1
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Bruzzone SEP, Ozenne B, Fisher PM, Ortega G, Jensen PS, Dam VH, Svarer C, Knudsen GM, Lesch KP, Frokjaer VG. No association between peripheral serotonin-gene-related DNA methylation and brain serotonin neurotransmission in the healthy and depressed state. Clin Epigenetics 2024; 16:71. [PMID: 38802956 PMCID: PMC11131311 DOI: 10.1186/s13148-024-01678-y] [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: 01/19/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Methylation of serotonin-related genes has been proposed as a plausible gene-by-environment link which may mediate environmental stress, depressive and anxiety symptoms. DNA methylation is often measured in blood cells, but little is known about the association between this peripheral epigenetic modification and brain serotonergic architecture. Here, we evaluated the association between whole-blood-derived methylation of four CpG sites in the serotonin transporter (SLC6A4) and six CpG sites of the tryptophan hydroxylase 2 (TPH2) gene and in-vivo brain levels of serotonin transporter (5-HTT) and serotonin 4 receptor (5-HT4) in a cohort of healthy individuals (N = 254) and, for 5-HT4, in a cohort of unmedicated patients with depression (N = 90). To do so, we quantified SLC6A4/TPH2 methylation using bisulfite pyrosequencing and estimated brain 5-HT4 and 5-HTT levels using positron emission tomography. In addition, we explored the association between SLC6A4 and TPH2 methylation and measures of early life and recent stress, depressive and anxiety symptoms on 297 healthy individuals. RESULTS We found no statistically significant association between peripheral DNA methylation and brain markers of serotonergic neurotransmission in patients with depression or in healthy individuals. In addition, although SLC6A4 CpG2 (chr17:30,236,083) methylation was marginally associated with the parental bonding inventory overprotection score in the healthy cohort, statistical significance did not remain after accounting for blood cell heterogeneity. CONCLUSIONS We suggest that findings on peripheral DNA methylation in the context of brain serotonin-related features should be interpreted with caution. More studies are needed to rule out a role of SLC6A4 and TPH2 methylation as biomarkers for environmental stress, depressive or anxiety symptoms.
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Affiliation(s)
- S E P Bruzzone
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - B Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - P M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - G Ortega
- Division of Molecular Psychiatry, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - P S Jensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - V H Dam
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - C Svarer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - G M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - K P Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6229 ER, Maastricht, The Netherlands
| | - V G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Psychiatric Centre Copenhagen, Mental Health Services, Frederiksberg, Capital Region of Denmark, Denmark.
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2
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Armand S, Langley C, Johansen A, Ozenne B, Overgaard-Hansen O, Larsen K, Jensen PS, Knudsen GM, Sahakian BJ, Stenbæk DS, Fisher PM. Functional brain responses to emotional faces after three to five weeks of intake of escitalopram in healthy individuals: a double-blind, placebo-controlled randomised study. Sci Rep 2024; 14:3149. [PMID: 38326352 PMCID: PMC10850508 DOI: 10.1038/s41598-024-51448-2] [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: 02/01/2023] [Accepted: 01/04/2024] [Indexed: 02/09/2024] Open
Abstract
Short-term intake of selective serotonin reuptake inhibitors (SSRIs) modulates threat-related amygdala responses in healthy individuals. However, how SSRI intake over a clinically relevant time period modulates threat-related amygdala responses is less clear. In a semi-randomised, double-blind, placebo-controlled study of 64 healthy individuals (SSRI n = 32, placebo n = 32), we examined the effect of 3-5 weeks of SSRI escitalopram (20 mg daily) on brain response to angry, fearful and neutral faces using BOLD fMRI. Data was analysed using a whole-brain region-wise approach extracting standardised effects (i.e., Cohen's D). The study was conducted at the Copenhagen University Hospital. A priori, we hypothesised that SSRI would attenuate amygdala responses to angry and fearful faces but not to neutral ones. Whether SSRI modulates correlations between amygdala responses to emotional faces and negative mood states was also explored. Compared to placebo, 3-5 weeks of SSRI intake did not significantly affect the amygdala response to angry, fearful, or neutral faces (|Cohen's D|< 0.2, PFWER = 1). Whole-brain, region-wise analyses revealed significant differences in frontal (|Cohen's D|< 0.6, PFWER < .01) and occipital regions (|Cohen's D|< 0.5, PFWER < .01). SSRI did not modulate correlations between amygdala responses to emotional faces and negative mood states. Our findings indicate that a 3-5 week SSRI intake impacts cortical responses to emotional stimuli, an effect possibly involved in SSRI's therapeutic efficacy.Trial registration Clinical Trials NCT04239339.
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Affiliation(s)
- Sophia Armand
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Annette Johansen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Oliver Overgaard-Hansen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kristian Larsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Steen Jensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Dea Siggard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Patrick MacDonald Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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3
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Bruzzone SEP, Nasser A, Aripaka SS, Spies M, Ozenne B, Jensen PS, Knudsen GM, Frokjaer VG, Fisher PM. Genetic contributions to brain serotonin transporter levels in healthy adults. Sci Rep 2023; 13:16426. [PMID: 37777558 PMCID: PMC10542378 DOI: 10.1038/s41598-023-43690-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023] Open
Abstract
The serotonin transporter (5-HTT) critically shapes serotonin neurotransmission by regulating extracellular brain serotonin levels; it remains unclear to what extent 5-HTT levels in the human brain are genetically determined. Here we applied [11C]DASB positron emission tomography to image brain 5-HTT levels and evaluated associations with five common serotonin-related genetic variants that might indirectly regulate 5-HTT levels (BDNF rs6265, SLC6A4 5-HTTLPR, HTR1A rs6295, HTR2A rs7333412, and MAOA rs1137070) in 140 healthy volunteers. In addition, we explored whether these variants could predict in vivo 5-HTT levels using a five-fold cross-validation random forest framework. MAOA rs1137070 T-carriers showed significantly higher brain 5-HTT levels compared to C-homozygotes (2-11% across caudate, putamen, midbrain, thalamus, hippocampus, amygdala and neocortex). We did not observe significant associations for the HTR1A rs6295 and HTR2A rs7333412 genotypes. Our previously observed lower subcortical 5-HTT availability for rs6265 met-carriers remained in the presence of these additional variants. Despite this significant association, our prediction models showed that genotype moderately improved prediction of 5-HTT in caudate, but effects were not statistically significant after adjustment for multiple comparisons. Our observations provide additional evidence that serotonin-related genetic variants modulate adult human brain serotonin neurotransmission.
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Affiliation(s)
- Silvia Elisabetta Portis Bruzzone
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sagar Sanjay Aripaka
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marie Spies
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Peter Steen Jensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe Gedsoe Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Patrick MacDonald Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
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Sankar A, Ozenne B, Dam VH, Svarer C, Jørgensen MB, Miskowiak KW, Frokjaer VG, Knudsen GM, Fisher PM. Association between brain serotonin 4 receptor binding and reactivity to emotional faces in depressed and healthy individuals. Transl Psychiatry 2023; 13:165. [PMID: 37169780 PMCID: PMC10175268 DOI: 10.1038/s41398-023-02440-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/13/2023] Open
Abstract
Brain serotonergic (5-HT) signaling is posited to modulate neural responses to emotional stimuli. Dysfunction in 5-HT signaling is implicated in major depressive disorder (MDD), a disorder associated with significant disturbances in emotion processing. In MDD, recent evidence points to altered 5-HT4 receptor (5-HT4R) levels, a promising target for antidepressant treatment. However, how these alterations influence neural processing of emotions in MDD remains poorly understood. This is the first study to examine the association between 5-HT4R binding and neural responses to emotions in patients with MDD and healthy controls. The study included one hundred and thirty-eight participants, comprising 88 outpatients with MDD from the NeuroPharm clinical trial (ClinicalTrials.gov identifier: NCT02869035) and 50 healthy controls. Participants underwent an [11C]SB207145 positron emission tomography (PET) scan to quantify 5-HT4R binding (BPND) and a functional magnetic resonance imaging (fMRI) scan during which they performed an emotional face matching task. We examined the association between regional 5-HT4R binding and corticolimbic responses to emotional faces using a linear latent variable model, including whether this association was moderated by depression status. We observed a positive correlation between 5-HT4R BPND and the corticolimbic response to emotional faces across participants (r = 0.20, p = 0.03). This association did not differ between groups (parameter estimate difference = 0.002, 95% CI = -0.008: 0.013, p = 0.72). Thus, in the largest PET/fMRI study of associations between serotonergic signaling and brain function, we found a positive association between 5-HT4R binding and neural responses to emotions that appear unaltered in MDD. Future clinical trials with novel pharmacological agents targeting 5-HT4R are needed to confirm whether they ameliorate emotion processing biases in MDD.
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Affiliation(s)
- Anjali Sankar
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke H Dam
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Martin B Jørgensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
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5
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Fisher PM, Ozenne B, Ganz M, Frokjaer VG, Dam VN, Penninx BW, Sankar A, Miskowiak K, Jensen PS, Knudsen GM, Jorgensen MB. Emotional faces processing in major depressive disorder and prediction of antidepressant treatment response: A NeuroPharm study. J Psychopharmacol 2022; 36:626-636. [PMID: 35549538 DOI: 10.1177/02698811221089035] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a prevalent neuropsychiatric illness for which it is important to resolve underlying brain mechanisms. Current treatments are often unsuccessful, precipitating a need to identify predictive markers. AIM We evaluated (1) alterations in brain responses to an emotional faces functional magnetic resonance imaging (fMRI) paradigm in individuals with MDD, compared to controls, (2) whether pretreatment brain responses predicted antidepressant treatment response, and (3) pre-post change in brain responses following treatment. METHODS Eighty-nine medication-free, depressed individuals and 115 healthy controls completed the fMRI paradigm. Depressed individuals completed a nonrandomized, open-label, 8-week treatment with escitalopram, including the option to switch to duloxetine after 4 weeks. We examined patient-control group differences in regional fMRI responses at baseline, whether baseline fMRI responses predicted treatment response at 8 weeks, including early life stress moderating effects, and change in fMRI responses in 36 depressed individuals rescanned following 8 weeks of treatment. RESULTS Task reaction time was 5% slower in patients. Multiple brain regions showed significant task-related responses, but we observed no statistically significant patient-control group differences (Cohen's d < 0.35). Patient pretreatment brain responses did not predict antidepressant treatment response (area under the curve of the receiver operator characteristic (AUC-ROC) < 0.6) and brain responses were not statistically significantly changed after treatment (Cohen's d < 0.33). CONCLUSION This represents the largest prediction study to date examining emotional faces fMRI features as predictors of antidepressant treatment response. Brain response to this fMRI emotional faces paradigm did not distinguish depressed individuals from healthy controls, nor was it predictive of antidepressant treatment response.Clinical Trial Registration: Site: https://clinicaltrials.gov, Trial Number: NCT02869035, Trial Title: Treatment Outcome in Major Depressive Disorder.
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Affiliation(s)
- Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Vibeke Nh Dam
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Brenda Wjh Penninx
- BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Anajli Sankar
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kamilla Miskowiak
- BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Peter S Jensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin B Jorgensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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6
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The Modulatory Role of Serotonin on Human Impulsive Aggression. Biol Psychiatry 2021; 90:447-457. [PMID: 34266672 DOI: 10.1016/j.biopsych.2021.05.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/29/2021] [Accepted: 05/16/2021] [Indexed: 12/15/2022]
Abstract
The hypothesis of chronically low brain serotonin levels as pathophysiologically linked to impulsive aggression has been around for several decades. Whereas the theory was initially based on indirect methods to probe serotonin function, our understanding of the neural mechanisms involved in impulsive aggression has progressed with recent advances in neuroimaging. The review integrates evidence based on data from several neuroimaging domains in humans. In vivo molecular neuroimaging findings demonstrate associations between impulsive aggression and high serotonin 1B and serotonin 4 receptor binding, high serotonin transporter levels, and low monoamine oxidase A levels, suggesting that low interstitial serotonin levels are a neurobiological risk factor for impulsive aggressive behavior. Imaging genetics suggests that serotonergic-related genetic polymorphisms associate with antisocial behavior, and some evidence indicates that the low-expressing monoamine oxidase A genotype specifically predisposes to impulsive aggression, which may be mediated by effects on corticolimbic function. Interventions that (presumably) alter serotonin levels have effects on brain activity within brain regions involved in impulsive aggression, notably the amygdala, dorsal striatum, anterior cingulate, insula, and prefrontal cortex. Based on these findings, we propose a model for the modulatory role of serotonin in impulsive aggression. Future studies should ensure that clinical features unique for impulsive aggression are appropriately assessed, and we propose investigations of knowledge gaps that can help confirm, refute, or modify our proposed model of impulsive aggression.
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7
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Kolla NJ, Bortolato M. The role of monoamine oxidase A in the neurobiology of aggressive, antisocial, and violent behavior: A tale of mice and men. Prog Neurobiol 2020; 194:101875. [PMID: 32574581 PMCID: PMC7609507 DOI: 10.1016/j.pneurobio.2020.101875] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/20/2020] [Accepted: 06/12/2020] [Indexed: 11/16/2022]
Abstract
Over the past two decades, research has revealed that genetic factors shape the propensity for aggressive, antisocial, and violent behavior. The best-documented gene implicated in aggression is MAOA (Monoamine oxidase A), which encodes the key enzyme for the degradation of serotonin and catecholamines. Congenital MAOA deficiency, as well as low-activity MAOA variants, has been associated with a higher risk for antisocial behavior (ASB) and violence, particularly in males with a history of child maltreatment. Indeed, the interplay between low MAOA genetic variants and early-life adversity is the best-documented gene × environment (G × E) interaction in the pathophysiology of aggression and ASB. Additional evidence indicates that low MAOA activity in the brain is strongly associated with a higher propensity for aggression; furthermore, MAOA inhibition may be one of the primary mechanisms whereby prenatal smoke exposure increases the risk of ASB. Complementary to these lines of evidence, mouse models of Maoa deficiency and G × E interactions exhibit striking similarities with clinical phenotypes, proving to be valuable tools to investigate the neurobiological mechanisms underlying antisocial and aggressive behavior. Here, we provide a comprehensive overview of the current state of the knowledge on the involvement of MAOA in aggression, as defined by preclinical and clinical evidence. In particular, we show how the convergence of human and animal research is proving helpful to our understanding of how MAOA influences antisocial and violent behavior and how it may assist in the development of preventative and therapeutic strategies for aggressive manifestations.
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Affiliation(s)
- Nathan J Kolla
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH) Research Imaging Centre, Toronto, ON, Canada; Violence Prevention Neurobiological Research Unit, CAMH, Toronto, ON, Canada; Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada; Translational Initiative on Antisocial Personality Disorder (TrIAD); Program of Research on Violence Etiology, Neurobiology, and Treatment (PReVENT).
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA; Translational Initiative on Antisocial Personality Disorder (TrIAD); Program of Research on Violence Etiology, Neurobiology, and Treatment (PReVENT).
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8
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Psychological mechanisms and functions of 5-HT and SSRIs in potential therapeutic change: Lessons from the serotonergic modulation of action selection, learning, affect, and social cognition. Neurosci Biobehav Rev 2020; 119:138-167. [PMID: 32931805 DOI: 10.1016/j.neubiorev.2020.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022]
Abstract
Uncertainty regarding which psychological mechanisms are fundamental in mediating SSRI treatment outcomes and wide-ranging variability in their efficacy has raised more questions than it has solved. Since subjective mood states are an abstract scientific construct, only available through self-report in humans, and likely involving input from multiple top-down and bottom-up signals, it has been difficult to model at what level SSRIs interact with this process. Converging translational evidence indicates a role for serotonin in modulating context-dependent parameters of action selection, affect, and social cognition; and concurrently supporting learning mechanisms, which promote adaptability and behavioural flexibility. We examine the theoretical basis, ecological validity, and interaction of these constructs and how they may or may not exert a clinical benefit. Specifically, we bridge crucial gaps between disparate lines of research, particularly findings from animal models and human clinical trials, which often seem to present irreconcilable differences. In determining how SSRIs exert their effects, our approach examines the endogenous functions of 5-HT neurons, how 5-HT manipulations affect behaviour in different contexts, and how their therapeutic effects may be exerted in humans - which may illuminate issues of translational models, hierarchical mechanisms, idiographic variables, and social cognition.
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9
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Köhler-Forsberg K, Jorgensen A, Dam VH, Stenbæk DS, Fisher PM, Ip CT, Ganz M, Poulsen HE, Giraldi A, Ozenne B, Jørgensen MB, Knudsen GM, Frokjaer VG. Predicting Treatment Outcome in Major Depressive Disorder Using Serotonin 4 Receptor PET Brain Imaging, Functional MRI, Cognitive-, EEG-Based, and Peripheral Biomarkers: A NeuroPharm Open Label Clinical Trial Protocol. Front Psychiatry 2020; 11:641. [PMID: 32792991 PMCID: PMC7391965 DOI: 10.3389/fpsyt.2020.00641] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 06/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Between 30 and 50% of patients with major depressive disorder (MDD) do not respond sufficiently to antidepressant regimens. The conventional pharmacological treatments predominantly target serotonergic brain signaling but better tools to predict treatment response and identify relevant subgroups of MDD are needed to support individualized and mechanistically targeted treatment strategies. The aim of this study is to investigate antidepressant-free patients with MDD using neuroimaging, electrophysiological, molecular, cognitive, and clinical examinations and evaluate their ability to predict clinical response to SSRI treatment as individual or combined predictors. METHODS We will include 100 untreated patients with moderate to severe depression (>17 on the Hamilton Depression Rating Scale 17) in a non-randomized open clinical trial. We will collect data from serotonin 4 receptor positron emission tomography (PET) brain scans, functional magnetic resonance imaging (fMRI), electroencephalogram (EEG), cognitive tests, psychometry, and peripheral biomarkers, before (at baseline), during, and after 12 weeks of standard antidepressant treatment. Patients will be treated with escitalopram, and in case of non-response at week 4 or intolerable side effects, offered to switch to a second line treatment with duloxetine. Our primary outcome (treatment response) is assessed using the Hamilton depression rating subscale 6-item scores at week 8, compared to baseline. In a subset of the patients (n = ~40), we will re-assess the neurobiological response (using PET, fMRI, and EEG) 8 weeks after initiated pharmacological antidepressant treatment, to map neurobiological signatures of treatment responses. Data from matched controls will either be collected or is already available from other cohorts. DISCUSSION The extensive investigational program with follow-up in this large cohort of participants provides a unique possibility to (a) uncover potential biomarkers for antidepressant treatment response, (b) apply the findings for future stratification of MDD, (c) advance the understanding of pathophysiological underpinnings of MDD, and (d) uncover how putative biomarkers change in response to 8 weeks of pharmacological antidepressant treatment. Our data can pave the way for a precision medicine approach for optimized treatment of MDD and also provides a resource for future research and data sharing. CLINICAL TRIAL REGISTRATION The study was registered at clinicaltrials.gov prior to initiation (NCT02869035; 08.16.2016, URL: https://clinicaltrials.gov/ct2/results?cond=&term=NCT02869035&cntry=&state=&city=&dist=).
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Affiliation(s)
- Kristin Köhler-Forsberg
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Anders Jorgensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Vibeke H Dam
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Cheng-Teng Ip
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Pharmacology, H. Lundbeck A/S, Valby, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Center Copenhagen, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Martin Balslev Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe Gedsoe Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
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10
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Three weeks of SSRI administration enhances the visual perceptual threshold - a randomized placebo-controlled study. Psychopharmacology (Berl) 2019; 236:1759-1769. [PMID: 30623228 DOI: 10.1007/s00213-018-5158-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 12/21/2018] [Indexed: 01/02/2023]
Abstract
RATIONALE The serotonergic system has been repeatedly linked to visual attention in general, but the effects of selective serotonin reuptake inhibitor (SSRI) on specific components of visual attention remain unknown. Changes in distinct perceptual and cognitive processes are not readily evident in most attention paradigms. OBJECTIVE In this study, we isolate basic components of visual attention to investigate potential effects of longer-term SSRI administration on non-emotional aspects of visual attention in healthy males. METHODS In a randomized double-blind placebo-controlled design, 32 young healthy males were tested on multiple attentional parameters, before and after a 3-week SSRI intervention with fluoxetine (40 mg daily) or placebo. Data were modeled with a computational theory of visual attention to derive independent estimates of five distinct components of visual attention. RESULTS The SSRI intervention selectively and significantly lowered the threshold for conscious visual perception. Specifically, we demonstrate that this improvement does not stem from a general increase in the speed of visual processing, as previously suggested, but specifically from a change in the perceptual threshold. CONCLUSIONS The study provides a novel description of the attentional dynamics affected by SSRI, while supporting previous findings on attentional effects of SSRI. Furthermore, it accentuates the utility of employing accuracy-based measures of attentional performance when conducting psychopharmacological research.
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11
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Østergaard L, Jørgensen MB, Knudsen GM. Low on energy? An energy supply-demand perspective on stress and depression. Neurosci Biobehav Rev 2018; 94:248-270. [DOI: 10.1016/j.neubiorev.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/09/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
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12
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da Cunha-Bang S, Fisher PM, Hjordt LV, Perfalk E, Beliveau V, Holst K, Knudsen GM. Men with high serotonin 1B receptor binding respond to provocations with heightened amygdala reactivity. Neuroimage 2018; 166:79-85. [DOI: 10.1016/j.neuroimage.2017.10.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/12/2017] [Accepted: 10/16/2017] [Indexed: 10/18/2022] Open
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13
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Stenbæk DS, Dam VH, Fisher PM, Hansen N, Hjordt LV, Frokjaer VG. No evidence for a role of the serotonin 4 receptor in five-factor personality traits: A positron emission tomography brain study. PLoS One 2017; 12:e0184403. [PMID: 28880910 PMCID: PMC5589219 DOI: 10.1371/journal.pone.0184403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/23/2017] [Indexed: 01/19/2023] Open
Abstract
Serotonin (5-HT) brain architecture appears to be implicated in normal personality traits as supported by genetic associations and studies using molecular brain imaging. However, so far, no studies have addressed potential contributions to variation in normal personality traits from in vivo serotonin 4 receptor (5-HT4R) brain availability, which has recently become possible to image with Positron Emission Tomography (PET). This is particularly relevant since availability of 5-HT4R has been shown to adapt to synaptic levels of 5-HT and thus offers information about serotonergic tone in the healthy brain. In 69 healthy participants (18 females), the associations between personality traits assessed with the five-factor NEO Personality Inventory-Revised (NEO PI-R) and regional cerebral 5-HT4R binding in neocortex, amygdala, hippocampus, and anterior cingulate cortex (ACC) were investigated using linear regression models. The associations between each of the five personality traits and a latent variable construct of global 5-HT4R levels were also evaluated using latent variable structural equation models. We found no significant associations between the five NEO personality traits and regional 5-HT4R binding (all p-values > .17) or the latent construct of global 5-HT4R levels (all p-values > .37). Our findings indicate that NEO personality traits and 5-HT4R are not related in healthy participants. Under the assumption that global 5-HT4R levels index 5-HT tone, our data also suggest that 5-HT tone per se is not directly implicated in normal personality traits.
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Affiliation(s)
- Dea Siggaard Stenbæk
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Center for Integrated Molecular Brain Imaging and Center for Experimental Medicine Neuropharmacology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- * E-mail:
| | - Vibeke Høyrup Dam
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Center for Integrated Molecular Brain Imaging and Center for Experimental Medicine Neuropharmacology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Patrick MacDonald Fisher
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Center for Integrated Molecular Brain Imaging and Center for Experimental Medicine Neuropharmacology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nanna Hansen
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Liv Vadskjær Hjordt
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Center for Integrated Molecular Brain Imaging and Center for Experimental Medicine Neuropharmacology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe Gedsoe Frokjaer
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Center for Integrated Molecular Brain Imaging and Center for Experimental Medicine Neuropharmacology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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14
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da Cunha-Bang S, Hjordt LV, Dam VH, Stenbæk DS, Sestoft D, Knudsen GM. Anterior cingulate serotonin 1B receptor binding is associated with emotional response inhibition. J Psychiatr Res 2017; 92:199-204. [PMID: 28502766 DOI: 10.1016/j.jpsychires.2017.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 05/02/2017] [Accepted: 05/05/2017] [Indexed: 01/10/2023]
Abstract
Serotonin has a well-established role in emotional processing and is a key neurotransmitter in impulsive aggression, presumably by facilitating response inhibition and regulating subcortical reactivity to aversive stimuli. In this study 44 men, of whom 19 were violent offenders and 25 were non-offender controls, completed an emotional Go/NoGo task requiring inhibition of prepotent motor responses to emotional facial expressions. We also measured cerebral serotonin 1B receptor (5-HT1BR) binding with [11C]AZ10419369 positron emission tomography within regions of the frontal cortex. We hypothesized that 5-HT1BR would be positively associated with false alarms (failures to inhibit nogo responses) in the context of aversive (angry and fearful) facial expressions. Across groups, we found that frontal cortex 5-HT1BR binding was positively correlated with false alarms when angry faces were go stimuli and neutral faces were nogo stimuli (p = 0.05, corrected alpha = 0.0125), but not with false alarms for non-emotional stimuli (failures to inhibit geometric figures). A posthoc analysis revealed the strongest association in anterior cingulate cortex (p = 0.006). In summary, 5-HT1BRs in the anterior cingulate are involved in withholding a prepotent response in the context of angry faces. Our findings suggest that serotonin modulates response inhibition in the context of certain emotional stimuli.
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Affiliation(s)
- Sofi da Cunha-Bang
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Denmark
| | - Liv Vadskjær Hjordt
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Vibeke Høyrup Dam
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Denmark
| | - Dorte Sestoft
- Ministry of Justice, Clinic of Forensic Psychiatry, Blegdamsvej 6B, DK-2200 Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark.
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15
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Tuominen L, Miettunen J, Cannon DM, Drevets WC, Frokjaer VG, Hirvonen J, Ichise M, Jensen PS, Keltikangas-Järvinen L, Klaver JM, Knudsen GM, Takano A, Suhara T, Hietala J. Neuroticism Associates with Cerebral in Vivo Serotonin Transporter Binding Differently in Males and Females. Int J Neuropsychopharmacol 2017; 20:963-970. [PMID: 29020405 PMCID: PMC5716061 DOI: 10.1093/ijnp/pyx071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/03/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Neuroticism is a major risk factor for affective disorders. This personality trait has been hypothesized to associate with synaptic availability of the serotonin transporter, which critically controls serotonergic tone in the brain. However, earlier studies linking neuroticism and serotonin transporter have failed to produce converging findings. Because sex affects both the serotonergic system and the risk that neuroticism poses to the individual, sex may modify the association between neuroticism and serotonin transporter, but this question has not been investigated by previous studies. METHODS Here, we combined data from 4 different positron emission tomography imaging centers to address whether neuroticism is related to serotonin transporter binding in vivo. The data set included serotonin transporter binding potential values from the thalamus and striatum and personality scores from 91 healthy males and 56 healthy females. We specifically tested if the association between neuroticism and serotonin transporter is different in females and males. RESULTS We found that neuroticism and thalamic serotonin transporter binding potentials were associated in both males and females, but with opposite directionality. Higher neuroticism associated with higher serotonin transporter binding potential in males (standardized beta 0.292, P=.008), whereas in females, higher neuroticism associated with lower serotonin transporter binding potential (standardized beta -0.288, P=.014). CONCLUSIONS The finding is in agreement with recent studies showing that the serotonergic system is involved in affective disorders differently in males and females and suggests that contribution of thalamic serotonin transporter to the risk of affective disorders depends on sex.
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Affiliation(s)
- Lauri Tuominen
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala),Correspondence: Lauri Tuominen, MD, PhD, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, 149 13th St, Charlestown, MA 02129 ()
| | - Jouko Miettunen
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Dara M Cannon
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Wayne C Drevets
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Vibe G Frokjaer
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Jussi Hirvonen
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Masanori Ichise
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Peter S Jensen
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Liisa Keltikangas-Järvinen
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Jacqueline M Klaver
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Gitte M Knudsen
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Akihiro Takano
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Tetsuya Suhara
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
| | - Jarmo Hietala
- Turku PET Centre, Turku University Hospital, Turku, Finland (Drs Tuominen, Hirvonen, and Hietala); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Cambridge, MA (Dr Tuominen); Center for Life Course Health Research, University of Oulu, Finland & Medical Research Center (MRC) Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (Dr Miettunen); Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland (Dr Cannon); Janssen Research & Development, LLC, of Johnson & Johnson, Titusville, NJ (Dr Drevets); Neurobiology Research Unit, Rigshospitalet, Denmark (Dr Knudsen); Center for Integrated Molecular Brain Imaging, Rigshospitalet, Denmark (Dr Frokjaer and Mr Jensen); Department of Radiology, University of Turku, Turku, Finland (Dr Hirvonen); Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Ichise, Takano, and Suhara); IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland (Dr Keltikangas-Järvinen); Department of Psychology, Southern Illinois University, Carbondale, Illinois (Dr Klaver); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Knudsen); Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Dr Takano); Department of Psychiatry, University of Turku, Turku, Finland (Dr Hietala)
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16
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Stenbæk DS, Fisher PM, Ozenne B, Andersen E, Hjordt LV, McMahon B, Hasselbalch SG, Frokjaer VG, Knudsen GM. Brain serotonin 4 receptor binding is inversely associated with verbal memory recall. Brain Behav 2017; 7:e00674. [PMID: 28413715 PMCID: PMC5390847 DOI: 10.1002/brb3.674] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 01/12/2017] [Accepted: 02/04/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND We have previously identified an inverse relationship between cerebral serotonin 4 receptor (5-HT 4R) binding and nonaffective episodic memory in healthy individuals. Here, we investigate in a novel sample if the association is related to affective components of memory, by examining the association between cerebral 5-HT 4R binding and affective verbal memory recall. METHODS Twenty-four healthy volunteers were scanned with the 5-HT 4R radioligand [11C]SB207145 and positron emission tomography, and were tested with the Verbal Affective Memory Test-24. The association between 5-HT 4R binding and affective verbal memory was evaluated using a linear latent variable structural equation model. RESULTS We observed a significant inverse association across all regions between 5-HT 4R binding and affective verbal memory performances for positive (p = 5.5 × 10-4) and neutral (p = .004) word recall, and an inverse but nonsignificant association for negative (p = .07) word recall. Differences in the associations with 5-HT 4R binding between word categories (i.e., positive, negative, and neutral) did not reach statistical significance. CONCLUSION Our findings replicate our previous observation of a negative association between 5-HT 4R binding and memory performance in an independent cohort and provide novel evidence linking 5-HT 4R binding, as a biomarker for synaptic 5-HT levels, to the mnestic processing of positive and neutral word stimuli in healthy humans.
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Affiliation(s)
- Dea S Stenbæk
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Brice Ozenne
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark.,Department of Biostatistics University of Copenhagen Copenhagen Denmark
| | - Emil Andersen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Liv V Hjordt
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Brenda McMahon
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Steen G Hasselbalch
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark.,Department of Neurology The Neuroscience Centre Danish Dementia Research Centre Rigshospitalet, University of Copenhagen Copenhagen Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging The Neuroscience Centre Rigshospitalet Copenhagen Denmark
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17
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Laursen HR, Henningsson S, Macoveanu J, Jernigan TL, Siebner HR, Holst KK, Skimminge A, Knudsen GM, Ramsoy TZ, Erritzoe D. Serotonergic neurotransmission in emotional processing: New evidence from long-term recreational poly-drug ecstasy use. J Psychopharmacol 2016; 30:1296-1304. [PMID: 27599522 DOI: 10.1177/0269881116662633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The brain's serotonergic system plays a crucial role in the processing of emotional stimuli, and several studies have shown that a reduced serotonergic neurotransmission is associated with an increase in amygdala activity during emotional face processing. Prolonged recreational use of ecstasy (3,4-methylene-dioxymethamphetamine [MDMA]) induces alterations in serotonergic neurotransmission that are comparable to those observed in a depleted state. In this functional magnetic resonance imaging (fMRI) study, we investigated the responsiveness of the amygdala to emotional face stimuli in recreational ecstasy users as a model of long-term serotonin depletion. Fourteen ecstasy users and 12 non-using controls underwent fMRI to measure the regional neural activity elicited in the amygdala by male or female faces expressing anger, disgust, fear, sadness, or no emotion. During fMRI, participants made a sex judgement on each face stimulus. Positron emission tomography with 11C-DASB was additionally performed to assess serotonin transporter (SERT) binding in the brain. In the ecstasy users, SERT binding correlated negatively with amygdala activity, and accumulated lifetime intake of ecstasy tablets was associated with an increase in amygdala activity during angry face processing. Conversely, time since the last ecstasy intake was associated with a trend toward a decrease in amygdala activity during angry and sad face processing. These results indicate that the effects of long-term serotonin depletion resulting from ecstasy use are dose-dependent, affecting the functional neural basis of emotional face processing.
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Affiliation(s)
- Helle Ruff Laursen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Susanne Henningsson
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark
| | - Julian Macoveanu
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Terry L Jernigan
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Klaus K Holst
- Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Arnold Skimminge
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Gitte M Knudsen
- Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Thomas Z Ramsoy
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Decision Neuroscience, Copenhagen Business School, Copenhagen, Denmark.,Singularity University, Moffett Field, CA, USA.,Neurons, Inc., Holbæk, Denmark
| | - David Erritzoe
- Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark .,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Centre for Neuropsychopharmacology, Imperial College London, London, UK
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18
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Reduced serotonin synthesis and regional cerebral blood flow after anxiolytic treatment of social anxiety disorder. Eur Neuropsychopharmacol 2016; 26:1775-1783. [PMID: 27642077 DOI: 10.1016/j.euroneuro.2016.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/07/2016] [Accepted: 09/01/2016] [Indexed: 12/21/2022]
Abstract
Social anxiety disorder (SAD) is associated with increased fear-related neural activity in the amygdala and we recently found enhanced serotonin synthesis rate in the same region. Anxiolytic agents like selective serotonin re-uptake inhibitors (SSRIs) and neurokinin-1 receptor (NK1R) antagonists reduce amygdala activity and may attenuate serotonin formation according to animal studies. Here, we examined the effects of SSRI pharmacotherapy, NK1R antagonism, and placebo on serotonin synthesis rate in relation to neural activity, measured as regional cerebral blood flow (rCBF), and symptom improvement in SAD. Eighteen SAD patients were randomized to receive daily double-blind treatment for six weeks either with the SSRI citalopram (n=6; 40mg), the NK1R antagonist GR205171 (n=6; 5mg; 4 weeks following 2 weeks of placebo), or placebo (n=6). Serotonin synthesis rate at rest and rCBF during stressful public speaking were assessed, before and after treatment, using positron emission tomography with the tracers [11C]5-hydroxytryptophan and [15O]water respectively. The Liebowitz Social Anxiety Scale (LSAS-SR) indexed symptom severity. All groups exhibited attenuated amygdala serotonin synthesis rate after treatment, which was associated with reduced amygdala rCBF during public speaking and accompanied by symptom improvement. These results are consistent with the notion that serotonin in the amygdala exerts an anxiogenic influence and, conversely, that anxiolysis is achieved through decreased serotonin formation in the amygdala.
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19
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Role of emotional processing in depressive responses to sex-hormone manipulation: a pharmacological fMRI study. Transl Psychiatry 2015; 5:e688. [PMID: 26624927 PMCID: PMC5068584 DOI: 10.1038/tp.2015.184] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/29/2015] [Accepted: 10/02/2015] [Indexed: 02/07/2023] Open
Abstract
Sex-hormone fluctuations may increase risk for developing depressive symptoms and alter emotional processing as supported by observations in menopausal and pre- to postpartum transition. In this double-blinded, placebo-controlled study, we used blood-oxygen level dependent functional magnetic resonance imaging (fMRI) to investigate if sex-steroid hormone manipulation with a gonadotropin-releasing hormone agonist (GnRHa) influences emotional processing. Fifty-six healthy women were investigated twice: at baseline (follicular phase of menstrual cycle) and 16 ± 3 days post intervention. At both sessions, fMRI-scans during exposure to faces expressing fear, anger, happiness or no emotion, depressive symptom scores and estradiol levels were acquired. The fMRI analyses focused on regions of interest for emotional processing. As expected, GnRHa initially increased and subsequently reduced estradiol to menopausal levels, which was accompanied by an increase in subclinical depressive symptoms relative to placebo. Women who displayed larger GnRHa-induced increase in depressive symptoms had a larger increase in both negative and positive emotion-elicited activity in the anterior insula. When considering the post-GnRHa scan only, depressive responses were associated with emotion-elicited activity in the anterior insula and amygdala. The effect on regional activity in anterior insula was not associated with the estradiol net decline, only by the GnRHa-induced changes in mood. Our data implicate enhanced insula recruitment during emotional processing in the emergence of depressive symptoms following sex-hormone fluctuations. This may correspond to the emotional hypersensitivity frequently experienced by women postpartum.
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20
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Madsen MK, Mc Mahon B, Andersen SB, Siebner HR, Knudsen GM, Fisher PM. Threat-related amygdala functional connectivity is associated with 5-HTTLPR genotype and neuroticism. Soc Cogn Affect Neurosci 2015; 11:140-9. [PMID: 26245837 DOI: 10.1093/scan/nsv098] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 07/30/2015] [Indexed: 01/27/2023] Open
Abstract
Communication between the amygdala and other brain regions critically regulates sensitivity to threat, which has been associated with risk for mood and affective disorders. The extent to which these neural pathways are genetically determined or correlate with risk-related personality measures is not fully understood. Using functional magnetic resonance imaging, we evaluated independent and interactive effects of the 5-HTTLPR genotype and neuroticism on amygdala functional connectivity during an emotional faces paradigm in 76 healthy individuals. Functional connectivity between left amygdala and medial prefrontal cortex (mPFC) and between both amygdalae and a cluster including posterior cingulate cortex, precuneus and visual cortex was significantly increased in 5-HTTLPR S' allele carriers relative to L(A)L(A) individuals. Neuroticism was negatively correlated with functional connectivity between right amygdala and mPFC and visual cortex, and between both amygdalae and left lateral orbitofrontal (lOFC) and ventrolateral prefrontal cortex (vlPFC). Notably, 5-HTTLPR moderated the association between neuroticism and functional connectivity between both amygdalae and left lOFC/vlPFC, such that S' carriers exhibited a more negative association relative to L(A)L(A) individuals. These findings provide novel evidence for both independent and interactive effects of 5-HTTLPR genotype and neuroticism on amygdala communication, which may mediate effects on risk for mood and affective disorders.
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Affiliation(s)
- Martin Korsbak Madsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark
| | - Brenda Mc Mahon
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark
| | - Sofie Bech Andersen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark
| | - Hartwig Roman Siebner
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark, Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark, and Department of Neurology, Copenhagen University Hospital Bispebjerg, 2400 Copenhagen NW, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark,
| | - Patrick MacDonald Fisher
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark
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21
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Fisher PM, Grady CL, Madsen MK, Strother SC, Knudsen GM. 5-HTTLPR differentially predicts brain network responses to emotional faces. Hum Brain Mapp 2015; 36:2842-51. [PMID: 25929825 DOI: 10.1002/hbm.22811] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/16/2015] [Accepted: 04/04/2015] [Indexed: 01/17/2023] Open
Abstract
The effects of the 5-HTTLPR polymorphism on neural responses to emotionally salient faces have been studied extensively, focusing on amygdala reactivity and amygdala-prefrontal interactions. Despite compelling evidence that emotional face paradigms engage a distributed network of brain regions involved in emotion, cognitive and visual processing, less is known about 5-HTTLPR effects on broader network responses. To address this, we evaluated 5-HTTLPR differences in the whole-brain response to an emotional faces paradigm including neutral, angry and fearful faces using functional magnetic resonance imaging in 76 healthy adults. We observed robust increased response to emotional faces in the amygdala, hippocampus, caudate, fusiform gyrus, superior temporal sulcus and lateral prefrontal and occipito-parietal cortices. We observed dissociation between 5-HTTLPR groups such that LA LA individuals had increased response to only angry faces, relative to neutral ones, but S' carriers had increased activity for both angry and fearful faces relative to neutral. Additionally, the response to angry faces was significantly greater in LA LA individuals compared to S' carriers and the response to fearful faces was significantly greater in S' carriers compared to LA LA individuals. These findings provide novel evidence for emotion-specific 5-HTTLPR effects on the response of a distributed set of brain regions including areas responsive to emotionally salient stimuli and critical components of the face-processing network. These findings provide additional insight into neurobiological mechanisms through which 5-HTTLPR genotype may affect personality and related risk for neuropsychiatric illness.
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Affiliation(s)
- Patrick M Fisher
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark.,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark
| | - Cheryl L Grady
- Rotman Research Institute at Baycrest, University of Toronto, Toronto, Canada.,Department of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Martin K Madsen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark.,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark
| | - Stephen C Strother
- Rotman Research Institute at Baycrest, University of Toronto, Toronto, Canada.,Department of Medical Physics, University of Toronto, Toronto, Canada
| | - Gitte M Knudsen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark.,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen O, Denmark
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