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Jing L, Ma C, Xu L, Richter-Levin G. Distinct Neural Representations and Cognitive Behaviors Attributable to Naturally Developed Active Avoidance or Reactive Escape Strategies in the Male Rat. Int J Neuropsychopharmacol 2023; 26:761-772. [PMID: 37725443 PMCID: PMC10674082 DOI: 10.1093/ijnp/pyad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/18/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The high individual variability in coping with stress is often attributed to genetic background differences, sustained environmental conditions, or a combination of both. However, the neural mechanisms underlying coping style variability are still poorly understood. METHODS Here we examined the impact of a single extended emotional challenge on coping style variability and the associated involvement of the hippocampus, medial prefrontal cortex (mPFC), and periaqueductal gray (PAG). Male Sprague-Dawley rats (n = 170) were trained in an extended 2-way shuttle avoidance (eTWSA) task for 7 days, and daily avoidance rates were measured. Forced swim test, elevated plus maze, or Morris water maze was tested before or after eTWSA exposure. Excitotoxic lesion of the hippocampal dentate gyrus (DG) was performed by Ibotenic infusion. Transient pharmacological blocking of DG, mPFC, or PAG was performed by muscimol or CNQX+TTX infusion. RESULTS Exposing rats to eTWSA was found to lead to naturally developing dichotomous, not continuous, coping styles, which we termed active avoidance (AA) or reactive escape (RE). Prior emotional responses did not predict the developing coping style. AA was associated with beneficial outcomes, including reduced behavioral despair and improved spatial learning. RE led to impaired spatial retrieval. AA was abolished by lesioning or pharmacological blocking of the DG. RE was prevented by blocking mPFC or PAG. CONCLUSION The results indicate that a single exposure to a significant emotional challenge can lead, in otherwise healthy individuals, to dichotomous development of an active or reactive coping style with distinctive neural correlates and subsequent behavioral significance.
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Affiliation(s)
- Liang Jing
- Sagol Department of Neurobiology, Department of Psychology, University of Haifa, Haifa, Israel
- The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Israel
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Chen Ma
- Sagol Department of Neurobiology, Department of Psychology, University of Haifa, Haifa, Israel
- Key Laboratory of Animal Models and Human Disease Mechanisms, Lab of Learning and Memory, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
- The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Israel
| | - Lin Xu
- Key Laboratory of Animal Models and Human Disease Mechanisms, Lab of Learning and Memory, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
- CAS Centre for Excellence in Brain Science and Intelligent Technology, Shanghai, China
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, China
- KIZ-SU Joint Laboratory of Animal Model and Drug Development, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Gal Richter-Levin
- Sagol Department of Neurobiology, Department of Psychology, University of Haifa, Haifa, Israel
- The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Israel
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Manzo C, Castagna A, Ruberto C, Ruotolo G. Does a steroid dementia syndrome really exist? A brief narrative review of what the literature highlights about the relationship between glucocorticoids and cognition. GERIATRIC CARE 2023. [DOI: 10.4081/gc.2022.10975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Glucocorticoids (GCs) may cause cognitive impairment through complex pathways involving specific receptors. In the human brain, hippocampal CA1 neurons exhibit the highest level of GCs receptors. Even the elderly expressed these receptors. The purpose of this brief review is to concentrate on the relationship between GCs and cognition in order to discuss the effects of the so-called steroid dementia in routine clinical practice.
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Chai AP, Chen XF, Xu XS, Zhang N, Li M, Li JN, Zhang L, Zhang D, Zhang X, Mao RR, Ding YQ, Xu L, Zhou QX. A Temporal Activity of CA1 Neurons Underlying Short-Term Memory for Social Recognition Altered in PTEN Mouse Models of Autism Spectrum Disorder. Front Cell Neurosci 2021; 15:699315. [PMID: 34335191 PMCID: PMC8319669 DOI: 10.3389/fncel.2021.699315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
Memory-guided social recognition identifies someone from previous encounters or experiences, but the mechanisms of social memory remain unclear. Here, we find that a short-term memory from experiencing a stranger mouse lasting under 30 min interval is essential for subsequent social recognition in mice, but that interval prolonged to hours by replacing the stranger mouse with a familiar littermate. Optogenetic silencing of dorsal CA1 neuronal activity during trials or inter-trial intervals disrupted short-term memory-guided social recognition, without affecting the ability of being sociable or long-term memory-guided social recognition. Postnatal knockdown or knockout of autism spectrum disorder (ASD)-associated phosphatase and tensin homolog (PTEN) gene in dorsal hippocampal CA1 similarly impaired neuronal firing rate in vitro and altered firing pattern during social recognition. These PTEN mice showed deficits in social recognition with stranger mouse rather than littermate and exhibited impairment in T-maze spontaneous alternation task for testing short-term spatial memory. Thus, we suggest that a temporal activity of dorsal CA1 neurons may underlie formation of short-term memory to be critical for organizing subsequent social recognition but that is possibly disrupted in ASD.
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Affiliation(s)
- An-Ping Chai
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
- The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Xue-Feng Chen
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
- School of Life Sciences, Yunnan University, Kunming, China
| | - Xiao-Shan Xu
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
| | - Na Zhang
- School of Life Sciences, Anhui University, Hefei, China
| | - Meng Li
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
| | - Jin-Nan Li
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
| | - Lei Zhang
- Department of Anatomy and Neurobiology, Tongji University School of Medicine, Shanghai, China
| | - Dai Zhang
- Institute of Mental Health, The Sixth Hospital of Peking University, Beijing, China
| | - Xia Zhang
- Department of Cellular and Molecular Medicine, Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON, Canada
| | - Rong-Rong Mao
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
| | - Yu-Qiang Ding
- Department of Anatomy and Neurobiology, Tongji University School of Medicine, Shanghai, China
| | - Lin Xu
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
- School of Life Sciences, Yunnan University, Kunming, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China
| | - Qi-Xin Zhou
- Key Laboratory of Animal Models and Human Disease Mechanisms, and Laboratory of Learning and Memory, and KIZ-SU Joint Laboratory of Animal Model and Drug Development, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, China
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Neurophysiologic Advance in Depressive Disorder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019. [PMID: 31784959 DOI: 10.1007/978-981-32-9271-0_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Enormous efforts for near half-century have harvested a plenty of understanding on major depressive disorder (MDD), although the underlying mechanisms are still elusive. The available antidepressants are far from satisfaction due to long-delay action (LDA) of antidepressant efficacy and low response rates in MDD patients. Notably, discovery of a single low-dose ketamine-producing rapid-onset and sustained antidepressant efficacy has inspired new research direction. These new studies have revealed ketamine's NMDAR-dependent and NMDAR-independent mechanisms, most of which are well known to be the key bases of synaptic plasticity as well as learning and memory. In fact, animal models of MDD are all based on the principle of learning and memory, i.e., the change of a behavior, for which monoaminergic and glutamatergic systems are the major modulators and executors, respectively. Reconsidering MDD as an aberrant form of emotion-related learning and memory would endow us a clearer research direction for developing new techniques or ways to prevent, diagnose, and treat MDD.
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Selegiline ameliorates depression-like behaviors in rodents and modulates hippocampal dopaminergic transmission and synaptic plasticity. Behav Brain Res 2019; 359:353-361. [DOI: 10.1016/j.bbr.2018.10.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/18/2018] [Accepted: 10/21/2018] [Indexed: 12/20/2022]
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Manzo C, Serra-Mestres J, Castagna A, Isetta M. Behavioral, Psychiatric, and Cognitive Adverse Events in Older Persons Treated with Glucocorticoids. MEDICINES (BASEL, SWITZERLAND) 2018; 5:E82. [PMID: 30071590 PMCID: PMC6163472 DOI: 10.3390/medicines5030082] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/26/2018] [Accepted: 07/30/2018] [Indexed: 01/22/2023]
Abstract
Background: Since the introduction of glucocorticoids (GCs) in the physician's pharmacological arsenal, it has been known that they are a cause of behavioral or psychiatric adverse events (BPAE), as well as of cognitive problems. To the best of our knowledge, the relationship between these adverse events and GCs in older persons has never been evaluated, except through case-reports or series with few cases. In this paper, a review of the literature regarding BPAEs and cognitive disorders in older people treated with CSs is undertaken. Methods: A comprehensive literature search for BPAEs was carried out on the three main bibliographic databases: EMBASE, MEDLINE and PsycINFO (NICE HDAS interface). Emtree terms were: Steroid, steroid therapy, mental disease, mania, delirium, agitation, depression, behavior change, dementia, major cognitive impairment, elderly. The search was restricted to all clinical studies and case reports with focus on the aged (65+ years) published in any language since 1998. Results: Data on the prevalence of the various BPAEs in older patients treated with GCs were very scarse, consisting mainly of case reports and of series with small numbers of patients. It was hence not possible to perform any statistical evaluation of the data (including meta-analysis). Amongst BPAEs, he possibility that delirium can be induced by GCs has been recently been questioned. Co-morbidities and polypharmacy were additional risk factors for BPAEs in older persons. Conclusions: Data on BPAEs in older persons treated with GCs, have several unmet needs that need to be further evaluated with appropriately designed studies.
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Affiliation(s)
- Ciro Manzo
- Rheumatologic Outpatient Clinic and Geronthorheumatologic Service, 80065 Sant'Agnello, Italy.
- Center for Cognitive Diseases and Dementias, 80038-ASL Napoli 3 Sud Pomigliano d'Arco, Italy.
| | - Jordi Serra-Mestres
- Department of Old Age Psychiatry, Central and North West London NHS Foundation Trust, London UB8 3NN, UK.
| | - Alberto Castagna
- Center for cognitive diseases and dementias, Catanzaro lido, ASP Catanzaro, 88100 Catanzaro, Italy.
| | - Marco Isetta
- Library and Knowledge services, Central and North West London NHS Foundation Trust, London UB8 3NN, UK.
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Abstract
Stress is associated with major depressive disorder (MDD), but the underlying mechanism remains elusive. However, some experiences, referred to as stress, may actually lead to resilience. It is thus critical first to define what type of stress may lead to MDD. Long-term potentiation (LTP) and long-term depression (LTD) are both sensitive to stress, but particularly to inescapable and not escapable stress. Thus, these are the psychological aspects of stress which contribute to the development of MDD, but by which mechanisms remains still elusive. Interestingly, the same stress may facilitate LTD and impair LTP in the CA1 region. In addition, repeated efforts are often required for learning under neutral conditions but single- or few learning trials are sufficient for forming stress-related memories. If LTP is crucial for normal learning, a combination of limited LTP and facilitated LTD appears to have higher efficiency for storing stress-related memories. Chronic psychological stress may cause a hyper-link among stress-related memories across the spatiotemporal due to shared quality of inescapability, leading to automatically negative appraisal through memory generalization mechanisms in MDD patients when encountering new distinct events which are perceived to share such similarity with previous experiences.
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The interhemispheric CA1 circuit governs rapid generalisation but not fear memory. Nat Commun 2017; 8:2190. [PMID: 29259187 PMCID: PMC5736595 DOI: 10.1038/s41467-017-02315-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 11/20/2017] [Indexed: 12/30/2022] Open
Abstract
Encoding specificity theory predicts most effective recall by the original conditions at encoding, while generalization endows recall flexibly under circumstances which deviate from the originals. The CA1 regions have been implicated in memory and generalization but whether and which locally separated mechanisms are involved is not clear. We report here that fear memory is quickly formed, but generalization develops gradually over 24 h. Generalization but not fear memory is impaired by inhibiting ipsilateral (ips) or contralateral (con) CA1, and by optogenetic silencing of the ipsCA1 projections onto conCA1. By contrast, in vivo fEPSP recordings reveal that ipsCA1–conCA1 synaptic efficacy is increased with delay over 24 h when generalization is formed but it is unchanged if generalization is disrupted. Direct excitation of ipsCA1–conCA1 synapses using chemogenetic hM3Dq facilitates generalization formation. Thus, rapid generalization is an active process dependent on bilateral CA1 regions, and encoded by gradual synaptic learning in ipsCA1–conCA1 circuit. Previous work has documented a slow form of memory generalization although a rapid one is demanded. Here the authors elucidate the role of the interhemispheric CA1-CA1 projection in a form of rapid generalization of contextual fear memory via gradual potentiation of these synapses over 24 h.
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Juvenile adversity and adult threat controllability in translational models of stress-related disorders. Curr Opin Behav Sci 2017. [DOI: 10.1016/j.cobeha.2017.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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10
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Ivanova OY, Dobryakova YV, Salozhin SV, Aniol VA, Onufriev MV, Gulyaeva NV, Markevich VA. Lentiviral Modulation of Wnt/β-Catenin Signaling Affects In Vivo LTP. Cell Mol Neurobiol 2016; 37:1227-1241. [PMID: 28012021 DOI: 10.1007/s10571-016-0455-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 12/16/2016] [Indexed: 12/16/2022]
Abstract
Wnt signaling is involved in hippocampal development and synaptogenesis. Numerous recent studies have been focused on the role of Wnt ligands in the regulation of synaptic plasticity. Inhibitors and activators of canonical Wnt signaling were demonstrated to decrease or increase, respectively, in vitro long-term potentiation (LTP) maintenance in hippocampal slices (Chen et al. in J Biol Chem 281:11910-11916, 2006; Vargas et al. in J Neurosci 34:2191-2202, 2014, Vargas et al. in Exp Neurol 264:14-25, 2015). Using lentiviral approach to down- and up-regulate the canonical Wnt signaling, we explored whether Wnt/β-catenin signaling is critical for the in vivo LTP. Chronic suppression of Wnt signaling induced an impairment of in vivo LTP expression 14 days after lentiviral suspension injection, while overexpression of Wnt3 was associated with a transient enhancement of in vivo LTP magnitude. Both effects were related to the early phase LTP and did not affect LTP maintenance. A loss-of-function study demonstrated decreased initial paired pulse facilitation ratio, β-catenin, and phGSK-3β levels. A gain-of-function study revealed not only an increase in PSD-95, β-catenin, and Cyclin D1 protein levels, but also a reduced phGSK-3β level and enhanced GSK-3β kinase activity. These results suggest a presynaptic dysfunction predominantly underlying LTP impairment while postsynaptic modifications are primarily involved in transient LTP amplification. This study is the first demonstration of the involvement of Wnt/β-catenin signaling in synaptic plasticity regulation in an in vivo LTP model.
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Affiliation(s)
- Olga Ya Ivanova
- Neurophysiology of Learning Lab, Functional Biochemistry of the Nervous System Lab, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Butlerova Str. 5a, 117485, Moscow, Russian Federation.
| | - Yulia V Dobryakova
- Neurophysiology of Learning Lab, Functional Biochemistry of the Nervous System Lab, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Butlerova Str. 5a, 117485, Moscow, Russian Federation
| | - Sergey V Salozhin
- Neurophysiology of Learning Lab, Functional Biochemistry of the Nervous System Lab, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Butlerova Str. 5a, 117485, Moscow, Russian Federation
| | - Viktor A Aniol
- Neurophysiology of Learning Lab, Functional Biochemistry of the Nervous System Lab, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Butlerova Str. 5a, 117485, Moscow, Russian Federation
| | - Mikhail V Onufriev
- Neurophysiology of Learning Lab, Functional Biochemistry of the Nervous System Lab, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Butlerova Str. 5a, 117485, Moscow, Russian Federation
| | - Natalia V Gulyaeva
- Neurophysiology of Learning Lab, Functional Biochemistry of the Nervous System Lab, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Butlerova Str. 5a, 117485, Moscow, Russian Federation
| | - Vladimir A Markevich
- Neurophysiology of Learning Lab, Functional Biochemistry of the Nervous System Lab, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Butlerova Str. 5a, 117485, Moscow, Russian Federation
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Zhao W, Yang W, Zheng S, Hu Q, Qiu P, Huang X, Hong X, Lan F. A new bioinformatic insight into the associated proteins in psychiatric disorders. SPRINGERPLUS 2016; 5:1967. [PMID: 27917343 PMCID: PMC5108746 DOI: 10.1186/s40064-016-3655-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 11/04/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Psychiatric diseases severely affect the quality of patients' lives and bring huge economic pressure to their families. Also, the great phenotypic variability among these patients makes it difficult to investigate the pathogenesis. Nowadays, bioinformatics is hopeful to be used as an effective tool for the diagnosis of psychiatric disorders, which can identify sensitive biomarkers and explore associated signaling pathways. METHODS In this study, we performed an integrated bioinformatic analysis on 1945 mental-associated proteins including 91 secreted proteins and 593 membrane proteins, which were screened from the Universal Protein Resource (Uniport) database. Then the function and pathway enrichment analyses, ontological classification, and constructed PPI network were executed. RESULTS Our present study revealed that the majority of mental proteins were closely related to metabolic processes and cellular processes. We also identified some significant molecular biomarkers in the progression of mental disorders, such as HRAS, ALS2, SLC6A1, SLC39A12, SIL1, IDUA, NEPH2 and XPO1. Furthermore, it was found that hub proteins, such as COMT, POMC, NPS and BDNF, might be the potential targets for mental disorders therapy. Finally, we demonstrated that psychiatric disorders may share the same signaling pathways with cancers, involving ESR1, BCL2 and MAPK3. CONCLUSION Our data are expected to contribute to explaining the possible mechanisms of psychiatric diseases and providing a useful reference for the diagnosis and therapy of them.
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Affiliation(s)
- Wenlong Zhao
- Department of Neurology, Affiliated Dongfang Hospital of Xiamen University (Fuzhou General Hospital), Fuzhou, Fujian People's Republic of China
| | - Wenjing Yang
- Department of Neurology, Affiliated Dongfang Hospital of Xiamen University (Fuzhou General Hospital), Fuzhou, Fujian People's Republic of China
| | - Shuanglin Zheng
- Department of Neurology, Affiliated Dongfang Hospital of Xiamen University (Fuzhou General Hospital), Fuzhou, Fujian People's Republic of China
| | - Qiong Hu
- Department of Neurology, Affiliated Dongfang Hospital of Xiamen University (Fuzhou General Hospital), Fuzhou, Fujian People's Republic of China
| | - Ping Qiu
- Department of Neurology, Affiliated Dongfang Hospital of Xiamen University (Fuzhou General Hospital), Fuzhou, Fujian People's Republic of China
| | - Xinghua Huang
- Department of Clinical Genetics and Experimental Medicine, Fuzhou General Hospital, No. 156, Xier Huan Road, Gulou District, Fuzhou, 350025 Fujian People's Republic of China
| | - Xiaoqian Hong
- Department of Neurology, Affiliated Dongfang Hospital of Xiamen University (Fuzhou General Hospital), Fuzhou, Fujian People's Republic of China
| | - Fenghua Lan
- Department of Clinical Genetics and Experimental Medicine, Fuzhou General Hospital, No. 156, Xier Huan Road, Gulou District, Fuzhou, 350025 Fujian People's Republic of China
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