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Parise LF, Joseph Burnett C, Russo SJ. Early life stress and altered social behaviors: A perspective across species. Neurosci Res 2023:S0168-0102(23)00200-6. [PMID: 37992997 PMCID: PMC11102940 DOI: 10.1016/j.neures.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 07/21/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
Childhood and adolescent affiliations guide how individuals engage in social relationships throughout their lifetime and adverse experiences can promote biological alterations that facilitate behavioral maladaptation. Indeed, childhood victims of abuse are more likely to be diagnosed with conduct or mood disorders which are both characterized by altered social engagement. A key domain particularly deserving of attention is aggressive behavior, a hallmark of many disorders characterized by deficits in reward processing. Animal models have been integral in identifying both the short- and long-term consequences of stress exposure and suggest that whether it is disruption to parental care or social isolation, chronic exposure to early life stress increases corticosterone, changes the expression of neurotransmitters and neuromodulators, and facilitates structural alterations to the hypothalamus, hippocampus, and amygdala, influencing how these brain regions communicate with other reward-related substrates. Herein, we describe how adverse early life experiences influence social behavioral outcomes across a wide range of species and highlight the long-term biological mechanisms that are most relevant to maladaptive aggressive behavior.
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Affiliation(s)
- Lyonna F Parise
- Icahn School of Medicine, Nash Family Department of Neuroscience and Friedman Brain Institute, New York, NY, USA.
| | - C Joseph Burnett
- Icahn School of Medicine, Nash Family Department of Neuroscience and Friedman Brain Institute, New York, NY, USA
| | - Scott J Russo
- Icahn School of Medicine, Nash Family Department of Neuroscience and Friedman Brain Institute, New York, NY, USA.
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2
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Chowdhury A, Rao BSS, Laxmi TR. Risky Decision-taking Task: a novel paradigm to assess the risk-taking behaviour in rats predisposed to early-life stress. J Neurosci Methods 2023; 392:109864. [PMID: 37080434 DOI: 10.1016/j.jneumeth.2023.109864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/31/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023]
Abstract
One of the characteristic features of adolescence is risk-taking behavioural traits. Uncontrolled risk-taking without proper assessment may have harmful impact on mental health later in life. Therefore, it is essential to identify it early for the preventable health problems. In the present study, we have designed a novel paradigm, viz. Risky Decision-taking Task (RDTT), to evaluate the spontaneous risk-taking behavioural repertoire in adolescent rodents. The task was designed based on both risk and cognitive factors. To validate and compare the risk-taking tendency, we have used early maternal separation and isolation (MS) stress model, as it is known to increase anxiety and curiosity-like behaviour at adolescence. We have used Sprague-Dawley rats of both sexes. Rats were exposed to MS stress for 10 days daily for six hours during stress hyporesponsive period (SHRP) from postnatal day 4 to 13. These rats were subjected to RDTT during adolescence. This task is a reward-based task where the latency to collect reward in the presence or absence of a risk factor is assessed. It consists of habituation, training to find the location of small and large rewards, reward preference for small and large reward and testing period under risky situation. Rats were trained individually to retrieve the valuation-based rewards under the risky, but innate aversive environments. The results from RDTT showed that as compared to controls, MS rats from both sexes showed reduced latency to collect large reward in the presence of a risk element and a reduced risk-index which is indicative of a higher risk-taking tendency in these rats. In addition, MS rats showed a trend towards anxiety-like behaviour as compared to controls in the Light-Dark Test. These results together show decreased risk latency for the large reward and reduced risk assessment in MS rats which is suggestive of more risk-taking tendency in these rats. Thus, we propose that RDTT paradigm can be used to evaluate the spontaneous risk-taking behavioural repertoire based on innate, spontaneous aversion and cognitive factors in rats.
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Affiliation(s)
- Abanti Chowdhury
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru - 560 029
| | - B S Shankaranarayana Rao
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru - 560 029
| | - T R Laxmi
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru - 560 029.
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3
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Liu Y, Li S, Zhang X, Wang L, Li Z, Wu W, Qin X, Zhou J, Ma C, Meng W, Kuang X, Yin F, Xia Q, Jiang B, Yang Y. Corticotropin releasing factor neurons in the visual cortex mediate long-term changes in visual function induced by early adversity. Neurobiol Stress 2022; 21:100504. [DOI: 10.1016/j.ynstr.2022.100504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
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Garvin MM, Bolton JL. Sex-specific behavioral outcomes of early-life adversity and emerging microglia-dependent mechanisms. Front Behav Neurosci 2022; 16:1013865. [PMID: 36268470 PMCID: PMC9577368 DOI: 10.3389/fnbeh.2022.1013865] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Early-life adversity (ELA) is known to alter brain circuit maturation as well as increase vulnerability to cognitive and emotional disorders. However, the importance of examining sex as a biological variable when researching the effects of ELA has not been considered until recently. This perspective discusses the sex-specific behavioral outcomes of ELA in both humans and animal models, then proposes microglia-mediated mechanisms as a potential underlying cause. Recent work in rodent models suggests that ELA provokes cognitive deficits, anhedonia, and alcohol abuse primarily in males, whereas females exhibit greater risk-taking and opioid addiction-related behaviors. In addition, emerging evidence identifies microglia as a key target of ELA. For example, we have recently shown that ELA inhibits microglial synapse engulfment and process dynamics in male mice, leading to an increase in excitatory synapse number onto corticotrophin-releasing hormone (CRH)-expressing neurons in the paraventricular nucleus of the hypothalamus (PVN) and aberrant stress responses later in life. However, ELA-induced synaptic rewiring of neural circuits differs in females during development, resulting in divergent behavioral outcomes. Thus, examining the role of microglia in the sex-specific mechanisms underlying ELA-induced neuropsychiatric disorders is an important topic for future research.
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Cheng Z, Su J, Zhang K, Jiang H, Li B. Epigenetic Mechanism of Early Life Stress-Induced Depression: Focus on the Neurotransmitter Systems. Front Cell Dev Biol 2022; 10:929732. [PMID: 35865627 PMCID: PMC9294154 DOI: 10.3389/fcell.2022.929732] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Depression has an alarmingly high prevalence worldwide. A growing body of evidence indicates that environmental factors significantly affect the neural development and function of the central nervous system and then induce psychiatric disorders. Early life stress (ELS) affects brain development and has been identified as a major cause of depression. It could promote susceptibility to stress in adulthood. Recent studies have found that ELS induces epigenetic changes that subsequently affect transcriptional rates of differentially expressed genes. The epigenetic modifications involved in ELS include histone modifications, DNA methylation, and non-coding RNA. Understanding of these genetic modifications may identify mechanisms that may lead to new interventions for the treatment of depression. Many reports indicate that different types of ELS induce epigenetic modifications of genes involved in the neurotransmitter systems, such as the dopaminergic system, the serotonergic system, the gamma-aminobutyric acid (GABA)-ergic system, and the glutamatergic system, which further regulate gene expression and ultimately induce depression-like behaviors. In this article, we review the effects of epigenetic modifications on the neurotransmitter systems in depression-like outcomes produced by different types of ELS in recent years, aiming to provide new therapeutic targets for patients who suffer from depression.
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Affiliation(s)
- Ziqian Cheng
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, Second Hospital of Jilin University, Changchun, China
- Engineering Lab on Screening of Antidepressant Drugs, Jilin Province Development and Reform Commission, Changchun, China
| | - Jingyun Su
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, Second Hospital of Jilin University, Changchun, China
- Engineering Lab on Screening of Antidepressant Drugs, Jilin Province Development and Reform Commission, Changchun, China
| | - Kai Zhang
- Central Laboratory, The Second Hospital of Jilin University, Jilin University, Changchun, China
| | - Huiyi Jiang
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Huiyi Jiang, ; Bingjin Li,
| | - Bingjin Li
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, Second Hospital of Jilin University, Changchun, China
- Engineering Lab on Screening of Antidepressant Drugs, Jilin Province Development and Reform Commission, Changchun, China
- *Correspondence: Huiyi Jiang, ; Bingjin Li,
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David M, Serena B, Jeremy B, Madeline T, Bernard BW. CRF-receptor1 modulation of the dopamine projection to prelimbic cortex facilitates cognitive flexibility after acute and chronic stress. Neurobiol Stress 2022; 16:100424. [PMID: 35005102 PMCID: PMC8718497 DOI: 10.1016/j.ynstr.2021.100424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/07/2021] [Accepted: 12/21/2021] [Indexed: 11/29/2022] Open
Abstract
Stress reduces cognitive flexibility and dopamine D1 receptor-related activity in the prelimbic cortex (PL), effects hypothesized to depend on reduced corticotropic releasing factor receptor type 1 (CRFr1) regulation of dopamine neurons in the ventral tegmental area (VTA). We assessed this hypothesis in rats by examining the effect of chronic unpredictable restraint stress (CUS), mild acute stress, or their combination on cognitive flexibility, CRFr1 expression in the VTA and D1-related activity in PL. In Experiment 1, rats received either CUS or equivalent handling for 14 days before being trained to press two levers to earn distinct food outcomes. Initial learning was assessed using an outcome devaluation test after which cognitive flexibility was assessed by reversing the outcomes earned by the actions. Prior to each reversal training session, half the CUS and controls receiving acute stress with action-outcome updating assessed using a second devaluation test and CRFr1 expression in the VTA assessed using in-situ hybridisation. Although CUS did not itself affect action-outcome learning, its combination with acute stress blocked reversal learning and decreased VTA CRFr1 expression after acute shock. The relationship between these latter two effects was assessed in Experiment 2 by pharmacologically disconnecting the VTA and PL, unilaterally blocking neurons expressing CRFr1 in the VTA and D1 receptors in the contralateral PL during reversal learning after acute stress. Acute stress again blocked reversal learning but only in the group with VTA-PL disconnection, demonstrating that VTA CRFr1-induced facilitation of dopaminergic activity in the PL is necessary for maintaining cognitive flexibility after acute stress. [250]. Acute stress increased CRF receptor1 expression in the VTA. Chronic stress attenuated the effect of acute stress on CRFr1 expression. Chronic stress plus acute stress produced a loss of cognitive flexibility. Blocking VTA CFRr1 and dopamine D1r in PL reduced cognitive flexibility following stress.
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Affiliation(s)
- Mor David
- School of Medical Sciences, University of Sydney, Australia
| | - Becchi Serena
- Decision Neuroscience Lab, University of New South Wales, Australia
| | - Bowring Jeremy
- School of Medical Sciences, University of Sydney, Australia
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Gomes MGS, Tractenberg SG, Orso R, Viola TW, Grassi-Oliveira R. Sex differences in risk behavior parameters in adolescent mice: Relationship with brain-derived neurotrophic factor in the medial prefrontal cortex. Neurosci Lett 2022; 766:136339. [PMID: 34762979 DOI: 10.1016/j.neulet.2021.136339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 02/08/2023]
Abstract
Adolescence is as a period of development characterized by impulsive and risk-seeking behaviors. Risk behaviors (RB) involves exposure to dangerous or negative consequences to achieve goal-directed behaviors, such as reward-seeking. On the other hand, risk aversion/assessment behaviors allow the individual to gather information or avoid potentially threatening situations. Evidence has suggested that both behavioral processes, RB and risk assessment (RA), may have sex-differences. However, sex-specific behavioral patterns implicated in RB and RA are not fully understood. To address that, we investigated sex differences in risk-behavioral parameters in a decision-making task developed for rodents. In addition, we investigated the potential role of sex-dependent differences in gene expression of brain-derived neurotrophic factor (BDNF) exon IV in the medial prefrontal cortex (mPFC), which has been implicated to mediate PFC-related behavioral dysfunctions. Male and female C57BL/6J adolescent mice were evaluated in the elevated plus-maze (EPM) to assess anxiety-like behaviors and in the predator-odor risk taking (PORT) task. The PORT task is a decision-making paradigm in which a conflict between the motivation towards reward pursuit and the threat elicited by predatory olfactory cues (coyote urine) is explored. After behavioral testing, animals were euthanized and BDNF exon IV gene expression was measured by RT-qPCR. Comparative and correlational analyses for behavioral and molecular parameters were performed for both sexes. We observed that female mice spent more time exploring the middle chamber of the PORT apparatus in the aversive condition, which is an indicative of avoidance behavior. Female mice also had a higher latency to collect the reward than male mice and presented less time exploring the open arms of the EPM. BDNF exon IV gene expression was higher among females, and there was a positive correlation between the BDNF and PORT behavioral parameters. Our findings suggest sex-dependent effects in the PORT task. Females presented higher RA and avoidance behavior profile and expressed higher levels of BDNF exon IV in the mPFC. Moreover, higher BDNF expression was correlated with RA behaviors, which suggests that adolescent females tend to evaluate the risks more than adolescent males and that BDNF gene expression may be mediating decision-making processes.
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Affiliation(s)
- Marco G S Gomes
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute of Rio Grande do Sul (BraIns), Pontifical University Catholic of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | - Saulo G Tractenberg
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute of Rio Grande do Sul (BraIns), Pontifical University Catholic of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | - Rodrigo Orso
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute of Rio Grande do Sul (BraIns), Pontifical University Catholic of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil; Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark
| | - Thiago W Viola
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute of Rio Grande do Sul (BraIns), Pontifical University Catholic of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute of Rio Grande do Sul (BraIns), Pontifical University Catholic of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil; Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark.
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Dion A, Muñoz PT, Franklin TB. Epigenetic mechanisms impacted by chronic stress across the rodent lifespan. Neurobiol Stress 2022; 17:100434. [PMID: 35198660 PMCID: PMC8841894 DOI: 10.1016/j.ynstr.2022.100434] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/20/2022] [Accepted: 01/22/2022] [Indexed: 01/27/2023] Open
Abstract
Exposures to stress at all stages of development can lead to long-term behavioural effects, in part through changes in the epigenome. This review describes rodent research suggesting that stress in prenatal, postnatal, adolescent and adult stages leads to long-term changes in epigenetic regulation in the brain which have causal impacts on rodent behaviour. We focus on stress-induced epigenetic changes that have been linked to behavioural deficits including poor learning and memory, and increased anxiety-like and depressive-like behaviours. Interestingly, aspects of these stress-induced behavioural changes can be transmitted to offspring across several generations, a phenomenon that has been proposed to result via epigenetic mechanisms in the germline. Here, we also discuss evidence for the differential impact of stress on the epigenome in males and females, conscious of the fact that the majority of published studies have only investigated males. This has led to a limited picture of the epigenetic impact of stress, highlighting the need for future studies to investigate females as well as males.
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Pallarés ME, Monteleone MC, Pastor V, Grillo Balboa J, Alzamendi A, Brocco MA, Antonelli MC. Early-Life Stress Reprograms Stress-Coping Abilities in Male and Female Juvenile Rats. Mol Neurobiol 2021; 58:5837-5856. [PMID: 34409559 DOI: 10.1007/s12035-021-02527-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/06/2021] [Indexed: 01/06/2023]
Abstract
Prenatal stress (PS) is a major risk factor for the development of emotional disorders in adulthood that may be mediated by an altered hypothalamic-pituitary-adrenal axis response to stress. Although the early onset of stress-related disorders is recognized as a major public health problem, to date, there are relatively few studies that have examined the incidence of early-life stressors in younger individuals. In this study, we assessed PS impact on the stress-coping response of juvenile offspring in behavioral tests and in the induced molecular changes in the hippocampus. Furthermore, we assessed if pregnancy stress could be driving changes in patterns of maternal behavior during early lactation. We found that PS modified stress-coping abilities of both sex offspring. In the hippocampus, PS increased the expression of bdnf-IV and crfr1 and induced sex difference changes on glucocorticoids and BDNF mRNA receptor levels. PS changed the hippocampal epigenetic landscape mainly in male offspring. Stress during pregnancy enhanced pup-directed behavior of stressed dams. Our study indicates that exposure to PS, in addition to enhanced maternal behavior, induces dynamic neurobehavioral variations at juvenile ages of the offspring that should be considered adaptive or maladaptive, depending on the characteristics of the confronting environment. Our present results highlight the importance to further explore risk factors that appear early in life that will be important to allow timely prevention strategies to later vulnerability to stress-related disorders.
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MESH Headings
- Animals
- Female
- Male
- Pregnancy
- Rats
- Adaptation, Psychological
- Anxiety/etiology
- Anxiety/genetics
- Anxiety/physiopathology
- Brain-Derived Neurotrophic Factor/biosynthesis
- Brain-Derived Neurotrophic Factor/genetics
- Corticosterone/blood
- Corticotropin-Releasing Hormone/biosynthesis
- Corticotropin-Releasing Hormone/genetics
- Elevated Plus Maze Test
- Gene Expression Regulation
- Glucocorticoids/biosynthesis
- Glucocorticoids/genetics
- Hippocampus/embryology
- Hippocampus/physiology
- Hypothalamo-Hypophyseal System/embryology
- Hypothalamo-Hypophyseal System/physiopathology
- Lactation/physiology
- Lactation/psychology
- Maternal Behavior
- Pituitary-Adrenal System/embryology
- Pituitary-Adrenal System/physiopathology
- Pregnancy Complications/physiopathology
- Pregnancy Complications/psychology
- Prenatal Exposure Delayed Effects
- Rats, Wistar
- Receptor, trkB/biosynthesis
- Receptor, trkB/genetics
- Receptors, Corticotropin-Releasing Hormone/biosynthesis
- Receptors, Corticotropin-Releasing Hormone/genetics
- Receptors, Glucocorticoid/biosynthesis
- Receptors, Glucocorticoid/genetics
- Restraint, Physical/adverse effects
- Sex Characteristics
- Stress, Physiological/physiology
- Stress, Psychological/physiopathology
- Swimming
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Affiliation(s)
- María Eugenia Pallarés
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina.
| | - Melisa Carolina Monteleone
- Instituto de Investigaciones Biotecnológicas (IIB), Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - Verónica Pastor
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina
| | - Jazmín Grillo Balboa
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina
| | - Ana Alzamendi
- Instituto Multidisciplinario de Biología Celular, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Marcela Adriana Brocco
- Instituto de Investigaciones Biotecnológicas (IIB), Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - Marta Cristina Antonelli
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina
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Kestering-Ferreira E, Tractenberg SG, Lumertz FS, Orso R, Creutzberg KC, Wearick-Silva LE, Viola TW, Grassi-Oliveira R. Long-term Effects of Maternal Separation on Anxiety-Like Behavior and Neuroendocrine Parameters in Adult Balb/c Mice. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2021; 5:24705470211067181. [PMID: 34993376 PMCID: PMC8725222 DOI: 10.1177/24705470211067181] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022]
Abstract
Introduction: Disruption of maternal care using maternal separation (MS) models has provided significant evidence of the deleterious long-term effects of early life stress. Several preclinical studies investigating MS showed multiple behavioral and biomolecular alterations. However, there is still conflicting results from MS studies, which represents a challenge for reliability and replicability of those findings. Objective: To address that, this study was conducted to investigate whether MS would affect anxiety-like behaviors using a battery of classical tasks, as well as central and peripheral stress-related biomarkers. Methods: Male Balb/c mice were exposed to MS from postnatal day (PND) 2 to 14 for 180-min per day. Two independent cohorts were performed to evaluate both baseline and anxiety-like behavior responses to MS at PND60. We performed composite scores to evaluate MS effects on anxiety and risk assessment phenotypes. Also, we assessed mRNA gene expression in the medial pre-frontal cortex (mPFC) of glucocorticoid and mineralocorticoid receptors (GR and MR) using real-time PCR and peripheral corticosterone levels (CORT) to investigate possible neurobiological correlates to anxiety behaviors. Results: We found increased anxiety-like behavior and decreased risk assessment and exploratory behaviors in MS mice. The animals exposed to MS also presented a decrease in MR mRNA expression and higher levels of CORT compared to controls. Conclusions: Our findings reinforce the body of evidence suggesting that long-term MS induces effects on anxiety and risk assessment phenotypes following the exposure to a standardized MS protocol. Moreover, MS affected the expression of MR mRNA and induced significant changes on CORT response. This data highlights that the reprograming MS effects on HPA axis could be mediate by MR gene expression in mPFC and chronic overactivity of peripheral CORT levels.
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Affiliation(s)
- Erika Kestering-Ferreira
- Developmental Cognitive Neuroscience Lab
(DCNL), Pontifical University Catholic of Rio Grande do Sul
| | - Saulo Gantes Tractenberg
- Developmental Cognitive Neuroscience Lab
(DCNL), Pontifical University Catholic of Rio Grande do Sul
| | | | - Rodrigo Orso
- Developmental Cognitive Neuroscience Lab
(DCNL), Pontifical University Catholic of Rio Grande do Sul
| | | | | | - Thiago Wendt Viola
- Developmental Cognitive Neuroscience Lab
(DCNL), Pontifical University Catholic of Rio Grande do Sul
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab
(DCNL), Pontifical University Catholic of Rio Grande do Sul
- Aarhus University, Denmark
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Orso R, Creutzberg KC, Kestering-Ferreira E, Wearick-Silva LE, Tractenberg SG, Grassi-Oliveira R. Maternal Separation Combined With Limited Bedding Increases Anxiety-Like Behavior and Alters Hypothalamic-Pituitary-Adrenal Axis Function of Male BALB/cJ Mice. Front Behav Neurosci 2020; 14:600766. [PMID: 33304248 PMCID: PMC7693708 DOI: 10.3389/fnbeh.2020.600766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/15/2020] [Indexed: 11/13/2022] Open
Abstract
Early life stress (ELS) is considered a risk factor for the development of psychiatric conditions, including depression and anxiety disorder. Individuals that live in adverse environments are usually exposed to multiple stressors simultaneously, such as maternal neglect, maltreatment, and limited resources. Nevertheless, most pre-clinical ELS models are designed to explore the impact of these events separately. For this reason, this study aims to investigate the effects of a combined model of ELS on anxiety-like behavior and hypothalamic-pituitary-adrenal (HPA) axis related targets. From PND 2 to PND 15 BALB/cJ mice were exposed simultaneously to maternal separation (MS; 3 h per day) and limited bedding (LB; ELS group) or left undisturbed (CT group). Maternal behavior was recorded in intercalated days, from PND 1 to PND 9. Male offspring were tested for anxiety-like behavior from PND 53 to PND 55 in the open field test (OF), elevated plus-maze (EPM), and light/dark test (LD). After behavioral testing, animals were euthanized, and glucocorticoid receptor (Nr3c1), corticotrophin-releasing hormone (Crh), and its receptor type 1 (Crhr1) gene expression in the hypothalamus were measured. Moreover, plasma corticosterone levels were analyzed. We observed that ELS dams presented altered quality of maternal care, characterized by a decrease in arched-back nursing, and an increase in passive nursing. Stressed dams also showed an increase in the number of exits from the nest when compared to CT dams. Furthermore, ELS animals showed increased anxiety-like behavior in the OF, EPM, and LD. Regarding gene expression, we identified an increase in hypothalamus Crh levels of ELS group when compared to CT animals, while no differences in Nr3c1 and Crhr1 expression were observed. Finally, stressed animals showed decreased levels of plasma corticosterone when compared to the CT group. In conclusion, we observed an alteration in maternal behavior in ELS dams. Later in life, animals exposed to the combined model of ELS showed increased levels of anxiety-like behavior. Moreover, the central and peripheral HPA measures observed could indicate a dysregulation in HPA function provoked by ELS exposure.
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Affiliation(s)
- Rodrigo Orso
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Erika Kestering-Ferreira
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Luis Eduardo Wearick-Silva
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Saulo Gantes Tractenberg
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Corticotropin-releasing factor infusion in the bed nucleus of the stria terminalis of lactating mice alters maternal care and induces behavioural phenotypes in offspring. Sci Rep 2020; 10:19985. [PMID: 33204022 PMCID: PMC7672063 DOI: 10.1038/s41598-020-77118-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/06/2020] [Indexed: 12/25/2022] Open
Abstract
The peripartum period is accompanied by numerous physiological and behavioural adaptations organised by the maternal brain. These changes are essential for adequate expression of maternal behaviour, thereby ensuring proper development of the offspring. The corticotropin-releasing factor (CRF) plays a key role in a variety of behaviours accompanying stress, anxiety, and depression. There is also evidence that CRF contributes to maladaptations during the peripartum period. We investigated the effects of CRF in the bed nucleus of the stria terminalis (BNST) of lactating mice during maternal care and analysed locomotor activity and anxiety-like behaviour in the offspring. The BNST has been implicated in anxiety behaviour and regulation of the stress response. The effects of intra-BNST CRF administration were compared with those induced by the limited bedding (LB) procedure, a model that produces altered maternal behaviour. BALB/cJ dams were exposed to five infusions of CRF or saline into the BNST in the first weeks after birth while the LB dams were exposed to limited nesting material from postnatal days (P) 2–9. Maternal behaviour was recorded in intercalated days, from P1-9. Offspring anxiety-like behaviour was assessed during adulthood using the open-field, elevated plus-maze, and light/dark tests. Both intra-BNST CRF and LB exposure produced altered maternal care, represented by decreased arched-back nursing and increased frequency of exits from the nest. These changes in maternal care resulted in robust sex-based differences in the offspring’s behavioural responses during adulthood. Females raised by CRF-infused dams exhibited increased anxiety-like behaviour, whereas males presented a significant decrease in anxiety. On the other hand, both males and females raised by dams exposed to LB showed higher locomotor activity. Our study demonstrates that maternal care is impaired by intra-BNST CRF administrations, and these maladaptations are similar to exposure to adverse early environments. These procedures, however, produce distinct phenotypes in mice during young adulthood and suggest sex-based differences in the susceptibility to poor maternal care.
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Dent CL, Rienecker KDA, Ward A, Wilkins JF, Humby T, Isles AR. Mice lacking paternal expression of imprinted Grb10 are risk-takers. GENES BRAIN AND BEHAVIOR 2020; 19:e12679. [PMID: 32488937 PMCID: PMC9393934 DOI: 10.1111/gbb.12679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/14/2020] [Accepted: 05/28/2020] [Indexed: 12/15/2022]
Abstract
The imprinted genes Grb10 and Nesp influence impulsive behavior on a delay discounting task in an opposite manner. A recently developed theory suggests that this pattern of behavior may be representative of predicted effects of imprinted genes on tolerance to risk. Here we examine whether mice lacking paternal expression of Grb10 show abnormal behavior across a number of measures indicative of risk‐taking. Although Grb10+/p mice show no difference from wild type (WT) littermates in their willingness to explore a novel environment, their behavior on an explicit test of risk‐taking, namely the Predator Odor Risk‐Taking task, is indicative of an increased willingness to take risks. Follow‐up tests suggest that this risk‐taking is not simply because of a general decrease in fear, or a general increase in motivation for a food reward, but reflects a change in the trade‐off between cost and reward. These data, coupled with previous work on the impulsive behavior of Grb10+/p mice in the delayed reinforcement task, and taken together with our work on mice lacking maternal Nesp, suggest that maternally and paternally expressed imprinted genes oppositely influence risk‐taking behavior as predicted.
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Affiliation(s)
- Claire L Dent
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Kira D A Rienecker
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Andrew Ward
- Department of Biology and Biochemistry, University of Bath, Bath, UK
| | | | - Trevor Humby
- Behavioural Genetics Group, School of Psychology, Cardiff University, Cardiff, UK
| | - Anthony R Isles
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
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14
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Honeycutt JA, Demaestri C, Peterzell S, Silveri MM, Cai X, Kulkarni P, Cunningham MG, Ferris CF, Brenhouse HC. Altered corticolimbic connectivity reveals sex-specific adolescent outcomes in a rat model of early life adversity. eLife 2020; 9:52651. [PMID: 31958061 PMCID: PMC7010412 DOI: 10.7554/elife.52651] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/17/2020] [Indexed: 12/11/2022] Open
Abstract
Exposure to early-life adversity (ELA) increases the risk for psychopathologies associated with amygdala-prefrontal cortex (PFC) circuits. While sex differences in vulnerability have been identified with a clear need for individualized intervention strategies, the neurobiological substrates of ELA-attributable differences remain unknown due to a paucity of translational investigations taking both development and sex into account. Male and female rats exposed to maternal separation ELA were analyzed with anterograde tracing from basolateral amygdala (BLA) to PFC to identify sex-specific innervation trajectories through juvenility (PD28) and adolescence (PD38;PD48). Resting-state functional connectivity (rsFC) was assessed longitudinally (PD28;PD48) in a separate cohort. All measures were related to anxiety-like behavior. ELA-exposed rats showed precocial maturation of BLA-PFC innervation, with females affected earlier than males. ELA also disrupted maturation of female rsFC, with enduring relationships between rsFC and anxiety-like behavior. This study is the first providing both anatomical and functional evidence for sex- and experience-dependent corticolimbic development. Having a traumatic childhood increases the risk a person will develop anxiety disorders later in life. Early life adversity affects men and women differently, but scientists do not yet know why. Learning more could help scientists develop better ways to prevent or treat anxiety disorders in men and women who experienced childhood trauma. Anxiety occurs when threat-detecting brain circuits turn on. These circuits begin working in infancy, and during childhood and adolescence, experiences shape the brain to hone the body’s responses to perceived threats. Two areas of the brain that are important hubs for anxiety-related brain circuits include the basolateral amygdala (BLA) and the prefrontal cortex (PFC). Now, Honeycutt et al. show that rats that experience early life adversity develop stronger connections between the BLA and PFC, and these changes occur earlier in female rats. In the experiments, one group of rats was repeatedly separated from their mothers and littermates (an early life trauma), while a second group was not. Honeycutt et al. examined the connections between the BLA and PFC in the two groups at three different time periods during their development: the juvenile stage, early adolescence, and late adolescence. The experiments showed stronger connections between the BLA and PFC begin to appear earlier in juvenile traumatized female rats. But these changes did not appear in their male counterparts until adolescence. Lastly, the rats that developed these strengthened BLA-PFC connections also behaved more anxiously later in life. This may mean that the ideal timing for interventions may be different for males and females. More work is needed to see if these results translate to humans and then to find the best times and methods to help people who experienced childhood trauma.
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Affiliation(s)
- Jennifer A Honeycutt
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
| | - Camila Demaestri
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
| | - Shayna Peterzell
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
| | - Marisa M Silveri
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, United States.,Department of Psychiatry, Harvard Medical School, Boston, United States
| | - Xuezhu Cai
- Center for Translational Neuroimaging, Department of Psychology, Northeastern University, Boston, United States
| | - Praveen Kulkarni
- Center for Translational Neuroimaging, Department of Psychology, Northeastern University, Boston, United States
| | - Miles G Cunningham
- Laboratory for Neural Reconstruction, Department of Psychiatry, McLean Hospital, Belmont, United States
| | - Craig F Ferris
- Center for Translational Neuroimaging, Department of Psychology, Northeastern University, Boston, United States
| | - Heather C Brenhouse
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
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15
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Tractenberg SG, Orso R, Creutzberg KC, Malcon LMC, Lumertz FS, Wearick-Silva LE, Viola TW, Riva MA, Grassi-Oliveira R. Vulnerable and resilient cognitive performance related to early life stress: The potential mediating role of dopaminergic receptors in the medial prefrontal cortex of adult mice. Int J Dev Neurosci 2020; 80:13-27. [PMID: 31907967 DOI: 10.1002/jdn.10004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 12/22/2019] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Exposure to early life stress (ELS) is known to have pronounced effects on the prefrontal cortex (PFC). However, not all individuals exposed to ELS manifest the same neurobiological and cognitive phenotypes when adults. Dopamine signaling could be a key factor in understanding the effects of stress on PFC-related cognitive function. OBJECTIVES We aimed to investigate the differential effects of ELS on cognitive performance of adult mice and the dopaminergic receptors expression in the PFC. METHODS BALB/c males were exposed to the maternal separation (MS) procedure and their cognitive performance on the eight-arm radial maze (8-RAM) were assessed during adulthood. For molecular-level assessments, we performed mRNA expression analyses for dopamine receptors-DRD1, DRD2, DRD3-and Hers1 expression in the medial PFC. RESULTS While MS produced an overall impairment on 8-RAM, the stressed animals could be divided in two groups based on their performance: those with impaired cognitive performance (vulnerable to maternal separation, V-MS) and those without any impairment (resilient to maternal separation, R-MS). V-MS animals showed increased DRD1 and DRD2 expression in comparison with other groups. Errors on 8-RAM were also positively correlated with DRD1 and DRD2 mRNA expression. CONCLUSIONS Our findings suggest a potential role of the dopaminergic system in the programming mechanisms of cognitive vulnerability and resilience related to ELS.
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Affiliation(s)
- Saulo G Tractenberg
- Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rodrigo Orso
- Developmental Cognitive Neuroscience Lab, Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Kerstin C Creutzberg
- Developmental Cognitive Neuroscience Lab, Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Luiza M C Malcon
- Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Francisco S Lumertz
- Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Luis Eduardo Wearick-Silva
- Developmental Cognitive Neuroscience Lab, Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Thiago W Viola
- Developmental Cognitive Neuroscience Lab, Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Rodrigo Grassi-Oliveira
- Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Developmental Cognitive Neuroscience Lab, Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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16
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Francesconi JA, Macaroy C, Sawant S, Hamrick H, Wahab S, Klein I, McGann JP. Sexually dimorphic behavioral and neural responses to a predator scent. Behav Brain Res 2020; 382:112467. [PMID: 31917240 DOI: 10.1016/j.bbr.2020.112467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/30/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022]
Abstract
Male and female C57BL/6 J mice were tested on the predator odor response task, where they needed to cross through a chamber of scented bedding to reach a sucrose reward. Following the behavioral testing, mouse brains were immunohistochemically labeled for expression of the immediate early gene c-fos. In the presence of the novel odorant methyl valerate (MV), both males and females exhibited increased exploration behaviors and delayed rewards compared to control bedding. However, in the presence of the predator odor phenylethylamine (PEA), males exhibited increased exploration that strongly resembled their behavior in MV (a non-predator odor) while females behaved very similarly to the clean bedding controls, quickly traversing the chamber to achieve the reward. Expression of c-fos exhibited significant sex by odor condition interactions overall across brain regions and in the anterior piriform cortex, cingulate cortex, and dorsomedial hypothalamus specifically. In all three regions we observed the general pattern that PEA exposure evoked elevated c-fos expression in females but suppressed c-fos expression in males. Taken together these data suggest that males and females may adopt different behavioral strategies in the presence of predator threat.
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Affiliation(s)
- Jennifer A Francesconi
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, 08854, USA.
| | - Cathleen Macaroy
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, 08854, USA
| | - Shreeya Sawant
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, 08854, USA
| | - Haleigh Hamrick
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, 08854, USA
| | - Sameerah Wahab
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, 08854, USA
| | - Ilana Klein
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, 08854, USA
| | - John P McGann
- Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, Piscataway, New Jersey, 08854, USA
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17
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Diana P, Joksimovic SM, Faisant A, Jevtovic-Todorovic V. Early exposure to general anesthesia impairs social and emotional development in rats. Mol Neurobiol 2020; 57:41-50. [PMID: 31494825 PMCID: PMC6980478 DOI: 10.1007/s12035-019-01755-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 11/25/2022]
Abstract
Several animal and emerging human studies suggest an association between an early exposure to general anesthesia (GA) and long-lasting problems with complex social and emotional behaviors such as inattentiveness, impulsivity, anxiogenic tendencies, as well as difficulties engaging in proper social intercourse, with significant increase in attention deficit and hyperactivity-type behaviors. To further investigate these behaviors, and to examine the potential of presently available rodent behavioral models to guide future assessments of long-term socio-emotional impairments in humans, we examined the long-term effects of GA on anxiety/fear and social behaviors. We exposed male and female Sprague-Dawley infant rats at the peak of their synaptogenesis to either GA containing midazolam (9 mg/kg, i.p.), 70% nitrous oxide (N2O) and 0.75% isoflurane (Iso) administered in 29-30% oxygen (experimental), or air (with 30% oxygen) plus the vehicle, 0.1% dimethyl sulfoxide (Sham) for 6 h. Behavioral experiments were conducted at adolescence (the open-field test) and young adulthood (the open-field test, the elevated plus-maze and the social novelty test). We report that an early exposure to GA during critical stages of brain development results in long-lasting increase in risk-taking tendencies and significant changes in the anxiety-related behaviors when tested in young adult rats. In addition, we noted novelty-seeking tendencies/less guarded behavior with changes in social discrimination. We conclude that early exposure to anesthesia may have lasting influences on emotional and social development. Importantly, our results show that currently used rodent behavioral models could be a good correlate to assess long-term socio-emotional GA-induced impairments observed in humans.
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Affiliation(s)
- Paolo Diana
- Department of Medicine, University of Padua, Padua, Italy
| | - Srdjan M Joksimovic
- Department of Anesthesiology, University of Colorado School of Medicine, 12801 E. 17th Avenue, Rm L18-4100, Aurora, CO, USA
| | - Azra Faisant
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Vesna Jevtovic-Todorovic
- Department of Anesthesiology, University of Colorado School of Medicine, 12801 E. 17th Avenue, Rm L18-4100, Aurora, CO, USA.
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