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Reid MA, Whiteman SE, Camden AA, Jeffirs SM, Weathers FW. Prefrontal metabolite alterations in individuals with posttraumatic stress disorder: a 7T magnetic resonance spectroscopy study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.16.603137. [PMID: 39071259 PMCID: PMC11275712 DOI: 10.1101/2024.07.16.603137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Background Evidence from animal and human studies suggests glutamatergic dysfunction in posttraumatic stress disorder (PTSD). The purpose of this study was to investigate glutamate abnormalities in the dorsolateral prefrontal cortex (DLFPC) of individuals with PTSD using 7T MRS, which has better spectral resolution and signal-to-noise ratio than lower field strengths, thus allowing for better spectral quality and higher sensitivity. We hypothesized that individuals with PTSD would have lower glutamate levels compared to trauma-exposed individuals without PTSD and individuals without trauma exposure. Additionally, we explored potential alterations in other neurometabolites and the relationship between glutamate and psychiatric symptoms. Methods Individuals with PTSD (n=27), trauma-exposed individuals without PTSD (n=27), and individuals without trauma exposure (n=26) underwent 7T MRS to measure glutamate and other neurometabolites in the left DLPFC. The severities of PTSD, depression, anxiety, and dissociation symptoms were assessed. Results We found that glutamate was lower in the PTSD and trauma-exposed groups compared to the group without trauma exposure. Furthermore, N-acetylaspartate (NAA) was lower and lactate was higher in the PTSD group compared to the group without trauma exposure. Glutamate was negatively correlated with depression symptom severity in the PTSD group. Glutamate was not correlated with PTSD symptom severity. Conclusion In this first 7T MRS study of PTSD, we observed altered concentrations of glutamate, NAA, and lactate. Our findings provide evidence for multiple possible pathological processes in individuals with PTSD. High-field MRS offers insight into the neurometabolic alterations associated with PTSD and is a powerful tool to probe trauma- and stress-related neurotransmission and metabolism in vivo.
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Affiliation(s)
- Meredith A. Reid
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
- AU Neuroimaging Center, Auburn University, Auburn, Alabama, USA
- Alabama Advanced Imaging Consortium, Auburn, Alabama, USA
| | - Sarah E. Whiteman
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Abigail A. Camden
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | | | - Frank W. Weathers
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
- National Center for PTSD, Boston, Massachusetts, USA
- VA Boston Healthcare System, Boston, Massachusetts, USA
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Singh U, Das B, Khanra S, Roy C. Resting state and activated brain glutamate-glutamine, brain lactate, cognition, and psychopathology among males with schizophrenia: A 3 Tesla proton magnetic resonance spectroscopic (1H-MRS) study. Indian J Psychiatry 2024; 66:82-89. [PMID: 38419937 PMCID: PMC10898519 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_621_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/09/2023] [Accepted: 12/25/2023] [Indexed: 03/02/2024] Open
Abstract
Background Research on glutamate (Glu) in schizophrenia has so far been inconclusive. Based on preclinical studies on Glu lactate interaction, researchers have now focused on brain lactate level as a sign of major pathology, including cognitive dysfunctions in the brain. Our study aimed to examine changes at resting and activated states in brain lactate and Glu-glutamine (Glx) at the anterior cingulate cortex (ACC) in schizophrenia. Methods A hospital-based prospective study was conducted with twenty-two male cases of schizophrenia and matched healthy controls (HCs). Positive and Negative Syndrome Scale (PANSS), Montreal Cognitive Assessment (MoCA), and Stroop tasks were administered among patients. Brain lactate and Glx at ACC were measured at resting state and during the Stroop test with proton magnetic resonance spectroscopy (1H-MRS) both at baseline and at remission and once among HC. Result Though MoCA scores improved significantly (P < 0.001) at remission from baseline among cases, repeated-measures analysis of variance (RM-ANOVA) did not find a significant time effect for Glx (P = 0.82) and lactate (P = 0.30) among cases from baseline to remission. Glx and lactate changed differently from baseline to remission. Conclusion Our study did not find significant differences in Glx and lactate between schizophrenia patients and HC. No significant time effect on Glx and lactate was observed from baseline to remission among schizophrenia cases. Different changes observed in Glx and lactate from baseline to remission require replication in future studies with larger sample size, longer follow-up period, and multivoxel MR assessment.
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Affiliation(s)
- Ujjwal Singh
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Basudeb Das
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Sourav Khanra
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Chandramouli Roy
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
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Maier S, Nickel K, Lange T, Oeltzschner G, Dacko M, Endres D, Runge K, Schumann A, Domschke K, Rousos M, Tebartz van Elst L. Increased cerebral lactate levels in adults with autism spectrum disorders compared to non-autistic controls: a magnetic resonance spectroscopy study. Mol Autism 2023; 14:44. [PMID: 37978557 PMCID: PMC10655272 DOI: 10.1186/s13229-023-00577-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Autism spectrum disorder (ASD) encompasses a heterogeneous group with varied phenotypes and etiologies. Identifying pathogenic subgroups could facilitate targeted treatments. One promising avenue is investigating energy metabolism, as mitochondrial dysfunction has been implicated in a subgroup of ASD. Lactate, an indicator of energy metabolic anomalies, may serve as a potential biomarker for this subgroup. This study aimed to examine cerebral lactate (Lac+) levels in high-functioning adults with ASD, hypothesizing elevated mean Lac+ concentrations in contrast to neurotypical controls (NTCs). MATERIALS AND METHODS Magnetic resonance spectroscopy (MRS) was used to study cerebral Lac+ in 71 adults with ASD and NTC, focusing on the posterior cingulate cortex (PCC). After quality control, 64 ASD and 58 NTC participants remained. Lac+ levels two standard deviations above the mean of the control group were considered elevated. RESULTS Mean PCC Lac+ levels were significantly higher in the ASD group than in the NTC group (p = 0.028; Cohen's d = 0.404), and 9.4% of the ASD group had elevated levels as compared to 0% of the NTCs (p = 0.029). No significant correlation was found between blood serum lactate levels and MRS-derived Lac+ levels. LIMITATIONS A cautious interpretation of our results is warranted due to a p value of 0.028. In addition, a higher than anticipated proportion of data sets had to be excluded due to poor spectral quality. CONCLUSION This study confirms the presence of elevated cerebral Lac+ levels in a subgroup of adults with ASD, suggesting the potential of lactate as a biomarker for mitochondrial dysfunction in a subgroup of ASD. The lower-than-expected prevalence (20% was expected) and moderate increase require further investigation to elucidate the underlying mechanisms and relationships with mitochondrial function.
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Affiliation(s)
- Simon Maier
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany.
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Thomas Lange
- Medical Physics, Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Michael Dacko
- Medical Physics, Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Kimon Runge
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Anke Schumann
- Department of General Paediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Michalis Rousos
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
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Battaglia M, Rossignol O, Lorenzo LE, Deguire J, Godin AG, D’Amato FR, De Koninck Y. Enhanced harm detection following maternal separation: Transgenerational transmission and reversibility by inhaled amiloride. SCIENCE ADVANCES 2023; 9:eadi8750. [PMID: 37792939 PMCID: PMC10550232 DOI: 10.1126/sciadv.adi8750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/01/2023] [Indexed: 10/06/2023]
Abstract
Early-life adversities are associated with altered defensive responses. Here, we demonstrate that the repeated cross-fostering (RCF) paradigm of early maternal separation is associated with enhancements of distinct homeostatic reactions: hyperventilation in response to hypercapnia and nociceptive sensitivity, among the first generation of RCF-exposed animals, as well as among two successive generations of their normally reared offspring, through matrilineal transmission. Parallel enhancements of acid-sensing ion channel 1 (ASIC1), ASIC2, and ASIC3 messenger RNA transcripts were detected transgenerationally in central neurons, in the medulla oblongata, and in periaqueductal gray matter of RCF-lineage animals. A single, nebulized dose of the ASIC-antagonist amiloride renormalized respiratory and nociceptive responsiveness across the entire RCF lineage. These findings reveal how, following an early-life adversity, a biological memory reducible to a molecular sensor unfolds, shaping adaptation mechanisms over three generations. Our findings are entwined with multiple correlates of human anxiety and pain conditions and suggest nebulized amiloride as a therapeutic avenue.
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Affiliation(s)
- Marco Battaglia
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Child Youth and Emerging Adult Programme, Centre for Addiction and Mental Health, Toronto, ON, Canada
- CERVO Brain Research Centre, Québec Mental Health Institute, Québec City, QC, Canada
- Department of Psychiatry and Neuroscience, Université Laval, Québec City, QC, Canada
| | - Orlane Rossignol
- CERVO Brain Research Centre, Québec Mental Health Institute, Québec City, QC, Canada
| | - Louis-Etienne Lorenzo
- CERVO Brain Research Centre, Québec Mental Health Institute, Québec City, QC, Canada
| | - Jasmin Deguire
- CERVO Brain Research Centre, Québec Mental Health Institute, Québec City, QC, Canada
| | - Antoine G. Godin
- CERVO Brain Research Centre, Québec Mental Health Institute, Québec City, QC, Canada
- Department of Psychiatry and Neuroscience, Université Laval, Québec City, QC, Canada
| | - Francesca R. D’Amato
- Institute of Biochemistry and Cell Biology, National Research Council, Rome, Italy
| | - Yves De Koninck
- CERVO Brain Research Centre, Québec Mental Health Institute, Québec City, QC, Canada
- Department of Psychiatry and Neuroscience, Université Laval, Québec City, QC, Canada
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MacDonald MI, Polkinghorne KR, MacDonald CJ, Leong P, Hamza K, Kathriachchige G, Osadnik CR, King PT, Bardin PG. Elevated blood lactate in COPD exacerbations associates with adverse clinical outcomes and signals excessive treatment with β 2 -agonists. Respirology 2023; 28:860-868. [PMID: 37400102 DOI: 10.1111/resp.14534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/31/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Raised blood lactate secondary to high dose β2 -agonist treatment has been reported in asthma exacerbations but has not been investigated during acute exacerbations of COPD (AECOPD). We explored associations of blood lactate measurements with disease outcomes and β2 -agonist treatments during AECOPD. METHODS Retrospective (n = 199) and prospective studies (n = 142) of patients hospitalized with AECOPD were conducted. The retrospective cohort was identified via medical records and the prospective cohort was recruited during hospitalization for AECOPD. Baseline demographics, comorbidities, β2 -agonist treatment, biochemical measurements and clinical outcomes were compared between patients with normal (≤2.0 mmol/L) versus elevated lactate (>2.0 mmol/L). Regression analyses examined associations of lactate measurements with β2 -agonist dosages. RESULTS Demographic data and comorbidities were similar between high versus normal lactate groups in both cohorts. The populations were elderly (mean >70 years), predominantly male (>60%) with reduced FEV1 (%) 48.2 ± 19 (prospective cohort). Lactate was elevated in approximately 50% of patients during AECOPD and not related to evidence of sepsis. In the prospective cohort, patients with high lactate had more tachypnoea, tachycardia, acidosis and hyperglycaemia (p < 0.05) and received more non-invasive ventilation (37% vs. 9.7%, p < 0.001, prospective cohort). There was a trend to longer hospitalization (6 vs. 5 days, p = 0.06, prospective cohort). Higher cumulative β2 -agonist dosages were linked to elevated lactate levels (OR 1.04, p = 0.01). CONCLUSION Elevated lactate during AECOPD was common, unrelated to sepsis and correlated with high cumulative doses of β2 -agonists. Raised lactate may indicate excessive β2 -agonist treatment and should now be investigated as a possible biomarker.
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Affiliation(s)
- Martin I MacDonald
- Monash Lung and Sleep, Monash Health, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
- Hudson Institute, Melbourne, Victoria, Australia
| | | | | | - Paul Leong
- Monash Lung and Sleep, Monash Health, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
- Hudson Institute, Melbourne, Victoria, Australia
| | - Kais Hamza
- Department of Mathematical Sciences, Monash University, Melbourne, Victoria, Australia
| | | | - Christian Robert Osadnik
- Monash Lung and Sleep, Monash Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Paul T King
- Monash Lung and Sleep, Monash Health, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
- Hudson Institute, Melbourne, Victoria, Australia
| | - Philip G Bardin
- Monash Lung and Sleep, Monash Health, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
- Hudson Institute, Melbourne, Victoria, Australia
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Caddye E, Pineau J, Reyniers J, Ronen I, Colasanti A. Lactate: A Theranostic Biomarker for Metabolic Psychiatry? Antioxidants (Basel) 2023; 12:1656. [PMID: 37759960 PMCID: PMC10526106 DOI: 10.3390/antiox12091656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
Alterations in neurometabolism and mitochondria are implicated in the pathophysiology of psychiatric conditions such as mood disorders and schizophrenia. Thus, developing objective biomarkers related to brain mitochondrial function is crucial for the development of interventions, such as central nervous system penetrating agents that target brain health. Lactate, a major circulatory fuel source that can be produced and utilized by the brain and body, is presented as a theranostic biomarker for neurometabolic dysfunction in psychiatric conditions. This concept is based on three key properties of lactate that make it an intriguing metabolic intermediate with implications for this field: Firstly, the lactate response to various stimuli, including physiological or psychological stress, represents a quantifiable and dynamic marker that reflects metabolic and mitochondrial health. Second, lactate concentration in the brain is tightly regulated according to the sleep-wake cycle, the dysregulation of which is implicated in both metabolic and mood disorders. Third, lactate universally integrates arousal behaviours, pH, cellular metabolism, redox states, oxidative stress, and inflammation, and can signal and encode this information via intra- and extracellular pathways in the brain. In this review, we expand on the above properties of lactate and discuss the methodological developments and rationale for the use of functional magnetic resonance spectroscopy for in vivo monitoring of brain lactate. We conclude that accurate and dynamic assessment of brain lactate responses might contribute to the development of novel and personalized therapies that improve mitochondrial health in psychiatric disorders and other conditions associated with neurometabolic dysfunction.
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Affiliation(s)
- Edward Caddye
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer BN1 9RR, UK
- Department of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer BN1 9RR, UK
| | - Julien Pineau
- Independent Researcher, Florianópolis 88062-300, Brazil
| | - Joshua Reyniers
- Department of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer BN1 9RR, UK
- School of Life Sciences, University of Sussex, Falmer BN1 9RR, UK
| | - Itamar Ronen
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer BN1 9RR, UK
| | - Alessandro Colasanti
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer BN1 9RR, UK
- Department of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer BN1 9RR, UK
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7
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Veeraiah P, Jansen JFA. Multinuclear Magnetic Resonance Spectroscopy at Ultra-High-Field: Assessing Human Cerebral Metabolism in Healthy and Diseased States. Metabolites 2023; 13:metabo13040577. [PMID: 37110235 PMCID: PMC10143499 DOI: 10.3390/metabo13040577] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
The brain is a highly energetic organ. Although the brain can consume metabolic substrates, such as lactate, glycogen, and ketone bodies, the energy metabolism in a healthy adult brain mainly relies on glucose provided via blood. The cerebral metabolism of glucose produces energy and a wide variety of intermediate metabolites. Since cerebral metabolic alterations have been repeatedly implicated in several brain disorders, understanding changes in metabolite levels and corresponding cell-specific neurotransmitter fluxes through different substrate utilization may highlight the underlying mechanisms that can be exploited to diagnose or treat various brain disorders. Magnetic resonance spectroscopy (MRS) is a noninvasive tool to measure tissue metabolism in vivo. 1H-MRS is widely applied in research at clinical field strengths (≤3T) to measure mostly high abundant metabolites. In addition, X-nuclei MRS including, 13C, 2H, 17O, and 31P, are also very promising. Exploiting the higher sensitivity at ultra-high-field (>4T; UHF) strengths enables obtaining unique insights into different aspects of the substrate metabolism towards measuring cell-specific metabolic fluxes in vivo. This review provides an overview about the potential role of multinuclear MRS (1H, 13C, 2H, 17O, and 31P) at UHF to assess the cerebral metabolism and the metabolic insights obtained by applying these techniques in both healthy and diseased states.
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Affiliation(s)
- Pandichelvam Veeraiah
- Scannexus (Ultra-High-Field MRI Center), 6229 EV Maastricht, The Netherlands
- Faculty of Health Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Jacobus F A Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands
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Burtscher J, Niedermeier M, Hüfner K, van den Burg E, Kopp M, Stoop R, Burtscher M, Gatterer H, Millet GP. The interplay of hypoxic and mental stress: Implications for anxiety and depressive disorders. Neurosci Biobehav Rev 2022; 138:104718. [PMID: 35661753 DOI: 10.1016/j.neubiorev.2022.104718] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
Adequate oxygen supply is essential for the human brain to meet its high energy demands. Therefore, elaborate molecular and systemic mechanism are in place to enable adaptation to low oxygen availability. Anxiety and depressive disorders are characterized by alterations in brain oxygen metabolism and of its components, such as mitochondria or hypoxia inducible factor (HIF)-pathways. Conversely, sensitivity and tolerance to hypoxia may depend on parameters of mental stress and the severity of anxiety and depressive disorders. Here we discuss relevant mechanisms of adaptations to hypoxia, as well as their involvement in mental stress and the etiopathogenesis of anxiety and depressive disorders. We suggest that mechanisms of adaptations to hypoxia (including metabolic responses, inflammation, and the activation of chemosensitive brain regions) modulate and are modulated by stress-related pathways and associated psychiatric diseases. While severe chronic hypoxia or dysfunctional hypoxia adaptations can contribute to the pathogenesis of anxiety and depressive disorders, harnessing controlled responses to hypoxia to increase cellular and psychological resilience emerges as a novel treatment strategy for these diseases.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Erwin van den Burg
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Ron Stoop
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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Distinct patterns of altered quantitative T1ρ and functional BOLD response associated with history of suicide attempts in bipolar disorder. Brain Imaging Behav 2022; 16:820-833. [PMID: 34601647 PMCID: PMC8975910 DOI: 10.1007/s11682-021-00552-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
Despite the high risk for suicide, relatively few studies have explored the relationship between suicide and brain imaging measures in bipolar disorder. In addition, fewer studies have explored the possibility that altered brain metabolism may be associated with suicide attempt. To begin to fill in these gaps, we evaluated functional (task based fMRI) and metabolic (quantitative T1ρ) differences associated with suicide attempt in participants with bipolar disorder. Thirty-nine participants with bipolar disorder underwent fMRI during a flashing checkerboard task and 27 also underwent quantitative T1ρ. The relationship between neuroimaging and history of suicide attempt was tested using multiple regression while adjusting for age, sex, and current mood state. Differences between two measures of suicide attempt (binary: yes/no and continuous: number of attempts) were quantified using the corrected Akaike Information Criterion. Participants who had attempted suicide had greater fMRI task-related activation in visual areas and the cerebellum. The number of suicide attempts was associated with a difference in BOLD response in the amygdala, prefrontal cortex, and cerebellum. Increased quantitative T1ρ was associated with number of suicide attempts in limbic, basal ganglia, and prefrontal cortex regions. This study is a secondary analysis with a modest sample size. Differences between measures of suicide history may be due to differences in statistical power. History of suicide was associated with limbic, prefrontal, and cerebellar alterations. Results comparing those with and without suicide attempts differed from results using number of suicide attempts, suggesting that these variables have different neurobiological underpinnings.
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Bouattour Y, Sautou V, Hmede R, El Ouadhi Y, Gouot D, Chennell P, Lapusta Y, Chapelle F, Lemaire JJ. A Minireview on Brain Models Simulating Geometrical, Physical, and Biochemical Properties of the Human Brain. Front Bioeng Biotechnol 2022; 10:818201. [PMID: 35419353 PMCID: PMC8996142 DOI: 10.3389/fbioe.2022.818201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
There is a growing body of evidences that brain surrogates will be of great interest for researchers and physicians in the medical field. They are currently mainly used for education and training purposes or to verify the appropriate functionality of medical devices. Depending on the purpose, a variety of materials have been used with specific and accurate mechanical and biophysical properties, More recently they have been used to assess the biocompatibility of implantable devices, but they are still not validated to study the migration of leaching components from devices. This minireview shows the large diversity of approaches and uses of brain phantoms, which converge punctually. All these phantoms are complementary to numeric models, which benefit, reciprocally, of their respective advances. It also suggests avenues of research for the analysis of leaching components from implantable devices.
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Affiliation(s)
- Yassine Bouattour
- Université Clermont Auvergne, CHU Clermont Ferrand, Clermont Auvergne INP, CNRS, ICCF, F-63000, Clermont-Ferrand, France
- *Correspondence: Yassine Bouattour, ; Jean-Jacques Lemaire,
| | - Valérie Sautou
- Université Clermont Auvergne, CHU Clermont Ferrand, Clermont Auvergne INP, CNRS, ICCF, F-63000, Clermont-Ferrand, France
| | - Rodayna Hmede
- Universite Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Youssef El Ouadhi
- Universite Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000, Clermont-Ferrand, France
- Service de Neurochirurgie, CHU Clermont Ferrand, F-63000, Clermont-Ferrand, France
| | - Dimitri Gouot
- Universite Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Philip Chennell
- Université Clermont Auvergne, CHU Clermont Ferrand, Clermont Auvergne INP, CNRS, ICCF, F-63000, Clermont-Ferrand, France
| | - Yuri Lapusta
- Universite Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Frédéric Chapelle
- Universite Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Jean-Jacques Lemaire
- Universite Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000, Clermont-Ferrand, France
- Service de Neurochirurgie, CHU Clermont Ferrand, F-63000, Clermont-Ferrand, France
- *Correspondence: Yassine Bouattour, ; Jean-Jacques Lemaire,
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Dahmani S, Kaliss N, VanMeter JW, Moore DJ, Ellis RJ, Jiang X. Alterations of Brain Metabolites in Adults With HIV: A Systematic Meta-analysis of Magnetic Resonance Spectroscopy Studies. Neurology 2021; 97:e1085-e1096. [PMID: 34253633 PMCID: PMC8456358 DOI: 10.1212/wnl.0000000000012394] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 05/20/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE A meta-analysis of proton magnetic resonance spectroscopy studies to investigate alterations in brain metabolites in people with HIV (PWH), the relationship between metabolite alterations and combination antiretroviral therapy (cART), and the relationship between metabolite alterations and cognitive impairment. METHODS The PubMed database was searched for studies published from 1997 to 2020. Twenty-seven studies were identified, which included 1255 PWH and 633 controls. Four metabolites (N-acetyl aspartate [NAA], myo-inositol [mI], choline [Cho], and glutamatergic metabolites [Glx]) from 5 brain regions (basal ganglia [BG], frontal gray and white matter [FGM and FWM], and parietal gray and white matter [PGM and PWM]) were pooled separately using random-effects meta-analysis. RESULTS During early HIV infection, metabolite alterations were largely limited to the BG, including Cho elevation, a marker of inflammation. cART led to global mI and Cho normalization (i.e., less elevations), but improvement in NAA was negligible. In chronic PWH on cART, there were consistent NAA reductions across brain regions, along with Cho and mI elevations in the FWM and BG, and Glx elevations in the FWM. Cognitive impairment was associated with NAA reduction and to a lesser degree mI elevation. CONCLUSIONS The BG are the primary region affected during early infection. cART is successful in partially controlling neuroinflammation (global mI and Cho normalization). However, neuronal dysfunction (NAA reductions) and neuroinflammation (mI and Cho elevations) persist and contribute to cognitive impairment in chronic PWH. Novel compounds targeting NAA signal pathways, along with better neuroinflammation control, may help to reduce cognitive impairment in PWH.
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Affiliation(s)
- Sophia Dahmani
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - Nicholas Kaliss
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - John W VanMeter
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - David J Moore
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - Ronald J Ellis
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - Xiong Jiang
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla.
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12
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Overall KL. Pharmacotherapeutics in clinical ethology: treatment efficacy, clinical pathology and outcome. BEHAVIOUR 2021. [DOI: 10.1163/1568539x-bja10096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
The use of psychopharmaceutical agents is a core aspect of treatment in veterinary behavioural medicine. Psychotropic medication use has shifted the focus of treatment from purely behavioural and environmental interventions to a multi-modal approach. Objective measures of efficacy are required for the licensing of medication. Pharmacotherapeutics have come to encompass supplements and diets, in addition to prescription medications. The first part of this paper examines the efficacy of medications, supplements and diets used in behavioural medicine. Foci include the role of evolution in the types of behavioural concerns reported, the importance of defining abnormal or pathological behaviour, use of terminology that supports stratified mechanistic diagnoses aid in understanding presentation and response clusters, and rational use of medication to relieve emotional, mental and behavioural suffering, given these diagnoses and clusters. The second part of this paper examines the extent to which variation in patient response to medication can enlighten us about mechanisms and outcomes of distress using a series of 3 patient populations who are the focus of studies on separation anxiety and noise reactivity. This response surface approach can be useful for understanding differences in populations in susceptibility to behavioural pathology and in medication response, and may suggest new avenues for drug development and application.
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Affiliation(s)
- Karen L. Overall
- Department of Health Management, Atlantic Veterinary College, UPEI, 550 University Avenue, Charlottetown, PEI, Canada C1A 4P3
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13
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Lai CH. Biomarkers in Panic Disorder. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2021. [DOI: 10.2174/2666082216999200918163245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Panic disorder (PD) is a kind of anxiety disorder that impacts the life quality
and functional perspectives in patients. However, the pathophysiological study of PD seems still
inadequate and many unresolved issues need to be clarified.
Objectives:
In this review article of biomarkers in PD, the investigator will focus on the findings of
magnetic resonance imaging (MRI) of the brain in the pathophysiology study. The MRI biomarkers
would be divided into several categories, on the basis of structural and functional perspectives.
Methods:
The structural category would include the gray matter and white matter tract studies. The
functional category would consist of functional MRI (fMRI), resting-state fMRI (Rs-fMRI), and
magnetic resonance spectroscopy (MRS). The PD biomarkers revealed by the above methodologies
would be discussed in this article.
Results:
For the gray matter perspectives, the PD patients would have alterations in the volumes of
fear network structures, such as the amygdala, parahippocampal gyrus, thalamus, anterior cingulate
cortex, insula, and frontal regions. For the white matter tract studies, the PD patients seemed to have
alterations in the fasciculus linking the fear network regions, such as the anterior thalamic radiation,
uncinate fasciculus, fronto-occipital fasciculus, and superior longitudinal fasciculus. For the fMRI
studies in PD, the significant results also focused on the fear network regions, such as the amygdala,
hippocampus, thalamus, insula, and frontal regions. For the Rs-fMRI studies, PD patients seemed to
have alterations in the regions of the default mode network and fear network model. At last, the
MRS results showed alterations in neuron metabolites of the hippocampus, amygdala, occipital
cortex, and frontal regions.
Conclusion:
The MRI biomarkers in PD might be compatible with the extended fear network model
hypothesis in PD, which included the amygdala, hippocampus, thalamus, insula, frontal regions, and
sensory-related cortex.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
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14
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Lactate induces synapse-specific potentiation on CA3 pyramidal cells of rat hippocampus. PLoS One 2020; 15:e0242309. [PMID: 33180836 PMCID: PMC7660554 DOI: 10.1371/journal.pone.0242309] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/31/2020] [Indexed: 02/07/2023] Open
Abstract
Neuronal activity within the physiologic range stimulates lactate production that, via metabolic pathways or operating through an array of G-protein-coupled receptors, regulates intrinsic excitability and synaptic transmission. The recent discovery that lactate exerts a tight control of ion channels, neurotransmitter release, and synaptic plasticity-related intracellular signaling cascades opens up the possibility that lactate regulates synaptic potentiation at central synapses. Here, we demonstrate that extracellular lactate (1–2 mM) induces glutamatergic potentiation on the recurrent collateral synapses of hippocampal CA3 pyramidal cells. This potentiation is independent of lactate transport and further metabolism, but requires activation of NMDA receptors, postsynaptic calcium accumulation, and activation of a G-protein-coupled receptor sensitive to cholera toxin. Furthermore, perfusion of 3,5- dihydroxybenzoic acid, a lactate receptor agonist, mimics this form of synaptic potentiation. The transduction mechanism underlying this novel form of synaptic plasticity requires G-protein βγ subunits, inositol-1,4,5-trisphosphate 3-kinase, PKC, and CaMKII. Activation of these signaling cascades is compartmentalized in a synapse-specific manner since lactate does not induce potentiation at the mossy fiber synapses of CA3 pyramidal cells. Consistent with this synapse-specific potentiation, lactate increases the output discharge of CA3 neurons when recurrent collaterals are repeatedly activated during lactate perfusion. This study provides new insights into the cellular mechanisms by which lactate, acting via a membrane receptor, contributes to the memory formation process.
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15
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Brain Branched-Chain Amino Acids in Maple Syrup Urine Disease: Implications for Neurological Disorders. Int J Mol Sci 2020; 21:ijms21207490. [PMID: 33050626 PMCID: PMC7590055 DOI: 10.3390/ijms21207490] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/02/2020] [Accepted: 10/09/2020] [Indexed: 12/16/2022] Open
Abstract
Maple syrup urine disease (MSUD) is an autosomal recessive disorder caused by decreased activity of the branched-chain α-ketoacid dehydrogenase complex (BCKDC), which catalyzes the irreversible catabolism of branched-chain amino acids (BCAAs). Current management of this BCAA dyshomeostasis consists of dietary restriction of BCAAs and liver transplantation, which aims to partially restore functional BCKDC activity in the periphery. These treatments improve the circulating levels of BCAAs and significantly increase survival rates in MSUD patients. However, significant cognitive and psychiatric morbidities remain. Specifically, patients are at a higher lifetime risk for cognitive impairments, mood and anxiety disorders (depression, anxiety, and panic disorder), and attention deficit disorder. Recent literature suggests that the neurological sequelae may be due to the brain-specific roles of BCAAs. This review will focus on the derangements of BCAAs observed in the brain of MSUD patients and will explore the potential mechanisms driving neurologic dysfunction. Finally, we will discuss recent evidence that implicates the relevance of BCAA metabolism in other neurological disorders. An understanding of the role of BCAAs in the central nervous system may facilitate future identification of novel therapeutic approaches in MSUD and a broad range of neurological disorders.
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16
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Shaffer JJ, Mani M, Schmitz SL, Xu J, Owusu N, Wu D, Magnotta VA, Wemmie JA. Proton Exchange Magnetic Resonance Imaging: Current and Future Applications in Psychiatric Research. Front Psychiatry 2020; 11:532606. [PMID: 33192650 PMCID: PMC7542226 DOI: 10.3389/fpsyt.2020.532606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 09/02/2020] [Indexed: 12/20/2022] Open
Abstract
Proton exchange provides a powerful contrast mechanism for magnetic resonance imaging (MRI). MRI techniques sensitive to proton exchange provide new opportunities to map, with high spatial and temporal resolution, compounds important for brain metabolism and function. Two such techniques, chemical exchange saturation transfer (CEST) and T1 relaxation in the rotating frame (T1ρ), are emerging as promising tools in the study of neurological and psychiatric illnesses to study brain metabolism. This review describes proton exchange for non-experts, highlights the current status of proton-exchange MRI, and presents advantages and drawbacks of these techniques compared to more traditional methods of imaging brain metabolism, including positron emission tomography (PET) and MR spectroscopy (MRS). Finally, this review highlights new frontiers for the use of CEST and T1ρ in brain research.
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Affiliation(s)
- Joseph J Shaffer
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Merry Mani
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Samantha L Schmitz
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
| | - Jia Xu
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Nana Owusu
- Department of Radiology, University of Iowa, Iowa City, IA, United States.,Pappajohn Biomedical Institute, University of Iowa, Iowa City, IA, United States.,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United States
| | - Dee Wu
- Department of Radiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Vincent A Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, United States.,Department of Psychiatry, University of Iowa, Iowa City, IA, United States.,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United States
| | - John A Wemmie
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States.,Pappajohn Biomedical Institute, University of Iowa, Iowa City, IA, United States.,Department of Veterans Affairs Medical Center, Iowa City, IA, United States.,Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, United States.,Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
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17
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Dehghani M, Do KQ, Magistretti P, Xin L. Lactate measurement by neurochemical profiling in the dorsolateral prefrontal cortex at 7T: accuracy, precision, and relaxation times. Magn Reson Med 2019; 83:1895-1908. [PMID: 31729080 DOI: 10.1002/mrm.28066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/17/2019] [Accepted: 10/14/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE This assesses the potential of measuring lactate in the human brain using three non-editing MRS methods at 7T and compares the accuracy and precision of the methods. METHODS 1 H MRS data were measured in the right dorsolateral prefrontal cortex using a semi-adiabatic spin-echo full-intensity acquired localized sequence with three different protocols: (I) TE = 16 ms, (II) TE = 110 ms, and (III) TE = 16 ms, TI = 300 ms. T1 and T2 relaxation times of lactate were also measured. Simulated spectra were generated for three protocols with known concentrations, using a range of spectral linewidths and SNRs to assess the effect of data quality on the measurement precision and accuracy. RESULTS Lactate was quantified in all three protocols with mean Cramér-Rao lower bound of 8% (I), 13% (II), and 7% (III). The T1 and T2 relaxation times of lactate were 1.9 ± 0.2 s and 94 ± 13 ms, respectively. Simulations predicted a spectral linewidth-associated underestimation of lactate measurement. Simulations, phantom and in vivo results showed that protocol II was most affected by this underestimation. In addition, the estimation error was insensitive to a broad range of spectral linewidth with protocol I. Within-session coefficient of variances of lactate were 6.1 ± 7.9% (I), 22.3 ± 12.3% (II), and 5.1 ± 5.4% (III), respectively. CONCLUSION We conclude that protocols I and III have the potential to measure lactate at 7T with good reproducibility, whereas the measurement accuracy and precision depend on spectral linewidth and SNR, respectively. Moreover, simulation is valuable for the optimization of measurement protocols in future study design and the correction for measurement bias.
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Affiliation(s)
- Masoumeh Dehghani
- Center for Psychiatric Neuroscience (CNP), Department of Psychiatry, Lausanne University Hospital-CHUV, Prilly-Lausanne, Switzerland
| | - Kim Q Do
- Center for Psychiatric Neuroscience (CNP), Department of Psychiatry, Lausanne University Hospital-CHUV, Prilly-Lausanne, Switzerland
| | - Pierre Magistretti
- Center for Psychiatric Neuroscience (CNP), Department of Psychiatry, Lausanne University Hospital-CHUV, Prilly-Lausanne, Switzerland.,BESE Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.,Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Lijing Xin
- Animal Imaging and Technology Core (AIT), Center for Biomedical Imaging (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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18
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Mellon SH, Bersani FS, Lindqvist D, Hammamieh R, Donohue D, Dean K, Jett M, Yehuda R, Flory J, Reus VI, Bierer LM, Makotkine I, Abu Amara D, Henn Haase C, Coy M, Doyle FJ, Marmar C, Wolkowitz OM. Metabolomic analysis of male combat veterans with post traumatic stress disorder. PLoS One 2019; 14:e0213839. [PMID: 30883584 PMCID: PMC6422302 DOI: 10.1371/journal.pone.0213839] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/02/2019] [Indexed: 12/26/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is associated with impaired major domains of psychology and behavior. Individuals with PTSD also have increased co-morbidity with several serious medical conditions, including autoimmune diseases, cardiovascular disease, and diabetes, raising the possibility that systemic pathology associated with PTSD might be identified by metabolomic analysis of blood. We sought to identify metabolites that are altered in male combat veterans with PTSD. In this case-control study, we compared metabolomic profiles from age-matched male combat trauma-exposed veterans from the Iraq and Afghanistan conflicts with PTSD (n = 52) and without PTSD (n = 51) (‘Discovery group’). An additional group of 31 PTSD-positive and 31 PTSD-negative male combat-exposed veterans was used for validation of these findings (‘Test group’). Plasma metabolite profiles were measured in all subjects using ultrahigh performance liquid chromatography/tandem mass spectrometry and gas chromatography/mass spectrometry. We identified key differences between PTSD subjects and controls in pathways related to glycolysis and fatty acid uptake and metabolism in the initial ‘Discovery group’, consistent with mitochondrial alterations or dysfunction, which were also confirmed in the ‘Test group’. Other pathways related to urea cycle and amino acid metabolism were different between PTSD subjects and controls in the ‘Discovery’ but not in the smaller ‘Test’ group. These metabolic differences were not explained by comorbid major depression, body mass index, blood glucose, hemoglobin A1c, smoking, or use of analgesics, antidepressants, statins, or anti-inflammatories. These data show replicable, wide-ranging changes in the metabolic profile of combat-exposed males with PTSD, with a suggestion of mitochondrial alterations or dysfunction, that may contribute to the behavioral and somatic phenotypes associated with this disease.
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Affiliation(s)
- Synthia H. Mellon
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, United States of America
- * E-mail:
| | - F. Saverio Bersani
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Daniel Lindqvist
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Rasha Hammamieh
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Duncan Donohue
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Kelsey Dean
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Marti Jett
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Rachel Yehuda
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Janine Flory
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Victor I. Reus
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Linda M. Bierer
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Iouri Makotkine
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Duna Abu Amara
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
| | - Clare Henn Haase
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
| | - Michelle Coy
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Francis J. Doyle
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Charles Marmar
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
- Stephen and Alexandra Cohen Veteran Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, United States of America
| | - Owen M. Wolkowitz
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
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19
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Watts ME, Pocock R, Claudianos C. Brain Energy and Oxygen Metabolism: Emerging Role in Normal Function and Disease. Front Mol Neurosci 2018; 11:216. [PMID: 29988368 PMCID: PMC6023993 DOI: 10.3389/fnmol.2018.00216] [Citation(s) in RCA: 202] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 06/01/2018] [Indexed: 01/09/2023] Open
Abstract
Dynamic metabolic changes occurring in neurons are critically important in directing brain plasticity and cognitive function. In other tissue types, disruptions to metabolism and the resultant changes in cellular oxidative state, such as increased reactive oxygen species (ROS) or induction of hypoxia, are associated with cellular stress. In the brain however, where drastic metabolic shifts occur to support physiological processes, subsequent changes to cellular oxidative state and induction of transcriptional sensors of oxidative stress likely play a significant role in regulating physiological neuronal function. Understanding the role of metabolism and metabolically-regulated genes in neuronal function will be critical in elucidating how cognitive functions are disrupted in pathological conditions where neuronal metabolism is affected. Here, we discuss known mechanisms regulating neuronal metabolism as well as the role of hypoxia and oxidative stress during normal and disrupted neuronal function. We also summarize recent studies implicating a role for metabolism in regulating neuronal plasticity as an emerging neuroscience paradigm.
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Affiliation(s)
- Michelle E Watts
- Queensland Brain Institute, The University of Queensland, St. Lucia, QLD, Australia
| | - Roger Pocock
- Development and Stem Cells Program, Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Charles Claudianos
- Queensland Brain Institute, The University of Queensland, St. Lucia, QLD, Australia.,Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
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20
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21
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Strawn JR, Vollmer LL, McMurray KM, Mills JA, Mossman SA, Varney ST, Schroeder HK, Sah R. Acid-sensing T cell death associated gene-8 receptor expression in panic disorder. Brain Behav Immun 2018; 67:36-41. [PMID: 28736033 PMCID: PMC5696091 DOI: 10.1016/j.bbi.2017.07.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND While disruption of acid-base homeostasis has been pathoetiologically implicated in panic disorder (PD), the mechanism by which pH imbalance is translated to panic pathophysiology is poorly understood. Recently, in a translational rodent model of PD, we reported a role of microglial acid sensing G-protein coupled receptor, T cell death associated gene-8 (TDAG8) in panic-associated behavior and physiology. However, the clinical validity of the TDAG8 receptor has not been investigated. OBJECTIVE To assess TDAG8 in PD, we evaluated TDAG8 receptor expression in adolescents and young adults with PD and healthy comparison subjects. METHODS Relative expression of TDAG8 mRNA was determined in peripheral blood mononuclear cells from patients with PD, and compared to expression in healthy subjects. Linear models were utilized to evaluate the relationship between TDAG8 expression and panic disorder symptom severity scale (PDSS) score as well as other potential explanatory variables (e.g., CRP, body mass index, sex, age). Models were refined based on the estimated parameter significance, evidence of omitted variable bias and Bayesian/Akaike information criteria. RESULTS Relative to healthy comparison subjects (n=17), expression of TDAG8 mRNA was significantly increased in patients with PD (n=15) (1.60±0.65 vs. 1.01±0.50, p=0.008). TDAG8 mRNA expression predicted PD symptom severity in a fixed effect model incorporating age and sex (p=0.003). CONCLUSIONS Collectively, our results suggest greater TDAG8 expression in patients with PD compared to healthy subjects, and directly link TDAG8 expression and the severity of the PD symptoms. Further investigation of the TDAG8 receptor in panic pathophysiology is warranted.
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Affiliation(s)
- Jeffrey R. Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45237,Cincinnati Children's Hospital Medical Center, Department of Psychiatry, Cincinnati, Ohio, 45219
| | - Lauren L. Vollmer
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45237
| | - Katherine M.J. McMurray
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45237
| | - Jeffrey A. Mills
- Carl Lindner College of Business, University of Cincinnati, Cincinnati, OH
| | - Sarah A. Mossman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45237
| | - Sara T. Varney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45237
| | - Heidi K. Schroeder
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45237
| | - Renu Sah
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45237,Neuroscience Graduate Program, University of Cincinnati, Cincinnati, OH 45219,VA Medical Center, Cincinnati, OH 45220
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22
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Leibold NK, van den Hove DLA, Viechtbauer W, Kenis G, Goossens L, Lange I, Knuts I, Smeets HJ, Myin-Germeys I, Steinbusch HW, Schruers KR. Amiloride-sensitive cation channel 2 genotype affects the response to a carbon dioxide panic challenge. J Psychopharmacol 2017; 31:1294-1301. [PMID: 28121219 DOI: 10.1177/0269881116686880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Until recently, genetic research into panic disorder (PD) has had only limited success. Inspired by rodent research, demonstrating that the acid-sensing ion channel 1a (ASIC1a) is critically involved in the behavioral fear response to carbon dioxide (CO2) exposure, variants in the human homologue gene amiloride-sensitive cation channel 2 (ACCN2) were shown to be associated with PD. However, the relationship between changes in brain pH and ACCN2, as done in rodents by CO2 exposure, has not been investigated yet in humans. Here, we examined this link between the ACCN2 gene and the response to CO2 exposure in two studies: in healthy volunteers as well as PD patients and using both behavioral and physiological outcome measures. More specifically, 107 healthy volunteers and 183 PD patients underwent a 35% CO2 inhalation. Negative affect was assessed using visual analogue scales and the panic symptom list (PSL), and, in healthy volunteers, cardiovascular measurements. The single nucleotide polymorphism rs10875995 was significantly associated with a higher emotional response in PD patients and with an increase in systolic as well as diastolic blood pressure in healthy subjects. In all measurements, subjects homozygous for the T-allele showed a heightened reactivity to CO2. Furthermore, a trend towards an rs685012 genotype effect on the emotional response was found in PD patients. We provide the first evidence that genetic variants in the ACCN2 are associated with differential sensitivity to CO2 in PD patients as well as healthy volunteers, further supporting ACCN2 as a promising candidate for future research to improve current treatment options.
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Affiliation(s)
- Nicole K Leibold
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Daniel LA van den Hove
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.,2 Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Wolfgang Viechtbauer
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Gunter Kenis
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Liesbet Goossens
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Iris Lange
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Inge Knuts
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Hubert J Smeets
- 3 Genome Center Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Inez Myin-Germeys
- 3 Genome Center Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Harry Wm Steinbusch
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Koen Rj Schruers
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
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Riske L, Thomas RK, Baker GB, Dursun SM. Lactate in the brain: an update on its relevance to brain energy, neurons, glia and panic disorder. Ther Adv Psychopharmacol 2017; 7:85-89. [PMID: 28255438 PMCID: PMC5315230 DOI: 10.1177/2045125316675579] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lactate is considered an important metabolite in the human body, but there has been considerable debate about its roles in brain function. Research in recent years has suggested that lactate from astrocytes may be crucial for supporting axonal function, especially during times of high metabolic demands or hypoglycemia. The astrocyte-neuron lactate transfer shuttle system serves a protective function to ensure a supply of substrates for brain metabolism, and oligodendrocytes appear to also influence availability of lactate. There is increasing evidence for lactate acting as a signaling molecule in the brain to link metabolism, substrate availability, blood flow and neuronal activity. This review will attempt to connect evidence to the relationship lactate has to panic disorder (PD), which suggests that its transporters, receptors or metabolism warrant investigation as potential therapeutic targets in PD.
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Affiliation(s)
- Laurel Riske
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Rejish K Thomas
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Glen B Baker
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Serdar M Dursun
- Department of Psychiatry (Neurochemical Research Unit, NRU), 12th Floor, Clinical Science Building, University of Alberta, Edmonton, AB, T6G 2G3, Canada
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Jahng GH, Oh J, Lee DW, Kim HG, Rhee HY, Shin W, Paik JW, Lee KM, Park S, Choe BY, Ryu CW. Glutamine and Glutamate Complex, as Measured by Functional Magnetic Resonance Spectroscopy, Alters During Face-Name Association Task in Patients with Mild Cognitive Impairment and Alzheimer's Disease. J Alzheimers Dis 2017; 52:145-59. [PMID: 27060946 DOI: 10.3233/jad-150877] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The metabolite response during a memory task in Alzheimer's disease (AD) patients is unknown. OBJECTIVE To investigate the metabolite changes in subjects with AD, amnestic mild cognitive impairment (aMCI), and cognitively normal (CN) elderly during a memory task using functional magnetic resonance spectroscopy (fMRS). METHODS This study involved 23 young normal controls (YC), 24 CN elderly, 24 aMCI, and 24 mild and probable AD individuals. fMRS data were acquired at the precuneus and posterior cingulate brain regions during a face-name association task. Statistical analyses of quantified metabolites were performed to evaluate differences of the metabolite values between the stimulation conditions and among the four subject groups. Receiver operating curve analysis was performed to evaluate whether the metabolic changes after functional activations can differentiate the subject groups. RESULT Glutamine and glutamate complex (Glx) was statistically significantly different between the fixation and repeat conditions in aMCI (p = 0.0492) as well as between the fixation and the novel conditions in the AD (p = 0.0412) group. The total N-acetylaspartate (tNAA) was statistically significantly different among the four subject groups in the fixation condition (DF = 3, F = 7.673, p < 0.001), the novel condition (DF = 3, F = 6.945, p < 0.001), and the repeat condition (DF = 3, F = 7.127, p < 0.001). tNAA, tCr, and mIns could be used to differentiate CN from aMCI. Furthermore, tNAA, tCr, Glx, and Glu could also differentiate CN from AD, and aMCI from AD. CONCLUSION Glx was altered during a stimulation that may be used to evaluate neuronal dysfunction in a demented patient. tNAA and tCr were reduced in patients with AD.
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Affiliation(s)
- Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Gangdong-gu, Seoul, Republic of Korea
| | - Janghoon Oh
- Department of Biomedical Engineering, Graduate School, Kyung Hee University, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Do-Wan Lee
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seocho-Gu, Seoul, Republic of Korea
| | - Hyug-Gi Kim
- Department of Biomedical Engineering, Graduate School, Kyung Hee University, Giheung-gu, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Gangdong-gu, Seoul, Republic of Korea
| | - Wonchul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Gangdong-gu, Seoul, Republic of Korea
| | - Jong-Woo Paik
- Department of Mental Health, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Kyung Mi Lee
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Soonchan Park
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Gangdong-gu, Seoul, Republic of Korea
| | - Bo-Young Choe
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seocho-Gu, Seoul, Republic of Korea
| | - Chang-Woo Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Gangdong-gu, Seoul, Republic of Korea
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25
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Differential behavioral sensitivity to carbon dioxide (CO 2) inhalation in rats. Neuroscience 2017; 346:423-433. [PMID: 28087339 DOI: 10.1016/j.neuroscience.2017.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/14/2016] [Accepted: 01/03/2017] [Indexed: 01/21/2023]
Abstract
Inhalation of carbon dioxide (CO2) is frequently employed as a biological challenge to evoke intense fear and anxiety. In individuals with panic disorder, CO2 reliably evokes panic attacks. Sensitivity to CO2 is highly heterogeneous among individuals, and although a genetic component is implicated, underlying mechanisms are not clear. Preclinical models that can simulate differential responsivity to CO2 are therefore relevant. In the current study we investigated CO2-evoked behavioral responses in four different rat strains: Sprague-Dawley (SD), Wistar (W), Long Evans (LE) and Wistar-Kyoto, (WK) rats. We also assessed tryptophan hydroxylase 2 (TPH-2)-positive serotonergic neurons in anxiety/panic regulatory subdivisions of the dorsal raphe nucleus (DR), as well as dopamine β hydroxylase (DβH)-positive noradrenergic neurons in the locus coeruleus, implicated in central CO2-chemosensitivity. Behavioral responsivity to CO2 inhalation varied between strains. CO2-evoked immobility was significantly higher in LE and WK rats as compared with W and SD cohorts. Differences were also observed in CO2-evoked rearing and grooming behaviors. Exposure to CO2 did not produce conditioned behavioral responses upon re-exposure to CO2 context in any strain. Reduced TPH-2-positive cell counts were observed specifically in the panic-regulatory dorsal raphe ventrolateral (DRVL)-ventrolateral periaqueductal gray (VLPAG) subdivision in CO2-sensitive strains. Conversely, DβH-positive cell counts within the LC were significantly higher in CO2-sensitive strains. Collectively, our data provide evidence for strain dependent, differential CO2-sensitivity and potential differences in monoaminergic systems regulating panic and anxiety. Comparative studies between CO2-vulnerable and resistant strains may facilitate the mechanistic understanding of differential CO2-sensitivity in the development of panic and anxiety disorders.
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Ernst J, Hock A, Henning A, Seifritz E, Boeker H, Grimm S. Increased pregenual anterior cingulate glucose and lactate concentrations in major depressive disorder. Mol Psychiatry 2017; 22:113-119. [PMID: 27184123 DOI: 10.1038/mp.2016.73] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/25/2016] [Accepted: 03/31/2016] [Indexed: 12/27/2022]
Abstract
There is ample evidence that glucose metabolism in the pregenual anterior cingulate cortex (PACC) is increased in major depressive disorder (MDD), whereas it is still unknown whether glucose levels per se are also elevated. Elevated cerebrospinal fluid (CSF) lactate concentrations in MDD patients might indicate that increased glycolytical metabolization of glucose to lactate in astrocytes either alone or in conjunction with mitochondrial dysfunction results in an accumulation of lactate and contributes to pathophysiological mechanisms of MDD. However, until now, no study investigated in vivo PACC glucose and lactate levels in MDD. Proton magnetic resonance spectroscopy was therefore used to test the hypothesis that patients with MDD have increased PACC glucose and lactate levels. In 40 healthy and depressed participants, spectra were acquired from the PACC using a maximum echo J-resolved spectroscopy protocol. Results show significant increases of glucose and lactate in patients, which are also associated with depression severity. These findings indicate impaired brain energy metabolism in MDD with increased fraction of energy utilization via glycolysis and reduced mitochondrial oxidative clearance of lactate. Targeting these metabolic disturbances might affect the balance of metabolic pathways regulating neuronal energetics and result in an attenuation of the elevated basal activity of brain regions within the neural circuitry of depression.
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Affiliation(s)
- J Ernst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - A Hock
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - A Henning
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.,Max Planck Institute for Biological Cybernetics, Tuebingen, Germany
| | - E Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - H Boeker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - S Grimm
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany
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Metabolomics approach reveals metabolic disorders and potential biomarkers associated with the developmental toxicity of tetrabromobisphenol A and tetrachlorobisphenol A. Sci Rep 2016; 6:35257. [PMID: 27734936 PMCID: PMC5062249 DOI: 10.1038/srep35257] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 09/26/2016] [Indexed: 12/18/2022] Open
Abstract
Tetrabromobisphenol A and tetrachlorobisphenol A are halogenated bisphenol A (H-BPA), and has raised concerns about their adverse effects on the development of fetuses and infants, however, the molecular mechanisms are unclear, and related metabolomics studies are limited. Accordingly, a metabolomics study based on gas chromatography-mass spectrometry was employed to elucidate the molecular developmental toxicology of H-BPA using the marine medaka (Oryzias melastigmas) embryo model. Here, we revealed decreased synthesis of nucleosides, amino acids and lipids, and disruptions in the TCA (tricarboxylic acid) cycle, glycolysis and lipid metabolism, thus inhibiting the developmental processes of embryos exposed to H-BPA. Unexpectedly, we observed enhanced neural activity accompanied by lactate accumulation and accelerated heart rates due to an increase in dopamine pathway and a decrease in inhibitory neurotransmitters following H-BPA exposure. Notably, disorders of the neural system, and disruptions in glycolysis, the TCA cycle, nucleoside metabolism, lipid metabolism, glutamate and aspartate metabolism induced by H-BPA exposure were heritable. Furthermore, lactate and dopa were identified as potential biomarkers of the developmental toxicity of H-BPA and related genetic effects. This study has demonstrated that the metabolomics approach is a useful tool for obtaining comprehensive and novel insights into the molecular developmental toxicity of environmental pollutants.
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Abstract
Neuroglia, the "glue" that fills the space between neurons in the central nervous system, takes active part in nerve cell signaling. Neuroglial cells, astroglia, oligodendroglia, and microglia, are together about as numerous as neurons in the brain as a whole, and in the cerebral cortex grey matter, but the proportion varies widely among brain regions. Glial volume, however, is less than one-fifth of the tissue volume in grey matter. When stimulated by neurons or other cells, neuroglial cells release gliotransmitters by exocytosis, similar to neurotransmitter release from nerve endings, or by carrier-mediated transport or channel flux through the plasma membrane. Gliotransmitters include the common neurotransmitters glutamate and GABA, the nonstandard amino acid d-serine, the high-energy phosphate ATP, and l-lactate. The latter molecule is a "buffer" between glycolytic and oxidative metabolism as well as a signaling substance recently shown to act on specific lactate receptors in the brain. Complementing neurotransmission at a synapse, neuroglial transmission often implies diffusion of the transmitter over a longer distance and concurs with the concept of volume transmission. Transmission from glia modulates synaptic neurotransmission based on energetic and other local conditions in a volume of tissue surrounding the individual synapse. Neuroglial transmission appears to contribute significantly to brain functions such as memory, as well as to prevalent neuropathologies.
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Affiliation(s)
- Vidar Gundersen
- SN-Lab, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, and CMBN/SERTA/Healthy Brain Ageing Centre, University of Oslo, Oslo, Norway; Department of Neurology, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Center for Healthy Aging, Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; and Brain and Muscle Energy Group, Department of Oral Biology and Division of Anatomy, Department of Molecular Medicine, University of Oslo, Oslo, Norway
| | - Jon Storm-Mathisen
- SN-Lab, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, and CMBN/SERTA/Healthy Brain Ageing Centre, University of Oslo, Oslo, Norway; Department of Neurology, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Center for Healthy Aging, Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; and Brain and Muscle Energy Group, Department of Oral Biology and Division of Anatomy, Department of Molecular Medicine, University of Oslo, Oslo, Norway
| | - Linda Hildegard Bergersen
- SN-Lab, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, and CMBN/SERTA/Healthy Brain Ageing Centre, University of Oslo, Oslo, Norway; Department of Neurology, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Center for Healthy Aging, Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; and Brain and Muscle Energy Group, Department of Oral Biology and Division of Anatomy, Department of Molecular Medicine, University of Oslo, Oslo, Norway
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Lifestyle Behaviours Add to the Armoury of Treatment Options for Panic Disorder: An Evidence-Based Reasoning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7017-43. [PMID: 26095868 PMCID: PMC4483746 DOI: 10.3390/ijerph120607017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 11/16/2022]
Abstract
This article presents an evidence-based reasoning, focusing on evidence of an Occupational Therapy input to lifestyle behaviour influences on panic disorder that also provides potentially broader application across other mental health problems (MHP). The article begins from the premise that we are all different. It then follows through a sequence of questions, examining incrementally how MHPs are experienced and classified. It analyses the impact of individual sensitivity at different levels of analysis, from genetic and epigenetic individuality, through neurotransmitter and body system sensitivity. Examples are given demonstrating the evidence base behind the logical sequence of investigation. The paper considers the evidence of how everyday routine lifestyle behaviour impacts on occupational function at all levels, and how these behaviours link to individual sensitivity to influence the level of exposure required to elicit symptomatic responses. Occupational Therapists can help patients by adequately assessing individual sensitivity, and through promoting understanding and a sense of control over their own symptoms. It concludes that present clinical guidelines should be expanded to incorporate knowledge of individual sensitivities to environmental exposures and lifestyle behaviours at an early stage.
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The brain acid–base homeostasis and serotonin: A perspective on the use of carbon dioxide as human and rodent experimental model of panic. Prog Neurobiol 2015; 129:58-78. [DOI: 10.1016/j.pneurobio.2015.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 04/16/2015] [Accepted: 04/20/2015] [Indexed: 12/14/2022]
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Vollmer LL, Strawn JR, Sah R. Acid-base dysregulation and chemosensory mechanisms in panic disorder: a translational update. Transl Psychiatry 2015; 5:e572. [PMID: 26080089 PMCID: PMC4471296 DOI: 10.1038/tp.2015.67] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/19/2015] [Accepted: 04/06/2015] [Indexed: 12/13/2022] Open
Abstract
Panic disorder (PD), a complex anxiety disorder characterized by recurrent panic attacks, represents a poorly understood psychiatric condition which is associated with significant morbidity and an increased risk of suicide attempts and completed suicide. Recently however, neuroimaging and panic provocation challenge studies have provided insights into the pathoetiology of panic phenomena and have begun to elucidate potential neural mechanisms that may underlie panic attacks. In this regard, accumulating evidence suggests that acidosis may be a contributing factor in induction of panic. Challenge studies in patients with PD reveal that panic attacks may be reliably provoked by agents that lead to acid-base dysbalance such as CO2 inhalation and sodium lactate infusion. Chemosensory mechanisms that translate pH into panic-relevant fear, autonomic, and respiratory responses are therefore of high relevance to the understanding of panic pathophysiology. Herein, we provide a current update on clinical and preclinical studies supporting how acid-base imbalance and diverse chemosensory mechanisms may be associated with PD and discuss future implications of these findings.
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Affiliation(s)
- L L Vollmer
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - J R Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH, USA,Cincinnati Children's Hospital Medical Center, Department of Psychiatry, Cincinnati, OH, USA
| | - R Sah
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH, USA,Veterens' Affairs Medical Center, Cincinnati, OH, USA,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, 2170 East Galbraith Road, Cincinnati, OH 45237, USA. E-mail:
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32
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How doth the little busy bee: unexpected metabolism. Trends Neurosci 2015; 38:1-2. [DOI: 10.1016/j.tins.2014.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 11/14/2014] [Accepted: 11/20/2014] [Indexed: 11/20/2022]
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Paul ED, Johnson PL, Shekhar A, Lowry CA. The Deakin/Graeff hypothesis: focus on serotonergic inhibition of panic. Neurosci Biobehav Rev 2014; 46 Pt 3:379-96. [PMID: 24661986 PMCID: PMC4170046 DOI: 10.1016/j.neubiorev.2014.03.010] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 02/15/2014] [Accepted: 03/01/2014] [Indexed: 12/20/2022]
Abstract
The Deakin/Graeff hypothesis proposes that different subpopulations of serotonergic neurons through topographically organized projections to forebrain and brainstem structures modulate the response to acute and chronic stressors, and that dysfunction of these neurons increases vulnerability to affective and anxiety disorders, including panic disorder. We outline evidence supporting the existence of a serotonergic system originally discussed by Deakin/Graeff that is implicated in the inhibition of panic-like behavioral and physiological responses. Evidence supporting this panic inhibition system comes from the following observations: (1) serotonergic neurons located in the 'ventrolateral dorsal raphe nucleus' (DRVL) as well as the ventrolateral periaqueductal gray (VLPAG) inhibit dorsal periaqueductal gray-elicited panic-like responses; (2) chronic, but not acute, antidepressant treatment potentiates serotonin's panicolytic effect; (3) contextual fear activates a central nucleus of the amygdala-DRVL/VLPAG circuit implicated in mediating freezing and inhibiting panic-like escape behaviors; (4) DRVL/VLPAG serotonergic neurons are central chemoreceptors and modulate the behavioral and cardiorespiratory response to panicogenic agents such as sodium lactate and CO2. Implications of the panic inhibition system are discussed.
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Affiliation(s)
- Evan D Paul
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
| | - Philip L Johnson
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
| | - Anantha Shekhar
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
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Abstract
BACKGROUND Abnormal brain pH has been suggested to play a critical role in panic disorder. To investigate this possibility, we employed a pH-sensitive magnetic resonance (MR) imaging strategy (T1 relaxation in the rotating frame [T1ρ]) and conventional blood oxygen level-dependent (BOLD) imaging. METHODS Thirteen panic disorder participants and 13 matched control subjects were enrolled in the study. T1ρ and BOLD were used to study the functional response to a visual flashing checkerboard and their relationship to panic symptoms assessed using the Beck Anxiety Inventory. RESULTS In response to visual stimulation, T1ρ imaging revealed a significantly greater increase in the visual cortex of panic disorder participants. T1ρ also detected a stimulus-evoked decrease in the anterior cingulate cortex. Blood oxygen level-dependent imaging detected no functional differences between groups. The correspondence between panic symptoms and functional T1ρ response identified significant relationships within the left inferior parietal lobe, left middle temporal gyrus, and right insula. No relationships were found between panic symptoms and the BOLD signal. CONCLUSIONS The data suggest greater activity-evoked T1ρ changes in the visual cortex and anterior cingulate cortex of panic disorder participants. These observations are consistent with a pH dysregulation in panic disorder. In addition, our data suggest that T1ρ imaging may provide information about panic disorder that is distinct from conventional BOLD imaging and may reflect abnormalities in pH and/or brain metabolism.
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Evaluation of activity-dependent functional pH and T1ρ response in the visual cortex. Neuroimage 2014; 95:336-43. [PMID: 24486980 DOI: 10.1016/j.neuroimage.2014.01.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 01/21/2014] [Accepted: 01/24/2014] [Indexed: 01/16/2023] Open
Abstract
Recent experiments suggest that T1 relaxation in the rotating frame (T1ρ) detects localized metabolic changes in the human visual cortex induced by a flashing checkerboard task. Possible sources of the T1ρ signal include pH, glucose, and glutamate concentrations as well as changes in cerebral blood volume. In this study we explored the relationship of the T1ρ signal changes related to cerebral blood volume changes by employing inferior saturation pulses. Our hypothesis was that there would be a contribution of cerebral blood volume to the functional T1ρ signal, but a majority of the signal would correspond to metabolic changes. In addition, the relationship between T1ρ and pH was explored by manipulating the frequency of the flashing checkerboard and imaging with T1ρ, BOLD, and (31)P spectroscopy. We hypothesized that T1ρ and pH changes would be sensitive to the stimulation frequency. To test this hypothesis, we used a full-field visual flashing checkerboard and varied the frequency between 1, 4, and 7Hz. Supporting our hypotheses, we found that approximately 73% of the measured signal change corresponds to metabolism in vivo and that increasing stimulation frequency increased responses measured by all three imaging modalities. The activation area detected by T1ρ overlapped to a large degree with that detected by BOLD, although the T1ρ response area was significantly smaller. (31)P spectroscopy detected a greater acidosis with the higher stimulation frequencies. These observations suggest that, similar to the BOLD response, the magnitude of the T1ρ and pH response depends on stimulation frequency and is thus likely to be activity-dependent.
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Petit JM, Gyger J, Burlet-Godinot S, Fiumelli H, Martin JL, Magistretti PJ. Genes involved in the astrocyte-neuron lactate shuttle (ANLS) are specifically regulated in cortical astrocytes following sleep deprivation in mice. Sleep 2013; 36:1445-58. [PMID: 24082304 DOI: 10.5665/sleep.3034] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES There is growing evidence indicating that in order to meet the neuronal energy demands, astrocytes provide lactate as an energy substrate for neurons through a mechanism called "astrocyte-neuron lactate shuttle" (ANLS). Since neuronal activity changes dramatically during vigilance states, we hypothesized that the ANLS may be regulated during the sleep-wake cycle. To test this hypothesis we investigated the expression of genes associated with the ANLS specifically in astrocytes following sleep deprivation. Astrocytes were purified by fluorescence-activated cell sorting from transgenic mice expressing the green fluorescent protein (GFP) under the control of the human astrocytic GFAP-promoter. DESIGN 6-hour instrumental sleep deprivation (TSD). SETTING Animal sleep research laboratory. PARTICIPANTS Young (P23-P27) FVB/N-Tg (GFAP-GFP) 14Mes/J (Tg) mice of both sexes and 7-8 week male Tg and FVB/Nj mice. INTERVENTIONS Basal sleep recordings and sleep deprivation achieved using a modified cage where animals were gently forced to move. MEASUREMENTS AND RESULTS Since Tg and FVB/Nj mice displayed a similar sleep-wake pattern, we performed a TSD in young Tg mice. Total RNA was extracted from the GFP-positive and GFP-negative cells sorted from cerebral cortex. Quantitative RT-PCR analysis showed that levels of Glut1, α-2-Na/K pump, Glt1, and Ldha mRNAs were significantly increased following TSD in GFP-positive cells. In GFP-negative cells, a tendency to increase, although not significant, was observed for Ldha, Mct2, and α-3-Na/K pump mRNAs. CONCLUSIONS This study shows that TSD induces the expression of genes associated with ANLS specifically in astrocytes, underlying the important role of astrocytes in the maintenance of the neuro-metabolic coupling across the sleep-wake cycle.
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Affiliation(s)
- Jean-Marie Petit
- LNDC, Brain Mind Institute, Life Sciences Faculty, Swiss Federal Institute of Technology, Lausanne, Switzerland ; Center for Psychiatric Neuroscience, Department of Psychiatry CHUV, Prilly, Switzerland
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Metabolic signaling by lactate in the brain. Trends Neurosci 2013; 36:396-404. [DOI: 10.1016/j.tins.2013.04.002] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/31/2013] [Accepted: 04/01/2013] [Indexed: 01/27/2023]
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Maddock RJ, Buonocore MH, Miller AR, Yoon JH, Soosman SK, Unruh AM. Abnormal activity-dependent brain lactate and glutamate+glutamine responses in panic disorder. Biol Psychiatry 2013; 73:1111-9. [PMID: 23332354 PMCID: PMC3636170 DOI: 10.1016/j.biopsych.2012.12.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 12/02/2012] [Accepted: 12/27/2012] [Indexed: 01/04/2023]
Abstract
BACKGROUND Prior evidence suggests panic disorder (PD) is characterized by neurometabolic abnormalities, including increased brain lactate responses to neural activation. Increased lactate responses could reflect a general upregulation of metabolic responses to neural activation. However, prior studies in PD have not measured activity-dependent changes in brain metabolites other than lactate. Here we examine activity-dependent changes in both lactate and glutamate plus glutamine (glx) in PD. METHODS Twenty-one PD patients (13 remitted, 8 symptomatic) and 12 healthy volunteers were studied. A single-voxel, J-difference, magnetic resonance spectroscopy editing sequence was used to measure lactate and glx changes in visual cortex induced by visual stimulation. RESULTS The PD patients had significantly greater activity-dependent increases in brain lactate than healthy volunteers. The differences were significant for both remitted and symptomatic PD patients, who did not differ from each other. Activity-dependent changes in glx were significantly smaller in PD patients than in healthy volunteers. The temporal correlation between lactate and glx changes was significantly stronger in control subjects than in PD patients. CONCLUSIONS The novel demonstration that glx responses are diminished and temporally decoupled from lactate responses in PD contradicts the model of a general upregulation of activity-dependent brain metabolic responses in PD. The increase in activity-dependent brain lactate accumulation appears to be a trait feature of PD. Given the close relationship between lactate and pH in the brain, the findings are consistent with a model of brain metabolic and pH dysregulation associated with altered function of acid-sensitive fear circuits contributing to trait vulnerability in PD.
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Affiliation(s)
- Richard J. Maddock
- Department of Psychiatry, University of California Davis Medical Center, Sacramento, CA 95817, USA,Imaging Research Center, University of California Davis Medical Center, Sacramento, CA 95817, USA
| | - Michael H. Buonocore
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA 95817, USA,Imaging Research Center, University of California Davis Medical Center, Sacramento, CA 95817, USA
| | - Amber R. Miller
- Department of Psychiatry, University of California Davis Medical Center, Sacramento, CA 95817, USA
| | - Jong H. Yoon
- Department of Psychiatry, University of California Davis Medical Center, Sacramento, CA 95817, USA,Imaging Research Center, University of California Davis Medical Center, Sacramento, CA 95817, USA
| | - Steffan K. Soosman
- Imaging Research Center, University of California Davis Medical Center, Sacramento, CA 95817, USA
| | - April M. Unruh
- Imaging Research Center, University of California Davis Medical Center, Sacramento, CA 95817, USA
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Kim JE, Dager SR, Lyoo IK. The role of the amygdala in the pathophysiology of panic disorder: evidence from neuroimaging studies. BIOLOGY OF MOOD & ANXIETY DISORDERS 2012; 2:20. [PMID: 23168129 PMCID: PMC3598964 DOI: 10.1186/2045-5380-2-20] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 09/19/2012] [Indexed: 01/04/2023]
Abstract
Although the neurobiological mechanisms underlying panic disorder (PD) are not yet clearly understood, increasing amount of evidence from animal and human studies suggests that the amygdala, which plays a pivotal role in neural network of fear and anxiety, has an important role in the pathogenesis of PD. This article aims to (1) review the findings of structural, chemical, and functional neuroimaging studies on PD, (2) relate the amygdala to panic attacks and PD development, (3) discuss the possible causes of amygdalar abnormalities in PD, (4) and suggest directions for future research.
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Affiliation(s)
- Jieun E Kim
- Department of Radiology, School of Medicine, University of Washington, 1100 NE 45th St, Ste 555, WA 98105, Seattle, USA.
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Brady RO, Cooper A, Jensen JE, Tandon N, Cohen B, Renshaw P, Keshavan M, Öngür D. A longitudinal pilot proton MRS investigation of the manic and euthymic states of bipolar disorder. Transl Psychiatry 2012; 2:e160. [PMID: 22968227 PMCID: PMC3565206 DOI: 10.1038/tp.2012.84] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Several lines of evidence implicate dysfunction in brain energy production as a key component of bipolar disorder. In particular, elevated brain lactate levels observed in this condition suggest a shift from aerobic to anaerobic metabolism, possibly as a result of mitochondrial abnormalities. Most prior imaging studies of brain metabolites were performed in either euthymic or depressed bipolar patients or compared different populations in different mood states. We sought to measure brain metabolite concentrations in the same patients in both manic and euthymic states. Given the dramatic changes in clinical state of bipolar disorder patients, we hypothesized that previously observed abnormalities in lactate concentrations in bipolar disorder might show state dependent changes. In this study 15 patients (mean age 36.1 years) diagnosed with bipolar I disorder underwent proton magnetic resonance spectroscopy of the anterior cingulate cortex and parieto-occipital cortex during hospitalization for acute mania (mean Young Mania Rating Scale (YMRS) 22.1). Seven of these subjects returned (mean interval 21.16 months) to have imaging repeated while euthymic (mean YMRS 2.0). A group of age- and gender-matched control participants (N=6) were scanned as well. We report that during mania, bipolar disorder subjects had lactate levels comparable to healthy control subjects but during euthymia these levels were significantly reduced. No significant change was observed for other metabolites. These results implicate mood dependent alterations in energy metabolism in the biology of bipolar disorder. Additionally, this finding has potential use as a biomarker for both evaluating novel treatments as well as diagnostic clarification between mood disorders.
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Affiliation(s)
- R O Brady
- Department of Psychiatry, Beth-Israel Deaconess Medical Center, Boston, MA, USA.
| | - A Cooper
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - J E Jensen
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Brain Imaging Center, McLean Hospital, Belmont, MA, USA
| | - N Tandon
- Department of Psychiatry, Beth-Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Massachusetts Mental Health Center, Boston, MA, USA
| | - B Cohen
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Shervert Frazier Research Institute, McLean Hospital, Belmont, MA, USA
| | - P Renshaw
- Brain Institute, University of Utah, Salt Lake City, UT, USA,Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - M Keshavan
- Department of Psychiatry, Beth-Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts Mental Health Center, Boston, MA, USA
| | - D Öngür
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA,Shervert Frazier Research Institute, McLean Hospital, Belmont, MA, USA
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41
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Revise the revised? New dimensions of the neuroanatomical hypothesis of panic disorder. J Neural Transm (Vienna) 2012; 120:3-29. [PMID: 22692647 DOI: 10.1007/s00702-012-0811-1] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Accepted: 04/16/2012] [Indexed: 12/14/2022]
Abstract
In 2000, Gorman et al. published a widely acknowledged revised version of their 1989 neuroanatomical hypothesis of panic disorder (PD). Herein, a 'fear network' was suggested to mediate fear- and anxiety-related responses: panic attacks result from a dysfunctional coordination of 'upstream' (cortical) and 'downstream' (brainstem) sensory information leading to heightened amygdala activity with subsequent behavioral, autonomic and neuroendocrine activation. Given the emergence of novel imaging methods such as fMRI and the publication of numerous neuroimaging studies regarding PD since 2000, a comprehensive literature search was performed regarding structural (CT, MRI), metabolic (PET, SPECT, MRS) and functional (fMRI, NIRS, EEG) studies on PD, which will be reviewed and critically discussed in relation to the neuroanatomical hypothesis of PD. Recent findings support structural and functional alterations in limbic and cortical structures in PD. Novel insights regarding structural volume increase or reduction, hyper- or hypoactivity, laterality and task-specificity of neural activation patterns emerged. The assumption of a generally hyperactive amygdala in PD seems to apply more to state than trait characteristics of PD, and involvement of further areas in the fear circuit, such as anterior cingulate and insula, is suggested. Furthermore, genetic risk variants have been proposed to partly drive fear network activity. Thus, the present state of knowledge generally supports limbic and cortical prefrontal involvement as originally proposed in the neuroanatomical hypothesis. Some modifications might be suggested regarding a potential extension of the fear circuit, genetic factors shaping neural network activity and neuroanatomically informed clinical subtypes of PD potentially guiding future treatment decisions.
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Abstract
Localized pH changes have been suggested to occur in the brain during normal function. However, the existence of such pH changes has also been questioned. Lack of methods for noninvasively measuring pH with high spatial and temporal resolution has limited insight into this issue. Here we report that a magnetic resonance imaging (MRI) strategy, T(1) relaxation in the rotating frame (T(1)ρ), is sufficiently sensitive to detect widespread pH changes in the mouse and human brain evoked by systemically manipulating carbon dioxide or bicarbonate. Moreover, T(1)ρ detected a localized acidosis in the human visual cortex induced by a flashing checkerboard. Lactate measurements and pH-sensitive (31)P spectroscopy at the same site also identified a localized acidosis. Consistent with the established role for pH in blood flow recruitment, T(1)ρ correlated with blood oxygenation level-dependent contrast commonly used in functional MRI. However, T(1)ρ was not directly sensitive to blood oxygen content. These observations indicate that localized pH fluctuations occur in the human brain during normal function. Furthermore, they suggest a unique functional imaging strategy based on pH that is independent of traditional functional MRI contrast mechanisms.
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Abstract
Panic disorder is a common and disabling illness for which treatments are too frequently ineffective. Greater knowledge of the underlying biology could aid the discovery of better therapies. Although panic attacks occur unpredictably, the ability to provoke them in the laboratory with challenge protocols provides an opportunity for crucial insight into the neurobiology of panic. Two of the most well-studied panic provocation challenges are CO(2) inhalation and lactate infusion. Although it remains unclear how these challenges provoke panic animal models of CO(2) and lactate action are beginning to emerge, and offer unprecedented opportunities to probe the molecules and circuits underlying panic attacks. Both CO(2) and lactate alter pH balance and may generate acidosis that can influence neuron function through a growing list of pH-sensitive receptors. These observations suggest that a key to better understanding of panic disorder may He in more knowledge of brain pH regulation and pH-sensitive receptors.
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Affiliation(s)
- John A Wemmie
- Department of Psychiatry, Interdisciplinary Graduate Program in Neuroscience, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
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Maddock RJ, Buonocore MH. MR spectroscopic studies of the brain in psychiatric disorders. Curr Top Behav Neurosci 2012; 11:199-251. [PMID: 22294088 DOI: 10.1007/7854_2011_197] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The measurement of brain metabolites with magnetic resonance spectroscopy (MRS) provides a unique perspective on the brain bases of neuropsychiatric disorders. As a context for interpreting MRS studies of neuropsychiatric disorders, we review the characteristic MRS signals, the metabolic dynamics,and the neurobiological significance of the major brain metabolites that can be measured using clinical MRS systems. These metabolites include N-acetylaspartate(NAA), creatine, choline-containing compounds, myo-inositol, glutamate and glutamine, lactate, and gamma-amino butyric acid (GABA). For the major adult neuropsychiatric disorders (schizophrenia, bipolar disorder, major depression, and the anxiety disorders), we highlight the most consistent MRS findings, with an emphasis on those with potential clinical or translational significance. Reduced NAA in specific brain regions in schizophrenia, bipolar disorder, post-traumatic stress disorder, and obsessive–compulsive disorder corroborate findings of reduced brain volumes in the same regions. Future MRS studies may help determine the extent to which the neuronal dysfunction suggested by these findings is reversible in these disorders. Elevated glutamate and glutamine (Glx) in patients with bipolar disorder and reduced Glx in patients with unipolar major depression support models of increased and decreased glutamatergic function, respectively, in those conditions. Reduced phosphomonoesters and intracellular pH in bipolar disorder and elevated dynamic lactate responses in panic disorder are consistent with metabolic models of pathogenesis in those disorders. Preliminary findings of an increased glutamine/glutamate ratio and decreased GABA in patients with schizophrenia are consistent with a model of NMDA hypofunction in that disorder. As MRS methods continue to improve, future studies may further advance our understanding of the natural history of psychiatric illnesses, improve our ability to test translational models of pathogenesis, clarify therapeutic mechanisms of action,and allow clinical monitoring of the effects of interventions on brain metabolicmarkers
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Gormanns P, Mueller NS, Ditzen C, Wolf S, Holsboer F, Turck CW. Phenome-transcriptome correlation unravels anxiety and depression related pathways. J Psychiatr Res 2011; 45:973-9. [PMID: 21255794 DOI: 10.1016/j.jpsychires.2010.12.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 12/01/2010] [Accepted: 12/21/2010] [Indexed: 01/26/2023]
Abstract
The identification of pathways pertinent to human diseases is critical for gaining a better understanding of their pathophysiology. Pathway knowledge in turn can provide disease marker information required for diagnosis, drug development and improved patient treatment. Psychiatric disorders including anxiety and depression are complex diseases and are caused by a combination of multiple genetic and environmental factors affecting certain brain circuits. Here we used a systems biology approach to identify molecular pathways that affect anxiety- and depression-like phenotypes. For this purpose we screened pathways for stable enrichment in a great number of publicly available transcriptome data from the Gene Expression Omnibus related to anxiety- and depression-like phenotypes. In case of anxiety our analysis implicate a dysregulation of carbohydrate metabolism, tight junction and the phosphatidylinositol signaling system, whereas for depression gap junction, gonadotropin-releasing hormone signaling and ubiquitin-mediated proteolysis pathways are affected. Furthermore, both anxiety and depression show a dysregulation of VEGF signaling, long term potentiation and the glycolysis pathway. Molecular entities that are part of the identified pathways can serve as biomarkers and potential therapeutic targets for diagnosis and treatment of depression and anxiety disorders.
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Affiliation(s)
- Philipp Gormanns
- Max Planck Institute of Psychiatry, Proteomics and Biomarkers, 80804 Munich, Germany
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Vigorous exercise increases brain lactate and Glx (glutamate+glutamine): a dynamic 1H-MRS study. Neuroimage 2011; 57:1324-30. [PMID: 21640838 DOI: 10.1016/j.neuroimage.2011.05.048] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 05/07/2011] [Accepted: 05/17/2011] [Indexed: 01/12/2023] Open
Abstract
Vigorous exercise increases lactate and glucose uptake by the brain in excess of the increase in brain oxygen uptake. The metabolic fate of this non-oxidized carbohydrate entering the brain is poorly understood, but accumulation of lactate in the brain and/or increased net synthesis of amino acid neurotransmitters are possible explanations. Previous proton magnetic resonance spectroscopy (1H-MRS) studies using conventional pulse sequences have not detected changes in brain lactate following exercise. This contrasts with 1H-MRS studies showing increased brain lactate when blood lactate levels are raised by an intravenous infusion of sodium lactate. Using a J-editing 1H-MRS technique for measuring lactate, we demonstrated a significant 19% increase in lactate in the visual cortex following graded exercise to approximately 85% of predicted maximum heart rate. However, the magnitude of the increase was insufficient to account for more than a small fraction of the non-oxidized carbohydrate entering the brain with exercise. We also report a significant 18% increase in Glx (combined signal from glutamate and glutamine) in visual cortex following exercise, which may represent an activity-dependent increase in glutamate. Future studies will be necessary to test the hypothesis that non-oxidized carbohydrate entering the brain during vigorous exercise is directed, in part, toward increased net synthesis of amino acid neurotransmitters. The possible relevance of these findings to panic disorder and major depression is discussed.
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An evidence-based causal model of panic disorder. J Anxiety Disord 2011; 25:381-8. [PMID: 21123028 DOI: 10.1016/j.janxdis.2010.10.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 10/29/2010] [Accepted: 10/29/2010] [Indexed: 11/21/2022]
Abstract
Recently, Fava and Morton (2009) described what they termed a 'causal model' of panic disorder (Causal modeling of panic disorder theories, Clinical Psychology Review, 29, 623-637). We examined several critical tenets of this proposed model, and offer significant revisions. Our revised causal model includes elements that have received empirical support, and exclude those with known limitations in explaining the etiology and treatment of panic disorder. Chief among these revisions are (1) an increased emphasis on anxiety sensitivity, (2) elimination of the more general psychodynamic conceptualization in favor of empirically supported findings regarding early attachment, and (3) placing biological and psychophysiological reactions as outcomes of false alarm threat, rather than causal mechanisms of panic.
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Figley CR, Stroman PW. The role(s) of astrocytes and astrocyte activity in neurometabolism, neurovascular coupling, and the production of functional neuroimaging signals. Eur J Neurosci 2011; 33:577-88. [DOI: 10.1111/j.1460-9568.2010.07584.x] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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49
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Dager SR. The vexing role of baseline: Implications for neuroimaging studies of panic disorder. Int J Psychophysiol 2010; 78:20-6. [DOI: 10.1016/j.ijpsycho.2010.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 01/09/2010] [Accepted: 01/12/2010] [Indexed: 11/29/2022]
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