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Ponserre M, Ionescu TM, Franz AA, Deiana S, Schuelert N, Lamla T, Williams RH, Wotjak CT, Hobson S, Dine J, Omrani A. Long-term adaptation of prefrontal circuits in a mouse model of NMDAR hypofunction. Neuropharmacology 2024; 254:109970. [PMID: 38685343 DOI: 10.1016/j.neuropharm.2024.109970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/12/2024] [Accepted: 04/25/2024] [Indexed: 05/02/2024]
Abstract
Pharmacological approaches to induce N-methyl-d-aspartate receptor (NMDAR) hypofunction have been intensively used to understand the aetiology and pathophysiology of schizophrenia. Yet, the precise cellular and molecular mechanisms that relate to brain network dysfunction remain largely unknown. Here, we used a set of complementary approaches to assess the functional network abnormalities present in male mice that underwent a 7-day subchronic phencyclidine (PCP 10 mg/kg, subcutaneously, once daily) treatment. Our data revealed that pharmacological intervention with PCP affected cognitive performance and auditory evoked gamma oscillations in the prefrontal cortex (PFC) mimicking endophenotypes of some schizophrenia patients. We further assessed PFC cellular function and identified altered neuronal intrinsic membrane properties, reduced parvalbumin (PV) immunostaining and diminished inhibition onto L5 PFC pyramidal cells. A decrease in the strength of optogenetically-evoked glutamatergic current at the ventral hippocampus to PFC synapse was also demonstrated, along with a weaker shunt of excitatory transmission by local PFC interneurons. On a macrocircuit level, functional ultrasound measurements indicated compromised functional connectivity within several brain regions particularly involving PFC and frontostriatal circuits. Herein, we reproduced a panel of schizophrenia endophenotypes induced by subchronic PCP application in mice. We further recapitulated electrophysiological signatures associated with schizophrenia and provided an anatomical reference to critical elements in the brain circuitry. Together, our findings contribute to a better understanding of the physiological underpinnings of deficits induced by subchronic NMDAR antagonist regimes and provide a test system for characterization of pharmacological compounds.
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Affiliation(s)
- Marion Ponserre
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Tudor M Ionescu
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Alessa A Franz
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Serena Deiana
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Niklas Schuelert
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Thorsten Lamla
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | | | - Carsten T Wotjak
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Scott Hobson
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Julien Dine
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Azar Omrani
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany.
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2
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Busch A, Roussy M, Luna R, Leavitt ML, Mofrad MH, Gulli RA, Corrigan B, Mináč J, Sachs AJ, Palaniyappan L, Muller L, Martinez-Trujillo JC. Neuronal activation sequences in lateral prefrontal cortex encode visuospatial working memory during virtual navigation. Nat Commun 2024; 15:4471. [PMID: 38796480 PMCID: PMC11127969 DOI: 10.1038/s41467-024-48664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 05/01/2024] [Indexed: 05/28/2024] Open
Abstract
Working memory (WM) is the ability to maintain and manipulate information 'in mind'. The neural codes underlying WM have been a matter of debate. We simultaneously recorded the activity of hundreds of neurons in the lateral prefrontal cortex of male macaque monkeys during a visuospatial WM task that required navigation in a virtual 3D environment. Here, we demonstrate distinct neuronal activation sequences (NASs) that encode remembered target locations in the virtual environment. This NAS code outperformed the persistent firing code for remembered locations during the virtual reality task, but not during a classical WM task using stationary stimuli and constraining eye movements. Finally, blocking NMDA receptors using low doses of ketamine deteriorated the NAS code and behavioral performance selectively during the WM task. These results reveal the versatility and adaptability of neural codes supporting working memory function in the primate lateral prefrontal cortex.
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Affiliation(s)
- Alexandra Busch
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada
- Department of Mathematics, University of Western Ontario, London, ON, Canada
| | - Megan Roussy
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada
- Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
| | - Rogelio Luna
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada
- Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
| | | | - Maryam H Mofrad
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada
- Department of Mathematics, University of Western Ontario, London, ON, Canada
| | - Roberto A Gulli
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Benjamin Corrigan
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada
- Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
| | - Ján Mináč
- Department of Mathematics, University of Western Ontario, London, ON, Canada
| | - Adam J Sachs
- The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Lena Palaniyappan
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Lyle Muller
- Robarts Research Institute, University of Western Ontario, London, ON, Canada.
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada.
- Department of Mathematics, University of Western Ontario, London, ON, Canada.
| | - Julio C Martinez-Trujillo
- Robarts Research Institute, University of Western Ontario, London, ON, Canada.
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada.
- Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada.
- Lawson Health Research Institute, London, ON, Canada.
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3
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Moujaes F, Ji JL, Rahmati M, Burt JB, Schleifer C, Adkinson BD, Savic A, Santamauro N, Tamayo Z, Diehl C, Kolobaric A, Flynn M, Rieser N, Fonteneau C, Camarro T, Xu J, Cho Y, Repovs G, Fineberg SK, Morgan PT, Seifritz E, Vollenweider FX, Krystal JH, Murray JD, Preller KH, Anticevic A. Ketamine induces multiple individually distinct whole-brain functional connectivity signatures. eLife 2024; 13:e84173. [PMID: 38629811 PMCID: PMC11023699 DOI: 10.7554/elife.84173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Ketamine has emerged as one of the most promising therapies for treatment-resistant depression. However, inter-individual variability in response to ketamine is still not well understood and it is unclear how ketamine's molecular mechanisms connect to its neural and behavioral effects. Methods We conducted a single-blind placebo-controlled study, with participants blinded to their treatment condition. 40 healthy participants received acute ketamine (initial bolus 0.23 mg/kg, continuous infusion 0.58 mg/kg/hr). We quantified resting-state functional connectivity via data-driven global brain connectivity and related it to individual ketamine-induced symptom variation and cortical gene expression targets. Results We found that: (i) both the neural and behavioral effects of acute ketamine are multi-dimensional, reflecting robust inter-individual variability; (ii) ketamine's data-driven principal neural gradient effect matched somatostatin (SST) and parvalbumin (PVALB) cortical gene expression patterns in humans, while the mean effect did not; and (iii) behavioral data-driven individual symptom variation mapped onto distinct neural gradients of ketamine, which were resolvable at the single-subject level. Conclusions These results highlight the importance of considering individual behavioral and neural variation in response to ketamine. They also have implications for the development of individually precise pharmacological biomarkers for treatment selection in psychiatry. Funding This study was supported by NIH grants DP5OD012109-01 (A.A.), 1U01MH121766 (A.A.), R01MH112746 (J.D.M.), 5R01MH112189 (A.A.), 5R01MH108590 (A.A.), NIAAA grant 2P50AA012870-11 (A.A.); NSF NeuroNex grant 2015276 (J.D.M.); Brain and Behavior Research Foundation Young Investigator Award (A.A.); SFARI Pilot Award (J.D.M., A.A.); Heffter Research Institute (Grant No. 1-190420) (FXV, KHP); Swiss Neuromatrix Foundation (Grant No. 2016-0111) (FXV, KHP); Swiss National Science Foundation under the framework of Neuron Cofund (Grant No. 01EW1908) (KHP); Usona Institute (2015 - 2056) (FXV). Clinical trial number NCT03842800.
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Affiliation(s)
- Flora Moujaes
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Masih Rahmati
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Joshua B Burt
- Department of Physics, Yale UniversityBostonUnited States
| | - Charles Schleifer
- David Geffen School of Medicine, University of California, Los AngelesLos AngelesUnited States
| | - Brendan D Adkinson
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
| | | | - Nicole Santamauro
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Caroline Diehl
- Department of Psychology, University of California, Los AngelesLos AngelesUnited States
| | | | - Morgan Flynn
- Department of Psychiatry, Vanderbilt University Medical CenterNashvilleUnited States
| | - Nathalie Rieser
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Terry Camarro
- Magnetic Resonance Research Center, Yale University School of MedicineNew HavenUnited States
| | - Junqian Xu
- Department of Radiology and Psychiatry, Baylor College of MedicineHoustonUnited States
| | - Youngsun Cho
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Child Study Center, Yale University School of MedicineNew HavenUnited States
| | - Grega Repovs
- Department of Psychology, University of LjubljanaLjubljanaSlovenia
| | - Sarah K Fineberg
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Peter T Morgan
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Bridgeport HospitalBridgeportUnited States
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - John H Krystal
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - John D Murray
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Physics, Yale UniversityBostonUnited States
- Department of Psychology, Yale UniversityNew HavenUnited States
| | - Katrin H Preller
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
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4
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Arnsten AFT, Wang M, D’Esposito M. Dynamic Network Connectivity: from monkeys to humans. Front Hum Neurosci 2024; 18:1353043. [PMID: 38384333 PMCID: PMC10879414 DOI: 10.3389/fnhum.2024.1353043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024] Open
Abstract
Human brain imaging research using functional MRI (fMRI) has uncovered flexible variations in the functional connectivity between brain regions. While some of this variability likely arises from the pattern of information flow through circuits, it may also be influenced by rapid changes in effective synaptic strength at the molecular level, a phenomenon called Dynamic Network Connectivity (DNC) discovered in non-human primate circuits. These neuromodulatory molecular mechanisms are found in layer III of the macaque dorsolateral prefrontal cortex (dlPFC), the site of the microcircuits shown by Goldman-Rakic to be critical for working memory. This research has shown that the neuromodulators acetylcholine, norepinephrine, and dopamine can rapidly change the strength of synaptic connections in layer III dlPFC by (1) modifying the depolarization state of the post-synaptic density needed for NMDA receptor neurotransmission and (2) altering the open state of nearby potassium channels to rapidly weaken or strengthen synaptic efficacy and the strength of persistent neuronal firing. Many of these actions involve increased cAMP-calcium signaling in dendritic spines, where varying levels can coordinate the arousal state with the cognitive state. The current review examines the hypothesis that some of the dynamic changes in correlative strength between cortical regions observed in human fMRI studies may arise from these molecular underpinnings, as has been seen when pharmacological agents or genetic alterations alter the functional connectivity of the dlPFC consistent with the macaque physiology. These DNC mechanisms provide essential flexibility but may also confer vulnerability to malfunction when dysregulated in cognitive disorders.
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Affiliation(s)
- Amy F. T. Arnsten
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, United States
| | - Min Wang
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, United States
| | - Mark D’Esposito
- Department of Psychology, Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
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5
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Vinnakota C, Schroeder A, Du X, Ikeda K, Ide S, Mishina M, Hudson M, Jones NC, Sundram S, Hill RA. Understanding the role of the NMDA receptor subunit, GluN2D, in mediating NMDA receptor antagonist-induced behavioral disruptions in male and female mice. J Neurosci Res 2024; 102:e25257. [PMID: 37814998 PMCID: PMC10953441 DOI: 10.1002/jnr.25257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/24/2023] [Accepted: 09/23/2023] [Indexed: 10/11/2023]
Abstract
Noncompetitive NMDA receptor (NMDAR) antagonists like phencyclidine (PCP) and ketamine cause psychosis-like symptoms in healthy humans, exacerbate schizophrenia symptoms in people with the disorder, and disrupt a range of schizophrenia-relevant behaviors in rodents, including hyperlocomotion. This is negated in mice lacking the GluN2D subunit of the NMDAR, suggesting the GluN2D subunit mediates the hyperlocomotor effects of these drugs. However, the role of GluN2D in mediating other schizophrenia-relevant NMDAR antagonist-induced behavioral disturbances, and in both sexes, is unclear. This study aimed to investigate the role of the GluN2D subunit in mediating schizophrenia-relevant behaviors induced by a range of NMDA receptor antagonists. Using both male and female GluN2D knockout (KO) mice, we examined the effects of the NMDAR antagonist's PCP, the S-ketamine enantiomer (S-ket), and the ketamine metabolite R-norketamine (R-norket) on locomotor activity, anxiety-related behavior, and recognition and short-term spatial memory. GluN2D-KO mice showed a blunted locomotor response to R-norket, S-ket, and PCP, a phenotype present in both sexes. GluN2D-KO mice of both sexes showed an anxious phenotype and S-ket, R-norket, and PCP showed anxiolytic effects that were dependent on sex and genotype. S-ket disrupted spatial recognition memory in females and novel object recognition memory in both sexes, independent of genotype. This datum identifies a role for the GluN2D subunit in sex-specific effects of NMDAR antagonists and on the differential effects of the R- and S-ket enantiomers.
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Affiliation(s)
- Chitra Vinnakota
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - Anna Schroeder
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - Xin Du
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - Kazutaka Ikeda
- Addictive Substance ProjectTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Soichiro Ide
- Addictive Substance ProjectTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Masayoshi Mishina
- Brain Science Laboratory, The Research Organization of Science and TechnologyRitsumeikan UniversityKusatsuJapan
| | - Matthew Hudson
- Department of NeuroscienceMonash UniversityClaytonVictoriaAustralia
| | | | - Suresh Sundram
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
- Mental Health ProgramMonash HealthClaytonVictoriaAustralia
| | - Rachel Anne Hill
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
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6
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Armfield N, Frank B, Chadwick C. A rapid, sensitive method for clinical monitoring of ketamine and norketamine by ultra-high-performance reverse-phase liquid chromatography tandem mass spectrometry. Ann Clin Biochem 2023:45632231224215. [PMID: 38111954 DOI: 10.1177/00045632231224215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
BACKGROUND Ketamine is an NMDAR antagonist with aggregating use across many areas of medicine. P450 enzymes heavily metabolise ketamine, where norketamine is a first pass formed metabolite following initial N-demethylation. Serum ketamine monitoring is becoming increasingly important, requiring a sensitive method with a robust lower limit of quantitation. METHODS Samples were prepared using protein precipitation or solid phase extraction. Ion suppression was investigated to optimise sample preparation technique, followed by reverse-phase chromatography coupled with tandem mass spectrometry to analyse extractions using a Waters Xevo TQ-S Micro and associated Acquity chromatography systems. Performance characteristics were analysed to validate the assay. RESULTS Ketamine and norketamine retention times were 1.28 and 1.23 min, respectively. Ketamine and norketamine precursor ions fragmented into 2 distinguishable product ions (238.14 > 207.18/125.06 and 224.1 > 178.96/124.86). Performance characteristics include an assay recovery of 103.7% (ketamine) and 96.3% (norketamine), lower limit of quantitation 36.2 µg/L (ketamine) and 38.9 µg/L (norketamine), and intra-assay imprecision ≤ 7.04% on average. CONCLUSIONS A robust and reproducible assay with limited sample preparation has been designed and validated. The linearity of the assay covers all ranges of interest reported in the literature. Ion suppression was clearly reduced via use of solid phase extraction. The method will form the basis of ketamine monitoring and providing valuable patient information on tolerance and metabolism.
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Affiliation(s)
- Nicholas Armfield
- The Neuroscience Laboratories, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Bernhard Frank
- Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Pain Research Institute, University of Liverpool, Liverpool, UK
| | - Carrie Chadwick
- The Neuroscience Laboratories, The Walton Centre NHS Foundation Trust, Liverpool, UK
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7
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Lansner A, Fiebig F, Herman P. Fast Hebbian plasticity and working memory. Curr Opin Neurobiol 2023; 83:102809. [PMID: 37980802 DOI: 10.1016/j.conb.2023.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/10/2023] [Accepted: 10/19/2023] [Indexed: 11/21/2023]
Abstract
Theories and models of working memory (WM) were at least since the mid-1990s dominated by the persistent activity hypothesis. The past decade has seen rising concerns about the shortcomings of sustained activity as the mechanism for short-term maintenance of WM information in the light of accumulating experimental evidence for so-called activity-silent WM and the fundamental difficulty in explaining robust multi-item WM. In consequence, alternative theories are now explored mostly in the direction of fast synaptic plasticity as the underlying mechanism. The question of non-Hebbian vs Hebbian synaptic plasticity emerges naturally in this context. In this review, we focus on fast Hebbian plasticity and trace the origins of WM theories and models building on this form of associative learning.
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Affiliation(s)
- Anders Lansner
- Stockholm University, Department of Mathematics, SE-106 91 Stockholm, Sweden; KTH Royal Institute of Technology, Dept of Computational Science and Technology, 100 44 Stockholm, Sweden; SeRC (Swedish e-Science Research Center), Sweden.
| | - Florian Fiebig
- KTH Royal Institute of Technology, Dept of Computational Science and Technology, 100 44 Stockholm, Sweden.
| | - Pawel Herman
- KTH Royal Institute of Technology, Dept of Computational Science and Technology, 100 44 Stockholm, Sweden; Digital Futures, KTH Royal Institute of Technology, Stockholm, Sweden; SeRC (Swedish e-Science Research Center), Sweden. https://twitter.com/PHermanKTHbrain
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8
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Arnsten AFT, Ishizawa Y, Xie Z. Scientific rationale for the use of α2A-adrenoceptor agonists in treating neuroinflammatory cognitive disorders. Mol Psychiatry 2023; 28:4540-4552. [PMID: 37029295 PMCID: PMC10080530 DOI: 10.1038/s41380-023-02057-4] [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: 11/20/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/09/2023]
Abstract
Neuroinflammatory disorders preferentially impair the higher cognitive and executive functions of the prefrontal cortex (PFC). This includes such challenging disorders as delirium, perioperative neurocognitive disorder, and the sustained cognitive deficits from "long-COVID" or traumatic brain injury. There are no FDA-approved treatments for these symptoms; thus, understanding their etiology is important for generating therapeutic strategies. The current review describes the molecular rationale for why PFC circuits are especially vulnerable to inflammation, and how α2A-adrenoceptor (α2A-AR) actions throughout the nervous and immune systems can benefit the circuits in PFC needed for higher cognition. The layer III circuits in the dorsolateral PFC (dlPFC) that generate and sustain the mental representations needed for higher cognition have unusual neurotransmission and neuromodulation. They are wholly dependent on NMDAR neurotransmission, with little AMPAR contribution, and thus are especially vulnerable to kynurenic acid inflammatory signaling which blocks NMDAR. Layer III dlPFC spines also have unusual neuromodulation, with cAMP magnification of calcium signaling in spines, which opens nearby potassium channels to rapidly weaken connectivity and reduce neuronal firing. This process must be tightly regulated, e.g. by mGluR3 or α2A-AR on spines, to prevent loss of firing. However, the production of GCPII inflammatory signaling reduces mGluR3 actions and markedly diminishes dlPFC network firing. Both basic and clinical studies show that α2A-AR agonists such as guanfacine can restore dlPFC network firing and cognitive function, through direct actions in the dlPFC, but also by reducing the activity of stress-related circuits, e.g. in the locus coeruleus and amygdala, and by having anti-inflammatory actions in the immune system. This information is particularly timely, as guanfacine is currently the focus of large clinical trials for the treatment of delirium, and in open label studies for the treatment of cognitive deficits from long-COVID.
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Affiliation(s)
- Amy F T Arnsten
- Department Neuroscience, Yale University School of Medicine, New Haven, CT, 056510, USA.
| | - Yumiko Ishizawa
- Department Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Zhongcong Xie
- Department Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
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9
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Linguiti S, Vogel JW, Sydnor VJ, Pines A, Wellman N, Basbaum A, Eickhoff CR, Eickhoff SB, Edwards RR, Larsen B, McKinstry-Wu A, Scott JC, Roalf DR, Sharma V, Strain EC, Corder G, Dworkin RH, Satterthwaite TD. Functional imaging studies of acute administration of classic psychedelics, ketamine, and MDMA: Methodological limitations and convergent results. Neurosci Biobehav Rev 2023; 154:105421. [PMID: 37802267 DOI: 10.1016/j.neubiorev.2023.105421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
Functional magnetic resonance imaging (fMRI) is increasingly used to non-invasively study the acute impact of psychedelics on the human brain. While fMRI is a promising tool for measuring brain function in response to psychedelics, it also has known methodological challenges. We conducted a systematic review of fMRI studies examining acute responses to experimentally administered psychedelics in order to identify convergent findings and characterize heterogeneity in the literature. We reviewed 91 full-text papers; these studies were notable for substantial heterogeneity in design, task, dosage, drug timing, and statistical approach. Data recycling was common, with 51 unique samples across 91 studies. Fifty-seven studies (54%) did not meet contemporary standards for Type I error correction or control of motion artifact. Psilocybin and LSD were consistently reported to moderate the connectivity architecture of the sensorimotor-association cortical axis. Studies also consistently reported that ketamine administration increased activation in the dorsomedial prefrontal cortex. Moving forward, use of best practices such as pre-registration, standardized image processing and statistical testing, and data sharing will be important in this rapidly developing field.
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Affiliation(s)
- Sophia Linguiti
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Jacob W Vogel
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Department of Clinical Sciences, Malmö, SciLifeLab, Lund University, Lund, Sweden
| | - Valerie J Sydnor
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Adam Pines
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Department of Psychiatry, Stanford University, Stanford, CA, United States
| | - Nick Wellman
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Allan Basbaum
- Department of Anatomy, University of California, San Francisco, United States
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine, (INM-1, INM-7), Research Centre Jülich, Jülich, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, (INM-1, INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Bart Larsen
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Andrew McKinstry-Wu
- Department of Anesthesiology and Critical Care, Neuroscience of Unconsciousness and Reanimation Research Alliance (NEURRAL), University of Pennsylvania, Philadelphia, United States
| | - J Cobb Scott
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA (Veterans Affairs) Medical Center, Philadelphia, PA, United States
| | - David R Roalf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Vaishnavi Sharma
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, United States
| | - Gregory Corder
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Robert H Dworkin
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Theodore D Satterthwaite
- Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
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10
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Ceanga M, Rahmati V, Haselmann H, Schmidl L, Hunter D, Brauer AK, Liebscher S, Kreye J, Prüss H, Groc L, Hallermann S, Dalmau J, Ori A, Heckmann M, Geis C. Human NMDAR autoantibodies disrupt excitatory-inhibitory balance, leading to hippocampal network hypersynchrony. Cell Rep 2023; 42:113166. [PMID: 37768823 DOI: 10.1016/j.celrep.2023.113166] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/30/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
Anti-NMDA receptor autoantibodies (NMDAR-Abs) in patients with NMDAR encephalitis cause severe disease symptoms resembling psychosis and cause cognitive dysfunction. After passive transfer of patients' cerebrospinal fluid or human monoclonal anti-GluN1-autoantibodies in mice, we find a disrupted excitatory-inhibitory balance resulting from CA1 neuronal hypoexcitability, reduced AMPA receptor (AMPAR) signaling, and faster synaptic inhibition in acute hippocampal slices. Functional alterations are also reflected in widespread remodeling of the hippocampal proteome, including changes in glutamatergic and GABAergic neurotransmission. NMDAR-Abs amplify network γ oscillations and disrupt θ-γ coupling. A data-informed network model reveals that lower AMPAR strength and faster GABAA receptor current kinetics chiefly account for these abnormal oscillations. As predicted in silico and evidenced ex vivo, positive allosteric modulation of AMPARs alleviates aberrant γ activity, reinforcing the causative effects of the excitatory-inhibitory imbalance. Collectively, NMDAR-Ab-induced aberrant synaptic, cellular, and network dynamics provide conceptual insights into NMDAR-Ab-mediated pathomechanisms and reveal promising therapeutic targets that merit future in vivo validation.
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Affiliation(s)
- Mihai Ceanga
- Section of Translational Neuroimmunology, Department of Neurology, Jena University Hospital, 07747 Jena, Germany
| | - Vahid Rahmati
- Section of Translational Neuroimmunology, Department of Neurology, Jena University Hospital, 07747 Jena, Germany
| | - Holger Haselmann
- Section of Translational Neuroimmunology, Department of Neurology, Jena University Hospital, 07747 Jena, Germany
| | - Lars Schmidl
- Section of Translational Neuroimmunology, Department of Neurology, Jena University Hospital, 07747 Jena, Germany
| | - Daniel Hunter
- Université de Bordeaux, CNRS, Interdisciplinary Institute for Neuroscience, UMR 5297, 33000 Bordeaux, France
| | - Anna-Katherina Brauer
- Institute of Clinical Neuroimmunology, Klinikum der Universität München, Ludwig Maximilians University Munich, Martinsried, Germany; Biomedical Center, Ludwig Maximilians University Munich, Martinsried, Germany
| | - Sabine Liebscher
- Institute of Clinical Neuroimmunology, Klinikum der Universität München, Ludwig Maximilians University Munich, Martinsried, Germany; Biomedical Center, Ludwig Maximilians University Munich, Martinsried, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Jakob Kreye
- Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany; Department of Pediatric Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Harald Prüss
- Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany
| | - Laurent Groc
- Université de Bordeaux, CNRS, Interdisciplinary Institute for Neuroscience, UMR 5297, 33000 Bordeaux, France
| | - Stefan Hallermann
- Carl Ludwig Institute for Physiology, Faculty of Medicine, Leipzig University, 04103 Leipzig, Germany
| | - Josep Dalmau
- Catalan Institution for Research and Advanced Studies (ICREA) and IDIBAPS-Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Alessandro Ori
- Leibniz Institute on Aging - Fritz Lipmann Institute (FLI), 07745 Jena, Germany
| | - Manfred Heckmann
- Department of Neurophysiology, Institute of Physiology, University of Würzburg, 97070 Würzburg, Germany
| | - Christian Geis
- Section of Translational Neuroimmunology, Department of Neurology, Jena University Hospital, 07747 Jena, Germany.
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11
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Martínez‐Cañada P, Perez‐Valero E, Minguillon J, Pelayo F, López‐Gordo MA, Morillas C. Combining aperiodic 1/f slopes and brain simulation: An EEG/MEG proxy marker of excitation/inhibition imbalance in Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12477. [PMID: 37662693 PMCID: PMC10474329 DOI: 10.1002/dad2.12477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
INTRODUCTION Accumulation and interaction of amyloid-beta (Aβ) and tau proteins during progression of Alzheimer's disease (AD) are shown to tilt neuronal circuits away from balanced excitation/inhibition (E/I). Current available techniques for noninvasive interrogation of E/I in the intact human brain, for example, magnetic resonance spectroscopy (MRS), are highly restrictive (i.e., limited spatial extent), have low temporal and spatial resolution and suffer from the limited ability to distinguish accurately between different neurotransmitters complicating its interpretation. As such, these methods alone offer an incomplete explanation of E/I. Recently, the aperiodic component of neural power spectrum, often referred to in the literature as the '1/f slope', has been described as a promising and scalable biomarker that can track disruptions in E/I potentially underlying a spectrum of clinical conditions, such as autism, schizophrenia, or epilepsy, as well as developmental E/I changes as seen in aging. METHODS Using 1/f slopes from resting-state spectral data and computational modeling, we developed a new method for inferring E/I alterations in AD. RESULTS We tested our method on recent freely and publicly available electroencephalography (EEG) and magnetoencephalography (MEG) datasets of patients with AD or prodromal disease and demonstrated the method's potential for uncovering regional patterns of abnormal excitatory and inhibitory parameters. DISCUSSION Our results provide a general framework for investigating circuit-level disorders in AD and developing therapeutic interventions that aim to restore the balance between excitation and inhibition.
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Affiliation(s)
- Pablo Martínez‐Cañada
- Department of Computer EngineeringAutomation and RoboticsUniversity of GranadaGranadaSpain
- Research Centre for Information and Communications Technologies (CITIC)University of GranadaGranadaSpain
| | - Eduardo Perez‐Valero
- Department of Computer EngineeringAutomation and RoboticsUniversity of GranadaGranadaSpain
- Research Centre for Information and Communications Technologies (CITIC)University of GranadaGranadaSpain
| | - Jesus Minguillon
- Research Centre for Information and Communications Technologies (CITIC)University of GranadaGranadaSpain
- Department of Signal TheoryTelematics and CommunicationsUniversity of GranadaGranadaSpain
| | - Francisco Pelayo
- Department of Computer EngineeringAutomation and RoboticsUniversity of GranadaGranadaSpain
- Research Centre for Information and Communications Technologies (CITIC)University of GranadaGranadaSpain
| | - Miguel A. López‐Gordo
- Research Centre for Information and Communications Technologies (CITIC)University of GranadaGranadaSpain
- Department of Signal TheoryTelematics and CommunicationsUniversity of GranadaGranadaSpain
| | - Christian Morillas
- Department of Computer EngineeringAutomation and RoboticsUniversity of GranadaGranadaSpain
- Research Centre for Information and Communications Technologies (CITIC)University of GranadaGranadaSpain
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12
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Hunt S, Leibner Y, Mertens EJ, Barros-Zulaica N, Kanari L, Heistek TS, Karnani MM, Aardse R, Wilbers R, Heyer DB, Goriounova NA, Verhoog MB, Testa-Silva G, Obermayer J, Versluis T, Benavides-Piccione R, de Witt-Hamer P, Idema S, Noske DP, Baayen JC, Lein ES, DeFelipe J, Markram H, Mansvelder HD, Schürmann F, Segev I, de Kock CPJ. Strong and reliable synaptic communication between pyramidal neurons in adult human cerebral cortex. Cereb Cortex 2023; 33:2857-2878. [PMID: 35802476 PMCID: PMC10016070 DOI: 10.1093/cercor/bhac246] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 12/25/2022] Open
Abstract
Synaptic transmission constitutes the primary mode of communication between neurons. It is extensively studied in rodent but not human neocortex. We characterized synaptic transmission between pyramidal neurons in layers 2 and 3 using neurosurgically resected human middle temporal gyrus (MTG, Brodmann area 21), which is part of the distributed language circuitry. We find that local connectivity is comparable with mouse layer 2/3 connections in the anatomical homologue (temporal association area), but synaptic connections in human are 3-fold stronger and more reliable (0% vs 25% failure rates, respectively). We developed a theoretical approach to quantify properties of spinous synapses showing that synaptic conductance and voltage change in human dendritic spines are 3-4-folds larger compared with mouse, leading to significant NMDA receptor activation in human unitary connections. This model prediction was validated experimentally by showing that NMDA receptor activation increases the amplitude and prolongs decay of unitary excitatory postsynaptic potentials in human but not in mouse connections. Since NMDA-dependent recurrent excitation facilitates persistent activity (supporting working memory), our data uncovers cortical microcircuit properties in human that may contribute to language processing in MTG.
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Affiliation(s)
| | | | - Eline J Mertens
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Natalí Barros-Zulaica
- Blue Brain Project, Ecole polytechnique fédérale de Lausanne, Campus Biotech, Geneva 1202, Switzerland
| | - Lida Kanari
- Blue Brain Project, Ecole polytechnique fédérale de Lausanne, Campus Biotech, Geneva 1202, Switzerland
| | - Tim S Heistek
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Mahesh M Karnani
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Romy Aardse
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - René Wilbers
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Djai B Heyer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Natalia A Goriounova
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | | | | | - Joshua Obermayer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Tamara Versluis
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Ruth Benavides-Piccione
- Laboratorio Cajal de Circuitos Corticales, Universidad Politécnica de Madrid and Instituto Cajal (CSIC), Pozuelo de Alarcón, Madrid 28223, Spain
| | - Philip de Witt-Hamer
- Neurosurgery Department, Amsterdam Universitair Medische Centra, location VUmc, 1081 HV Amsterdam, the Netherlands
| | - Sander Idema
- Neurosurgery Department, Amsterdam Universitair Medische Centra, location VUmc, 1081 HV Amsterdam, the Netherlands
| | - David P Noske
- Neurosurgery Department, Amsterdam Universitair Medische Centra, location VUmc, 1081 HV Amsterdam, the Netherlands
| | - Johannes C Baayen
- Neurosurgery Department, Amsterdam Universitair Medische Centra, location VUmc, 1081 HV Amsterdam, the Netherlands
| | - Ed S Lein
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Javier DeFelipe
- Laboratorio Cajal de Circuitos Corticales, Universidad Politécnica de Madrid and Instituto Cajal (CSIC), Pozuelo de Alarcón, Madrid 28223, Spain
| | - Henry Markram
- Blue Brain Project, Ecole polytechnique fédérale de Lausanne, Campus Biotech, Geneva 1202, Switzerland
| | - Huibert D Mansvelder
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Felix Schürmann
- Blue Brain Project, Ecole polytechnique fédérale de Lausanne, Campus Biotech, Geneva 1202, Switzerland
| | - Idan Segev
- Department of Neurobiology and Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, 9190501 Jerusalem, Israel
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Driesen NR, Herman P, Rowland MA, Thompson G, Qiu M, He G, Fineberg S, Barron DS, Helgeson L, Lacadie C, Chow R, Gueorguieva R, Straun TC, Krystal JH, Hyder F. Ketamine Effects on Energy Metabolism, Functional Connectivity and Working Memory in Healthy Humans. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.21.529425. [PMID: 36865249 PMCID: PMC9980048 DOI: 10.1101/2023.02.21.529425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Working memory (WM) is a crucial resource for temporary memory storage and the guiding of ongoing behavior. N-methyl-D-aspartate glutamate receptors (NMDARs) are thought to support the neural underpinnings of WM. Ketamine is an NMDAR antagonist that has cognitive and behavioral effects at subanesthetic doses. To shed light on subanesthetic ketamine effects on brain function, we employed a multimodal imaging design, combining gas-free calibrated functional magnetic resonance imaging (fMRI) measurement of oxidative metabolism (CMRO 2 ), resting-state cortical functional connectivity assessed with fMRI, and WM-related fMRI. Healthy subjects participated in two scan sessions in a randomized, double-blind, placebo-controlled design. Ketamine increased CMRO 2 and cerebral blood flow (CBF) in prefrontal cortex (PFC) and other cortical regions. However, resting-state cortical functional connectivity was not affected. Ketamine did not alter CBF-CMRO 2 coupling brain-wide. Higher levels of basal CMRO 2 were associated with lower task-related PFC activation and WM accuracy impairment under both saline and ketamine conditions. These observations suggest that CMRO 2 and resting-state functional connectivity index distinct dimensions of neural activity. Ketamine’s impairment of WM-related neural activity and performance appears to be related to its ability to produce cortical metabolic activation. This work illustrates the utility of direct measurement of CMRO 2 via calibrated fMRI in studies of drugs that potentially affect neurovascular and neurometabolic coupling.
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Javitt DC. Cognitive Impairment Associated with Schizophrenia: From Pathophysiology to Treatment. Annu Rev Pharmacol Toxicol 2023; 63:119-141. [PMID: 36151052 DOI: 10.1146/annurev-pharmtox-051921-093250] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cognitive impairment is a core feature of schizophrenia and a major contributor to poor functional outcomes. Methods for assessment of cognitive dysfunction in schizophrenia are now well established. In addition, there has been increasing appreciation in recent years of the additional role of social cognitive impairment in driving functional outcomes and of the contributions of sensory-level dysfunction to higher-order impairments. At the neurochemical level, acute administration of N-methyl-d-aspartate receptor (NMDAR) antagonists reproduces the pattern of neurocognitive dysfunction associated with schizophrenia, encouraging the development of treatments targeted at both NMDAR and its interactome. At the local-circuit level, an auditory neurophysiological measure, mismatch negativity, has emerged both as a veridical index of NMDAR dysfunction and excitatory/inhibitory imbalance in schizophrenia and as a critical biomarker for early-stage translational drug development. Although no compounds have yet been approved for treatment of cognitive impairment associated with schizophrenia, several candidates are showing promise in early-phase testing.
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Affiliation(s)
- Daniel C Javitt
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; .,Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
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15
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Jannati A, Oberman LM, Rotenberg A, Pascual-Leone A. Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation. Neuropsychopharmacology 2023; 48:191-208. [PMID: 36198876 PMCID: PMC9700722 DOI: 10.1038/s41386-022-01453-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique for focal brain stimulation based on electromagnetic induction where a fluctuating magnetic field induces a small intracranial electric current in the brain. For more than 35 years, TMS has shown promise in the diagnosis and treatment of neurological and psychiatric disorders in adults. In this review, we provide a brief introduction to the TMS technique with a focus on repetitive TMS (rTMS) protocols, particularly theta-burst stimulation (TBS), and relevant rTMS-derived metrics of brain plasticity. We then discuss the TMS-EEG technique, the use of neuronavigation in TMS, the neural substrate of TBS measures of plasticity, the inter- and intraindividual variability of those measures, effects of age and genetic factors on TBS aftereffects, and then summarize alterations of TMS-TBS measures of plasticity in major neurological and psychiatric disorders including autism spectrum disorder, schizophrenia, depression, traumatic brain injury, Alzheimer's disease, and diabetes. Finally, we discuss the translational studies of TMS-TBS measures of plasticity and their therapeutic implications.
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Affiliation(s)
- Ali Jannati
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
- F. M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Lindsay M Oberman
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Alexander Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- F. M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA.
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA.
- Guttmann Brain Health Institute, Institut Guttmann, Barcelona, Spain.
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16
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Willms J, McCauley B, Kerr L, Presto P, Arun A, Shah N, Irby K, Strawn M, Kopel J. Case report: Medical student types journals during ketamine infusions for suicidal ideation, treatment-resistant depression, post-traumatic stress disorder, and generalized anxiety disorder. Front Psychiatry 2022; 13:1020214. [PMID: 36620675 PMCID: PMC9811588 DOI: 10.3389/fpsyt.2022.1020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
Suicide is the most common cause of death in male resident physicians and the second most common cause of death in resident physicians overall. Physicians also experience high rates of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and burnout. These conditions frequently develop during medical school, and threaten not only physicians but the patients they care for. A 30-year-old medical student presented to our clinic with a history of treatment-resistant depression (TRD), generalized anxiety disorder (GAD), PTSD, and 5 years of daily suicidal ideation. Previous treatments included therapy, lifestyle modifications, and various combinations of six antidepressants. These interventions had little effect on the patient's mental health. The patient was treated at our clinic with an 8-month regimen of IV ketamine infusions and ketamine-assisted psychotherapy (KAP). The patient achieved remission from suicidality and PTSD within 1 month; and TRD and GAD within 7 months. The patient's Patient Health Questionnaire (PHQ-9) score decreased from 25 (severe depression) to 1 (not depressed). These findings suggest that ketamine and KAP may represent effective interventions for mental health applications in healthcare professionals. The patient made the unique decision to attempt to type narrative journals during four of his ketamine infusions (doses ranged from 1.8 to 2.1 mg/kg/h IV). The patient successfully typed detailed journals throughout each 1-h ketamine infusion. To our knowledge, these journals represent the first independently typed, first-person, real-time narratives of ketamine-induced non ordinary states of consciousness. The transcripts of these journals may provide useful insights for clinicians, particularly in the context of KAP.
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Affiliation(s)
- Joshua Willms
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, United States
- Denovo Therapy, Lubbock, TX, United States
- Researchers for Change, Lubbock, TX, United States
| | | | | | - Peyton Presto
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Ankith Arun
- Researchers for Change, Lubbock, TX, United States
| | - Nazeen Shah
- Researchers for Change, Lubbock, TX, United States
| | - Kierra Irby
- Researchers for Change, Lubbock, TX, United States
| | - Megan Strawn
- Researchers for Change, Lubbock, TX, United States
| | - Jonathan Kopel
- Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, United States
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Kawazoe K, McGlynn R, Felix W, Sevilla R, Liao S, Kulkarni P, Ferris CF. Dose-dependent effects of esketamine on brain activity in awake mice: A BOLD phMRI study. Pharmacol Res Perspect 2022; 10:e01035. [PMID: 36504448 PMCID: PMC9743060 DOI: 10.1002/prp2.1035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 12/14/2022] Open
Abstract
Pharmacological magnetic resonance imaging (phMRI) is a noninvasive method used to evaluate neural circuitry involved in the behavioral effects of drugs like ketamine, independent of their specific biochemical mechanism. The study was designed to evaluate the immediate effect of esketamine, the S-isomer of (±) ketamine on brain activity in awake mice using blood oxygenation level dependent (BOLD) imaging. It was hypothesized the prefrontal cortex, hippocampus, and brain areas associated with reward and motivation would show a dose-dependent increase in brain activity. Mice were given vehicle, 1.0, 3.3, or 10 mg/kg esketamine I.P. and imaged for 10 min post-treatment. Data for each treatment were registered to a 3D MRI mouse brain atlas providing site-specific information on 134 different brain areas. There was a global change in brain activity for both positive and negative BOLD signal affecting over 50 brain areas. Many areas showed a dose-dependent decrease in positive BOLD signal, for example, cortex, hippocampus, and thalamus. The most common profile when comparing the three doses was a U-shape with the 3.3 dose having the lowest change in signal. At 1.0 mg/kg there was a significant increase in positive BOLD in forebrain areas and hippocampus. The anticipated dose-dependent increase in BOLD was not realized; instead, the lowest dose of 1.0 mg/kg had the greatest effect on brain activity. The prefrontal cortex and hippocampus were significantly activated corroborating previous imaging studies in humans and animals. The unexpected sensitivity to the 1.0 mg/kg dose of esketamine could be explained by imaging in fully awake mice without the confound of anesthesia and/or its greater affinity for the N-methyl-d-aspartate receptor (NMDAR) receptor than (±) ketamine.
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Affiliation(s)
- Kyrsten Kawazoe
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Ryan McGlynn
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Wilder Felix
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Raquel Sevilla
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Siyang Liao
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Praveen Kulkarni
- Center for Translational NeuroimagingNortheastern UniversityMassachusettsBostonUSA
| | - Craig F. Ferris
- Department of Pharmaceutical SciencesNortheastern UniversityBostonMassachusettsUSA
- Center for Translational NeuroimagingNortheastern UniversityMassachusettsBostonUSA
- Department of PsychologyNortheastern UniversityBostonMassachusettsUSA
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18
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Ho NF, Lin AY, Tng JXJ, Chew QH, Cheung MWL, Javitt DC, Sim K. Abnormalities in visual cognition and associated impaired interactions between visual and attentional networks in schizophrenia and brief psychotic disorder. Psychiatry Res Neuroimaging 2022; 327:111545. [PMID: 36272310 DOI: 10.1016/j.pscychresns.2022.111545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/08/2022] [Accepted: 09/23/2022] [Indexed: 12/04/2022]
Abstract
The extent and nature of cognitive impairment in brief psychotic disorder remains unclear, being rarely studied unlike schizophrenia. The present study hence sought to directly compare the visual cognitive dysfunction and its associated brain networks in brief psychotic disorder and schizophrenia. Data from picture completion (a complex visual task) and whole-brain functional connectome from resting-state fMRI were acquired from a sample of clinically stable patients with an established psychotic disorder (twenty with brief psychotic disorder, twenty with schizophrenia) and twenty-nine healthy controls. Group differences and the inter-relationships in task performances and brain networks were tested. Picture completion task deficits were found in brief psychotic disorder compared with healthy controls, though the deficits were less than schizophrenia. Task performance also correlated with severity of psychotic symptoms in patients. The task performance was inversely correlated with the functional connectivity between peripheral visual and attentional networks (dorsal attention and salience ventral attention), with increased functional connectivity in brief psychotic disorder compared with healthy controls and in schizophrenia compared with brief psychotic disorder. Present findings showed pronounced visual cognitive impairments in brief psychotic disorder that were worse in schizophrenia, underpinned by abnormal interactions between higher-order attentional and lower-order visual processing networks.
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Affiliation(s)
- New Fei Ho
- Institute of Mental Health, Singapore; Duke-National University of Singapore Medical School, Singapore.
| | | | | | | | | | | | - Kang Sim
- Institute of Mental Health, Singapore
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Huang J, Tong J, Zhang P, Zhou Y, Li Y, Tan S, Wang Z, Yang F, Kochunov P, Chiappelli J, Tian B, Tian L, Hong LE, Tan Y. Elevated salivary kynurenic acid levels related to enlarged choroid plexus and severity of clinical phenotypes in treatment-resistant schizophrenia. Brain Behav Immun 2022; 106:32-39. [PMID: 35940451 DOI: 10.1016/j.bbi.2022.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023] Open
Abstract
Patients with treatment-resistant schizophrenia (TRS) suffer severe, long-term psychotic symptoms and chronic stress. Salivary kynurenic acid (KYNA) and choroid plexus were evidenced to relate to psychological stress. We hypothesized that TRS patients would have higher salivary KYNA levels than patients who respond to antipsychotics (NTRS) and healthy controls (HC), and increased salivary KYNA levels are associated with clinical phenotypes and choroid plexus volume. A total of 66 HC participants, 53 patients with TRS and 46 with NTRS were enrolled. Salivary KYNA levels were measured by liquid chromatography-tandem mass spectrometry, choroid plexus volume by magnetic resonance imaging, and cognitive functions with the MATRICS Consensus Cognitive Battery. The TRS group had significantly higher salivary KYNA levels than the NTRS group (p = 0.003), who in turn had higher salivary KYNA than HC (p = 0.02). Higher salivary KYNA levels were associated with larger choroid plexus volume (r = 0.48, p = 0.004); lower attention/vigilance (r = -0.44, p = 0.004), verbal learning (r = -0.44, p = 0.004), total MCCB score (r = -0.42, p = 0.005); and a higher total PANSS score (r = 0.48, p = 0.004) in TRS patients. An enlarged choroid plexus also related to worse attention/vigilance (r = -0.39, p = 0.03), verbal learning (r = -0.55, p = 0.001), total MCCB score (r = -0.41, p = 0.02) and clinical symptoms (r = 0.48, p = 0.004) in TRS patients only. We conclude that elevated salivary KYNA levels and associated choroid plexus enlargement are clinically relevant indicators of TRS, with salivary KYNA being particularly valuable as a peripheral marker. Our findings should benefit TRS research and benefit the improvement of personalized treatment.
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Affiliation(s)
- Junchao Huang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Jinghui Tong
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Ping Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Yanfang Zhou
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Yanli Li
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Zhiren Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Fude Yang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA
| | - Baopeng Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China
| | - Li Tian
- Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, PR China.
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20
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Zhornitsky S, Tourjman V, Pelletier J, Assaf R, Li CSR, Potvin S. Acute effects of ketamine and esketamine on cognition in healthy subjects: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110575. [PMID: 35568275 DOI: 10.1016/j.pnpbp.2022.110575] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Impairment in cognition is frequently associated with acute ketamine administration. However, some questions remain unanswered as to which deficits are most prominent and what variables modulate these effects. METHODS A literature search yielded 56 experimental studies of acute ketamine administration that assessed cognition in 1041 healthy volunteers. A multivariate meta-analysis was performed, and effect sizes were estimated for eleven cognitive domains: attention, executive function, response inhibition, social cognition, speed of processing, verbal / language, verbal learning, verbal memory, visual learning & memory, visuospatial abilities, and working memory. RESULTS There were small-to-moderate impairments across all cognitive domains. Deficits in verbal learning / memory were most prominent, whereas response inhibition was the least affected. Meta-regression analysis revealed that the negative effects of ketamine on cognition are dependent on infusion dose and plasma level, but unaffected by enantiomer type, route of administration, sex or age. A publication bias was observed. DISCUSSION Acute ketamine broadly impairs cognition across all domains among healthy individuals. Verbal learning and memory figures most prominently in cognitive impairment elicited by acute ketamine administration.
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Affiliation(s)
- Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Valérie Tourjman
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Julie Pelletier
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Roxane Assaf
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA; Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
| | - Stéphane Potvin
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
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21
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Dlg Is Required for Short-Term Memory and Interacts with NMDAR in the Drosophila Brain. Int J Mol Sci 2022; 23:ijms23169187. [PMID: 36012453 PMCID: PMC9409279 DOI: 10.3390/ijms23169187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022] Open
Abstract
The vertebrates’ scaffold proteins of the Dlg-MAGUK family are involved in the recruitment, clustering, and anchoring of glutamate receptors to the postsynaptic density, particularly the NMDA subtype glutamate-receptors (NRs), necessary for long-term memory and LTP. In Drosophila, the only gene of the subfamily generates two main products, dlgA, broadly expressed, and dlgS97, restricted to the nervous system. In the Drosophila brain, NRs are expressed in the adult brain and are involved in memory, however, the role of Dlg in these processes and its relationship with NRs has been scarcely explored. Here, we show that the dlg mutants display defects in short-term memory in the olfactory associative-learning paradigm. These defects are dependent on the presence of DlgS97 in the Mushroom Body (MB) synapses. Moreover, Dlg is immunoprecipitated with NRs in the adult brain. Dlg is also expressed in the larval neuromuscular junction (NMJ) pre and post-synaptically and is important for development and synaptic function, however, NR is absent in this synapse. Despite that, we found changes in the short-term plasticity paradigms in dlg mutant larval NMJ. Together our results show that larval NMJ and the adult brain relies on Dlg for short-term memory/plasticity, but the mechanisms differ in the two types of synapses.
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22
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Aberrant maturation and connectivity of prefrontal cortex in schizophrenia-contribution of NMDA receptor development and hypofunction. Mol Psychiatry 2022; 27:731-743. [PMID: 34163013 PMCID: PMC8695640 DOI: 10.1038/s41380-021-01196-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 06/02/2021] [Accepted: 06/10/2021] [Indexed: 02/06/2023]
Abstract
The neurobiology of schizophrenia involves multiple facets of pathophysiology, ranging from its genetic basis over changes in neurochemistry and neurophysiology, to the systemic level of neural circuits. Although the precise mechanisms associated with the neuropathophysiology remain elusive, one essential aspect is the aberrant maturation and connectivity of the prefrontal cortex that leads to complex symptoms in various stages of the disease. Here, we focus on how early developmental dysfunction, especially N-methyl-D-aspartate receptor (NMDAR) development and hypofunction, may lead to the dysfunction of both local circuitry within the prefrontal cortex and its long-range connectivity. More specifically, we will focus on an "all roads lead to Rome" hypothesis, i.e., how NMDAR hypofunction during development acts as a convergence point and leads to local gamma-aminobutyric acid (GABA) deficits and input-output dysconnectivity in the prefrontal cortex, which eventually induce cognitive and social deficits. Many outstanding questions and hypothetical mechanisms are listed for future investigations of this intriguing hypothesis that may lead to a better understanding of the aberrant maturation and connectivity associated with the prefrontal cortex.
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23
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Demchenko I, Tassone VK, Kennedy SH, Dunlop K, Bhat V. Intrinsic Connectivity Networks of Glutamate-Mediated Antidepressant Response: A Neuroimaging Review. Front Psychiatry 2022; 13:864902. [PMID: 35722550 PMCID: PMC9199367 DOI: 10.3389/fpsyt.2022.864902] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
Conventional monoamine-based pharmacotherapy, considered the first-line treatment for major depressive disorder (MDD), has several challenges, including high rates of non-response. To address these challenges, preclinical and clinical studies have sought to characterize antidepressant response through monoamine-independent mechanisms. One striking example is glutamate, the brain's foremost excitatory neurotransmitter: since the 1990s, studies have consistently reported altered levels of glutamate in MDD, as well as antidepressant effects following molecular targeting of glutamatergic receptors. Therapeutically, this has led to advances in the discovery, testing, and clinical application of a wide array of glutamatergic agents, particularly ketamine. Notably, ketamine has been demonstrated to rapidly improve mood symptoms, unlike monoamine-based interventions, and the neurobiological basis behind this rapid antidepressant response is under active investigation. Advances in brain imaging techniques, including functional magnetic resonance imaging, magnetic resonance spectroscopy, and positron emission tomography, enable the identification of the brain network-based characteristics distinguishing rapid glutamatergic modulation from the effect of slow-acting conventional monoamine-based pharmacology. Here, we review brain imaging studies that examine brain connectivity features associated with rapid antidepressant response in MDD patients treated with glutamatergic pharmacotherapies in contrast with patients treated with slow-acting monoamine-based treatments. Trends in recent brain imaging literature suggest that the activity of brain regions is organized into coherent functionally distinct networks, termed intrinsic connectivity networks (ICNs). We provide an overview of major ICNs implicated in depression and explore how treatment response following glutamatergic modulation alters functional connectivity of limbic, cognitive, and executive nodes within ICNs, with well-characterized anti-anhedonic effects and the enhancement of "top-down" executive control. Alterations within and between the core ICNs could potentially exert downstream effects on the nodes within other brain networks of relevance to MDD that are structurally and functionally interconnected through glutamatergic synapses. Understanding similarities and differences in brain ICNs features underlying treatment response will positively impact the trajectory and outcomes for adults suffering from MDD and will facilitate the development of biomarkers to enable glutamate-based precision therapeutics.
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Affiliation(s)
- Ilya Demchenko
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Vanessa K Tassone
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sidney H Kennedy
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katharine Dunlop
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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24
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Stein H, Barbosa J, Compte A. Towards biologically constrained attractor models of schizophrenia. Curr Opin Neurobiol 2021; 70:171-181. [PMID: 34839146 DOI: 10.1016/j.conb.2021.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 12/31/2022]
Abstract
Alterations in neuromodulation or synaptic transmission in biophysical attractor network models, as proposed by the dominant dopaminergic and glutamatergic theories of schizophrenia, successfully mimic working memory (WM) deficits in people with schizophrenia (PSZ). Yet, multiple, often opposing alterations in memory circuits can lead to the same behavioral patterns in these network models. Here, we critically revise the computational and experimental literature that links NMDAR hypofunction to WM precision loss in PSZ. We show in network simulations that currently available experimental evidence cannot set apart competing biophysical accounts. Critical points to resolve are the effects of increases vs. decreases in E/I ratio (e.g. through NMDAR blockade) on firing rate tuning and shared noise modulations and possible concomitant deficits in short-term plasticity. We argue that these concerted experimental and computational efforts will lead to a better understanding of the neurobiology underlying cognitive deficits in PSZ.
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Affiliation(s)
- Heike Stein
- Laboratoire de Neurosciences Cognitives et Computationnelles, Département d'Études Cognitives, École Normale Supérieure, INSERM U960, PSL University, Paris, France
| | - Joao Barbosa
- Laboratoire de Neurosciences Cognitives et Computationnelles, Département d'Études Cognitives, École Normale Supérieure, INSERM U960, PSL University, Paris, France
| | - Albert Compte
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
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25
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Riggs LM, An X, Pereira EFR, Gould TD. (R,S)-ketamine and (2R,6R)-hydroxynorketamine differentially affect memory as a function of dosing frequency. Transl Psychiatry 2021; 11:583. [PMID: 34772915 PMCID: PMC8590048 DOI: 10.1038/s41398-021-01685-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 12/14/2022] Open
Abstract
A single subanesthetic infusion of ketamine can rapidly alleviate symptoms of treatment-resistant major depression. Since repeated administration is required to sustain symptom remission, it is important to characterize the potential untoward effects of prolonged ketamine exposure. While studies suggest that ketamine can alter cognitive function, it is unclear to what extent these effects are modulated by the frequency or chronicity of treatment. To test this, male and female adolescent (postnatal day [PD] 35) and adult (PD 60) BALB/c mice were treated for four consecutive weeks, either daily or thrice-weekly, with (R,S)-ketamine (30 mg/kg, intraperitoneal) or its biologically active metabolite, (2R,6R)-hydroxynorketamine (HNK; 30 mg/kg, intraperitoneal). Following drug cessation, memory performance was assessed in three operationally distinct tasks: (1) novel object recognition to assess explicit memory, (2) Y-maze to assess working memory, and (3) passive avoidance to assess implicit memory. While drug exposure did not influence working memory performance, thrice-weekly ketamine and daily (2R,6R)-HNK led to explicit memory impairment in novel object recognition independent of sex or age of exposure. Daily (2R,6R)-HNK impaired implicit memory in the passive-avoidance task whereas thrice-weekly (2R,6R)-HNK tended to improve it. These differential effects on explicit and implicit memory possibly reflect the unique mechanisms by which ketamine and (2R,6R)-HNK alter the functional integrity of neural circuits that subserve these distinct cognitive domains, a topic of clinical and mechanistic relevance to their antidepressant actions. Our findings also provide additional support for the importance of dosing frequency in establishing the cognitive effects of repeated ketamine exposure.
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Affiliation(s)
- Lace M Riggs
- Program in Neuroscience and Training Program in Integrative Membrane Biology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Xiaoxian An
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Edna F R Pereira
- Department of Epidemiology and Public Health, Division of Translational Toxicology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Todd D Gould
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
- Veterans Affairs Maryland Health Care System, Baltimore, MD, 21201, USA.
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26
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Effects of Ketamine and Midazolam on Simultaneous EEG/fMRI Data During Working Memory Processes. Brain Topogr 2021; 34:863-880. [PMID: 34642836 DOI: 10.1007/s10548-021-00876-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/20/2021] [Indexed: 10/20/2022]
Abstract
Reliable measures of cognitive brain activity from functional neuroimaging techniques may provide early indications of efficacy in clinical trials. Functional magnetic resonance imaging and electroencephalography provide complementary spatiotemporal information and simultaneous recording of these two modalities can remove inter-session drug response and environment variability. We sought to assess the effects of ketamine and midazolam on simultaneous electrophysiological and hemodynamic recordings during working memory (WM) processes. Thirty participants were included in a placebo-controlled, three-way crossover design with ketamine and midazolam. Compared to placebo, ketamine administration attenuated theta power increases and alpha power decreases and midazolam attenuated low beta band decreases to increasing WM load. Additionally, ketamine caused larger blood-oxygen-dependent (BOLD) signal increases in the supplementary motor area and angular gyrus, and weaker deactivations of the default mode network (DMN), whereas no difference was found between midazolam and placebo. Ketamine administration caused positive temporal correlations between frontal-midline theta (fm-theta) power and the BOLD signal to disappear and attenuated negative correlations. However, the relationship between fm-theta and the BOLD signal from DMN areas was maintained in some participants during ketamine administration, as increasing theta strength was associated with stronger BOLD signal reductions in these areas. The presence of, and ability to manipulate, both positive and negative associations between the BOLD signal and fm-theta suggest the presence of multiple fm-theta components involved in WM processes, with ketamine administration disrupting one or more of these theta-linked WM strategies.
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27
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Arnsten AFT, Datta D, Wang M. The genie in the bottle-magnified calcium signaling in dorsolateral prefrontal cortex. Mol Psychiatry 2021; 26:3684-3700. [PMID: 33319854 PMCID: PMC8203737 DOI: 10.1038/s41380-020-00973-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 02/07/2023]
Abstract
Neurons in the association cortices are particularly vulnerable in cognitive disorders such as schizophrenia and Alzheimer's disease, while those in primary visual cortex remain relatively resilient. This review proposes that the special molecular mechanisms needed for higher cognitive operations confer vulnerability to dysfunction, atrophy, and neurodegeneration when regulation is lost due to genetic and/or environmental insults. Accumulating data suggest that higher cortical circuits rely on magnified levels of calcium (from NMDAR, calcium channels, and/or internal release from the smooth endoplasmic reticulum) near the postsynaptic density to promote the persistent firing needed to maintain, manipulate, and store information without "bottom-up" sensory stimulation. For example, dendritic spines in the primate dorsolateral prefrontal cortex (dlPFC) express the molecular machinery for feedforward, cAMP-PKA-calcium signaling. PKA can drive internal calcium release and promote calcium flow through NMDAR and calcium channels, while in turn, calcium activates adenylyl cyclases to produce more cAMP-PKA signaling. Excessive levels of cAMP-calcium signaling can have a number of detrimental effects: for example, opening nearby K+ channels to weaken synaptic efficacy and reduce neuronal firing, and over a longer timeframe, driving calcium overload of mitochondria to induce inflammation and dendritic atrophy. Thus, calcium-cAMP signaling must be tightly regulated, e.g., by agents that catabolize cAMP or inhibit its production (PDE4, mGluR3), and by proteins that bind calcium in the cytosol (calbindin). Many genetic or inflammatory insults early in life weaken the regulation of calcium-cAMP signaling and are associated with increased risk of schizophrenia (e.g., GRM3). Age-related loss of regulatory proteins which result in elevated calcium-cAMP signaling over a long lifespan can additionally drive tau phosphorylation, amyloid pathology, and neurodegeneration, especially when protective calcium binding proteins are lost from the cytosol. Thus, the "genie" we need for our remarkable cognitive abilities may make us vulnerable to cognitive disorders when we lose essential regulation.
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Affiliation(s)
- Amy F T Arnsten
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA.
| | - Dibyadeep Datta
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Min Wang
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
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28
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Burt JB, Preller KH, Demirtas M, Ji JL, Krystal JH, Vollenweider FX, Anticevic A, Murray JD. Transcriptomics-informed large-scale cortical model captures topography of pharmacological neuroimaging effects of LSD. eLife 2021; 10:e69320. [PMID: 34313217 PMCID: PMC8315798 DOI: 10.7554/elife.69320] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Psychoactive drugs can transiently perturb brain physiology while preserving brain structure. The role of physiological state in shaping neural function can therefore be investigated through neuroimaging of pharmacologically induced effects. Previously, using pharmacological neuroimaging, we found that neural and experiential effects of lysergic acid diethylamide (LSD) are attributable to agonism of the serotonin-2A receptor (Preller et al., 2018). Here, we integrate brain-wide transcriptomics with biophysically based circuit modeling to simulate acute neuromodulatory effects of LSD on human cortical large-scale spatiotemporal dynamics. Our model captures the inter-areal topography of LSD-induced changes in cortical blood oxygen level-dependent (BOLD) functional connectivity. These findings suggest that serotonin-2A-mediated modulation of pyramidal-neuronal gain is a circuit mechanism through which LSD alters cortical functional topography. Individual-subject model fitting captures patterns of individual neural differences in pharmacological response related to altered states of consciousness. This work establishes a framework for linking molecular-level manipulations to systems-level functional alterations, with implications for precision medicine.
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Affiliation(s)
- Joshua B Burt
- Department of Psychiatry, Yale UniversityNew HavenUnited States
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Murat Demirtas
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Jie Lisa Ji
- Department of Psychiatry, Yale UniversityNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
| | - John H Krystal
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
| | - John D Murray
- Department of Psychiatry, Yale UniversityNew HavenUnited States
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
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29
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Ventriglio A, Bellomo A, Favale D, Bonfitto I, Vitrani G, Di Sabatino D, Cuozzo E, Di Gioia I, Mauro P, Giampaolo P, Alessandro V, De Berardis D. Oxidative Stress in the Early Stage of Psychosis. Curr Top Med Chem 2021; 21:1457-1470. [PMID: 34218786 DOI: 10.2174/1568026621666210701105839] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND In the past few decades, increasing evidence in the literature has appeared describing the role of the antioxidant defense system and redox signaling in the multifactorial pathophysiology of psychosis. It is of interest to clinicians and researchers alike that abnormalities of the antioxidant defense system are associated with alterations of cellular membranes, immune functions and neurotransmission, all of which have some clinical implications. METHODS This narrative review summarizes the evidence regarding oxidative stress in the early stages of psychosis. We included 136 peer-reviewed articles published from 2007 to 2020 on PubMed EMBASE, The Cochrane Library and Google Scholar. RESULTS Patients affected by psychotic disorders show a decreased level of non-enzymatic antioxidants, an increased level of lipid peroxides, nitric oxides, and a homeostatic imbalance of purine catabolism. In particular, a significantly reduced antioxidant defense has been described in the early onset first episode of psychosis, including reduced levels of glutathione. Also, it has been shown that a decreased basal low -antioxidant capacity correlates with cognitive deficits and negative symptoms, mostly related to glutamate-receptor hypofunction. In addition, atypical antipsychotic drugs seem to show significant antioxidant activity. These factors are critical in order to treat cases of first-onset psychosis effectively. CONCLUSION This systematic review indicates the importance that must be given to anti-oxidant defense systems.
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Affiliation(s)
- Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Donato Favale
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Iris Bonfitto
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanna Vitrani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Dario Di Sabatino
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Edwige Cuozzo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Ilaria Di Gioia
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Pettorruso Mauro
- Department of Neurosciences, Imaging and Clinical Sciences, Univerity of Chieti, Italy
| | - Perna Giampaolo
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Murphy N, Lijffijt M, Ramakrishnan N, Vo-Le B, Vo-Le B, Iqbal S, Iqbal T, O'Brien B, Smith MA, Swann AC, Mathew SJ. Does mismatch negativity have utility for NMDA receptor drug development in depression? ACTA ACUST UNITED AC 2021; 44:61-73. [PMID: 33825765 PMCID: PMC8827377 DOI: 10.1590/1516-4446-2020-1685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
CLINICAL TRIAL REGISTRATION Rapid antidepressant effects associated with ketamine have shifted the landscape for the development of therapeutics to treat major depressive disorder (MDD) from a monoaminergic to glutamatergic model. Treatment with ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, may be effective, but has many non-glutamatergic targets, and clinical and logistical problems are potential challenges. These factors underscore the importance of manipulations of binding mechanics to produce antidepressant effects without concomitant clinical side effects. This will require identification of efficient biomarkers to monitor target engagement. The mismatch negativity (MMN) is a widely used electrophysiological signature linked to the activity of NMDA receptors (NMDAR) in humans and animals and validated in pre-clinical and clinical studies of ketamine. In this review, we explore the flexibility of the MMN and its capabilities for reliable use in drug development for NMDAR antagonists in MDD. We supplement this with findings from our own research with three distinct NMDAR antagonists. The research described illustrates that there are important distinctions between the mechanisms of NMDAR antagonism, which are further crystallized when considering the paradigm used to study the MMN. We conclude that the lack of standardized methodology currently prevents MMN from being ready for common use in drug discovery. This manuscript describes data collected from the following National Institutes of Health (NIH) and Veterans Affairs (VA) studies: AV-101, NCT03583554; lanicemine, NCT03166501; ketamine, NCT02556606.
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Affiliation(s)
- Nicholas Murphy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA.,The Menninger Clinic, Houston, TX, USA
| | - Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Nithya Ramakrishnan
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Bylinda Vo-Le
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Brittany Vo-Le
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Sidra Iqbal
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Tabish Iqbal
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Brittany O'Brien
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Mark A Smith
- VistaGen Therapeutics, Inc., South San Francisco, CA, USA.,Medical College of Georgia, Augusta, GA, USA
| | - Alan C Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Sanjay J Mathew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA.,The Menninger Clinic, Houston, TX, USA
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31
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Huang J, Tong J, Zhang P, Zhou Y, Cui Y, Tan S, Wang Z, Yang F, Kochunov P, Chiappelli J, Tian B, Tian L, Tan Y, Hong LE. Effects of neuroactive metabolites of the tryptophan pathway on working memory and cortical thickness in schizophrenia. Transl Psychiatry 2021; 11:198. [PMID: 33795641 PMCID: PMC8016899 DOI: 10.1038/s41398-021-01311-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/19/2021] [Accepted: 03/11/2021] [Indexed: 01/10/2023] Open
Abstract
A number of tryptophan metabolites known to be neuroactive have been examined for their potential associations with cognitive deficits in schizophrenia. Among these metabolites, kynurenic acid (KYNA), 5-hydroxyindole (5-HI), and quinolinic acid (QUIN) are documented in their diverse effects on α-7 nicotinic acetylcholine receptor (α7nAChR) and/or N-methyl-D-aspartate receptor (NMDAR), two of the receptor types thought to contribute to cognitive impairment in schizophrenia. In this study, serum levels of KYNA, 5-HI, and QUIN were measured in 195 patients with schizophrenia and in 70 healthy controls using liquid chromatography-tandem mass spectrometry; cognitive performance in MATRICS Consensus Cognitive Battery and cortical thickness measured by magnetic resonance imaging were obtained. Patients with schizophrenia had significantly lower serum KYNA (p < 0.001) and QUIN (p = 0.02) levels, and increased 5-HI/KYNA (p < 0.001) and QUIN/KYNA ratios (p < 0.001) compared with healthy controls. Multiple linear regression showed that working memory was positively correlated with serum 5-HI levels (t = 2.10, p = 0.04), but inversely correlated with KYNA concentrations (t = -2.01, p = 0.05) in patients. Patients with high 5-HI and low KYNA had better working memory than other subgroups (p = 0.01). Higher 5-HI levels were associated with thicker left lateral orbitofrontal cortex (t = 3.71, p = 2.94 × 10-4) in patients. The different effects of 5-HI and KYNA on working memory may appear consistent with their opposite receptor level mechanisms. Our findings appear to provide a new insight into the dynamic roles of tryptophan pathway metabolites on cognition, which may benefit novel therapeutic development that targets cognitive impairment in schizophrenia.
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Affiliation(s)
- Junchao Huang
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Jinghui Tong
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Ping Zhang
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Yanfang Zhou
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Yimin Cui
- grid.411472.50000 0004 1764 1621Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Shuping Tan
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Zhiren Wang
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Fude Yang
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Peter Kochunov
- grid.411024.20000 0001 2175 4264Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD USA
| | - Joshua Chiappelli
- grid.411024.20000 0001 2175 4264Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD USA
| | - Baopeng Tian
- grid.414351.60000 0004 0530 7044Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Li Tian
- grid.10939.320000 0001 0943 7661Faculty of Medicine, Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China.
| | - L. Elliot Hong
- grid.411024.20000 0001 2175 4264Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD USA
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Kuo HI, Qi FX, Paulus W, Kuo MF, Nitsche MA. Noradrenergic Enhancement of Motor Learning, Attention, and Working Memory in Humans. Int J Neuropsychopharmacol 2021; 24:490-498. [PMID: 33617635 PMCID: PMC8278798 DOI: 10.1093/ijnp/pyab006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/15/2020] [Accepted: 02/18/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Noradrenaline has an important role as a neuromodulator of the central nervous system. Noradrenergic enhancement was recently shown to enhance glutamate-dependent cortical facilitation and long term potentiation-like plasticity. As cortical excitability and plasticity are closely linked to various cognitive processes, here we aimed to explore whether these alterations are associated with respective cognitive performance changes. Specifically, we assessed the impact of noradrenergic enhancement on motor learning (serial reaction time task), attentional processes (Stroop interference task), and working memory performance (n-back letter task). METHODS The study was conducted in a cross-over design. Twenty-five healthy humans performed the respective cognitive tasks after a single dose of the noradrenaline reuptake inhibitor reboxetine or placebo administration. RESULTS The results show that motor learning, attentional processes, and working memory performance in healthy participants were improved by reboxetine application compared with placebo. CONCLUSIONS The results of the present study thus suggest that noradrenergic enhancement can improve memory formation and executive functions in healthy humans. The respective changes are in line with related effects of noradrenaline on cortical excitability and plasticity.
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Affiliation(s)
- Hsiao-I Kuo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan,Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Feng-Xue Qi
- Key Laboratory of Sport Training of General Admission of Sport of China, Beijing Sport University, Xinxin Road, Haidian District, Beijing, China,Department of Sport Training, Sport Coaching College, Beijing Sport University, Beijing, China
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Min-Fang Kuo
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Michael A Nitsche
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany,Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany,Correspondence: M. A. Nitsche, MD, Department Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Ardeystrasse 67, 44139 Dortmund, Germany ()
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Abdallah CG, Ahn KH, Averill LA, Nemati S, Averill CL, Fouda S, Ranganathan M, Morgan PT, D’Souza DC, Mathalon DH, Krystal JH, Driesen NR. A robust and reproducible connectome fingerprint of ketamine is highly associated with the connectomic signature of antidepressants. Neuropsychopharmacology 2021; 46:478-485. [PMID: 32967000 PMCID: PMC7852889 DOI: 10.1038/s41386-020-00864-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/15/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Abstract
Over the past decade, various N-methyl-D-aspartate modulators have failed in clinical trials, underscoring the challenges of developing novel rapid-acting antidepressants based solely on the receptor or regional targets of ketamine. Thus, identifying the effect of ketamine on the brain circuitry and networks is becoming increasingly critical. In this longitudinal functional magnetic resonance imaging study of data from 265 participants, we used a validated predictive model approach that allows the full assessment of brain functional connectivity, without the need for seed selection or connectivity summaries. First, we identified a connectome fingerprint (CFP) in healthy participants (Cohort A, n = 25) during intravenous infusion of a subanesthetic dose of ketamine, compared to normal saline. We then demonstrated the robustness and reproducibility of the discovered ketamine CFP in two separate healthy samples (Cohort B, n = 22; Cohort C, n = 18). Finally, we investigated the ketamine CFP connectivity at 1-week post treatment in major depressive disorder patients randomized to 8 weeks of sertraline or placebo (Cohort D, n = 200). We found a significant, robust, and reproducible ketamine CFP, consistent with reduced connectivity within the primary cortices and within the executive network, but increased connectivity between the executive network and the rest of the brain. Compared to placebo, the ketamine CFP connectivity changes at 1 week predicted response to sertraline at 8 weeks. In each of Cohorts A-C, ketamine significantly increased connectivity in a previously identified antidepressant CFP. Investigating the brain connectivity networks, we successfully identified a robust and reproducible ketamine biomarker that is related to the mechanisms of antidepressants.
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Affiliation(s)
- Chadi G. Abdallah
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA ,grid.413890.70000 0004 0420 5521Michael E. DeBakey VA Medical Center, Houston, TX USA ,grid.39382.330000 0001 2160 926XMenninger Department of Psychiatry, Baylor College of Medicine, Houston, TX USA
| | - Kyung-Heup Ahn
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Lynnette A. Averill
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Samaneh Nemati
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Christopher L. Averill
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Samar Fouda
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Mohini Ranganathan
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Peter T. Morgan
- grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Deepak C. D’Souza
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Daniel H. Mathalon
- grid.266102.10000 0001 2297 6811San Francisco VA Medical Center, University of California, San Francisco, CA USA
| | - John H. Krystal
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Naomi R. Driesen
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT USA ,grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
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Assessment of brain cholesterol metabolism biomarker 24S-hydroxycholesterol in schizophrenia. NPJ SCHIZOPHRENIA 2020; 6:34. [PMID: 33219208 PMCID: PMC7680117 DOI: 10.1038/s41537-020-00121-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/03/2020] [Indexed: 11/08/2022]
Abstract
Plasma 24S-hydroxycholesterol mostly originates in brain tissue and likely reflects the turnover of cholesterol in the central nervous system. As cholesterol is disproportionally enriched in many key brain structures, 24S-hydroxycholesterol is a promising biomarker for psychiatric and neurologic disorders that impact brain structure. We hypothesized that, as schizophrenia patients have widely reported gray and white matter deficits, they would have abnormal levels of plasma 24S-hydroxycholesterol, and that plasma levels of 24S-hydroxycholesterol would be associated with brain structural and functional biomarkers for schizophrenia. Plasma levels of 24S-hydroxycholesterol were measured in 226 individuals with schizophrenia and 204 healthy controls. The results showed that levels of 24S-hydroxycholesterol were not significantly different between patients and controls. Age was significantly and negatively correlated with 24S-hydroxycholesterol in both groups, and in both groups, females had significantly higher levels of 24S-hydroxycholesterol compared to males. Levels of 24S-hydroxycholesterol were not related to average fractional anisotropy of white matter or cortical thickness, or to cognitive deficits in schizophrenia. Based on these results from a large sample and using multiple brain biomarkers, we conclude there is little to no value of plasma 24S-hydroxycholesterol as a brain metabolite biomarker for schizophrenia.
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Reduced serial dependence suggests deficits in synaptic potentiation in anti-NMDAR encephalitis and schizophrenia. Nat Commun 2020; 11:4250. [PMID: 32843635 PMCID: PMC7447775 DOI: 10.1038/s41467-020-18033-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/31/2020] [Indexed: 01/06/2023] Open
Abstract
A mechanistic understanding of core cognitive processes, such as working memory, is crucial to addressing psychiatric symptoms in brain disorders. We propose a combined psychophysical and biophysical account of two symptomatologically related diseases, both linked to hypofunctional NMDARs: schizophrenia and autoimmune anti-NMDAR encephalitis. We first quantified shared working memory alterations in a delayed-response task. In both patient groups, we report a markedly reduced influence of previous stimuli on working memory contents, despite preserved memory precision. We then simulated this finding with NMDAR-dependent synaptic alterations in a microcircuit model of prefrontal cortex. Changes in cortical excitation destabilized within-trial memory maintenance and could not account for disrupted serial dependence in working memory. Rather, a quantitative fit between data and simulations supports alterations of an NMDAR-dependent memory mechanism operating on longer timescales, such as short-term potentiation. Stein, Barbosa et al. show that anti-NMDAR encephalitis and schizophrenia are characterized by reduced serial dependence in spatial working memory. Cortical network simulations show that this can be parsimoniously explained by a reduction in NMDAR-dependent short-term synaptic potentiation in these diseases.
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Gold JM, Bansal S, Anticevic A, Cho YT, Repovš G, Murray JD, Hahn B, Robinson BM, Luck SJ. Refining the Empirical Constraints on Computational Models of Spatial Working Memory in Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:913-922. [PMID: 32741701 DOI: 10.1016/j.bpsc.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/23/2020] [Accepted: 05/07/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Impairments in spatial working memory (sWM) have been well documented in schizophrenia. Here we provide a comprehensive test of a microcircuit model of WM performance in schizophrenia that predicts enhanced effects of increasing delay duration and distractors based on a hypothesized imbalance of excitatory and inhibitory processes. METHODS Model predictions were tested in 41 people with schizophrenia (PSZ) and 32 healthy control subjects (HCS) performing an sWM task. In one condition, a single target location was followed by delays of 0, 2, 4, or 8 seconds. In a second condition, distractors were presented during the 4-second delay interval at 20°, 30°, 40°, 50°, or 90° from the original target location. RESULTS PSZ showed less precise sWM representations than HCS, and the rate of memory drift over time was greater in PSZ than in HCS. Relative to HCS, the spatial recall responses of PSZ were more repelled by distractors presented close to the target location and more attracted by distractors presented far from the target location. The degree of attraction to distant distractors was correlated with the rate of memory drift in the absence of distractors. CONCLUSIONS Consistent with the microcircuit model, PSZ exhibited both a greater rate of drift and greater attraction to distant distractors relative to HCS. These two effects were correlated, consistent with the proposal that they arise from a single underlying mechanism. However, the repulsion effects produced by nearby distractors were not predicted by the model and thus require an updated modeling framework.
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Affiliation(s)
- James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.
| | - Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Grega Repovš
- Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Benjamin M Robinson
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis, Davis, California
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Kummerfeld E, Ma S, Blackman RK, DeNicola AL, Redish AD, Vinogradov S, Crowe DA, Chafee MV. Cognitive Control Errors in Nonhuman Primates Resembling Those in Schizophrenia Reflect Opposing Effects of NMDA Receptor Blockade on Causal Interactions Between Cells and Circuits in Prefrontal and Parietal Cortices. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:705-714. [PMID: 32513554 DOI: 10.1016/j.bpsc.2020.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The causal biology underlying schizophrenia is not well understood, but it is likely to involve a malfunction in how neurons adjust synaptic connections in response to patterns of activity in networks. We examined statistical dependencies between neural signals at the cell, local circuit, and distributed network levels in prefrontal and parietal cortices of monkeys performing a variant of the AX continuous performance task paradigm. We then quantified changes in the pattern of neural interactions across levels of scale following NMDA receptor (NMDAR) blockade and related these changes to a pattern of cognitive control errors closely matching the performance of patients with schizophrenia. METHODS We recorded the spiking activity of 1762 neurons along with local field potentials at multiple electrode sites in prefrontal and parietal cortices concurrently, and we generated binary time series indicating the presence or absence of spikes in single neurons or local field potential power above or below a threshold. We then applied causal discovery analysis to the time series to detect statistical dependencies between the signals (causal interactions) and compared the pattern of these interactions before and after NMDAR blockade. RESULTS Global blockade of NMDAR produced distinctive and frequently opposite changes in neural interactions at the cell, local circuit, and network levels in prefrontal and parietal cortices. Cognitive control errors were associated with decreased interactions at the cell level and with opposite changes at the network level in prefrontal and parietal cortices. CONCLUSIONS NMDAR synaptic deficits change causal interactions between neural signals at different levels of scale that correlate with schizophrenia-like deficits in cognitive control.
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Affiliation(s)
- Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota
| | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota
| | - Rachael K Blackman
- Medical Scientist Training Program, University of Minnesota, Minneapolis, Minnesota; Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota; Brain Sciences Center, Veterans Administration Medical Center, Minneapolis, Minnesota
| | - Adele L DeNicola
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota; Brain Sciences Center, Veterans Administration Medical Center, Minneapolis, Minnesota
| | - A David Redish
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - David A Crowe
- Department of Biology, Augsburg University, Minneapolis, Minnesota
| | - Matthew V Chafee
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota; Brain Sciences Center, Veterans Administration Medical Center, Minneapolis, Minnesota.
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McKendrick G, Garrett H, Jones HE, McDevitt DS, Sharma S, Silberman Y, Graziane NM. Ketamine Blocks Morphine-Induced Conditioned Place Preference and Anxiety-Like Behaviors in Mice. Front Behav Neurosci 2020; 14:75. [PMID: 32508606 PMCID: PMC7253643 DOI: 10.3389/fnbeh.2020.00075] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022] Open
Abstract
Patients suffering from opioid use disorder often relapse during periods of abstinence, which is posited to be caused by negative affective states that drive motivated behaviors. Here, we explored whether conditioning mice with morphine in a conditioned place preference (CPP) training paradigm evoked anxiety-like behavior during morphine abstinence. To do this, mice were conditioned with morphine (10 mg/kg, i.p.) for 5 days. Twenty-four hours following conditioning, anxiety levels were tested by measuring time in the open arms of the elevated plus-maze. The next day, mice were placed in the three-compartment chamber to measure morphine-induced CPP. Our results show that following morphine conditioning, mice spent significantly less time in the open arm of the elevated plus-maze and expressed robust morphine CPP on CPP test day. Furthermore, we found that an acute treatment with (R,S)-ketamine (10 mg/kg, i.p.), a medication demonstrating promise for preventing anxiety-related phenotypes, 30 min before testing on post-conditioning day 1, increased time spent in the open arm of the elevated plus-maze in saline- and morphine-conditioned mice. Additionally, we found that the second injection of ketamine 30 min before CPP tests on post-conditioning day 2 prevented morphine-induced CPP, which lasted for up to 28 days post-conditioning. Furthermore, we found that conditioning mice with 10% (w/v) sucrose using an oral self-administration procedure did not evoke anxiety-like behavior, but elicited robust CPP, which was attenuated by ketamine treatment 30 min before CPP tests. Overall, our results suggest that the ketamine-induced block of morphine CPP may not be attributed solely to alleviating negative affective states, but potentially through impaired memory of morphine-context associations.
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Affiliation(s)
- Greer McKendrick
- Neuroscience Graduate Program, Penn State College of Medicine, Hershey, PA, United States.,Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Hannah Garrett
- Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Holly E Jones
- Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, United States.,Summer Undergraduate Research Internship Program, Penn State College of Medicine, Hershey, PA, United States
| | - Dillon S McDevitt
- Neuroscience Graduate Program, Penn State College of Medicine, Hershey, PA, United States.,Summer Undergraduate Research Internship Program, Penn State College of Medicine, Hershey, PA, United States
| | - Sonakshi Sharma
- Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Yuval Silberman
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Pennsylvania State University, Hershey, PA, United States
| | - Nicholas M Graziane
- Departments of Anesthesiology and Perioperative Medicine and Pharmacology, Penn State College of Medicine, Hershey, PA, United States
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Shiga T, Horikoshi S, Kanno K, Kanno-Nozaki K, Hikita M, Itagaki S, Miura I, Yabe H. Plasma levels of dopamine metabolite correlate with mismatch negativity in patients with schizophrenia. Psychiatry Clin Neurosci 2020; 74:289-293. [PMID: 31994282 DOI: 10.1111/pcn.12984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/20/2019] [Accepted: 01/17/2020] [Indexed: 01/10/2023]
Abstract
AIM Mismatch negativity (MMN) deficit is one of the most robust and replicable findings in schizophrenia, and primarily reflects deficient functioning of the N-methyl-D-aspartate (NMDA) receptor system. Although the dopamine receptor is known not to modulate MMN over the short term, it is unclear whether the dopamine system affects MMN in the long term. METHODS We explored correlations between MMN and levels of plasma dopamine and serotonin metabolites in 18 patients with schizophrenia psychiatrically evaluated with the Positive and Negative Syndrome Scale (PANSS). RESULTS A significant negative correlation exists between MMN amplitude and plasma levels of dopamine metabolites. Plasma serotonin metabolite levels were not correlated with MMN. The PANSS total score and Negative score also showed negative correlations with MMN amplitude. CONCLUSION The usual strong therapeutic blockade of dopamine receptors applied in cases of schizophrenia may reduce MMN over the long term.
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Affiliation(s)
- Tetsuya Shiga
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Sho Horikoshi
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Kazuko Kanno
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Keiko Kanno-Nozaki
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Masayuki Hikita
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
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Abstract
Working memory is characterized by neural activity that persists during the retention interval of delay tasks. Despite the ubiquity of this delay activity across tasks, species and experimental techniques, our understanding of this phenomenon remains incomplete. Although initially there was a narrow focus on sustained activation in a small number of brain regions, methodological and analytical advances have allowed researchers to uncover previously unobserved forms of delay activity various parts of the brain. In light of these new findings, this Review reconsiders what delay activity is, where in the brain it is found, what roles it serves and how it may be generated.
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Affiliation(s)
- Kartik K Sreenivasan
- Division of Science and Mathematics, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.
| | - Mark D'Esposito
- Helen Wills Neuroscience Institute and Department of Psychology, University of California, Berkeley, CA, USA.
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Yurgelun-Todd DA, Renshaw PF, Goldsmith P, Uz T, Macek TA. A randomized, placebo-controlled, phase 1 study to evaluate the effects of TAK-063 on ketamine-induced changes in fMRI BOLD signal in healthy subjects. Psychopharmacology (Berl) 2020; 237:317-328. [PMID: 31773211 PMCID: PMC7018803 DOI: 10.1007/s00213-019-05366-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 09/22/2019] [Indexed: 12/14/2022]
Abstract
RATIONALE Phosphodiesterase 10A inhibitor TAK-063 has shown effects that suggest efficacy in schizophrenia treatment. OBJECTIVE This randomized, double-blind, placebo-controlled, incomplete-crossover study investigated effects of single oral administration of TAK-063 on ketamine-induced changes in blood oxygen level-dependent (BOLD) signal in healthy males. METHODS Healthy men aged 18 to 45 years with normal magnetic resonance imaging (MRI) scans and electroencephalogram measurements at screening were eligible. Each subject was randomized to one of nine treatment schedules: all subjects received placebo and two of three doses of TAK-063 followed by ketamine. The primary endpoint was ketamine-induced brain activity in select regions of the brain during resting state. Secondary endpoints included pharmacokinetic parameters of TAK-063, proportion of subjects with treatment-emergent adverse events (AEs), and percentage of subjects meeting criteria for abnormal safety laboratory tests and vital sign measurements. RESULTS The study comprised 27 subjects. Prior to ketamine infusion, TAK-063 exerted region-specific effects on resting state functional MRI (fMRI) BOLD signal. After ketamine administration, TAK-063 reduced the Cohen's effect size for resting-state fMRI BOLD signal in key brain regions examined, and exerted similar effects on BOLD signal during the working memory task across all doses. TAK-063 was safe and well tolerated. CONCLUSIONS Our results are consistent with non-clinical studies of ketamine and TAK-063 and clinical studies of ketamine and risperidone. It is unknown whether these data are predictive of potential antipsychotic efficacy, and further analyses are required.
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Affiliation(s)
| | - Perry F Renshaw
- The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA
| | - Paul Goldsmith
- Takeda Development Center Europe, Ltd., 61 Aldwych, London, WC2B 4AE, UK
| | - Tolga Uz
- Takeda Development Center Americas, Inc., One Takeda Parkway, Deerfield, IL, 60015, USA
| | - Thomas A Macek
- Takeda Development Center Americas, Inc., One Takeda Parkway, Deerfield, IL, 60015, USA
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Qi F, Liu T, Zhang X, Gao X, Li Z, Chen L, Lin C, Wang L, Wang ZJ, Tang H, Chen Z. Ketamine reduces remifentanil-induced postoperative hyperalgesia mediated by CaMKII-NMDAR in the primary somatosensory cerebral cortex region in mice. Neuropharmacology 2020; 162:107783. [PMID: 31541650 DOI: 10.1016/j.neuropharm.2019.107783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022]
Abstract
Remifentanil is commonly used clinically for perioperative pain relief, but it may induce postoperative hyperalgesia. Low doses of ketamine have remained a common choice in clinical practice, but the mechanisms of ketamine have not yet been fully elucidated. In this study, we examined the possible effects of ketamine on calcium/calmodulin-dependent protein kinase II α (CaMKIIα) and N-methyl-d-aspartate receptor (NMDAR) subunit NR2B in a mouse model of remifentanil-induced postoperative hyperalgesia (RIPH) in the primary somatosensory cerebral cortex (SI) region. The paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were used to assess mechanical allodynia and thermal hyperalgesia, respectively, before and after intraoperative remifentanil administration. Before surgery, mice received intrathecal injections of the following drugs: ketamine, NMDA, BayK8644 (CaMKII activator), and KN93 (CaMKII inhibitor). Immunofluorescence was performed to determine the anatomical location and expression of activated CaMKIIα, phosphorylated CaMKIIα (p-CaMKIIα). Additionally, western blotting was performed to assess p-CaMKIIα and NMDAR expression levels in the SI region. Remifentanil decreased the PWMT and PWTL at 0.5 h, 2 h, and 5 h and increased p-CaMKIIα expression in the SI region. Ketamine increased the PWMT and PWTL and reversed the p-CaMKIIα upregulation. Both BayK8644 and NMDA reversed the effect of ketamine, decreased the PWMT and PWTL, and upregulated p-CaMKIIα expression. In contrast, KN93 enhanced the effect of ketamine by reducing hyperalgesia and downregulating p-CaMKIIα expression. These results suggested that ketamine reversed RIPH by inhibiting the phosphorylation of CaMKIIα and the NMDA receptor in the SI region in mice.
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Affiliation(s)
- Fang Qi
- Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Gulin, Guangxi, 541004, China; Department of Anesthesiology, Jingzhou Central Hospital, The Second Clinical Medical College,Yangtze University, Jingzhou, Hubei, 434020, China
| | - Tianping Liu
- Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Gulin, Guangxi, 541004, China; Department of Anesthesiology, The First College of Clinical Medical Science, China Three Gorges University,Yichang Central People's Hospital, Yichang, Hubei, 443003, China
| | - Xiaoyu Zhang
- Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Gulin, Guangxi, 541004, China
| | - Xiaowei Gao
- Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Gulin, Guangxi, 541004, China
| | - Zigang Li
- Department of Anesthesiology, Women's Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, 310006, China
| | - Ling Chen
- Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Gulin, Guangxi, 541004, China
| | - Chen Lin
- Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Gulin, Guangxi, 541004, China
| | - Linlin Wang
- Department of physiology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Zaijie Jim Wang
- Department of Biopharmaceutical Sciences, University of Illinois, Chicago, IL, 60607, USA
| | - Huifang Tang
- Department of pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, Zhejiang, 310058, China.
| | - Zhijun Chen
- Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Gulin, Guangxi, 541004, China; Department of Anesthesiology, Wuhan NO. 1 Hospital, Wuhan, Hubei, 430022, China.
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43
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Frau R, Traccis F, Bortolato M. Neurobehavioural complications of sleep deprivation: Shedding light on the emerging role of neuroactive steroids. J Neuroendocrinol 2020; 32:e12792. [PMID: 31505075 PMCID: PMC6982588 DOI: 10.1111/jne.12792] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/06/2019] [Accepted: 09/05/2019] [Indexed: 01/05/2023]
Abstract
Sleep deprivation (SD) is associated with a broad spectrum of cognitive and behavioural complications, including emotional lability and enhanced stress reactivity, as well as deficits in executive functions, decision making and impulse control. These impairments, which have profound negative consequences on the health and productivity of many individuals, reflect alterations of the prefrontal cortex (PFC) and its connectivity with subcortical regions. However, the molecular underpinnings of these alterations remain elusive. Our group and others have begun examining how the neurobehavioural outcomes of SD may be influenced by neuroactive steroids, a family of molecules deeply implicated in sleep regulation and the stress response. These studies have revealed that, similar to other stressors, acute SD leads to increased synthesis of the neurosteroid allopregnanolone in the PFC. Whereas this up-regulation is likely aimed at counterbalancing the detrimental impact of oxidative stress induced by SD, the increase in prefrontal allopregnanolone levels contributes to deficits in sensorimotor gating and impulse control, signalling a functional impairment of PFC. This scenario suggests that the synthesis of neuroactive steroids during acute SD may be enacted as a neuroprotective response in the PFC; however, such compensation may in turn set off neurobehavioural complications by interfering with the corticolimbic connections responsible for executive functions and emotional regulation.
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Affiliation(s)
- Roberto Frau
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato (CA), Italy
- National Institute of Neuroscience (INN), University of Cagliari, Monserrato (CA), Italy
| | - Francesco Traccis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato (CA), Italy
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City (UT), USA
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44
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Pérez MÁ, Morales C, Santander O, García F, Gómez I, Peñaloza-Sancho V, Fuentealba P, Dagnino-Subiabre A, Moya PR, Fuenzalida M. Ketamine-Treatment During Late Adolescence Impairs Inhibitory Synaptic Transmission in the Prefrontal Cortex and Working Memory in Adult Rats. Front Cell Neurosci 2019; 13:372. [PMID: 31481877 PMCID: PMC6710447 DOI: 10.3389/fncel.2019.00372] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022] Open
Abstract
Schizophrenia (SZ) is associated with changes in the structure and function of several brain areas. Several findings suggest that these impairments are related to a dysfunction in γ-aminobutyric acid (GABA) neurotransmission in brain areas such as the medial prefrontal cortex (mPFC), the hippocampus (HPC) and the primary auditory cortex (A1); however, it is still unclear how the GABAergic system is disrupted in these brain areas. Here, we examined the effect of ketamine (Ket) administration during late adolescence in rats on inhibition in the mPFC-, ventral HPC (vHPC), and A1. We observe that Ket treatment reduced the expression of the calcium-binding protein parvalbumin (PV) and the GABA-producing enzyme glutamic acid decarboxylase 67 (GAD67) as well as decreased inhibitory synaptic efficacy in the mPFC. In addition, Ket-treated rats performed worse in executive tasks that depend on the integrity and proper functioning of the mPFC. Conversely, we do not find such changes in vHPC or A1. Together, our results provide strong experimental support for the hypothesis that during adolescence, the function of the mPFC is more susceptible than that of HPC or A1 to NMDAR hypofunction, showing apparent structure specificity. Thus, the impairment of inhibitory circuitry in mPFC could be a convergent primary site of SZ-like behavior during the adulthood.
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Affiliation(s)
- Miguel Ángel Pérez
- Laboratorio de Plasticidad Neuronal, Universidad de Valparaíso, Valparaíso, Chile.,Facultad de Ciencias, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile.,Escuela de Ciencias de la Salud, Carrera de Kinesiología, Universidad Viña del Mar, Viña del Mar, Chile
| | - Camila Morales
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Valparaíso, Chile
| | - Odra Santander
- Laboratorio de Plasticidad Neuronal, Universidad de Valparaíso, Valparaíso, Chile.,Facultad de Ciencias, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile.,Programa de Doctorado en Ciencias, Mención Neurociencias, Universidad de Valparaíso, Chile
| | - Francisca García
- Laboratorio de Plasticidad Neuronal, Universidad de Valparaíso, Valparaíso, Chile.,Facultad de Ciencias, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile.,Programa de Doctorado en Ciencias, Mención Neurociencias, Universidad de Valparaíso, Chile
| | - Isabel Gómez
- Laboratorio de Neurogenética, Universidad de Valparaíso, Valparaíso, Chile
| | - Valentín Peñaloza-Sancho
- Facultad de Ciencias, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile.,Laboratorio de Neurobiología del Estrés, Universidad de Valparaíso, Valparaíso, Chile
| | - Pablo Fuentealba
- Laboratory of Neural Circuits, Centro de Neurociencia Universidad Católica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alexies Dagnino-Subiabre
- Facultad de Ciencias, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile.,Laboratorio de Neurobiología del Estrés, Universidad de Valparaíso, Valparaíso, Chile
| | - Pablo R Moya
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Valparaíso, Chile.,Laboratorio de Neurogenética, Universidad de Valparaíso, Valparaíso, Chile
| | - Marco Fuenzalida
- Laboratorio de Plasticidad Neuronal, Universidad de Valparaíso, Valparaíso, Chile.,Facultad de Ciencias, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile
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45
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Bonhomme V, Staquet C, Montupil J, Defresne A, Kirsch M, Martial C, Vanhaudenhuyse A, Chatelle C, Larroque SK, Raimondo F, Demertzi A, Bodart O, Laureys S, Gosseries O. General Anesthesia: A Probe to Explore Consciousness. Front Syst Neurosci 2019; 13:36. [PMID: 31474839 PMCID: PMC6703193 DOI: 10.3389/fnsys.2019.00036] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/24/2019] [Indexed: 12/24/2022] Open
Abstract
General anesthesia reversibly alters consciousness, without shutting down the brain globally. Depending on the anesthetic agent and dose, it may produce different consciousness states including a complete absence of subjective experience (unconsciousness), a conscious experience without perception of the environment (disconnected consciousness, like during dreaming), or episodes of oriented consciousness with awareness of the environment (connected consciousness). Each consciousness state may potentially be followed by explicit or implicit memories after the procedure. In this respect, anesthesia can be considered as a proxy to explore consciousness. During the recent years, progress in the exploration of brain function has allowed a better understanding of the neural correlates of consciousness, and of their alterations during anesthesia. Several changes in functional and effective between-region brain connectivity, consciousness network topology, and spatio-temporal dynamics of between-region interactions have been evidenced during anesthesia. Despite a set of effects that are common to many anesthetic agents, it is still uneasy to draw a comprehensive picture of the precise cascades during general anesthesia. Several questions remain unsolved, including the exact identification of the neural substrate of consciousness and its components, the detection of specific consciousness states in unresponsive patients and their associated memory processes, the processing of sensory information during anesthesia, the pharmacodynamic interactions between anesthetic agents, the direction-dependent hysteresis phenomenon during the transitions between consciousness states, the mechanisms of cognitive alterations that follow an anesthetic procedure, the identification of an eventual unitary mechanism of anesthesia-induced alteration of consciousness, the relationship between network effects and the biochemical or sleep-wake cycle targets of anesthetic agents, as well as the vast between-studies variations in dose and administration mode, leading to difficulties in between-studies comparisons. In this narrative review, we draw the picture of the current state of knowledge in anesthesia-induced unconsciousness, from insights gathered on propofol, halogenated vapors, ketamine, dexmedetomidine, benzodiazepines and xenon. We also describe how anesthesia can help understanding consciousness, we develop the above-mentioned unresolved questions, and propose tracks for future research.
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Affiliation(s)
- Vincent Bonhomme
- Anesthesia and Intensive Care Laboratory, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium.,University Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liege, Belgium.,Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège (CHU Lièege), Liege, Belgium
| | - Cécile Staquet
- Anesthesia and Intensive Care Laboratory, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium.,Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège (CHU Lièege), Liege, Belgium
| | - Javier Montupil
- Anesthesia and Intensive Care Laboratory, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium.,University Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liege, Belgium.,Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège (CHU Lièege), Liege, Belgium
| | - Aline Defresne
- Anesthesia and Intensive Care Laboratory, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium.,University Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liege, Belgium.,Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège (CHU Lièege), Liege, Belgium
| | - Murielle Kirsch
- Anesthesia and Intensive Care Laboratory, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium.,Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège (CHU Lièege), Liege, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation & Perception Research Group, GIGA-Consciousness, Department of Algology, GIGA Institute, University of Liege, Centre Hospitalier Universitaire de Liège (CHU Lièege), Liege, Belgium
| | - Camille Chatelle
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
| | - Stephen Karl Larroque
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
| | - Federico Raimondo
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
| | - Athena Demertzi
- Physiology of Cognition Research Lab, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
| | - Olivier Bodart
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liege, Liege, Belgium
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Over-expression of miR-34a induces rapid cognitive impairment and Alzheimer's disease-like pathology. Brain Res 2019; 1721:146327. [PMID: 31295467 DOI: 10.1016/j.brainres.2019.146327] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/28/2019] [Accepted: 07/07/2019] [Indexed: 01/24/2023]
Abstract
Autosomal dominant Alzheimer disease (AD) is caused by rare mutations in one of three specific genes. This is in contrast to idiopathic, late-onset AD (LOAD), which has a more polygenetic risk profile and represents more than 95% of cases. Previously, we have demonstrated that increased expression of microRNA (miRNA)-34a (miR-34a) in AD brain targets genes linked to synaptic plasticity, energy metabolism, and resting state network activity. Here we report the generation of a heterozygous, conditional miR-34a overexpression mouse (miR-34a+/-(TetR-TetO-miR-34a) Transgenic Mice). Doxycycline-treated mice of either sex exhibited profound behavioral impairment compared to untreated groups with only 1-2 months of over-expression of miR-34a. Cognitive impairment of individual mice in T- and Y-maze tasks correlated with elevated miR-34a expression in many parts of the brain including the hippocampus and prefrontal cortex, regions which are known to be involved in this task and implicated in LOAD dysfunction. Immunocytochemistry of brain sections from mice show high amyloid β and phosphorylated tau-specific staining in the hippocampus and cortex. Analysis of protein samples from these mice revealed that miR-34a targets specific genes involved in memory formation, amyloid precursor protein (APP) metabolism and phosphorylation-dephosphorylation of tau. Thus, our results suggest that the polygenetic dysfunction caused by miR-34a may occur in LOAD and disclose miR-34a as a potential therapeutic target. SIGNIFICANCE STATEMENT: Late-onset Alzheimer disease (LOAD) is associated with multiple gene alleles, a polygenetic profile of risk factors that is difficult to model in animals. Our approach to modeling LOAD was to produce a conditional over-expressing, miR-34a mouse using doxycycline-induction to activate expression. We observed that miR-34a over-expression results in a rapid cognitive impairment, associated with accumulation of intracellular Aβ and tau hyperphosphorylation in multiple brain regions. Targets for miR-34a, including ADAM10, NMDAR 2B, and SIRT1 RNAs, were profoundly reduced by miR-34a over-expression. Collectively, these results indicate that a rapid, profound cognitive decline and Alzheimer's disease neuropathology can be induced with miR-34a over-expression, suggesting that this animal model may represent a polygenetic risk factor model for LOAD.
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Ionescu DF, Felicione JM, Gosai A, Cusin C, Shin P, Shapero BG, Deckersbach T. Ketamine-Associated Brain Changes: A Review of the Neuroimaging Literature. Harv Rev Psychiatry 2019; 26:320-339. [PMID: 29465479 PMCID: PMC6102096 DOI: 10.1097/hrp.0000000000000179] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Major depressive disorder (MDD) is one of the most prevalent conditions in psychiatry. Patients who do not respond to traditional monoaminergic antidepressant treatments have an especially difficult-to-treat type of MDD termed treatment-resistant depression. Subanesthetic doses of ketamine-a glutamatergic modulator-have shown great promise for rapidly treating patients with the most severe forms of depression. As such, ketamine represents a promising probe for understanding the pathophysiology of depression and treatment response. Through neuroimaging, ketamine's mechanism may be elucidated in humans. Here, we review 47 articles of ketamine's effects as revealed by neuroimaging studies. Some important brain areas emerge, especially the subgenual anterior cingulate cortex. Furthermore, ketamine may decrease the ability to self-monitor, may increase emotional blunting, and may increase activity in reward processing. Further studies are needed, however, to elucidate ketamine's mechanism of antidepressant action.
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Affiliation(s)
- Dawn F. Ionescu
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | | | - Aishwarya Gosai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Cristina Cusin
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Philip Shin
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Benjamin G. Shapero
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA
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48
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Abdallah CG, Averill CL, Ramage AE, Averill LA, Goktas S, Nemati S, Krystal JH, Roache JD, Resick PA, Young-McCaughan S, Peterson AL, Fox P. Salience Network Disruption in U.S. Army Soldiers With Posttraumatic Stress Disorder. ACTA ACUST UNITED AC 2019; 3. [PMID: 31131337 PMCID: PMC6529942 DOI: 10.1177/2470547019850467] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Better understanding of the neurobiology of posttraumatic stress disorder
(PTSD) may be critical to developing novel, effective therapeutics. Here, we
conducted a data-driven investigation using a well-established, graph-based
topological measure of nodal strength to determine the extent of functional
dysconnectivity in a cohort of active duty U.S. Army soldiers with PTSD
compared to controls. Methods A total of 102 participants with (n = 50) or without PTSD (n = 52) completed
functional magnetic resonance imaging at rest and during symptom provocation
using subject-specific script imagery. Vertex/voxel global brain
connectivity with global signal regression (GBCr), a measure of nodal
strength, was calculated as the average of its functional connectivity with
all other vertices/voxels in the brain gray matter. Results In contrast to resting state, where there were no group differences, we found
a significantly higher GBCr during symptom provocation, in PTSD participants
compared to controls, in areas within the right hemisphere, including
anterior insula, caudal-ventrolateral prefrontal, and rostral-ventrolateral
parietal cortices. Overall, these clusters overlapped with the ventral and
dorsal salience networks. Post hoc analysis showed increased GBCr in these
salience clusters during symptom provocation compared to resting state. In
addition, resting-state GBCr in the salience clusters predicted GBCr during
symptom provocation in PTSD participants but not in controls. Conclusion In PTSD, increased connectivity within the salience network has been
previously hypothesized, based primarily on seed-based connectivity
findings. The current results strongly support this hypothesis using
whole-brain network measure in a fully data-driven approach. It remains to
be seen in future studies whether these identified salience disturbances
would normalize following treatment.
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Affiliation(s)
- Chadi G Abdallah
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Christopher L Averill
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Amy E Ramage
- Department of Communication Sciences and Disorders, University of New Hampshire, Durham, New Hampshire
| | - Lynnette A Averill
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Selin Goktas
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Samaneh Nemati
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - John H Krystal
- National Center for PTSD - Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - John D Roache
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Patricia A Resick
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Stacey Young-McCaughan
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Alan L Peterson
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas.,Department of Psychology, University of Texas at San Antonio, San Antonio, Texas
| | - Peter Fox
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas.,Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, Texas.,Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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49
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Fleming LM, Javitt DC, Carter CS, Kantrowitz JT, Girgis RR, Kegeles LS, Ragland JD, Maddock RJ, Lesh TA, Tanase C, Robinson J, Potter WZ, Carlson M, Wall MM, Choo TH, Grinband J, Lieberman J, Krystal JH, Corlett PR. A multicenter study of ketamine effects on functional connectivity: Large scale network relationships, hubs and symptom mechanisms. NEUROIMAGE-CLINICAL 2019; 22:101739. [PMID: 30852397 PMCID: PMC6411494 DOI: 10.1016/j.nicl.2019.101739] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/24/2019] [Accepted: 02/27/2019] [Indexed: 12/14/2022]
Abstract
Ketamine is an uncompetitive N-methyl-d-aspartate (NMDA) glutamate receptor antagonist. It induces effects in healthy individuals that mimic symptoms associated with schizophrenia. We sought to root these experiences in altered brain function, specifically aberrant resting state functional connectivity (rsfMRI). In the present study, we acquired rsfMRI data under ketamine and placebo in a between-subjects design and analyzed seed-based measures of rsfMRI using large-scale networks, dorsolateral prefrontal cortex (DLPFC) and sub-nuclei of the thalamus. We found ketamine-induced alterations in rsfMRI connectivity similar to those seen in patients with schizophrenia, some changes that may be more comparable to early stages of schizophrenia, and other connectivity signatures seen in patients that ketamine did not recreate. We do not find any circuits from our regions of interest that correlates with positive symptoms of schizophrenia in our sample, although we find that DLPFC connectivity with ACC does correlate with a mood measure. These results provide support for ketamine's use as a model of certain biomarkers of schizophrenia, particularly for early or at-risk patients. Ketamine altered connectivity in default mode network, thalamus and DLPFC at rest. Similar patterns of altered connectivity are seen with ketamine as in psychotic patients. Mood symptoms correlated with DLPFC connectivity with ACC and frontal orbital cortex.
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Affiliation(s)
- Leah M Fleming
- Department of Psychiatry, Yale University, New Haven, CT, United States of America; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, United States of America
| | - Daniel C Javitt
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, NY, United States of America
| | - Cameron S Carter
- Department of Psychiatry, University of California, Davis, United States of America
| | - Joshua T Kantrowitz
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, NY, United States of America
| | - Ragy R Girgis
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Lawrence S Kegeles
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - John D Ragland
- Department of Psychiatry, University of California, Davis, United States of America
| | - Richard J Maddock
- Department of Psychiatry, University of California, Davis, United States of America
| | - Tyler A Lesh
- Department of Psychiatry, University of California, Davis, United States of America
| | - Costin Tanase
- Department of Psychiatry, University of California, Davis, United States of America
| | - James Robinson
- Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, NY, United States of America
| | - William Z Potter
- National Institute of Mental Health, Rockville, MD, United States of America
| | - Marlene Carlson
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Melanie M Wall
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America; National Institute of Mental Health, Rockville, MD, United States of America
| | - Tse-Hwei Choo
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Jack Grinband
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Jeffrey Lieberman
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - John H Krystal
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Philip R Corlett
- Department of Psychiatry, Yale University, New Haven, CT, United States of America.
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50
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Cho YT, Lam NH, Starc M, Santamauro N, Savic A, Diehl CK, Schleifer CH, Moujaes F, Srihari VH, Repovs G, Murray JD, Anticevic A. Effects of reward on spatial working memory in schizophrenia. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 127:695-709. [PMID: 30335439 DOI: 10.1037/abn0000369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reward processing and cognition are disrupted in schizophrenia (SCZ), yet how these processes interface is unknown. In SCZ, deficits in reward representation may affect motivated, goal-directed behaviors. To test this, we examined the effects of monetary reward on spatial working memory (WM) performance in patients with SCZ. To capture complimentary effects, we tested biophysically grounded computational models of neuropharmacologic manipulations onto a canonical fronto-parietal association cortical microcircuit capable of WM computations. Patients with SCZ (n = 33) and healthy control subjects (HCS; n = 32) performed a spatial WM task with 2 reward manipulations: reward cues presented prior to each trial, or contextually prior to a block of trials. WM performance was compared with cortical circuit models of WM subjected to feed-forward glutamatergic excitation, feed-forward GABAergic inhibition, or recurrent modulation strengthening local connections. Results demonstrated that both groups improved WM performance to reward cues presented prior to each trial (HCS d = -0.62; SCZ d = -1.0), with percent improvement correlating with baseline WM performance (r = .472, p < .001). However, rewards presented contextually before a block of trials did not improve WM performance in patients with SCZ (d = 0.01). Modeling simulations achieved improved WM precision through strengthened local connections via neuromodulation, or feed-forward inhibition. Taken together, this work demonstrates that patients with SCZ can improve WM performance to short-term, but not longer-term rewards-thus, motivated behaviors may be limited by strength of reward representation. A potential mechanism for transiently improved WM performance may be strengthening of local fronto-parietal microcircuit connections via neuromodulation or feed-forward inhibitory drive. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine
| | | | | | | | | | | | | | - Flora Moujaes
- Department of Psychiatry, Yale University School of Medicine
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine
| | - Grega Repovs
- Department of Psychology, University of Ljubljana
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine
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