogawa A, Baba A, Hashimoto H. Prostaglandin D 2 signaling mediated by the CRTH2 receptor is involved in MK-801-induced cognitive dysfunction. Behav Brain Res 2016; 314:77-86. [DOI: 10.1016/j.bbr.2016.07.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/25/2016] [Accepted: 07/29/2016] [Indexed: 02/05/2023]
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George E, Elman I, Becerra L, Berg S, Borsook D. Pain in an era of armed conflicts: Prevention and treatment for warfighters and civilian casualties. Prog Neurobiol 2016; 141:25-44. [PMID: 27084355 DOI: 10.1016/j.pneurobio.2016.04.002] [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: 02/09/2016] [Revised: 03/23/2016] [Accepted: 04/08/2016] [Indexed: 12/13/2022]
Abstract
Chronic pain is a common squealae of military- and terror-related injuries. While its pathophysiology has not yet been fully elucidated, it may be potentially related to premorbid neuropsychobiological status, as well as to the type of injury and to the neural alterations that it may evoke. Accordingly, optimized approaches for wounded individuals should integrate primary, secondary and tertiary prevention in the form of thorough evaluation of risk factors along with specific interventions to contravene and mitigate the ensuing chronicity. Thus, Premorbid Events phase may encompass assessments of psychological and neurobiological vulnerability factors in conjunction with fostering preparedness and resilience in both military and civilian populations at risk. Injuries per se phase calls for immediate treatment of acute pain in the field by pharmacological agents that spare and even enhance coping and adaptive capabilities. The key objective of the Post Injury Events is to prevent and/or reverse maladaptive peripheral- and central neural system's processes that mediate transformation of acute to chronic pain and to incorporate timely interventions for concomitant mental health problems including post-traumatic stress disorder and addiction We suggest that the proposed continuum of care may avert more disability and suffering than the currently employed less integrated strategies. While the requirements of the armed forces present a pressing need for this integrated continuum and a framework in which it can be most readily implemented, this approach may be also instrumental for the care of civilian casualties.
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Affiliation(s)
- E George
- Center for Pain and the Brain, Harvard Medical School (HMS), United States; Department of Anesthesia, Critical Care and Pain Medicine, MGH, HMS, Boston, MA, United States; Commander, MC, USN (Ret), United States
| | - I Elman
- Center for Pain and the Brain, Harvard Medical School (HMS), United States; Department of Psychiatry, Boonshoft School of Medicine and Dayton VA Medical Center, United States; Veterans Administration Medical Center, Dayton, OH, United States
| | - L Becerra
- Center for Pain and the Brain, Harvard Medical School (HMS), United States; Department of Anesthesia, Critical Care and Pain Medicine, BCH, HMS, Boston, MA, United States; Departments of Psychiatry and Radiology, MGH, Boston, MA, United States
| | - Sheri Berg
- Center for Pain and the Brain, Harvard Medical School (HMS), United States; Department of Anesthesia, Critical Care and Pain Medicine, MGH, HMS, Boston, MA, United States
| | - D Borsook
- Center for Pain and the Brain, Harvard Medical School (HMS), United States; Department of Anesthesia, Critical Care and Pain Medicine, BCH, HMS, Boston, MA, United States; Departments of Psychiatry and Radiology, MGH, Boston, MA, United States.
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Ong Lai Teik D, Lee XS, Lim CJ, Low CM, Muslima M, Aquili L. Ginseng and Ginkgo Biloba Effects on Cognition as Modulated by Cardiovascular Reactivity: A Randomised Trial. PLoS One 2016; 11:e0150447. [PMID: 26938637 PMCID: PMC4777384 DOI: 10.1371/journal.pone.0150447] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 02/10/2016] [Indexed: 01/03/2023] Open
Abstract
Background There is some evidence to suggest that ginseng and Ginkgo biloba can improve cognitive performance, however, very little is known about the mechanisms associated with such improvement. Here, we tested whether cardiovascular reactivity to a task is associated with cognitive improvement. Methodology/Principal findings Using a double-blind, placebo controlled, crossover design, participants (N = 24) received two doses of Panax Ginseng (500, 1000 mg) or Ginkgo Biloba (120, 240 mg) (N = 24), and underwent a series of cognitive tests while systolic, diastolic, and heart rate readings were taken. Ginkgo Biloba improved aspects of executive functioning (Stroop and Berg tasks) in females but not in males. Ginseng had no effect on cognition. Ginkgo biloba in females reversed the initial (i.e. placebo) increase in cardiovascular reactivity (systolic and diastolic readings increased compared to baseline) to cognitive tasks. This effect (reversal) was most notable after those tasks (Stroop and Iowa) that elicited the greatest cardiovascular reactivity during placebo. In males, although ginkgo also decreased cardiovascular readings, it did so from an initial (placebo) blunted response (i.e. decrease or no change from baseline) to cognitive tasks. Ginseng, on the contrary, increased cardiovascular readings compared to placebo. Conclusions/Significance These results suggest that cardiovascular reactivity may be a mechanism by which ginkgo but not ginseng, in females is associated with certain forms of cognitive improvement. Trial Registration ClinicalTrials.gov NCT02386852
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Affiliation(s)
| | - Xiao Shiang Lee
- Department of Psychology, Sunway University, Bandar Sunway, Malaysia
| | - Chu Jian Lim
- Department of Psychology, Sunway University, Bandar Sunway, Malaysia
| | - Chia Mei Low
- Department of Psychology, Sunway University, Bandar Sunway, Malaysia
| | - Mariyam Muslima
- Department of Psychology, Sunway University, Bandar Sunway, Malaysia
| | - Luca Aquili
- Department of Psychology, Sunway University, Bandar Sunway, Malaysia
- * E-mail:
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McKlveen JM, Myers B, Herman JP. The medial prefrontal cortex: coordinator of autonomic, neuroendocrine and behavioural responses to stress. J Neuroendocrinol 2015; 27:446-56. [PMID: 25737097 PMCID: PMC4580281 DOI: 10.1111/jne.12272] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/10/2015] [Accepted: 02/26/2015] [Indexed: 12/13/2022]
Abstract
Responding to real or potential threats in the environment requires the coordination of autonomic, neuroendocrine and behavioural processes to promote adaptation and survival. These diverging systems necessitate input from the limbic forebrain to integrate and modulate functional output in accordance with contextual demand. In the present review, we discuss the potential role of the medial prefrontal cortex (mPFC) as a coordinator of behavioural and physiological stress responses across multiple temporal and contextual domains. Furthermore, we highlight converging evidence from rodent and human research indicating the necessity of the mPFC for modulating physiological energetic systems to mobilise or limit energetic resources as needed to ultimately promote behavioural adaptation in the face of stress. We review the literature indicating that glucocorticoids act as one of the primary messengers in the reallocation of energetic resources having profound effects locally within the mPFC, as well as shaping how the mPFC acts within a network of brain structures to modulate responses to stress. Finally, we discuss how both rodent and human studies point toward a critical role of the mPFC in the coordination of anticipatory responses to stress and why this distinction is an important one to make in stress neurobiology.
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Affiliation(s)
- Jessica M. McKlveen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, 45237, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - Brent Myers
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, 45237, USA
| | - James P. Herman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, 45237, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, OH, 45267, USA
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Snyder K, Barry M, Plona Z, Ho A, Zhang XY, Valentino RJ. The impact of social stress during adolescence or adulthood and coping strategy on cognitive function of female rats. Behav Brain Res 2015; 286:175-83. [PMID: 25746514 DOI: 10.1016/j.bbr.2015.02.047] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/18/2015] [Accepted: 02/24/2015] [Indexed: 01/03/2023]
Abstract
The age of stressor exposure can determine its neurobehavioral impact. For example, exposure of adolescent male rats to resident-intruder stress impairs cognitive flexibility in adulthood. The current study examined the impact of this stressor in female rats. Rats were exposed to resident-intruder stress during early adolescence (EA), mid-adolescence (MA) or adulthood (Adult). They were tested in an operant strategy-shifting task for side discrimination (SD), reversal learning (REV) and strategy set-shifting (SHIFT) the following week. Performance varied with age, stress and coping style. MA and EA rats performed SD and SHIFT better than other ages, respectively. Social stress impaired performance in rats depending on their coping strategy as determined by a short (SL) or long (LL) latency to become subordinate. SL rats were impaired in SD and REV, whereas EA-LL rats were impaired in SHIFT. These impairing effects of female adolescent stress did not endure into adulthood. Strategy set-shifting performance for female adolescents was positively correlated with medial prefrontal cortex (mPFC) activation as indicated by c-fos expression suggesting that this region is engaged during task performance. This contrasts with the inverse relationship between these indices reported for male adolescent rats. Together, the results demonstrate that social stress produces cognitive impairments for female rats that depend on age and coping style but unlike males, the impairing effects of female adolescent social stress are immediate and do not endure into adulthood. Sex differences in the impact of adolescent social stress on cognition may reflect differences in mPFC engagement during the task.
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Affiliation(s)
- Kevin Snyder
- The University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Mark Barry
- The University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Zachary Plona
- The University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Andrew Ho
- The University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Xiao-Yan Zhang
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
| | - Rita J Valentino
- The University of Pennsylvania, Philadelphia, PA 19104, USA; The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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Shirazi SN, Friedman AR, Kaufer D, Sakhai SA. Glucocorticoids and the Brain: Neural Mechanisms Regulating the Stress Response. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015. [DOI: 10.1007/978-1-4939-2895-8_10] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Valenchon M, Lévy F, Fortin M, Leterrier C, Lansade L. Stress and temperament affect working memory performance for disappearing food in horses, Equus caballus. Anim Behav 2013. [DOI: 10.1016/j.anbehav.2013.09.026] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Farrell MR, Sengelaub DR, Wellman CL. Sex differences and chronic stress effects on the neural circuitry underlying fear conditioning and extinction. Physiol Behav 2013; 122:208-15. [PMID: 23624153 PMCID: PMC3812406 DOI: 10.1016/j.physbeh.2013.04.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 04/11/2013] [Accepted: 04/16/2013] [Indexed: 11/20/2022]
Abstract
There are sex differences in the rates of many stress-sensitive psychological disorders such as posttraumatic stress disorder (PTSD). As medial prefrontal cortex and amygdala are implicated in many of these disorders, understanding differential stress effects in these regions may shed light on the mechanisms underlying sex-dependent expression of disorders like depression and anxiety. Prefrontal cortex and amygdala are key regions in the neural circuitry underlying fear conditioning and extinction, which thus has emerged as a useful model of stress influences on the neural circuitry underlying regulation of emotional behavior. This review outlines the current literature on sex differences and stress effects on dendritic morphology within medial prefrontal cortex and basolateral amygdala. Such structural differences and/or alterations can have important effects on fear conditioning and extinction, behaviors that are mediated by the basolateral amygdala and prefrontal cortex, respectively. Given the importance of extinction-based exposure therapy as a treatment for anxiety disorders such as PTSD, understanding the neural mechanisms by which stress differentially influences fear learning and extinction in males and females is an important goal for developing sex-appropriate interventions for stress-related disorders.
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Affiliation(s)
- Mollee R Farrell
- Department of Psychological & Brain Sciences, Program in Neuroscience, and Center for the Integrative Study of Animal Behavior, Indiana University, Bloomington, IN 47405, United States.
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Keil MF, Briassoulis G, Nesterova M, Miraftab N, Gokarn N, Wu TJ, Stratakis CA. Threat bias in mice with inactivating mutations of Prkar1a. Neuroscience 2013; 241:206-14. [PMID: 23531435 PMCID: PMC3646976 DOI: 10.1016/j.neuroscience.2013.03.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/13/2013] [Accepted: 03/14/2013] [Indexed: 01/18/2023]
Abstract
Anxiety disorders are associated with abnormalities in the neural processing of threat-related stimuli. However, the neurobiological mechanisms underlying threat bias in anxiety are not well understood. We recently reported that a Prkar1a heterozygote (Prkar1a(+/-)) mouse with haploinsufficiency for the main regulatory subunit (R1α) of protein kinase A (PKA) exhibits an anxiety-like phenotype associated with increased cAMP signaling in the amygdala. Prkar1a(+/-) mice provide a novel model to test the direct effect of altered PKA expression and subsequent anxiety-like behavioral phenotype on the response to threat. We hypothesized that Prkar1a(+/-)mice would exhibit a bias in threat detection since increased amygdala activity during emotional stimuli is associated with a maladaptive response. We measured behavior and PKA activity in brain areas after exposure to predator or control odor exposure in male Prkar1a(+/-) and wild-type (WT) littermates. Indeed, there were significant differences in the behavioral response to threat detection; WT mice showed the expected response of decrease in exploratory behavior during predator vs. control odor exposure, while Prkar1a(+/-) mice did not alter their behavior between conditions. Basal and total PKA activity was independently associated with genotype, with an interaction between genotype and threat condition. Prkar1a(+/-) mice had higher PKA activity in amygdala and ventromedial hypothalamus in response to predator odor. In contrast, WT mice had higher PKA activity in amygdala and orbitofrontal cortex after exposure to control odor. Dysregulated PKA activity in the amygdala-prefrontal cortex circuitry in Prkar1a(+/-) mice is associated with behavioral phenotype of anxiety and a bias for threat. This is likely related to a failure to inhibit the amydgala response, which is an effect of the genotype. These results suggest that the alteration in PKA signaling in Prkar1a(+/-) mice is not ubiquitous in the brain; tissue-specific effects of the cAMP/PKA pathway are related to threat detection and fear sensitization.
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Affiliation(s)
- M F Keil
- Section on Endocrinology and Genetics, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, MD 20892, USA.
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Sandi C. Stress and cognition. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2013; 4:245-261. [DOI: 10.1002/wcs.1222] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Carmen Sandi
- Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
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Shanmugan S, Epperson CN. Estrogen and the prefrontal cortex: towards a new understanding of estrogen's effects on executive functions in the menopause transition. Hum Brain Mapp 2012; 35:847-65. [PMID: 23238908 DOI: 10.1002/hbm.22218] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 09/25/2012] [Accepted: 10/03/2012] [Indexed: 01/03/2023] Open
Abstract
Midlife decline in cognition, specifically in areas of executive functioning, is a frequent concern for which menopausal women seek clinical intervention. The dependence of executive processes on prefrontal cortex function suggests estrogen effects on this brain region may be key in identifying the sources of this decline. Recent evidence from rodent, nonhuman primate, and human subject studies indicates the importance of considering interactions of estrogen with neurotransmitter systems, stress, genotype, and individual life events when determining the cognitive effects of menopause and estrogen therapy.
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Affiliation(s)
- Sheila Shanmugan
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Penn Center for Women's Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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