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Li X, Ramos-Rolón AP, Kass G, Pereira-Rufino LS, Shifman N, Shi Z, Volkow ND, Wiers CE. Imaging neuroinflammation in individuals with substance use disorders. J Clin Invest 2024; 134:e172884. [PMID: 38828729 PMCID: PMC11142750 DOI: 10.1172/jci172884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Increasing evidence suggests a role of neuroinflammation in substance use disorders (SUDs). This Review presents findings from neuroimaging studies assessing brain markers of inflammation in vivo in individuals with SUDs. Most studies investigated the translocator protein 18 kDa (TSPO) using PET; neuroimmune markers myo-inositol, choline-containing compounds, and N-acetyl aspartate using magnetic resonance spectroscopy; and fractional anisotropy using MRI. Study findings have contributed to a greater understanding of neuroimmune function in the pathophysiology of SUDs, including its temporal dynamics (i.e., acute versus chronic substance use) and new targets for SUD treatment.
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Affiliation(s)
- Xinyi Li
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania, USA
| | - Astrid P. Ramos-Rolón
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania, USA
| | - Gabriel Kass
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania, USA
| | - Lais S. Pereira-Rufino
- Departamento de Morfologia e Genética, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Naomi Shifman
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania, USA
| | - Zhenhao Shi
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania, USA
| | - Nora D. Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, Maryland, USA
| | - Corinde E. Wiers
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania, USA
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2
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O'Neill J, Diaz MP, Alger JR, Pochon JB, Ghahremani D, Dean AC, Tyndale RF, Petersen N, Marohnic S, Karaiskaki A, London ED. Smoking, tobacco dependence, and neurometabolites in the dorsal anterior cingulate cortex. Mol Psychiatry 2023; 28:4756-4765. [PMID: 37749232 PMCID: PMC10914613 DOI: 10.1038/s41380-023-02247-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
Cigarette smoking has a major impact on global health and morbidity, and positron emission tomographic research has provided evidence for reduced inflammation in the human brain associated with cigarette smoking. Given the consequences of inflammatory dysfunction for health, the question of whether cigarette smoking affects neuroinflammation warrants further investigation. The goal of this project therefore was to validate and extend evidence of hypoinflammation related to smoking, and to examine the potential contribution of inflammation to clinical features of smoking. Using magnetic resonance spectroscopy, we measured levels of neurometabolites that are putative neuroinflammatory markers. N-acetyl compounds (N-acetylaspartate + N-acetylaspartylglutamate), glutamate, creatine, choline-compounds (phosphocholine + glycerophosphocholine), and myo-inositol, have all been linked to neuroinflammation, but they have not been examined as such with respect to smoking. We tested whether people who smoke cigarettes have brain levels of these metabolites consistent with decreased neuroinflammation, and whether clinical features of smoking are associated with levels of these metabolites. The dorsal anterior cingulate cortex was chosen as the region-of-interest because of previous evidence linking it to smoking and related states. Fifty-four adults who smoked daily maintained overnight smoking abstinence before testing and were compared with 37 nonsmoking participants. Among the smoking participants, we tested for associations of metabolite levels with tobacco dependence, smoking history, craving, and withdrawal. Levels of N-acetyl compounds and glutamate were higher, whereas levels of creatine and choline compounds were lower in the smoking group as compared with the nonsmoking group. In the smoking group, glutamate and creatine levels correlated negatively with tobacco dependence, and creatine correlated negatively with lifetime smoking, but none of the metabolite levels correlated with craving or withdrawal. The findings indicate a link between smoking and a hypoinflammatory state in the brain, specifically in the dorsal anterior cingulate cortex. Smoking may thereby increase vulnerability to infection and brain injury.
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Affiliation(s)
- Joseph O'Neill
- Division of Child & Adolescent Psychiatry, Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Maylen Perez Diaz
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
- Biogen, Inc., Nashville, TN, USA
| | - Jeffry R Alger
- Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jean-Baptiste Pochon
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dara Ghahremani
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andrew C Dean
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Rachel F Tyndale
- Department of Pharmacology & Toxicology, and Department of Psychiatry, University of Toronto, and Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Nicole Petersen
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Shane Marohnic
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andrea Karaiskaki
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D London
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA.
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3
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Bhat UA, Kumar SA, Chakravarty S, Patel AB, Kumar A. Differential Effects of Chronic Ethanol Use on Mouse Neuronal and Astroglial Metabolic Activity. Neurochem Res 2023:10.1007/s11064-023-03922-y. [PMID: 37069415 DOI: 10.1007/s11064-023-03922-y] [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: 11/29/2022] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 04/19/2023]
Abstract
Chronic alcohol use disorder, a major risk factor for the development of neuropsychiatric disorders including addiction to other substances, is associated with several neuropathology including perturbed neuronal and glial activities in the brain. It affects carbon metabolism in specific brain regions, and perturbs neuro-metabolite homeostasis in neuronal and glial cells. Alcohol induced changes in the brain neurochemical profile accompany the negative emotional state associated with dysregulated reward and sensitized stress response to withdrawal. However, the underlying alterations in neuro-astroglial activities and neurochemical dysregulations in brain regions after chronic alcohol use are poorly understood. This study evaluates the impact of chronic ethanol use on the regional neuro-astroglial metabolic activity using 1H-[13C]-NMR spectroscopy in conjunction with infusion of [1,6-13C2]glucose and sodium [2-13C]acetate, respectively, after 48 h of abstinence. Besides establishing detailed 13C labeling of neuro-metabolites in a brain region-specific manner, our results show chronic ethanol induced-cognitive deficits along with a reduction in total glucose oxidation rates in the hippocampus and striatum. Furthermore, using [2-13C]acetate infusion, we showed an alcohol-induced increase in astroglial metabolic activity in the hippocampus and prefrontal cortex. Interestingly, increased astroglia activity in the hippocampus and prefrontal cortex was associated with a differential expression of monocarboxylic acid transporters that are regulating acetate uptake and metabolism in the brain.
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Affiliation(s)
- Unis Ahmad Bhat
- Epigenetics and Neuropsychiatric Disorders Laboratory, CSIR-Centre for Cellular and Molecular Biology (CCMB), Uppal Road, Habsiguda, Hyderabad, Telangana State (TS), 500007, India
| | - Sreemantula Arun Kumar
- Applied Biology, CSIR-Indian Institute of Chemical Technology, Hyderabad, Telangana, India
| | - Sumana Chakravarty
- Applied Biology, CSIR-Indian Institute of Chemical Technology, Hyderabad, Telangana, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Anant Bahadur Patel
- Epigenetics and Neuropsychiatric Disorders Laboratory, CSIR-Centre for Cellular and Molecular Biology (CCMB), Uppal Road, Habsiguda, Hyderabad, Telangana State (TS), 500007, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
- NMR Microimaging and Spectroscopy, CSIR-Centre for Cellular and Molecular Biology (CCMB), Uppal Road, Habsiguda, Hyderabad, Telangana State (TS), 500007, India.
| | - Arvind Kumar
- Epigenetics and Neuropsychiatric Disorders Laboratory, CSIR-Centre for Cellular and Molecular Biology (CCMB), Uppal Road, Habsiguda, Hyderabad, Telangana State (TS), 500007, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
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4
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Zöllner HJ, Thiel TA, Füllenbach ND, Jördens MS, Ahn S, Wilms LM, Ljimani A, Häussinger D, Butz M, Wittsack HJ, Schnitzler A, Oeltzschner G. J-difference GABA-edited MRS reveals altered cerebello-thalamo-cortical metabolism in patients with hepatic encephalopathy. Metab Brain Dis 2023; 38:1221-1238. [PMID: 36729261 PMCID: PMC10897767 DOI: 10.1007/s11011-023-01174-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023]
Abstract
Hepatic encephalopathy (HE) is a common neurological manifestation of liver cirrhosis and is characterized by an increase of ammonia in the brain accompanied by a disrupted neurotransmitter balance, including the GABAergic and glutamatergic systems. The aim of this study is to investigate metabolic abnormalities in the cerebello-thalamo-cortical system of HE patients using GABA-edited MRS and links between metabolite levels, disease severity, critical flicker frequency (CFF), motor performance scores, and blood ammonia levels. GABA-edited MRS was performed in 35 participants (16 controls, 19 HE patients) on a clinical 3 T MRI system. MRS voxels were placed in the right cerebellum, left thalamus, and left motor cortex. Levels of GABA+ and of other metabolites of interest (glutamine, glutamate, myo-inositol, glutathione, total choline, total NAA, and total creatine) were assessed. Group differences in metabolite levels and associations with clinical metrics were tested. GABA+ levels were significantly increased in the cerebellum of patients with HE. GABA+ levels in the motor cortex were significantly decreased in HE patients, and correlated with the CFF (r = 0.73; p < .05) and motor performance scores (r = -0.65; p < .05). Well-established HE-typical metabolite patterns (increased glutamine, decreased myo-inositol and total choline) were confirmed in all three regions and were closely linked to clinical metrics. In summary, our findings provide further evidence for alterations in the GABAergic system in the cerebellum and motor cortex in HE. These changes were accompanied by characteristic patterns of osmolytes and oxidative stress markers in the cerebello-thalamo-cortical system. These metabolic disturbances are a likely contributor to HE motor symptoms in HE. In patients with hepatic encephalopathy, GABA+ levels in the cerebello-thalamo-cortical loop are significantly increased in the cerebellum and significantly decreased in the motor cortex. GABA+ levels in the motor cortex strongly correlate with critical flicker frequency (CFF) and motor performance score (pegboard test tPEG), but not blood ammonia levels (NH3).
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Affiliation(s)
- Helge Jörn Zöllner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
| | - Thomas A Thiel
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nur-Deniz Füllenbach
- Department of Gastroenterology, Hepatology and Infectiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Markus S Jördens
- Department of Gastroenterology, Hepatology and Infectiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Lena M Wilms
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Markus Butz
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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5
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Asch RH, Hillmer AT, Baldassarri SR, Esterlis I. The metabotropic glutamate receptor 5 as a biomarker for psychiatric disorders. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 168:265-310. [PMID: 36868631 DOI: 10.1016/bs.irn.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The role of glutamate system in the etiology and pathophysiology of psychiatric disorders has gained considerable attention in the past two decades, including dysregulation of the metabotropic glutamatergic receptor subtype 5 (mGlu5). Thus, mGlu5 may represent a promising therapeutic target for psychiatric conditions, particularly stress-related disorders. Here, we describe mGlu5 findings in mood disorders, anxiety, and trauma disorders, as well as substance use (specifically nicotine, cannabis, and alcohol use). We highlight insights gained from positron emission tomography (PET) studies, where possible, and discuss findings from treatment trials, when available, to explore the role of mGlu5 in these psychiatric disorders. Through the research evidence reviewed in this chapter, we make the argument that, not only is dysregulation of mGlu5 evident in numerous psychiatric disorders, potentially functioning as a disease "biomarker," the normalization of glutamate neurotransmission via changes in mGlu5 expression and/or modulation of mGlu5 signaling may be a needed component in treating some psychiatric disorders or symptoms. Finally, we hope to demonstrate the utility of PET as an important tool for investigating mGlu5 in disease mechanisms and treatment response.
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Affiliation(s)
- Ruth H Asch
- Department of Psychiatry, Yale University, New Haven, CT, United States.
| | - Ansel T Hillmer
- Department of Psychiatry, Yale University, New Haven, CT, United States; Department of Radiology and Biomedical Imaging, New Haven, CT, United States
| | - Stephen R Baldassarri
- Yale Program in Addiction Medicine, Yale University, New Haven, CT, United States; Department of Internal Medicine, Yale University, New Haven, CT, United States
| | - Irina Esterlis
- Department of Psychiatry, Yale University, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States
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6
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McCunn P, Chen X, Gimi B, Green AI, Khokhar JY. Glutamine and GABA alterations in cingulate cortex may underlie alcohol drinking in a rat model of co-occurring alcohol use disorder and schizophrenia: an 1H-MRS study. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:67. [PMID: 35999232 PMCID: PMC9399110 DOI: 10.1038/s41537-022-00272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
Alcohol use disorder commonly occurs in patients with schizophrenia and significantly worsens the clinical course of the disorder. The neurobiological underpinnings of alcohol drinking are not well understood. Magnetic resonance spectroscopy (MRS) has been used to assess the neurochemical substrates that may be associated with alcohol drinking in patients; however, the causal impact of these findings remains elusive, highlighting the need for studies in animal models. This study performed MRS in the neonatal ventral hippocampal lesioned (NVHL) rat model, a model of co-occurring schizophrenia and substance use disorders. NVHL lesions (or sham surgeries) were performed on post-natal day 7 and animals were given brief exposure to alcohol during adolescence (10% v/v in a 2-bottle choice design). Animals were re-exposed to alcohol during adulthood (20% v/v) until a stable drinking baseline was established, and then forced into abstinence to control for the effects of differential alcohol drinking. Animals were scanned for MRS after one month of abstinence. NVHL rats consumed significantly more alcohol than sham rats and in the cingulate cortex showed significantly higher levels of GABA and glutamine. Significantly lower GABA levels were observed in the nucleus accumbens. No differences between the NVHL and sham animals were observed in the hippocampus. Correlation analysis revealed that GABA and glutamine concentrations in the cingulate cortex significantly correlated with the rats' alcohol drinking prior to 30 days of forced abstinence. These findings suggest that a potential dysfunction in the glutamate/GABA-glutamine cycle may contribute to alcohol drinking in a rat model of schizophrenia, and this dysfunction could be targeted in future treatment-focused studies.
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Affiliation(s)
- Patrick McCunn
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Xi Chen
- Department of Radiology, Biomedical NMR Research Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Barjor Gimi
- Department of Radiology, Biomedical NMR Research Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Alan I Green
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Jibran Y Khokhar
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
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7
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Kirkland AE, Browning BD, Green R, Leggio L, Meyerhoff DJ, Squeglia LM. Brain metabolite alterations related to alcohol use: a meta-analysis of proton magnetic resonance spectroscopy studies. Mol Psychiatry 2022; 27:3223-3236. [PMID: 35508628 PMCID: PMC10578135 DOI: 10.1038/s41380-022-01594-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 11/08/2022]
Abstract
Alcohol misuse and alcohol use disorder (AlUD) have neurobiological consequences. This meta-analysis of proton magnetic resonance spectroscopy (MRS) studies aimed to assess the differences in brain metabolite levels in alcohol misuse and AUD relative to controls (PROSPERO registration: CRD42020209890). Hedge's g with random-effects modeling was used. Sub-group and meta-regression techniques explored potential sources of demographic and MRS parameter heterogeneity. A comprehensive literature review identified 43 studies, resulting in 69 models across gray and white matter (GM, WM). Lower N-acetylaspartate levels were found in frontal, anterior cingulate cortex (ACC), hippocampal, and cerebellar GM, and frontal and parietal WM, suggesting decreased neuronal and axonal viability. Lower choline-containing metabolite levels (all metabolites contributing to choline peak) were found in frontal, temporal, thalamic, and cerebellar GM, and frontal and parietal WM, suggesting membrane alterations related to alcohol misuse. Lower creatine-containing metabolite levels (Cr; all metabolites contributing to Cr peak) were found in temporal and occipital cortical GM, while higher levels were noted in midbrain/brainstem GM; this finding may have implications for using Cr as an internal reference. The lack of significant group differences in glutamate-related levels is possibly related to biological and methodological complexities. The few studies reporting on GABA found lower levels restricted to the ACC. Confounding variables were age, abstinence duration, treatment status, and MRS parameters (echo time, quantification type, data quality). This first meta-analysis of proton MRS studies consolidates the numerous individual studies to identify neurometabolite alterations within alcohol misuse and AUD. Future studies can leverage this new formalized information to investigate treatments that might effectively target the observed disturbances.
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Affiliation(s)
- Anna E Kirkland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Brittney D Browning
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - ReJoyce Green
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Lorenzo Leggio
- National Institutes of Health, NIDA and NIAAA, Baltimore, MD, USA
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California San Francisco and VA Medical Center, San Francisco, CA, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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8
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Smart K, Worhunsky PD, Scheinost D, Angarita GA, Esterlis I, Carson RE, Krystal JH, O'Malley SS, Cosgrove KP, Hillmer AT. Multimodal neuroimaging of metabotropic glutamate 5 receptors and functional connectivity in alcohol use disorder. Alcohol Clin Exp Res 2022; 46:770-782. [PMID: 35342968 PMCID: PMC9117461 DOI: 10.1111/acer.14816] [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: 11/17/2021] [Revised: 03/15/2022] [Accepted: 03/19/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND People recovering from alcohol use disorder (AUD) show altered resting brain connectivity. The metabotropic glutamate 5 (mGlu5) receptor is an important regulator of synaptic plasticity potentially linked with synchronized brain activity and a target of interest in treating AUD. The goal of this work was to assess potential relationships of brain connectivity at rest with mGlu5 receptor availability in people with AUD at two time points early in abstinence. METHODS Forty-eight image data sets were acquired with a multimodal neuroimaging battery that included resting-state functional magnetic resonance imaging (fMRI) and mGlu5 receptor positron emission tomography (PET) with the radiotracer [18 F]FPEB. Participants with AUD (n = 14) were scanned twice, at approximately 1 and 4 weeks after beginning supervised abstinence. [18 F]FPEB PET results were published previously. Primary comparisons of fMRI outcomes were performed between the AUD group and healthy controls (HCs; n = 23) and assessed changes over time within the AUD group. Relationships between resting-state connectivity measures and mGlu5 receptor availability were explored within groups. RESULTS Compared to HCs, global functional connectivity of the orbitofrontal cortex was higher in the AUD group at 4 weeks of abstinence (p = 0.003), while network-level functional connectivity within the default mode network (DMN) was lower (p < 0.04). Exploratory multimodal analyses showed that mGlu5 receptor availability was correlated with global connectivity across all brain regions (HCs, r = 0.41; AUD group at 1 week of abstinence, r = 0.50 and at 4 weeks, r = 0.46; all p < 0.0001). Furthermore, a component of cortical and striatal mGlu5 availability was correlated with connectivity between the DMN and salience networks in HCs (r = 0.60, p = 0.003) but not in the AUD group (p > 0.3). CONCLUSIONS These preliminary findings of altered global and network connectivity during the first month of abstinence from drinking may reflect the loss of efficient network function, while exploratory relationships with mGlu5 receptor availability suggest a potential glutamatergic relationship with network coherence.
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Affiliation(s)
- Kelly Smart
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Patrick D Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
| | - Gustavo A Angarita
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Richard E Carson
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Kelly P Cosgrove
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ansel T Hillmer
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
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9
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Monroy-Jaramillo N, Martínez-Magaña JJ, Pérez-Aldana BE, Ortega-Vázquez A, Montalvo-Ortiz J, López-López M. The role of alcohol intake in the pharmacogenetics of treatment with clozapine. Pharmacogenomics 2022; 23:371-392. [PMID: 35311547 DOI: 10.2217/pgs-2022-0006] [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] [Indexed: 12/12/2022] Open
Abstract
Clozapine (CLZ) is an atypical antipsychotic reserved for patients with refractory psychosis, but it is associated with a significant risk of severe adverse reactions (ADRs) that are potentiated with the concomitant use of alcohol. Additionally, pharmacogenetic studies have explored the influence of several genetic variants in CYP450, receptors and transporters involved in the interindividual response to CLZ. Herein, we systematically review the current multiomics knowledge behind the interaction between CLZ and alcohol intake, and how its concomitant use might modulate the pharmacogenetics. CYP1A2*1F, *1C and other alleles not yet discovered could support a precision medicine approach for better therapeutic effects and fewer CLZ ADRs. CLZ monitoring systems should be amended and include alcohol intake to protect patients from severe CLZ ADRs.
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Affiliation(s)
- Nancy Monroy-Jaramillo
- Department of Genetics, National Institute of Neurology & Neurosurgery, Manuel Velasco Suárez, La Fama, Tlalpan, Mexico City, 14269, Mexico
| | - José Jaime Martínez-Magaña
- Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, Orange, West Haven, CT 06477, USA
| | - Blanca Estela Pérez-Aldana
- Doctorado en Ciencias Biológicas y de la Salud, Metropolitan Autonomous University, Campus Xochimilco, Villa Quietud, Coyoacán, Mexico City, 04960, Mexico
| | - Alberto Ortega-Vázquez
- Metropolitan Autonomous University, Campus Xochimilco, Villa Quietud, Coyoacán, Mexico City, 04960, Mexico
| | - Janitza Montalvo-Ortiz
- Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, Orange, West Haven, CT 06477, USA
| | - Marisol López-López
- Metropolitan Autonomous University, Campus Xochimilco, Villa Quietud, Coyoacán, Mexico City, 04960, Mexico
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10
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Blood glutamine synthetase signaling in alcohol use disorder and racial disparity. Transl Psychiatry 2022; 12:71. [PMID: 35194024 PMCID: PMC8863875 DOI: 10.1038/s41398-022-01837-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 01/01/2023] Open
Abstract
As of 2018, 14.4 million adults ages 18 and older in the U.S had alcohol use disorder (AUD). However, only about 8% of adults who had AUD in the past year received treatment. Surveys have also shown racial disparities regarding AUD treatments. Thus, it is imperative to identify racial disparities in AUD patients, as it may indicate a specific underlying pathophysiology in an AUD subpopulation. To identify racial disparity in AUD, we enrolled 64 cohorts, including 26 AUD participants and 38 healthy controls, from Northwest Louisiana using community-based enrollment. Then, we used psychometric scales to assess alcohol drinking patterns and measured blood metabolites change using LC-MS/MS. Alcohol-related scales from the questionnaires did not differ between the Caucasian AUD participants and African-American AUD participants. From blood metabolomics analyses, we identified that 6 amino acids were significantly different by AUD status and or race. Interestingly, Caucasian AUD participants had a higher glutamate metabolism mediated by glutamine synthetase (GS). The correlation between blood glutamate/glutamine ratio and GS activity was only significant in the Caucasian AUD group whereas no changes were observed in African-American AUD group or controls. Taken together, our findings from this sample population demonstrate that blood GS is a potential biomarker associated with Caucasian AUD, which is an important step towards the application of a new pharmacological treatment for AUD.
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11
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Moe FD, Moltu C, McKay JR, Nesvåg S, Bjornestad J. Is the relapse concept in studies of substance use disorders a 'one size fits all' concept? A systematic review of relapse operationalisations. Drug Alcohol Rev 2021; 41:743-758. [PMID: 34792839 DOI: 10.1111/dar.13401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
ISSUES Relapse is a theoretical construct and empirical object of inquiry. It is unclear how relapse is operationalised with regard to the various phases in substance use disorders (SUD). The aim was to investigate relapse operationalisations in SUDs studies after short- and long-term abstinence and remission, recovery and slip/lapse. APPROACH Systematic review using the following databases: Epistemonikos, Cochrane Central Register of Controlled Trials (CENTRAL and DARE), MEDLINE, EMBASE, Google Scholar, CINAHL, Web of Science and PsycINFO. Search returned 3426 articles, with 276 meeting the following inclusion criteria: empirical study published in English in a peer-reviewed journal; samples meet diagnostic criteria for dependence syndrome or moderate-severe drug use disorder or alcohol use disorder; reports relapse, abstinence, recovery, remission, slip or lapse. Review protocol registration: PROSPERO (CRD42020154062). KEY FINDINGS Thirty-two percent of the studies had no definition of 'relapse'. Most relapse operationalisations were defined according to measure (26%), time (17%), use (26%) and amount and frequency (27%). Of the 16 studies with a follow-up duration of up to 2 years, one (6%) contained a definition of 'long-term abstinence'. Of the 64 studies with a follow-up duration of more than 2 years, four (6%) contained a definition of 'long-term abstinence'. Of those, one (2%) mentioned 'early relapse' and one (2%) mentioned 'late relapse'. IMPLICATIONS Future research is needed to explore the possible difference between early and late relapse. Moreover, working to increase consensus on relapse operationalisations in SUD research is warranted. CONCLUSIONS We identified no consensus on relapse operationalisations nor agreement on the differentiation between early and late relapse. The clinical utility of current relapse operationalisations seems low and may compromise knowledge accumulation about relapse and implementation of research into treatment.
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Affiliation(s)
- Fredrik D Moe
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - James R McKay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.,Philadelphia VA Medical Center, Philadelphia, USA.,Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Sverre Nesvåg
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Jone Bjornestad
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.,Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,TIPS-Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
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12
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Prisciandaro JJ, Hoffman M, Brown TR, Voronin K, Book S, Bristol E, Anton RF. Effects of Gabapentin on Dorsal Anterior Cingulate Cortex GABA and Glutamate Levels and Their Associations With Abstinence in Alcohol Use Disorder: A Randomized Clinical Trial. Am J Psychiatry 2021; 178:829-837. [PMID: 34256607 PMCID: PMC9161238 DOI: 10.1176/appi.ajp.2021.20121757] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although gabapentin has demonstrated efficacy in mitigating alcohol withdrawal symptoms and preventing relapse drinking in individuals with alcohol use disorder (AUD), the neurobiological mechanisms of action underlying these therapeutic effects remain unknown. The present study evaluated changes in GABA and glutamate levels in the dorsal anterior cingulate cortex (dACC) as candidate mechanisms of action. METHODS In a 16-week randomized clinical trial, 68 adults with AUD, including a history of alcohol withdrawal syndrome, received 1,200 mg/day of gabapentin (N=37) or placebo (N=31) and nine medical management visits after ≥72 hours of abstinence. Proton MR spectroscopy (1H-MRS) estimates of dACC levels of GABA (N=67) and glutamate (N=64) were acquired before start of treatment and again approximately 14 days after randomization. Percent days abstinent was reported via timeline followback interview. RESULTS The effects of gabapentin on GABA and glutamate levels were significantly associated with participants' percent days abstinent during early treatment. Specifically, gabapentin was associated with greater increases in glutamate and greater decreases in GABA levels in participants who remained mostly or entirely abstinent, and yet the opposite in participants who drank on more than half of the days preceding the second scan. Furthermore, gabapentin-treated participants with greater increases in glutamate levels during early treatment had significantly more percent days abstinent across the remainder of the study, relative to placebo-treated participants. CONCLUSIONS In addition to providing insight into the mechanisms through which gabapentin may promote abstinence in individuals with AUD, this study also provides evidence for a biomarker of efficacious treatment that may be used to evaluate other glutamatergic or GABAergic medications for AUD and related conditions.
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Affiliation(s)
- James J. Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC, Corresponding author,
| | - Michaela Hoffman
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Truman R. Brown
- Department of Radiology, Medical University of SC, Charleston, SC
| | - Konstantin Voronin
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Sarah Book
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Emily Bristol
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Raymond F. Anton
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
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13
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Grecco GG, Chumin EJ, Dzemidzic M, Cheng H, Finn P, Newman S, Dydak U, Yoder KK. Anterior cingulate cortex metabolites and white matter microstructure: a multimodal study of emergent alcohol use disorder. Brain Imaging Behav 2021; 15:2436-2444. [PMID: 34097282 DOI: 10.1007/s11682-020-00443-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/17/2020] [Accepted: 12/28/2020] [Indexed: 12/27/2022]
Abstract
Multimodal imaging is increasingly used to address neuropathology associated with alcohol use disorder (AUD). Few studies have investigated relationships between metabolite concentrations and white matter (WM) integrity; currently, there are no such data in AUD. In this preliminary study, we used complementary neuroimaging techniques, magnetic resonance spectroscopy (MRS), and diffusion weighted imaging (DWI), to study AUD neurophysiology. We tested for relationships between metabolites in the dorsal anterior cingulate cortex (dACC) and adjacent WM microstructure in young adult AUD and control (CON) subjects. Sixteen AUD and fourteen CON underwent whole-brain DWI and MRS of the dACC. Outcomes were dACC metabolites, and diffusion tensor metrics of dACC-adjacent WM. Multiple linear regression terms included WM region, group, and region × group for prediction of dACC metabolites. dACC myo-inositol was positively correlated with axial diffusivity in the left anterior corona radiata (p < 0.0001) in CON but not AUD (group effect: p < 0.001; region × group: p < 0.001; Bonferroni-corrected). In the bilateral anterior corona radiata and right genu of the corpus callosum, glutamate was negatively related to mean diffusivity in AUD, but not CON subjects (all model terms: p < 0.05, uncorrected). In AUD subjects, dACC glutamate was negatively correlated with AUD symptom severity. This is likely the first integrative study of cortical metabolites and WM integrity in young individuals with AUD. Differential relationships between dACC metabolites and adjacent WM tract integrity in AUD could represent early consequences of hazardous drinking, and/or novel biomarkers of early-stage AUD. Additional studies are required to replicate these findings, and to determine the behavioral relevance of these results.
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Affiliation(s)
- Gregory G Grecco
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.,Medical Scientist Training Program, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Evgeny J Chumin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.,Indiana University Network Science Institute, Bloomington, IN, USA
| | - Mario Dzemidzic
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hu Cheng
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Peter Finn
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Sharlene Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Ulrike Dydak
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Karmen K Yoder
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA. .,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA. .,Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
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14
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McQueen G, Sendt KV, Gillespie A, Avila A, Lally J, Vallianatou K, Chang N, Ferreira D, Borgan F, Howes OD, Barker GJ, Lythgoe DJ, Stone JM, McGuire P, MacCabe JH, Egerton A. Changes in Brain Glutamate on Switching to Clozapine in Treatment-Resistant Schizophrenia. Schizophr Bull 2021; 47:662-671. [PMID: 33398325 PMCID: PMC8084451 DOI: 10.1093/schbul/sbaa156] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
It has been suggested that the antipsychotic clozapine may modulate brain glutamate, and that this effect could contribute to its efficacy in treatment-resistant schizophrenia (TRS). The aim of this study was to examine the effects of clozapine on brain glutamate in TRS longitudinally. This study examined individuals with TRS before and 12 weeks after switching from a non-clozapine antipsychotic to treatment with clozapine as part of their normal clinical care. Proton magnetic resonance spectroscopy (1H-MRS) measured concentrations, corrected for voxel tissue content, of glutamate (Glucorr), and glutamate plus glutamine (Glxcorr) in the anterior cingulate cortex (ACC) and right caudate nucleus. Symptoms were monitored using the Positive and Negative Syndrome Scale (PANSS). Of 37 recruited patients (27 men, 39.30 years old, 84% clozapine naïve), 25 completed 1H-MRS at both timepoints. 12 weeks of clozapine was associated with a longitudinal reduction in Glucorr in the caudate (n = 23, F = 7.61 P = .01) but not in the ACC (n = 24, F = 0.02, P = .59). Percentage reduction in caudate Glucorr was positively correlated with percentage improvement in symptoms (total PANSS score, n = 23, r = .42, P = .04). These findings indicate that reductions in glutamate in the caudate nucleus may contribute to symptomatic improvement during the first months of clozapine treatment.
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Affiliation(s)
- Grant McQueen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Kyra-Verena Sendt
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Amy Gillespie
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Alessia Avila
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK.,Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kalliopi Vallianatou
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Nynn Chang
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Diogo Ferreira
- Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Faith Borgan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Gareth J Barker
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - David J Lythgoe
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - James M Stone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - James H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
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15
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Mahajan VR, Elvig SK, Vendruscolo LF, Koob GF, Darcey VL, King MT, Kranzler HR, Volkow ND, Wiers CE. Nutritional Ketosis as a Potential Treatment for Alcohol Use Disorder. Front Psychiatry 2021; 12:781668. [PMID: 34916977 PMCID: PMC8670944 DOI: 10.3389/fpsyt.2021.781668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022] Open
Abstract
Alcohol use disorder (AUD) is a chronic, relapsing brain disorder, characterized by compulsive alcohol seeking and disrupted brain function. In individuals with AUD, abstinence from alcohol often precipitates withdrawal symptoms than can be life threatening. Here, we review evidence for nutritional ketosis as a potential means to reduce withdrawal and alcohol craving. We also review the underlying mechanisms of action of ketosis. Several findings suggest that during alcohol intoxication there is a shift from glucose to acetate metabolism that is enhanced in individuals with AUD. During withdrawal, there is a decline in acetate levels that can result in an energy deficit and could contribute to neurotoxicity. A ketogenic diet or ingestion of a ketone ester elevates ketone bodies (acetoacetate, β-hydroxybutyrate and acetone) in plasma and brain, resulting in nutritional ketosis. These effects have been shown to reduce alcohol withdrawal symptoms, alcohol craving, and alcohol consumption in both preclinical and clinical studies. Thus, nutritional ketosis may represent a unique treatment option for AUD: namely, a nutritional intervention that could be used alone or to augment the effects of medications.
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Affiliation(s)
- Vikrant R Mahajan
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - Sophie K Elvig
- Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Baltimore, MD, United States
| | - Leandro F Vendruscolo
- Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Baltimore, MD, United States
| | - George F Koob
- Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Baltimore, MD, United States
| | - Valerie L Darcey
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States
| | - M Todd King
- National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, United States
| | - Henry R Kranzler
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, United States
| | - Corinde E Wiers
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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16
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Wiers CE, Cunningham SI, Tomasi DG, Ernst T, Chang L, Shokri-Kojori E, Wang GJ, Volkow ND. Elevated thalamic glutamate levels and reduced water diffusivity in alcohol use disorder: Association with impulsivity. Psychiatry Res Neuroimaging 2020; 305:111185. [PMID: 32957041 PMCID: PMC9347183 DOI: 10.1016/j.pscychresns.2020.111185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/31/2022]
Abstract
Alcohol induces neuroinflammation but its role in cognitive impairment and impulsivity in alcohol use disorder (AUD) has been poorly investigated. We used proton magnetic resonance spectroscopy to measure brain glutamate (Glu) levels and diffusion-weighted imaging to measure functional anisotropy (FA) in the thalamus and ventral anterior cingulate cortex (vACC) in 15 recently detoxified patients with AUD and 14 matched controls. Compared to controls, AUD patients showed higher Glu levels (p = 0.04) and lower FA in the thalamus (p = 0.04) but not in the vACC. In AUD, thalamic Glu levels (r = 0.62, p = 0.019) and FA (r=-0.55, p = 0.034) were associated with severity of drinking (drinks/week). Compared to controls, AUD patients showed higher scores on Conners' Adult ADHD Rating Scale for impulsivity (p = 0.03), which correlated with glutamate levels in the thalamus (r = 0.58, p = 0.03) and vACC (r = 0.55, p = 0.036). In a second cohort of AUD patients (n = 32), Glu in dorsal ACC (dACC) also correlated with Barrett Impulsiveness Scale total score (r = 0.43, p = 0.014). We interpret the elevated thalamic Glu levels and the parallel reduction in FA in AUD-which correlated with drinking severity-as possible evidence of neurotoxicity from neuroinflammation. The association of Glu with impulsivity suggests that neurotoxic effects of chronic alcohol exposure in the thalamus and dACC may contribute to impulsivity.
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Affiliation(s)
- Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA.
| | | | - Dardo G Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD. USA
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD. USA; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute on Drug Abuse, Bethesda, MD, USA.
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17
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Prisciandaro JJ, Schacht JP, Prescot AP, Brenner HM, Renshaw PF, Brown TR, Anton RF. Intraindividual changes in brain GABA, glutamate, and glutamine during monitored abstinence from alcohol in treatment-naive individuals with alcohol use disorder. Addict Biol 2020; 25:e12810. [PMID: 31373138 PMCID: PMC7953366 DOI: 10.1111/adb.12810] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/13/2019] [Accepted: 06/24/2019] [Indexed: 12/17/2022]
Abstract
Proton magnetic resonance spectroscopy (1 H-MRS) studies have demonstrated abnormal levels of a variety of neurometabolites in treatment-seeking individuals with moderate-severe alcohol use disorder (AUD) following acute withdrawal. In contrast, few studies have investigated neurochemical changes across early abstinence in less severe, treatment-naïve AUD. The present study, which represents the primary report of a research grant from ABMRF/The Alcohol Research Fund, measured dorsal anterior cingulate cortex (dACC) GABA, glutamate, and glutamine levels in treatment-naïve AUD (n = 23) via three 1 H-MRS scans spaced across a planned week of abstinence from alcohol. In addition to AUD participants, 12 light drinkers completed two scans, separated by 48 hours, to ensure that results in AUD were not produced by between-scan differences other than abstinence from alcohol. 1 H-MRS spectra were acquired in dACC at each scan using 2D J-resolved point-resolved spectroscopy. Linear mixed modeling results demonstrated a significant increase in GABA, but not glutamate or glutamine (Ps = .237-.626), levels between scans 1 and 2 (+8.88%, .041), with no difference between scans 2 and 3 (+1.00%, .836), in AUD but not LD (F = 1.24, .290) participants. Exploratory regression analyses tentatively revealed a number of significant prospective associations between changes in glutamine levels and heavy drinking, craving, and withdrawal symptoms. Most notably, the present study demonstrated return from abnormally low to normal GABA levels in treatment-naïve AUD within 3 days of their last drink; the pattern of results was consistent with glutamate and glutamine disturbances being exclusive to relatively more severe AUD.
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Affiliation(s)
- James J. Prisciandaro
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston SC USA
| | - Joseph P. Schacht
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston SC USA
| | | | - Helena M. Brenner
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston SC USA
| | - Perry F. Renshaw
- Department of Psychiatry University of Utah Salt Lake City UT USA
| | - Truman R. Brown
- Department of Radiology Medical University of South Carolina Charleston SC USA
| | - Raymond F. Anton
- Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston SC USA
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18
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Deda O, Virgiliou C, Armitage EG, Orfanidis A, Taitzoglou I, Wilson ID, Loftus N, Gika HG. Metabolic Phenotyping Study of Mouse Brains Following Acute or Chronic Exposures to Ethanol. J Proteome Res 2020; 19:4071-4081. [PMID: 32786683 DOI: 10.1021/acs.jproteome.0c00440] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The chronic and acute effect of ethanol administration on the metabolic phenotype of mouse brain was studied in a C57BL/6 mouse model of ethanol abuse using both untargeted and targeted ultra performance liquid chromatography-tandem mass spectrometry. Two experiments based on either chronic (8 week) exposure to ethanol of both male and female mice or acute exposure of male mice for 11 days, plus 2 oral gavage doses of 25% ethanol, were undertaken. Marked differences were found in amino acids, nucleotides, nucleosides, and related metabolites as well as a number of different lipids. Using untargeted metabolite profiling, acute ethanol exposure found significant decreases in several metabolites including nucleosides, fatty acids, glycerophosphocholine, and a number of phospholipids, while chronic exposure resulted in increases in several amino acids with notable decreases in adenosine, acetylcarnitine, and galactosylceramides. Similarly, targeted metabolite analysis, focusing on the hydrophilic fraction of the brain tissue extract, identified significant decreases in the metabolism of amino acids and derivatives, as well as purine degradation especially after chronic exposure to ethanol.
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Affiliation(s)
- Olga Deda
- Laboratory of Forensic Medicine and Toxicology, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.,Biomic_Auth, Bioanalysis and Omics Lab, Centre for Interdisciplinary Research of Aristotle University of Thessaloniki, Innovation Area of Thessaloniki, Thermi 57001, Greece
| | - Christina Virgiliou
- Biomic_Auth, Bioanalysis and Omics Lab, Centre for Interdisciplinary Research of Aristotle University of Thessaloniki, Innovation Area of Thessaloniki, Thermi 57001, Greece.,Department of Chemistry, Aristotle University, Thessaloniki 54124, Greece
| | | | - Amvrosios Orfanidis
- Laboratory of Forensic Medicine and Toxicology, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Ioannis Taitzoglou
- School of Veterinary Medicine, Aristotle University, Thessaloniki 54124, Greece
| | - Ian D Wilson
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College, London SW7 2AZ, U.K
| | - Neil Loftus
- Shimadzu Corporation, Manchester M17 1GP, U.K
| | - Helen G Gika
- Laboratory of Forensic Medicine and Toxicology, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.,Biomic_Auth, Bioanalysis and Omics Lab, Centre for Interdisciplinary Research of Aristotle University of Thessaloniki, Innovation Area of Thessaloniki, Thermi 57001, Greece
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19
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Muller AM, Meyerhoff DJ. Does an Over-Connected Visual Cortex Undermine Efforts to Stay Sober After Treatment for Alcohol Use Disorder? Front Psychiatry 2020; 11:536706. [PMID: 33362591 PMCID: PMC7758478 DOI: 10.3389/fpsyt.2020.536706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 11/11/2020] [Indexed: 11/13/2022] Open
Abstract
A fine-tuned interplay of highly synchronized activity within and between the brain's communities is a crucial feature of the brain's functional organization. We wanted to investigate in individuals with alcohol use disorder (AUD) the degree to which the interplay of the brain's community-architecture and the extended brain reward system (eBRS) is affected by drinking status (relapse or abstinence). We used Graph Theory Analysis of resting-state fMRI data from treatment seekers at 1 month of abstinence to model the brain's intrinsic community configuration and their follow-up data as abstainers or relapsers 3 months later to quantify the degree of global across-community interaction between the eBRS and the intrinsic communities at both timepoints. After 1 month of abstinence, the ventromedial PFC in particular showed a significantly higher global across-community interaction in the 22 future relapsers when compared to 30 light/non-drinking controls. These differences were no longer present 3 months later when the relapsers had resumed drinking. We found no significant differences between abstainers and controls at either timepoint. Post hoc tests revealed that one eBRS region, the ventromedial PFC, showed a significant global across-community interaction with a community comprising the visual cortex in relapsers at baseline. In contrast, abstainers showed a significant negative association of the ventromedial PFC with the visual cortex. The increased across-community interaction of the ventromedial PFC and the visual cortex in relapsers at timepoint 1 may be an early indicator for treatment failure in a subgroup of AUD patients.
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Affiliation(s)
- Angela M Muller
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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20
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Ueno F, Suzuki T, Nakajima S, Matsushita S, Mimura M, Miyazaki T, Takahashi T, Uchida H. Alteration in AMPA receptor subunit expression and receptor binding among patients with addictive disorders: A systematic review of human postmortem studies. Neuropsychopharmacol Rep 2019; 39:148-155. [PMID: 31070872 PMCID: PMC7292281 DOI: 10.1002/npr2.12058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/12/2019] [Accepted: 04/02/2019] [Indexed: 02/06/2023] Open
Abstract
Background and Objectives Altered trafficking of α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA) receptors has been reported in postmortem studies and suggested the involvement of AMPA receptors in the pathophysiology underpinning addictive disorders. However, these findings seemed mixed. Methods A systematic literature search was conducted, using PubMed and Embase (last search, August 2018), to identify human postmortem studies that examined the expression of proteins and mRNA of AMPA receptor subunits in patients with addictive disorders in comparison with healthy controls. Results Twelve (18 studies) out of 954 articles were identified to be relevant. Eight studies included alcohol use disorders, and four studies included heroin/cocaine abusers. The most frequently investigated regions were the hippocampus (three studies), amygdala (three studies), and putamen (three studies). In summary, two out of the three studies showed an increase in the expression of AMPA receptors in the hippocampus, while the other study found no change. Two studies to examine the amygdala demonstrated either a decreased or no change in receptor expression or binding. Concerning putamen, two studies showed no significant change whereas an overexpression of receptors was observed in the other. Conclusions and Scientific Significance The hippocampus and amygdala may be pertinent to addictive disorders through their functions on learning and memory, whereas findings in other regions were inconsistent across the studies. Human postmortem studies are prone to degenerative changes after death. Moreover, only qualitative assessment was conducted because of the limited, heterogenous data. These limitations emphasize the need to investigate AMPA receptors in the living human brains. Postmortem studies on AMPA receptors in patients with addiction show that the hippocampus and amygdala may be pertinent to addictive disorders through their functions on learning and memory, whereas findings in other regions were inconsistent across the studies. Human postmortem studies are prone to degenerative changes after death, which emphasizes the need to investigate AMPA receptors in the living human brains.![]()
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Affiliation(s)
- Fumihiko Ueno
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takefumi Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry and Clinical Ethics, University of Yamanashi, Kofu, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sachio Matsushita
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Miyazaki
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takuya Takahashi
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, New York
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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21
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Fritz M, Klawonn AM, Zahr NM. Neuroimaging in alcohol use disorder: From mouse to man. J Neurosci Res 2019; 100:1140-1158. [PMID: 31006907 DOI: 10.1002/jnr.24423] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/15/2019] [Accepted: 03/14/2019] [Indexed: 02/06/2023]
Abstract
This article provides an overview of recent advances in understanding the effects of alcohol use disorders (AUD) on the brain from the perspective of magnetic resonance imaging (MRI) research in preclinical models and clinical studies. As a noninvasive investigational tool permitting assessment of morphological, metabolic, and hemodynamic changes over time, MRI offers insight into the dynamic course of alcoholism beginning with initial exposure through periods of binge drinking and escalation, sobriety, and relapse and has been useful in differential diagnosis of neurological diseases associated with AUD. Structural MRI has revealed acute and chronic effects of alcohol on both white and gray matter volumes. MR Spectroscopy, able to quantify brain metabolites in vivo, has shed light on biochemical alterations associated with alcoholism. Diffusion tensor imaging permits microstructural characterization of white matter fiber tracts. Functional MRI has allowed for elucidation of hemodynamic responses at rest and during task engagement. Positron emission tomography, a non-MRI imaging tool, has led to a deeper understanding of alcohol-induced receptor and neurotransmitter changes during various stages of drinking and abstinence. Together, such in vivo imaging tools have expanded our understanding of the dynamic course of alcoholism including evidence for regional specificity of the effects of AUD, hints at mechanisms underlying the shift from casual to compulsive use of alcohol, and profound recovery with sustained abstinence.
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Affiliation(s)
- Michael Fritz
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Anna M Klawonn
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Natalie M Zahr
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.,Neuroscience Program, SRI International, Menlo Park, California
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22
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Monnig MA, Woods AJ, Walsh E, Martone CM, Blumenthal J, Monti PM, Cohen RA. Cerebral Metabolites on the Descending Limb of Acute Alcohol: A Preliminary 1H MRS Study. Alcohol Alcohol 2019; 54:487-496. [PMID: 31322647 DOI: 10.1093/alcalc/agz062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/28/2019] [Accepted: 06/28/2019] [Indexed: 12/19/2022] Open
Abstract
AIMS Chronic alcohol use is associated with cerebral metabolite abnormalities, yet alcohol's acute effects on neurometabolism are not well understood. This preliminary study investigated cerebral metabolite changes in vivo on the descending limb of blood alcohol in healthy moderate drinkers. METHODS In a pre/post design, participants (N = 13) completed magnetic resonance imaging (MRI) scans prior to and approximately 5 hours after consuming a moderate dose of alcohol (0.60 grams alcohol per kilogram of body weight). Magnetic resonance spectroscopy (1H MRS) was used to quantify cerebral metabolites related to glutamatergic transmission (Glx) and neuroimmune activity (Cho, GSH, myo-inositol) in the thalamus and frontal white matter. RESULTS Breath alcohol concentration (BrAC) peaked at 0.070±0.008% (mean ± standard deviation) and averaged 0.025±0.011% directly prior to the descending limb scan. In the thalamus, Glx/Cr and Cho/Cr were significantly elevated on the descending limb scan relative to baseline. BrAC area under the curve, an index of alcohol exposure during the session, was significantly, positively associated with levels of Glx/Cr, Cho/Cr and GSH/Cr in the thalamus. GSH/Cr on the descending limb was inversely correlated with subjective alcohol sedation. CONCLUSIONS This study offers preliminary evidence of alcohol-related increases in Glx/Cr, Cho/Cr and GSH/Cr on the descending limb of blood alcohol concentration. Findings add novel information to previous research on neurometabolic changes at peak blood alcohol in healthy individuals and during withdrawal in individuals with alcohol use disorder.
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Affiliation(s)
- Mollie A Monnig
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology and Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Edward Walsh
- Department of Neuroscience, Brown University, Providence, RI, USA
| | | | - Jonah Blumenthal
- Undergraduate Neuroscience Program, Brown University, Providence, RI, USA
| | - Peter M Monti
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Ronald A Cohen
- Department of Clinical and Health Psychology and Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
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23
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Prisciandaro JJ, Schacht JP, Prescot AP, Renshaw PF, Brown TR, Anton RF. Brain Glutamate, GABA, and Glutamine Levels and Associations with Recent Drinking in Treatment-Naïve Individuals with Alcohol Use Disorder Versus Light Drinkers. Alcohol Clin Exp Res 2019; 43:221-226. [PMID: 30537347 DOI: 10.1111/acer.13931] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/27/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Proton magnetic resonance spectroscopy (1 H-MRS) studies have demonstrated abnormal levels of a variety of neurometabolites in inpatients/outpatients with alcohol use disorder (AUD) following acute alcohol withdrawal relative to healthy controls. In contrast, few studies have compared neurometabolite levels between less severe, treatment-naïve AUD individuals and light drinkers (LD) or related them to recent alcohol consumption. The present study compared neurometabolite levels between treatment-naïve AUD and LD individuals. METHODS Twenty treatment-naïve individuals with AUD and 20 demographically matched LD completed an 1 H-MRS scan, approximately 2.5 days following their last reported drink. 1 H-MRS data were acquired in dorsal anterior cingulate (dACC) using a 2-dimensional J-resolved point-resolved spectroscopy sequence. dACC neurometabolite levels, with a focus on glutamate, glutamine, and GABA, were compared between AUD and LD participants. The associations between metabolite levels and recent drinking were explored. RESULTS AUD participants had significantly lower concentrations of GABA (Cohen's d = 0.79, p = 0.017) and glutamine (Cohen's d = 1.12, p = 0.005), but not glutamate (Cohen's d = 0.05, p = 0.893), relative to LD. As previously reported, AUD participants' glutamate and N-acetylaspartate concentrations were inversely associated with their number of heavy drinking days. In contrast, neither number of drinking (mean p = 0.56) nor heavy drinking (mean p = 0.47) days were associated with metabolite concentrations in LD. CONCLUSIONS The present study demonstrated significantly lower levels of prefrontal γ-aminobutyric acid and glutamine in treatment-naïve individuals with AUD relative to LD. Whether these findings reflect the neurotoxic consequence and/or neuroadaptive response of alcohol consumption versus a predrinking trait, and therefore a more durable neurochemical disturbance, awaits elucidation from longitudinal studies.
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Affiliation(s)
- James J Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Joseph P Schacht
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Andrew P Prescot
- Department of Radiology, University of Utah, Salt Lake City, Utah
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, Utah
| | - Truman R Brown
- Department of Radiology, Medical University of South Carolina, Charleston, South Carolina
| | - Raymond F Anton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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24
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Betka S, Harris L, Rae C, Palfi B, Pfeifer G, Sequeira H, Duka T, Critchley H. Signatures of alcohol use in the structure and neurochemistry of insular cortex: a correlational study. Psychopharmacology (Berl) 2019; 236:2579-2591. [PMID: 31011757 PMCID: PMC6695346 DOI: 10.1007/s00213-019-05228-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/18/2019] [Indexed: 12/16/2022]
Abstract
RATIONALE Insular cortex supports the representation of motivational feelings through the integration of interoceptive information concerning bodily physiology. Compromised insular integrity is implicated in alcohol and drug use disorders. Alcohol-associated insular dysfunction may arise through aberrant glutamatergic neurotransmission associated with selective neuronal death and atrophy. OBJECTIVE In a sample of alcohol users, we combined magnetic resonance spectroscopy (MRS) with voxel and surface-based morphometry (VBM, SBM) to test the hypothesis that the neurochemical and structural properties of the insula relate to alcohol use. METHODS Twenty-three healthy individuals were characterized by measures of alcohol use and subjective craving. Right mid-insula glutamate/glutamine (Glx) and total N-acetylaspartate/N-acetyl-aspartylglutamate (TNAA) concentrations were measured using MRS. Right insular structure was quantified using VBM and SBM parameters. We tested for predictive associations between these neuroimaging and behavioral/psychometric measures using Bayesian statistics. RESULTS Reduced insular Glx concentration was associated with increased alcohol compulsions and, to a lesser extent, with greater alcohol use severity. Anecdotal evidence for a negative relationship between alcohol use severity and levels of insular gyrification was also observed. CONCLUSIONS This study is, to date, the first characterization of the neurochemical and morphological integrity of insular cortex in alcohol users. Our data seem to reveal a negative relationship between alcohol use and the neurochemical and structural integrity of the insula, a critical substrate for motivational behavior. These neurobiological characteristics might contribute to loss of control toward compulsive drinking with prolonged and excessive alcohol use.
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Affiliation(s)
- Sophie Betka
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK.
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, BN1 9QH, UK.
- University of Lille, SCALab, CNRS UMR 9193, 59045, Lille, France.
| | - Lisa Harris
- Radiological Science, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Charlotte Rae
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| | - Bence Palfi
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
- School of Psychology, University of Sussex, Brighton, UK
| | - Gaby Pfeifer
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK
| | | | - Theodora Duka
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, BN1 9QH, UK
- Sussex Addiction Research and Intervention Centre (SARIC), University of Sussex, Brighton, UK
| | - Hugo Critchley
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
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25
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Role of glutamatergic system and mesocorticolimbic circuits in alcohol dependence. Prog Neurobiol 2018; 171:32-49. [PMID: 30316901 DOI: 10.1016/j.pneurobio.2018.10.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/08/2018] [Accepted: 10/08/2018] [Indexed: 02/06/2023]
Abstract
Emerging evidence demonstrates that alcohol dependence is associated with dysregulation of several neurotransmitters. Alterations in dopamine, glutamate and gamma-aminobutyric acid release are linked to chronic alcohol exposure. The effects of alcohol on the glutamatergic system in the mesocorticolimbic areas have been investigated extensively. Several studies have demonstrated dysregulation in the glutamatergic systems in animal models exposed to alcohol. Alcohol exposure can lead to an increase in extracellular glutamate concentrations in mesocorticolimbic brain regions. In addition, alcohol exposure affects the expression and functions of several glutamate receptors and glutamate transporters in these brain regions. In this review, we discussed the effects of alcohol exposure on glutamate receptors, glutamate transporters and glutamate homeostasis in each area of the mesocorticolimbic system. In addition, we discussed the genetic aspect of alcohol associated with glutamate and reward circuitry. We also discussed the potential therapeutic role of glutamate receptors and glutamate transporters in each brain region for the treatment of alcohol dependence. Finally, we provided some limitations on targeting the glutamatergic system for potential therapeutic options for the treatment alcohol use disorders.
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26
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Mullins PG. Towards a theory of functional magnetic resonance spectroscopy (fMRS): A meta-analysis and discussion of using MRS to measure changes in neurotransmitters in real time. Scand J Psychol 2018; 59:91-103. [PMID: 29356002 DOI: 10.1111/sjop.12411] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/01/2017] [Indexed: 02/06/2023]
Abstract
Proton magnetic resonance spectroscopy is a powerful tool to investigate neurochemistry and physiology in vivo. Recently researchers have started to use MRS to measure neurotransmitter changes related to neural activity, so called functional MRS (fMRS). Particular interest has been placed on measuring glutamate changes associated with neural function, but differences are reported in the size of changes seen. This review discusses fMRS, and includes meta-analyses of the relative size of glutamate changes seen in fMRS, and the impact experimental design and stimulus paradigm may have. On average glutamate was found to increase by 6.97% (±1.739%) in response to neural activation. However, factors of experimental design may have a large impact on the size of these changes. For example an increase of 4.749% (±1.45%) is seen in block studies compared to an increase of 13.429% (±3.59) in studies using event related paradigms. The stimulus being investigated also seems to play a role with prolonged visual stimuli showing a small mean increase in glutamate of 2.318% (±1.227%) while at the other extreme, pain stimuli show a mean stimulation effect of 14.458% (±3.736%). These differences are discussed with regards to possible physiologic interpretations, as well experimental design implications.
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27
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Cheng H, Kellar D, Lake A, Finn P, Rebec GV, Dharmadhikari S, Dydak U, Newman S. Effects of Alcohol Cues on MRS Glutamate Levels in the Anterior Cingulate. Alcohol Alcohol 2018; 53:209-215. [PMID: 29329417 DOI: 10.1093/alcalc/agx119] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 12/20/2017] [Indexed: 11/13/2022] Open
Abstract
Growing evidence suggests that glutamate neurotransmission plays a critical role in alcohol addiction. Cue-induced change of glutamate has been observed in animal studies but never been investigated in humans. This work investigates cue-induced change in forebrain glutamate in individuals with alcohol use disorder (AUD). A total of 35 subjects (17 individuals with AUD and 18 healthy controls) participated in this study. The glutamate concentration was measured with single-voxel 1H-MR spectroscopy at the dorsal anterior cingulate. Two MRS sessions were performed in succession, the first to establish basal glutamate levels and the second to measure the change in response to alcohol cues. The changes in glutamate were quantified for both AUD subjects and controls. A mixed model ANOVA and t-tests were performed for statistical analysis. ANOVA revealed a main effect of cue-induced decrease of glutamate level in the anterior cingulate cortex (ACC). A significant interaction revealed that only AUD subjects showed significant decrease of glutamate in the ACC. There were no significant group differences in the level of basal glutamate. However, a negative correlation was found between the basal glutamate level and the number of drinking days in the past 2 weeks for the AUD subjects. Collectively, our results indicate that glutamate in key areas of the forebrain reward circuit is modulated by alcohol cues in early alcohol dependence.
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Affiliation(s)
- Hu Cheng
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Derek Kellar
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Allison Lake
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Peter Finn
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - George V Rebec
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Shalmali Dharmadhikari
- School of Health Sciences, Purdue University, West Lafayette, IN, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, West Lafayette, IN, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sharlene Newman
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
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28
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Morley KC, Lagopoulos J, Logge W, Chitty K, Baillie A, Haber PS. Neurometabolite Levels in Alcohol Use Disorder Patients During Baclofen Treatment and Prediction of Relapse to Heavy Drinking. Front Psychiatry 2018; 9:412. [PMID: 30233431 PMCID: PMC6131632 DOI: 10.3389/fpsyt.2018.00412] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/13/2018] [Indexed: 12/20/2022] Open
Abstract
Background and Aims: Baclofen, a GABAB agonist, is used as a treatment for alcohol dependence. We aimed to examine brain metabolites following administration of baclofen or placebo in alcohol dependent individuals enrolled in a randomized placebo-controlled trial. Methods: Participants included 31 alcohol dependent individuals (recent drinking: N = 16; and abstinent: N = 15) who had received daily baclofen (BAC 30-75 mg = 20) or placebo (PL = 11) for at least 2 weeks (average 17 days). Using in vivo proton magnetic resonance spectroscopy (1H-MRS), spectra from the right parietal lobe were analyzed to obtain measures of GABA, Glutamate (Glu), Glutathione (GSH) and N-Acetyl Apartate (NAA) 120 min following administration of PL or BAC. Results: When weighting alcohol dependent participants according to recent alcohol consumption (within 24 h), there were significant differences between BAC and PL on parietal concentrations of GSH (p < 0.01) and NAA (p < 0.05). Multiple linear regression revealed a significant predictive effect of GSH on heavy drinking days at 12 weeks follow-up (Model: F = 14.28, R2 = 0.85; GSH: B = -1.22, p = 0.01) and also percentage days abstinent at 12 weeks follow-up (Model: F = 6.50, R2 = 0.72; GSH: B = 0.99, p = 0.06). Conclusion: Our data provide preliminary evidence that the effect of baclofen may be mediated by increased parietal concentrations of the antioxidant GSH and NAA in recently drinking alcohol dependent patients. GSH/Cr levels were also predictive of improved drinking outcomes in the trial and suggests a role for neural oxidative stress in alcohol use disorder.
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Affiliation(s)
- Kirsten C Morley
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience, University of Sunshine Coast, Birtinya, QLD, Australia
| | - Warren Logge
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Kate Chitty
- School of Pharmacology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Andrew Baillie
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Paul S Haber
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Sydney, NSW, Australia
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29
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Online effects of transcranial direct current stimulation on prefrontal metabolites in gambling disorder. Neuropharmacology 2017; 131:51-57. [PMID: 29221791 DOI: 10.1016/j.neuropharm.2017.12.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 02/07/2023]
Abstract
Gambling disorder is characterized by persistent maladaptive gambling behaviors and is now considered among substance-related and addictive disorders. There is still unmet therapeutic need for these clinical populations, however recent advances indicate that interventions targeting the Glutamatergic/GABAergic system hold promise in reducing symptoms in substance-related and addictive disorders, including gambling disorder. There is some data indicating that transcranial direct current stimulation may hold clinical benefits in substance use disorders and modulate levels of brain metabolites including glutamate and GABA. The goal of the present work was to test whether this non-invasive neurostimulation method modulates key metabolites in gambling disorder. We conducted a sham-controlled, crossover, randomized study, blinded at two levels in order to characterize the effects of transcranial direct current stimulation over the dorsolateral prefrontal cortex on neural metabolites levels in sixteen patients with gambling disorder. Metabolite levels were measured with magnetic resonance spectroscopy from the right dorsolateral prefrontal cortex and the right striatum during active and sham stimulation. Active as compared to sham stimulation elevated prefrontal GABA levels. There were no significant changes between stimulation conditions in prefrontal glutamate + glutamine and N-acetyl Aspartate, or in striatal metabolite levels. Results also indicated positive correlations between metabolite levels during active, but not sham, stimulation and levels of risk taking, impulsivity and craving. Our findings suggest that transcranial direct current stimulation can modulate GABA levels in patients with gambling disorder which may represent an interesting future therapeutic avenue.
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30
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Effects of sequential ethanol exposure and repeated high-dose methamphetamine on striatal and hippocampal dopamine, serotonin and glutamate tissue content in Wistar rats. Neurosci Lett 2017; 665:61-66. [PMID: 29174641 DOI: 10.1016/j.neulet.2017.11.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/04/2017] [Accepted: 11/20/2017] [Indexed: 11/20/2022]
Abstract
Alcohol (ethanol) and methamphetamine (METH) co-abuse is a major public health issue. Ethanol or METH exposure has been associated with changes in neurotransmitter levels in several central brain regions. However, little is known about the effect of sequential exposure to ethanol and METH on glutamate, dopamine and serotonin tissue content in striatum and hippocampus. In this study, we investigated the effects of sequential exposure to ethanol and METH on tissue content of these neurotransmitters. Male Wistar rats were orally gavaged with either ethanol (6g/kg) or water for seven days. Rats were administered with high dose of METH (10mg/kg, i.p. every 2h×4) or saline on Day 8 and euthanized 48h of last METH or saline i.p. injection. In the striatum, sequential exposure to ethanol and METH increased glutamate tissue content while reducing dopamine and serotonin tissue content as compared to the group exposed to ethanol alone. In the hippocampus, sequential exposure to ethanol and METH decreased serotonin tissue content as compared to the group that was exposed to ethanol alone. However, this study showed that ethanol has no additive effect to METH on tissue content of dopamine and serotonin as compared to METH in the striatum and hippocampus. This study demonstrated that sequential exposure of ethanol and METH has an additive effect on tissue content of certain neurotransmitters in the brain.
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31
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Schulte MHJ, Kaag AM, Wiers RW, Schmaal L, van den Brink W, Reneman L, Homberg JR, van Wingen GA, Goudriaan AE. Prefrontal Glx and GABA concentrations and impulsivity in cigarette smokers and smoking polysubstance users. Drug Alcohol Depend 2017; 179:117-123. [PMID: 28763779 DOI: 10.1016/j.drugalcdep.2017.06.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 12/22/2022]
Abstract
Glutamate and GABA play an important role in substance dependence. However, it remains unclear whether this holds true for different substance use disorders and how this is related to risk-related traits such as impulsivity. We, therefore, compared Glx (as a proxy measure for glutamate) and GABA concentrations in the dorsal anterior cingulate cortex (dACC) of 48 male cigarette smokers, 61 male smoking polysubstance users, and 90 male healthy controls, and investigated the relationship with self-reported impulsivity and substance use. Glx and GABA concentrations were measured using proton Magnetic Resonance Spectroscopy. Impulsivity, smoking, alcohol and cocaine use severity and cannabis use were measured using self-report instruments. Results indicate a trend towards group differences in Glx. Post-hoc analyses showed a difference between smokers and healthy controls (p=0.04) and a trend towards higher concentrations in smoking polysubstance users and healthy controls (p=0.09), but no differences between smokers and smoking polysubstance users. dACC GABA concentrations were not significantly different between groups. Smoking polysubstance users were more impulsive than smokers, and both groups were more impulsive than controls. No significant associations were observed between dACC neurotransmitter concentrations and impulsivity and level and severity of smoking, alcohol or cocaine use or the presence of cannabis use. The results indicate that differences in dACC Glx are unrelated to type and level of substance use. No final conclusion can be drawn on the lack of GABA differences due to assessment difficulties. The relationship between dACC neurotransmitter concentrations and cognitive impairments other than self-reported impulsivity should be further investigated.
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Affiliation(s)
- Mieke H J Schulte
- Addiction, Development, and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands.
| | - Anne Marije Kaag
- Addiction, Development, and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Reinout W Wiers
- Addiction, Development, and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, The Netherlands
| | - Lianne Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Judith R Homberg
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, The Netherlands
| | - Guido A van Wingen
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands; Spinoza center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands; Arkin Mental Health, Amsterdam, The Netherlands
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Prisciandaro JJ, Tolliver BK, Prescot AP, Brenner HM, Renshaw PF, Brown TR, Anton RF. Unique prefrontal GABA and glutamate disturbances in co-occurring bipolar disorder and alcohol dependence. Transl Psychiatry 2017; 7:e1163. [PMID: 28675386 PMCID: PMC5538121 DOI: 10.1038/tp.2017.141] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/09/2017] [Accepted: 05/15/2017] [Indexed: 12/25/2022] Open
Abstract
Bipolar disorder (BD) and alcohol dependence (AD) frequently co-occur, and co-occurring BD and AD are associated with devastating public health costs. Minimal neurobiological research exists to guide the development of effective treatments for this treatment-resistant population. We believe the present study represents the first investigation of prefrontal gamma-aminobutyric acid (GABA) and glutamate levels in co-occurring BD and current AD. The participants were 78 individuals who met DSM-IV criteria for BD I/II and current AD (n=20), BD I/II alone (n=19), current AD alone (n=20) or no diagnosis (n=19). The participants completed a baseline diagnostic visit, then returned approximately 4 days later for a two-dimensional J-resolved proton magnetic resonance spectroscopy (1H-MRS) acquisition in dorsal anterior cingulate cortex (dACC). All participants were required to demonstrate ⩾1 week of abstinence from alcohol/drugs via serial biomarker testing before 1H-MRS. A 2 × 2 factorial analysis of variance of cerebrospinal fluid (CSF)-corrected GABA/water concentrations demonstrated a significant BD × AD interaction (F=2.91, P<0.05), signifying uniquely low levels of GABA in BD+AD; this effect doubled when the sample was restricted to individuals who consumed alcohol within 2 weeks of 1H-MRS. There were no overall effects of BD/AD on CSF-corrected glutamate/water levels. However, the BD × AD interaction, signifying uniquely low levels of glutamate in BD+AD, approached statistical significance (F=3.83, P=0.06) in individuals who consumed alcohol within 2 weeks of 1H-MRS. The dACC GABA levels were significantly, negatively associated with Barratt Impulsiveness Scale (r=-0.28, P=0.02) and Obsessive Compulsive Drinking Scale (r=-0.35, P<0.01) scores. If replicated, these results may suggest that future treatment studies should preferentially evaluate therapeutics in BD+AD known to increase prefrontal GABA and glutamate levels.
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Affiliation(s)
- J J Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, PO Box 250861, Charleston, SC 29425, USA. E-mail:
| | - B K Tolliver
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - A P Prescot
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - H M Brenner
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - P F Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - T R Brown
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - R F Anton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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33
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How much alcohol is in ketamine's antidepressant action? Life Sci 2017; 168:54-57. [DOI: 10.1016/j.lfs.2016.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 10/22/2016] [Accepted: 11/03/2016] [Indexed: 12/29/2022]
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Bonnet U. How much of ketamine's antidepressant response is shared with ethanol? Br J Psychiatry 2016; 209:434-435. [PMID: 27802986 DOI: 10.1192/bjp.209.5.434b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Udo Bonnet
- Udo Bonnet, Psychiatrist, MD, Professor, Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Germany.
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Bernier D, Bartha R, McAllindon D, Hanstock CC, Marchand Y, Dillen KNH, Gallant M, Good KP, Tibbo PG. Illness versus substance use effects on the frontal white matter in early phase schizophrenia: A 4Tesla (1)H-MRS study. Schizophr Res 2016; 175:4-11. [PMID: 27161760 DOI: 10.1016/j.schres.2016.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Young adults with early phase schizophrenia often report a past or current pattern of illicit substance use and/or alcohol misuse. Still, little is known about the cumulative and separate effects of each stressor on white matter tissue, at this vulnerable period of brain development. METHODS Participants involved 24 healthy controls with a past or current history of sustained illicit drug use and/or alcohol misuse (users), 23 healthy controls without such history (normative data), and 27 users with early phase schizophrenia. (1)H-MRS data were acquired from a large frontal volume encompassing 95% of white matter, using a 4Tesla scanner (LASER sequence, TR/TE 3200/46ms). RESULTS Reduced levels of choline-containing compounds (Cho) were specific to the effect of illness (Cohen's d=0.68), with 22% of the variance in Cho levels accounted for by duration of illness. Reduced levels of myoInositol (d=1.10) and creatine plus phosphocreatine (d=1.07) were specific to the effects of illness plus substance use. Effect of substance use on its own was revealed by reductions in levels of glutamate plus glutamine (d=0.83) in control users relative to normative data. CONCLUSIONS The specific effect of illness on white matter might indicate a decreased synthesis of membrane phospholipids or alternatively, reduced membrane cellular density. In terms of limitations, this study did not include patients without a lifetime history of substance use (non-users), and the specific effect of each substance used could not be studied separately.
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Affiliation(s)
- Denise Bernier
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Robert Bartha
- Robarts Research Institute, University of Western Ontario, Ontario, Canada
| | - David McAllindon
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada; Biomedical Translational Imaging Centre, Halifax, Nova Scotia, Canada
| | | | - Yannick Marchand
- Faculty of Computer Science, Department of Psychology and Neuroscience, Dalhousie University, Nova Scotia, Canada
| | - Kim N H Dillen
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Michelle Gallant
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Kimberly P Good
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada.
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Frye MA, Hinton DJ, Karpyak VM, Biernacka JM, Gunderson LJ, Geske J, Feeder SE, Choi DS, Port JD. Elevated Glutamate Levels in the Left Dorsolateral Prefrontal Cortex Are Associated with Higher Cravings for Alcohol. Alcohol Clin Exp Res 2016; 40:1609-16. [PMID: 27439218 DOI: 10.1111/acer.13131] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/18/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Quantifying craving longitudinally during the course of withdrawal, early abstinence, and relapse is essential for optimal management of alcohol use disorder (AUD). In an effort to identify biological correlates of craving, we used proton magnetic resonance spectroscopy (1H-MRS) to investigate the correlation between craving and glutamate levels in the left dorsolateral prefrontal cortex (LDLPFC) of patients with AUD. METHODS Participants underwent 1H-MRS of the LDLPFC with 2-dimensional J-resolved (2DJ) averaged PRESS. MRS data were processed with LCModel and cerebrospinal fluid (CSF)-corrected to generate metabolite concentrations. The Penn Alcohol Craving Scale (PACS) and the 30-day time line follow-back (TLFB 30) were used to quantify craving for alcohol and drinking patterns, respectively. RESULTS There was a statistically significant positive correlation between CSF-corrected glutamate ([Glu]) levels and PACS scores (n = 14; p = 0.005). When PACS scores were dichotomized (< or ≥median = 16), [Glu] levels were significantly higher in the high- versus low-craving group (p = 0.007). In addition, there was a significant negative correlation between CSF-corrected N-acetyl aspartic acid ([NAA]) levels and mean number of drinks per drinking day in the past month (n = 13; TLFB 30; p = 0.012). When mean TLFB 30 was dichotomized (< or ≥median = 7.86), [NAA] levels were significantly lower in subjects that consumed more alcoholic beverages. There was no significant correlation between [Glu] and [NAA] levels with other measures of drinking behavior and or depression symptom severity. CONCLUSIONS While limited by small sample size, these data suggest that glutamate levels in LDLPFC are associated with alcohol craving intensity in patients with AUD. Further study with larger sample size is needed to replicate this finding and evaluate the merits of glutamate spectroscopy as a biological correlate of alcohol craving intensity and a guide to treatment interventions.
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Affiliation(s)
- Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - David J Hinton
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, Minnesota.,Neurobiology of Disease Program, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Victor M Karpyak
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Joanna M Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota.,Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Lee J Gunderson
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Jennifer Geske
- Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Scott E Feeder
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Doo-Sup Choi
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, Minnesota.,Neurobiology of Disease Program, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - John D Port
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota.,Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota
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Oeltzschner G, Butz M, Wickrath F, Wittsack HJ, Schnitzler A. Covert hepatic encephalopathy: elevated total glutathione and absence of brain water content changes. Metab Brain Dis 2016; 31:517-27. [PMID: 26563124 DOI: 10.1007/s11011-015-9760-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/06/2015] [Indexed: 01/20/2023]
Abstract
Recent pathophysiological models suggest that oxidative stress and hyperammonemia lead to a mild brain oedema in hepatic encephalopathy (HE). Glutathione (GSx) is a major cellular antioxidant and known to be involved in the interception of both. The aim of this work was to study total glutathione levels in covert HE (minimal HE and HE grade 1) and to investigate their relationship with local brain water content, levels of glutamine (Gln), myo-inositol (mI), neurotransmitter levels, critical flicker frequency (CFF), and blood ammonia. Proton magnetic resonance spectroscopy ((1)H MRS) data were analysed from visual and sensorimotor cortices of thirty patients with covert HE and 16 age-matched healthy controls. Total glutathione levels (GSx/Cr) were quantified with respect to creatine. Furthermore, quantitative MRI brain water content measures were evaluated. Data were tested for links with the CFF and blood ammonia. GSx/Cr was elevated in the visual (mHE) and sensorimotor (mHE, HE 1) MRS volumes and correlated with blood ammonia levels (both P < 0.001). It was further linked to Gln/Cr and mI/Cr (P < 0.01 in visual, P < 0.001 in sensorimotor) and to GABA/Cr (P < 0.01 in visual). Visual GSx/Cr correlated with brain water content in the thalamus, nucleus caudatus, and visual cortex (P < 0.01). Brain water measures did neither show group effects nor correlations with CFF or blood ammonia. Elevated total glutathione levels in covert HE (< HE 2) correlate with blood ammonia and may be a regional-specific reaction to hyperammonemia and oxidative stress. Brain water content is locally linked to visual glutathione levels, but appears not to be associated with changes of clinical parameters. This might suggest that cerebral oedema is only marginally responsible for the symptoms of covert HE.
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Affiliation(s)
- Georg Oeltzschner
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Universitätsstr. 1, D-40225, Düsseldorf, Germany.
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, D-40225, Düsseldorf, Germany.
| | - Markus Butz
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Universitätsstr. 1, D-40225, Düsseldorf, Germany
| | - Frithjof Wickrath
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, D-40225, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, D-40225, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Universitätsstr. 1, D-40225, Düsseldorf, Germany
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Bell RL, Hauser S, Rodd ZA, Liang T, Sari Y, McClintick J, Rahman S, Engleman EA. A Genetic Animal Model of Alcoholism for Screening Medications to Treat Addiction. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2016; 126:179-261. [PMID: 27055615 PMCID: PMC4851471 DOI: 10.1016/bs.irn.2016.02.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The purpose of this review is to present up-to-date pharmacological, genetic, and behavioral findings from the alcohol-preferring P rat and summarize similar past work. Behaviorally, the focus will be on how the P rat meets criteria put forth for a valid animal model of alcoholism with a highlight on its use as an animal model of polysubstance abuse, including alcohol, nicotine, and psychostimulants. Pharmacologically and genetically, the focus will be on the neurotransmitter and neuropeptide systems that have received the most attention: cholinergic, dopaminergic, GABAergic, glutamatergic, serotonergic, noradrenergic, corticotrophin releasing hormone, opioid, and neuropeptide Y. Herein, we sought to place the P rat's behavioral and neurochemical phenotypes, and to some extent its genotype, in the context of the clinical literature. After reviewing the findings thus far, this chapter discusses future directions for expanding the use of this genetic animal model of alcoholism to identify molecular targets for treating drug addiction in general.
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Affiliation(s)
- R L Bell
- Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, United States.
| | - S Hauser
- Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Z A Rodd
- Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, United States
| | - T Liang
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Y Sari
- University of Toledo, Toledo, OH, United States
| | - J McClintick
- Center for Medical Genomics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - S Rahman
- Department of Pharmaceutical Sciences, South Dakota State University, Brookings, SD, United States
| | - E A Engleman
- Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, United States
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Prisciandaro JJ, Schacht JP, Prescot AP, Renshaw PF, Brown TR, Anton RF. Associations Between Recent Heavy Drinking and Dorsal Anterior Cingulate N-Acetylaspartate and Glutamate Concentrations in Non-Treatment-Seeking Individuals with Alcohol Dependence. Alcohol Clin Exp Res 2016; 40:491-6. [PMID: 26853538 DOI: 10.1111/acer.12977] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/27/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Proton magnetic resonance spectroscopy ((1) H-MRS) studies have consistently found abnormal brain concentrations of N-acetylaspartate (NAA) and glutamate in individuals with alcohol use disorders (AUD) relative to light drinkers. However, most such studies have focused on individuals in treatment for severe alcohol dependence (AD), and few studies have investigated associations between neurochemical concentrations and recent alcohol consumption. This study focused on associations between recent drinking and prefrontal neurometabolite concentrations in nonsevere, non-treatment-seeking individuals with AUD. METHODS Nineteen treatment-naïve alcohol-dependent individuals aged 21 to 40 completed a (1) H-MRS scan. Single-voxel (1) H-MRS spectra were acquired in dorsal anterior cingulate cortex (dACC) using a 2-dimensional J-resolved point resolved spectroscopy sequence. Associations between recent heavy drinking, assessed using the Timeline FollowBack, and dACC metabolite concentrations were estimated via regression controlling for within-voxel tissue composition. RESULTS Participants provided a negative breathalyzer reading and reported between 1 and 5 days (M = 2.45, SD = 1.23) since their last drink. Number of heavy drinking days in the 14 days preceding the scan (M = 4.84, SD = 3.32) was significantly inversely associated with both glutamate/water (β = -0.63, t(17) = -3.37, p = 0.004) and NAA/water concentrations (β = -0.59, t(17) = -2.98, p = 0.008). CONCLUSIONS This study extends the literature by demonstrating inverse associations between recent heavy drinking and dACC glutamate and NAA concentrations in a sample of nonsevere, non-treatment-seeking individuals with AD. These findings may support the hypothesis that amount of recent alcohol consumption may account for differences in neuronal metabolism, even in nonsevere, non-treatment-seeking alcoholics.
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Affiliation(s)
- James J Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Joseph P Schacht
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Andrew P Prescot
- Department of Radiology, University of Utah, Salt Lake City, Utah
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, Utah
| | - Truman R Brown
- Department of Radiology, Medical University of South Carolina, Charleston, South Carolina
| | - Raymond F Anton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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Moeller SJ, London ED, Northoff G. Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: Relationships to resting-state functional connectivity. Neurosci Biobehav Rev 2016; 61:35-52. [PMID: 26657968 PMCID: PMC4731270 DOI: 10.1016/j.neubiorev.2015.11.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/05/2015] [Accepted: 11/21/2015] [Indexed: 12/29/2022]
Abstract
Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications.
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Affiliation(s)
- Scott J Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Edythe D London
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Georg Northoff
- Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, Ottawa, Canada.
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Das SC, Althobaiti YS, Alshehri FS, Sari Y. Binge ethanol withdrawal: Effects on post-withdrawal ethanol intake, glutamate-glutamine cycle and monoamine tissue content in P rat model. Behav Brain Res 2016; 303:120-5. [PMID: 26821293 DOI: 10.1016/j.bbr.2016.01.052] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/18/2016] [Accepted: 01/22/2016] [Indexed: 12/28/2022]
Abstract
Alcohol withdrawal syndrome (AWS) is a medical emergency situation which appears after abrupt cessation of ethanol intake. Decreased GABA-A function and increased glutamate function are known to exist in the AWS. However, the involvement of glutamate transporters in the context of AWS requires further investigation. In this study, we used a model of ethanol withdrawal involving abrupt cessation of binge ethanol administration (4 g/kg/gavage three times a day for three days) using male alcohol-preferring (P) rats. After 48 h of withdrawal, P rats were re-exposed to voluntary ethanol intake. The amount of ethanol consumed was measured during post-withdrawal phase. In addition, the expression of GLT-1, GLAST and xCT were determined in both medial prefrontal cortex (mPFC) and nucleus accumbens (NAc). We also measured glutamine synthetase (GS) activity, and the tissue content of glutamate, glutamine, dopamine and serotonin in both mPFC and NAc. We found that binge ethanol withdrawal escalated post-withdrawal ethanol intake, which was associated with downregulation of GLT-1 expression in both mPFC and NAc. The expression of GLAST and xCT were unchanged in the ethanol-withdrawal (EW) group compared to control group. Tissue content of glutamate was significantly lower in both mPFC and NAc, whereas tissue content of glutamine was higher in mPFC but unchanged in NAc in the EW group compared to control group. The GS activity was unchanged in both mPFC and NAc. The tissue content of DA was significantly lower in both mPFC and NAc, whereas tissue content of serotonin was unchanged in both mPFC and NAc. These findings provide important information of the critical role of GLT-1 in context of AWS.
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Affiliation(s)
- Sujan C Das
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, United States
| | - Yusuf S Althobaiti
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, United States
| | - Fahad S Alshehri
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, United States
| | - Youssef Sari
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, United States.
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Bell RL, Hauser SR, McClintick J, Rahman S, Edenberg HJ, Szumlinski KK, McBride WJ. Ethanol-Associated Changes in Glutamate Reward Neurocircuitry: A Minireview of Clinical and Preclinical Genetic Findings. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2015; 137:41-85. [PMID: 26809998 DOI: 10.1016/bs.pmbts.2015.10.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Herein, we have reviewed the role of glutamate, the major excitatory neurotransmitter in the brain, in a number of neurochemical, -physiological, and -behavioral processes mediating the development of alcohol dependence. The findings discussed include results from both preclinical as well as neuroimaging and postmortem clinical studies. Expression levels for a number of glutamate-associated genes and/or proteins are modulated by alcohol abuse and dependence. These changes in expression include metabotropic receptors and ionotropic receptor subunits as well as different glutamate transporters. Moreover, these changes in gene expression parallel the pharmacologic manipulation of these same receptors and transporters. Some of these gene expression changes may have predated alcohol abuse and dependence because a number of glutamate-associated polymorphisms are related to a genetic predisposition to develop alcohol dependence. Other glutamate-associated polymorphisms are linked to age at the onset of alcohol-dependence and initial level of response/sensitivity to alcohol. Finally, findings of innate and/or ethanol-induced glutamate-associated gene expression differences/changes observed in a genetic animal model of alcoholism, the P rat, are summarized. Overall, the existing literature indicates that changes in glutamate receptors, transporters, enzymes, and scaffolding proteins are crucial for the development of alcohol dependence and there is a substantial genetic component to these effects. This indicates that continued research into the genetic underpinnings of these glutamate-associated effects will provide important novel molecular targets for treating alcohol abuse and dependence.
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Affiliation(s)
- Richard L Bell
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
| | - Sheketha R Hauser
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jeanette McClintick
- Departments of Biochemistry and Molecular Biology and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana , USA
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, South Dakota State University, Brookings, South Dakota, USA
| | - Howard J Edenberg
- Departments of Biochemistry and Molecular Biology and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana , USA
| | - Karen K Szumlinski
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, California, USA
| | - William J McBride
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Hillmer AT, Mason GF, Fucito LM, O'Malley SS, Cosgrove KP. How Imaging Glutamate, γ-Aminobutyric Acid, and Dopamine Can Inform the Clinical Treatment of Alcohol Dependence and Withdrawal. Alcohol Clin Exp Res 2015; 39:2268-82. [PMID: 26510169 DOI: 10.1111/acer.12893] [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: 04/02/2015] [Accepted: 08/29/2015] [Indexed: 12/29/2022]
Abstract
Neuroimaging studies have dramatically advanced our understanding of the neurochemical basis of alcohol dependence, a major public health issue. In this paper, we review the research generated from neurochemical specific imaging modalities including magnetic resonance spectroscopy, positron emission tomography, and single-photon emission computed tomography in studies of alcohol dependence and withdrawal. We focus on studies interrogating γ-aminobutyric acid (GABA), glutamate, and dopamine, as these are prominent neurotransmitter systems implicated in alcohol dependence. Highlighted findings include diminished dopaminergic functioning and modulation of the GABA system by tobacco smoking during alcohol withdrawal. Then, we consider how these findings impact the clinical treatment of alcohol dependence and discuss directions for future experiments to address existing gaps in the literature, for example, sex differences and smoking comorbidity. These and other considerations provide opportunities to build upon the current neurochemistry imaging literature of alcohol dependence and withdrawal, which may usher in improved therapeutic and relapse prevention strategies.
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Affiliation(s)
- Ansel T Hillmer
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Graeme F Mason
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Lisa M Fucito
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Stephanie S O'Malley
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Kelly P Cosgrove
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
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Prefrontal and Striatal Glutamate Differently Relate to Striatal Dopamine: Potential Regulatory Mechanisms of Striatal Presynaptic Dopamine Function? J Neurosci 2015; 35:9615-21. [PMID: 26134644 DOI: 10.1523/jneurosci.0329-15.2015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
UNLABELLED Theoretical and animal work has proposed that prefrontal cortex (PFC) glutamate inhibits dopaminergic inputs to the ventral striatum (VS) indirectly, whereas direct VS glutamatergic afferents have been suggested to enhance dopaminergic inputs to the VS. In the present study, we aimed to investigate relationships of glutamate and dopamine measures in prefrontostriatal circuitries of healthy humans. We hypothesized that PFC and VS glutamate, as well as their balance, are differently associated with VS dopamine. Glutamate concentrations in the left lateral PFC and left striatum were assessed using 3-Tesla proton magnetic resonance spectroscopy. Striatal presynaptic dopamine synthesis capacity was measured by fluorine-18-l-dihydroxyphenylalanine (F-18-FDOPA) positron emission tomography. First, a negative relationship was observed between glutamate concentrations in lateral PFC and VS dopamine synthesis capacity (n = 28). Second, a positive relationship was revealed between striatal glutamate and VS dopamine synthesis capacity (n = 26). Additionally, the intraindividual difference between PFC and striatal glutamate concentrations correlated negatively with VS dopamine synthesis capacity (n = 24). The present results indicate an involvement of a balance in PFC and striatal glutamate in the regulation of VS dopamine synthesis capacity. This notion points toward a potential mechanism how VS presynaptic dopamine levels are kept in a fine-tuned range. A disruption of this mechanism may account for alterations in striatal dopamine turnover as observed in mental diseases (e.g., in schizophrenia). SIGNIFICANCE STATEMENT The present work demonstrates complementary relationships between prefrontal and striatal glutamate and ventral striatal presynaptic dopamine using human imaging measures: a negative correlation between prefrontal glutamate and presynaptic dopamine and a positive relationship between striatal glutamate and presynaptic dopamine are revealed. The results may reflect a regulatory role of prefrontal and striatal glutamate for ventral striatal presynaptic dopamine levels. Such glutamate-dopamine relationships improve our understanding of neurochemical interactions in prefrontostriatal circuits and have implications for the neurobiology of mental disease.
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Thoma RJ, Long J, Monnig M, Yeo RA, Petropoulos H, Gasparovic C, Pommy J, Mullins PG. 1H-MRS glutamate level predicts auditory sensory gating in alcohol dependence: Preliminary results. NEUROPSYCHIATRIC ELECTROPHYSIOLOGY 2015; 1. [PMID: 34012554 PMCID: PMC8130891 DOI: 10.1186/s40810-015-0014-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: Impairment in auditory sensory gating (ASG) has been documented in alcohol dependence [1]. Likewise, it has been shown that ASG becomes abnormal during alcohol administration in otherwise healthy individuals [2]. Patterns of gating abnormality associated with alcohol use are likely associated with an alcohol responsive neurochemical like glutamate (Glu), particularly since it is well-established that alcohol affects NMDA receptors and that glutamatergic functioning is abnormal in both acute alcohol use and in alcohol dependence [3]. Hence, a link between Glu metabolite levels and ASG was hypothesized. It was first hypothesized that Glu and ASG abnormality would be found in groups with alcohol dependence. A second hypothesis was that across groups, greater Glu would predict reduced ASG. Methods: Groups were comprised of healthy, non-drinking controls (Controls, N = 4), individuals with current alcohol dependence (AUD-current, N = 6), and with alcohol dependence in remission for at least 1 year (AUD-remission, N = 6). Participants underwent a diagnostic assessment for alcohol consumption, MRI, 1H-MRS for in vivo assessment of Glu and other metabolites, and MEG scanning during a paired click protocol. ASG was computed as the ratio of the source strength of the 50 ms component in the event related field (ERF) to the second click in the pair divided by the source strength of the 50 ms component to the first click in the pair. Results: Univariate MANOVAs controlling for age and gender revealed a significant effect for group on Glu and ASG, such that ASG ratios were significantly elevated, implying weakened gating. Glu concentration was reduced in AUD-current relative to the other two groups. Further analysis revealed that when additionally controlling for the group effect, reduced Glu predicted increasing impairment in ASG. Conclusions: The overall results were consistent with the hypothesis that differences in Glu metabolite levels associated with alcohol dependence result in impaired ASG.
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Affiliation(s)
- Robert J Thoma
- Departments of Psychiatry and Psychology, University of New Mexico, Albuquerque, NM 87131, USA.,Mind Research Network, Albuquerque, 1100 Yale NE, Albuquerque, NM, USA
| | - Jason Long
- Departments of Psychiatry and Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Mollie Monnig
- Departments of Psychiatry and Psychology, University of New Mexico, Albuquerque, NM 87131, USA.,Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI 02912, USA
| | - Ronald A Yeo
- Departments of Psychiatry and Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Helen Petropoulos
- Departments of Psychiatry and Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Charles Gasparovic
- Departments of Psychiatry and Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Jessica Pommy
- Departments of Psychiatry and Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Paul G Mullins
- Bangor Imaging Unit, School of Psychology, Bangor University, Adeilad Brigantia, Penrallt Road, Bangor LL57 2ASGwynedd, UK
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Niciu MJ, Luckenbaugh DA, Ionescu DF, Richards EM, Vande Voort JL, Ballard ED, Brutsche NE, Furey ML, Zarate CA. Ketamine's antidepressant efficacy is extended for at least four weeks in subjects with a family history of an alcohol use disorder. Int J Neuropsychopharmacol 2014; 18:pyu039. [PMID: 25539512 PMCID: PMC4303351 DOI: 10.1093/ijnp/pyu039] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND A single subanesthetic infusion of the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine has rapid and potent antidepressant properties in treatment-resistant major depressive disorder (TRD). As a family history of an alcohol use disorder is a positive predictor of ketamine's antidepressant response and the strength of the association increases over time, we hypothesized that depressed subjects with a family history of an alcohol use disorder would have greater antidepressant durability and that riluzole would augment and/or extend ketamine's antidepressant efficacy. METHODS Fifty-two TRD subjects received an open-label infusion of ketamine (0.5mg/kg over 40 minutes), and, four to six hours post-infusion, were randomized to either flexible-dose (100-200mg/day) riluzole or placebo in the following proportions: Family History Positive (FHP) riluzole (n = 10), FHP placebo (n = 9), Family History Negative (FHN) riluzole (n = 16), and FHN placebo (n = 17). RESULTS FHP subjects randomized to placebo had a greater antidepressant response than FHN subjects; however, contrary to our initial hypothesis, there was no significant difference in antidepressant efficacy with riluzole. Although potentially underpowered, there was no difference in overall time-to-relapse based on randomization status (riluzole responders: n = 15, placebo responders: n = 17). Yet, time-to-relapse was longer in FHP placebo responders (n = 8) compared to FHN placebo responders (n = 9) with, again, no significant difference in time-to-relapse in FHP riluzole responders (n = 6) compared to FHN riluzole responders (n = 9). CONCLUSIONS Ketamine's extended antidepressant durability in FHP TRD should be considered in the design and analysis of ketamine depression trials.
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Affiliation(s)
- Mark J Niciu
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche).
| | - David A Luckenbaugh
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
| | - Dawn F Ionescu
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
| | - Erica M Richards
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
| | - Jennifer L Vande Voort
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
| | - Elizabeth D Ballard
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
| | - Nancy E Brutsche
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
| | - Maura L Furey
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
| | - Carlos A Zarate
- National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch, Bethesda, MD (Drs Niciu, Ionescu, Richards, Vande Voort, Ballard, Furey, and Zarate, Mr Luckenbaugh, and Ms Brutsche)
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47
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Enoch MA, Rosser AA, Zhou Z, Mash DC, Yuan Q, Goldman D. Expression of glutamatergic genes in healthy humans across 16 brain regions; altered expression in the hippocampus after chronic exposure to alcohol or cocaine. GENES, BRAIN, AND BEHAVIOR 2014; 13:758-68. [PMID: 25262781 PMCID: PMC4241133 DOI: 10.1111/gbb.12179] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 08/25/2014] [Accepted: 09/25/2014] [Indexed: 12/29/2022]
Abstract
We analyzed global patterns of expression in genes related to glutamatergic neurotransmission (glutamatergic genes) in healthy human adult brain before determining the effects of chronic alcohol and cocaine exposure on gene expression in the hippocampus. RNA-Seq data from 'BrainSpan' was obtained across 16 brain regions from nine control adults. We also generated RNA-Seq data from postmortem hippocampus from eight alcoholics, eight cocaine addicts and eight controls. Expression analyses were undertaken of 28 genes encoding glutamate ionotropic (AMPA, kainate, NMDA) and metabotropic receptor subunits, together with glutamate transporters. The expression of each gene was fairly consistent across the brain with the exception of the cerebellum, the thalamic mediodorsal nucleus and the striatum. GRIN1, encoding the essential NMDA subunit, had the highest expression across all brain regions. Six factors accounted for 84% of the variance in global gene expression. GRIN2B (encoding GluN2B), was up-regulated in both alcoholics and cocaine addicts (FDR corrected P = 0.008). Alcoholics showed up-regulation of three genes relative to controls and cocaine addicts: GRIA4 (encoding GluA4), GRIK3 (GluR7) and GRM4 (mGluR4). Expression of both GRM3 (mGluR3) and GRIN2D (GluN2D) was up-regulated in alcoholics and down-regulated in cocaine addicts relative to controls. Glutamatergic genes are moderately to highly expressed throughout the brain. Six factors explain nearly all the variance in global gene expression. At least in the hippocampus, chronic alcohol use largely up-regulates glutamatergic genes. The NMDA GluN2B receptor subunit might be implicated in a common pathway to addiction, possibly in conjunction with the GABAB1 receptor subunit.
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Affiliation(s)
- Mary-Anne Enoch
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Alexandra A. Rosser
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Zhifeng Zhou
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | | | - Qiaoping Yuan
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - David Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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Abstract
Neuroimaging, including PET, MRI, and MRS, is a powerful approach to the study of brain function. This article reviews neuroimaging findings related to alcohol and other drugs of abuse that have been published since 2011. Uses of neuroimaging are to characterize patients to determine who will fare better in treatment and to investigate the reasons underlying the effect on outcomes. Neuroimaging is also used to characterize the acute and chronic effects of substances on the brain and how those effects are related to dependence, relapse, and other drug effects. The data can be used to provide encouraging information for patients, as several studies have shown that long-term abstinence is associated with at least partial normalization of neurological abnormalities.
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Affiliation(s)
- Mark J Niciu
- National Institutes of Health and Department of Health and Human Services, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, 10 Center Dr., Building 10/CRC, Room 7-5545, Bethesda, MD 20892, USA
| | - Graeme F Mason
- Yale University Department of Diagnostic Radiology and Psychiatry, New Haven, CT, USA
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49
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Meyerhoff DJ. Brain proton magnetic resonance spectroscopy of alcohol use disorders. HANDBOOK OF CLINICAL NEUROLOGY 2014; 125:313-37. [PMID: 25307583 DOI: 10.1016/b978-0-444-62619-6.00019-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This chapter critically reviews brain proton magnetic resonance spectroscopy ((1)H MRS) studies performed since 1994 in individuals with alcohol use disorders (AUD). We describe the neurochemicals that can be measured in vivo at the most common magnetic field strengths, summarize our knowledge about their general brain functions, and briefly explain some basic human (1)H MRS methods. Both cross-sectional and longitudinal research of individuals in treatment and of treatment-naïve individuals with AUD are discussed and interpreted on the basis of reported neuropathology. As AUDs are highly comorbid with chronic cigarette smoking and illicit substance abuse, we also summarize reports on their respective influences on regional proton metabolite levels. After reviewing research on neurobiologic correlates of relapse and genetic influences on brain metabolite levels, we finish with suggestions on future directions for (1)H MRS studies in AUDs. The review demonstrates that brain metabolic alterations associated with AUDs as well as their cognitive correlates are not simply a consequence of chronic alcohol consumption. Future MR research of AUDs in general has to be better prepared - and supported - to study clinically complex relationships between personality characteristics, comorbidities, neurogenetics, lifestyle, and living environment, as all these factors critically affect an individual's neurometabolic profile. (1)H MRS is uniquely positioned to tackle these complexities by contributing to a comprehensive biopsychosocial profile of individuals with AUD: it can provide non-invasive biochemical information on select regions of the brain at comparatively low overall cost for the ultimate purpose of informing more efficient treatments of AUDs.
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Affiliation(s)
- Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
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50
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Chronic and acute alcohol administration induced neurochemical changes in the brain: comparison of distinct zebrafish populations. Amino Acids 2014; 46:921-30. [PMID: 24381007 DOI: 10.1007/s00726-013-1658-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 12/20/2013] [Indexed: 01/27/2023]
Abstract
The zebrafish is increasingly utilized in the analysis of the effects of ethanol (alcohol) on brain function and behavior. We have shown significant population-dependent alcohol-induced changes in zebrafish behavior and have started to analyze alterations in dopaminergic and serotoninergic responses. Here, we analyze the effects of alcohol on levels of selected neurochemicals using a 2 × 3 (chronic × acute) between-subject alcohol exposure paradigm randomized for two zebrafish populations, AB and SF. Each fish first received the particular chronic treatment (0 or 0.5 vol/vol% alcohol) and subsequently the acute exposure (0, 0.5 or 1.0% alcohol). We report changes in levels of dopamine, DOPAC, serotonin, 5HIAA, glutamate, GABA, aspartate, glycine and taurine as quantified from whole brain extracts using HPLC. We also analyze monoamine oxidase and tyrosine hydroxylase enzymatic activity. The results demonstrate that compared to SF, AB is more responsive to both acute alcohol exposure and acute alcohol withdrawal at the level of neurochemistry, a finding that correlates well with prior behavioral observations and one which suggests the involvement of genes in the observed alcohol effects. We discuss correlations between the current results and prior behavioral findings, and stress the importance of characterization of zebrafish strains for future behavior genetic and psychopharmacology studies.
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