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Loftis JM, Ramani S, Firsick EJ, Hudson R, Le-Cook A, Murnane KS, Vandenbark A, Shirley RL. Immunotherapeutic treatment of inflammation in mice exposed to methamphetamine. Front Psychiatry 2023; 14:1259041. [PMID: 38025429 PMCID: PMC10666795 DOI: 10.3389/fpsyt.2023.1259041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/15/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Currently, there are no FDA-approved medications to treat methamphetamine addiction, including the inflammatory, neurotoxic, and adverse neuropsychiatric effects. We have shown that partial (p)MHC class II constructs (i.e., Recombinant T-cell receptor Ligand - RTL1000), comprised of the extracellular α1 and β1 domains of MHC class II molecules linked covalently to myelin oligodendrocyte glycoprotein (MOG)-35-55 peptide, can address the neuroimmune effects of methamphetamine addiction through its ability to bind to and down-regulate CD74 expression, block macrophage migration inhibitory factor (MIF) signaling, and reduce levels of pro-inflammatory chemokine ligand 2 (CCL2). The present study evaluated the effects of our third-generation pMHC II construct, DRmQ, on cognitive function and concentration of inflammatory cytokines in the frontal cortex, a region critical for cognitive functions such as memory, impulse control, and problem solving. Methods Female and male C57BL/6J mice were exposed to methamphetamine (or saline) via subcutaneous (s.c.) injections administered four times per day every other day for 14 days. Following methamphetamine exposure, mice received immunotherapy (DRmQ or ibudilast) or vehicle s.c. injections daily for five days. Cognitive function was assessed using the novel object recognition test (NORT). To evaluate the effects of immunotherapy on inflammation in the frontal cortex, multiplex immunoassays were conducted. ANOVA was used to compare exploration times on the NORT and immune factor concentrations. Results Post hoc analysis revealed increased novel object exploration time in MA-DRmQ treated mice, as compared to MA-VEH treated mice (non-significant trend). One-way ANOVA detected a significant difference across the groups in the concentration of macrophage inflammatory protein-2 (MIP-2) (p = 0.03). Post hoc tests indicated that mice treated with methamphetamine and DRmQ or ibudilast had significantly lower levels of MIP-2 in frontal cortex, as compared to mice treated with methamphetamine and vehicle (p > 0.05). Discussion By specifically targeting CD74, our DRQ constructs can block the signaling of MIF, inhibiting the downstream signaling and pro-inflammatory effects that contribute to and perpetuate methamphetamine addiction.
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Affiliation(s)
- Jennifer M. Loftis
- Research and Development Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States
- Methamphetamine Research Center, Oregon Health & Science University, Portland, OR, United States
| | - Sankrith Ramani
- Research and Development Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - Evan J. Firsick
- Research and Development Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - Rebekah Hudson
- Research and Development Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - Anh Le-Cook
- Research and Development Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - Kevin S. Murnane
- Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Arthur Vandenbark
- Research and Development Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
- Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR, United States
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Chen YH, Yang J, Wu H, Beier KT, Sawan M. Challenges and future trends in wearable closed-loop neuromodulation to efficiently treat methamphetamine addiction. Front Psychiatry 2023; 14:1085036. [PMID: 36911117 PMCID: PMC9995819 DOI: 10.3389/fpsyt.2023.1085036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Achieving abstinence from drugs is a long journey and can be particularly challenging in the case of methamphetamine, which has a higher relapse rate than other drugs. Therefore, real-time monitoring of patients' physiological conditions before and when cravings arise to reduce the chance of relapse might help to improve clinical outcomes. Conventional treatments, such as behavior therapy and peer support, often cannot provide timely intervention, reducing the efficiency of these therapies. To more effectively treat methamphetamine addiction in real-time, we propose an intelligent closed-loop transcranial magnetic stimulation (TMS) neuromodulation system based on multimodal electroencephalogram-functional near-infrared spectroscopy (EEG-fNIRS) measurements. This review summarizes the essential modules required for a wearable system to treat addiction efficiently. First, the advantages of neuroimaging over conventional techniques such as analysis of sweat, saliva, or urine for addiction detection are discussed. The knowledge to implement wearable, compact, and user-friendly closed-loop systems with EEG and fNIRS are reviewed. The features of EEG and fNIRS signals in patients with methamphetamine use disorder are summarized. EEG biomarkers are categorized into frequency and time domain and topography-related parameters, whereas for fNIRS, hemoglobin concentration variation and functional connectivity of cortices are described. Following this, the applications of two commonly used neuromodulation technologies, transcranial direct current stimulation and TMS, in patients with methamphetamine use disorder are introduced. The challenges of implementing intelligent closed-loop TMS modulation based on multimodal EEG-fNIRS are summarized, followed by a discussion of potential research directions and the promising future of this approach, including potential applications to other substance use disorders.
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Affiliation(s)
- Yun-Hsuan Chen
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
| | - Jie Yang
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
| | - Hemmings Wu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kevin T Beier
- Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA, United States.,Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States.,Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States.,Department of Pharmaceutical Sciences, University of California, Irvine, Irvine, CA, United States.,Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Mohamad Sawan
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
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Bel-Bahar TS, Khan AA, Shaik RB, Parvaz MA. A scoping review of electroencephalographic (EEG) markers for tracking neurophysiological changes and predicting outcomes in substance use disorder treatment. Front Hum Neurosci 2022; 16:995534. [PMID: 36325430 PMCID: PMC9619053 DOI: 10.3389/fnhum.2022.995534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Substance use disorders (SUDs) constitute a growing global health crisis, yet many limitations and challenges exist in SUD treatment research, including the lack of objective brain-based markers for tracking treatment outcomes. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity, and although much is known about EEG activity in acute and chronic substance use, knowledge regarding EEG in relation to abstinence and treatment outcomes is sparse. We performed a scoping review of longitudinal and pre-post treatment EEG studies that explored putative changes in brain function associated with abstinence and/or treatment in individuals with SUD. Following PRISMA guidelines, we identified studies published between January 2000 and March 2022 from online databases. Search keywords included EEG, addictive substances (e.g., alcohol, cocaine, methamphetamine), and treatment related terms (e.g., abstinence, relapse). Selected studies used EEG at least at one time point as a predictor of abstinence or other treatment-related outcomes; or examined pre- vs. post-SUD intervention (brain stimulation, pharmacological, behavioral) EEG effects. Studies were also rated on the risk of bias and quality using validated instruments. Forty-four studies met the inclusion criteria. More consistent findings included lower oddball P3 and higher resting beta at baseline predicting negative outcomes, and abstinence-mediated longitudinal decrease in cue-elicited P3 amplitude and resting beta power. Other findings included abstinence or treatment-related changes in late positive potential (LPP) and N2 amplitudes, as well as in delta and theta power. Existing studies were heterogeneous and limited in terms of specific substances of interest, brief times for follow-ups, and inconsistent or sparse results. Encouragingly, in this limited but maturing literature, many studies demonstrated partial associations of EEG markers with abstinence, treatment outcomes, or pre-post treatment-effects. Studies were generally of good quality in terms of risk of bias. More EEG studies are warranted to better understand abstinence- or treatment-mediated neural changes or to predict SUD treatment outcomes. Future research can benefit from prospective large-sample cohorts and the use of standardized methods such as task batteries. EEG markers elucidating the temporal dynamics of changes in brain function related to abstinence and/or treatment may enable evidence-based planning for more effective and targeted treatments, potentially pre-empting relapse or minimizing negative lifespan effects of SUD.
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Affiliation(s)
- Tarik S. Bel-Bahar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Anam A. Khan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Riaz B. Shaik
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Muhammad A. Parvaz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Intermittent Theta-Burst Stimulation Increases the Working Memory Capacity of Methamphetamine Addicts. Brain Sci 2022; 12:brainsci12091212. [PMID: 36138948 PMCID: PMC9496808 DOI: 10.3390/brainsci12091212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to explore the effect of intermittent theta-burst stimulation (iTBS) on visual working memory for people suffering from methamphetamine use disorder (MUD). Five sessions of iTBS were carried over the left dorsolateral prefrontal cortex (DLPFC) or the vertex as a sham control, with each session in one day. Orientation free-recall tasks were conducted before the iTBS stimulation, after the first and fifth sessions of stimulation. Results showed that when compared with the sham group, a single session of iTBS over the left DLPFC improved participants’ working memory performance. Specifically, iTBS over the left DLPFC increased the working memory capacity and such effects enlarged with multiple sessions. The present finding suggested that iTBS over DLPFC could be a promising intervention method to enhance the cognitive function of addicts with MUD.
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