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Brand K, Mellick W, Tolliver B, Prisciandaro JJ. A sense of urgency: Trait impulsivity in co-occurring bipolar and alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39198886 DOI: 10.1111/acer.15430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 08/06/2024] [Accepted: 08/08/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Bipolar disorder (BD) and alcohol use disorder (AUD) often co-occur, with BD + AUD characterized by higher levels of impulsivity relative to either disorder alone. Emotional facets of impulsivity (e.g., "urgency," measured by the UPPS-P), however, remain underexplored in this population and could have distinct associations with clinical correlates. METHODS This cross-sectional study used a two-by-two (BDxAD) factorial design, including groups with BD + AD (n = 28), BD (n = 29), AD (n = 28), and healthy controls (HC) (n = 27), to identify between-group differences among the five subscales of the UPPS-P. Associations of UPPS-P subscales with Barratt Impulsiveness Scale (BIS) total scores and clinical variables of interest were also examined. RESULTS BD + AD had the highest scores for every UPPS-P subscale but Sensation Seeking, with the Positive and Negative Urgency subscales having the largest main effects for both BD and AD. BIS-11 total scores were most correlated with the urgency subscales of the UPPS-P. Negative Urgency was found to be uniquely relevant to clinical measures in the BD + AD group. Rapid cycling was associated with both urgency subscales and BIS-11 scores, and the Alcohol Dependence Scale was most correlated with the Premeditation subscale. LIMITATIONS Cross sectional design and predominantly white sample. CONCLUSIONS Unlike the BIS-11, UPPS-P is able to distinguish emotional from nonemotional facets of impulsivity, something especially relevant to people with co-occurring BD + AD, where fluid emotionality is a key part of symptom presentation. For this reason, the UPPS-P should be utilized in future studies and clinical settings measuring trait impulsivity in this population.
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Affiliation(s)
- Kaiya Brand
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, South Carolina, USA
| | - William Mellick
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Bryan Tolliver
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, South Carolina, USA
| | - James J Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, South Carolina, USA
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2
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Ueno F, Sakuma M, Nakajima S, Tsugawa S, Ochi R, Tani H, Noda Y, Graff-Guerrero A, Uchida H, Mimura M, Oshima S, Matsushita S. Acetaldehyde-mediated increase in glutamatergic and N-acetylaspartate neurometabolite levels in the midcingulate cortex of ALDH2*1/*2 heterozygous young adults. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:58-71. [PMID: 38206287 DOI: 10.1111/acer.15231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND To elucidate the neurobiology underlying alcohol's effect on the human brain, we examined the acute effects of moderate alcohol administration on levels of glutamatergic neurometabolites and N-acetylaspartate, an amino acid found in neurons, may reflect disordered neuronal integrity. METHODS Eighteen healthy Japanese participants (7 males/11 females) aged 20-30 years who were heterozygous for an inactive allele of acetaldehyde dehydrogenase-2 (ALDH/*1/*2) were included. Participants underwent an intravenous alcohol infusion using the clamp method at a target blood alcohol concentration (BAC) of 0.50 mg/mL for 90 min within a range of ±0.05 mg/mL. We examined glutamate + glutamine (Glx) and N-acetylaspartate N-acetylaspartylglutamate (NAA) levels in the midcingulate cortex (MCC) using 3 T 1 H-MRS PRESS at baseline, 90 min, and 180 min (i.e., 90 min after alcohol infusion was finished). A two-way repeated-measures analysis of variance was used to assess longitudinal changes in Glx and NAA levels, with time and sex as within- and between-subject factors, respectively. Pearson's correlation coefficients were calculated among neurometabolite levels and BAC or blood acetaldehyde concentration (BAAC). RESULTS Both Glx (F(2,32) = 8.15, p = 0.004, η2 = 0.15) and NAA (F(2,32) = 5.01, p = 0.04, η2 = 0.07) levels were increased after alcohol injection. There were no sex or time × sex interaction effects observed. NAA levels were positively correlated with BAAC at 90 min (r(13) = 0.77, p = 0.01). There were no associations between neurometabolite levels and BAC. CONCLUSIONS Both Glx and NAA levels in the MCC increased in response to the administration of moderate concentrations of alcohol. Given positive associations between NAA levels and BAAC and the hypothetical glutamate release via dopamine pathways, the effects of drinking on the MCC in the acute phase may be ascribed to acetaldehyde metabolized from alcohol.
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Affiliation(s)
- Fumihiko Ueno
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | | | - Shinichiro Nakajima
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sakiko Tsugawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ryo Ochi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Tani
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ariel Graff-Guerrero
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shunji Oshima
- Sustainable Technology Laboratories, Asahi Quality and Innovations, Ltd., Moriya, Japan
| | - Sachio Matsushita
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
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3
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Wang S, Fang X, Wen X, Yang C, Yang Y, Zhang T. Prioritization of risk genes for Alzheimer's disease: an analysis framework using spatial and temporal gene expression data in the human brain based on support vector machine. Front Genet 2023; 14:1190863. [PMID: 37867597 PMCID: PMC10587557 DOI: 10.3389/fgene.2023.1190863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023] Open
Abstract
Background: Alzheimer's disease (AD) is a complex disorder, and its risk is influenced by multiple genetic and environmental factors. In this study, an AD risk gene prediction framework based on spatial and temporal features of gene expression data (STGE) was proposed. Methods: We proposed an AD risk gene prediction framework based on spatial and temporal features of gene expression data. The gene expression data of providers of different tissues and ages were used as model features. Human genes were classified as AD risk or non-risk sets based on information extracted from relevant databases. Support vector machine (SVM) models were constructed to capture the expression patterns of genes believed to contribute to the risk of AD. Results: The recursive feature elimination (RFE) method was utilized for feature selection. Data for 64 tissue-age features were obtained before feature selection, and this number was reduced to 19 after RFE was performed. The SVM models were built and evaluated using 19 selected and full features. The area under curve (AUC) values for the SVM model based on 19 selected features (0.740 [0.690-0.790]) and full feature sets (0.730 [0.678-0.769]) were very similar. Fifteen genes predicted to be risk genes for AD with a probability greater than 90% were obtained. Conclusion: The newly proposed framework performed comparably to previous prediction methods based on protein-protein interaction (PPI) network properties. A list of 15 candidate genes for AD risk was also generated to provide data support for further studies on the genetic etiology of AD.
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Affiliation(s)
- Shiyu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Xixian Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Xiang Wen
- Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Beijing, China
| | - Congying Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Ying Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Tianxiao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- National Anti-Drug Laboratory Shaanxi Regional Center, Xi’an, China
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4
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Simmonite M, Steeby CJ, Taylor SF. Medial Frontal Cortex GABA Concentrations in Psychosis Spectrum and Mood Disorders: A Meta-analysis of Proton Magnetic Resonance Spectroscopy Studies. Biol Psychiatry 2023; 93:125-136. [PMID: 36335069 PMCID: PMC10184477 DOI: 10.1016/j.biopsych.2022.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Abnormalities of GABAergic (gamma-aminobutyric acidergic) systems may play a role in schizophrenia and mood disorders. Magnetic resonance spectroscopy allows for noninvasive in vivo quantification of GABA; however, studies of GABA in schizophrenia have yielded inconsistent findings. This may stem from grouping together disparate voxels from functionally heterogeneous regions. METHODS We searched PubMed for magnetic resonance spectroscopy studies of GABA in the medial frontal cortex (MFC) in patients with schizophrenia, bipolar disorder, and depression and in individuals meeting criteria for ultra-high risk for psychosis. Voxel placements were classified as rostral-, rostral-mid-, mid-, or posterior MFC, and meta-analyses were conducted for each group for each subregion. RESULTS Of 341 screened articles, 23 studies of schizophrenia, 6 studies of bipolar disorder, 20 studies of depression, and 7 studies of ultra-high risk met the inclusion criteria. Meta-analysis revealed lower mid- (standardized mean difference [SMD] = -0.28, 95% CI, -0.48 to -0.07, p < .01) and posterior (SMD = -0.29, 95% CI, -0.49 to -0.09, p < .01) MFC GABA in schizophrenia and increased rostral MFC GABA in bipolar disorder (SMD = 0.76, 95% CI, 0.25 to -1.25, p < .01). In depression, reduced rostral MFC GABA (SMD = -0.36, 95% CI, -0.64 to -0.08, p = .01) did not survive correction for multiple comparisons. We found no evidence for GABA differences in individuals at ultra-high risk for psychosis. CONCLUSIONS While limited by small numbers of published studies, these results substantiate the relevance of GABA in the pathophysiology of psychosis spectrum and mood disorders and underline the importance of voxel placement.
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Affiliation(s)
- Molly Simmonite
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Department of Psychology, University of Michigan, Ann Arbor, Michigan.
| | - Clara J Steeby
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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Chabert J, Allauze E, Pereira B, Chassain C, De Chazeron I, Rotgé JY, Fossati P, Llorca PM, Samalin L. Glutamatergic and N-Acetylaspartate Metabolites in Bipolar Disorder: A Systematic Review and Meta-Analysis of Proton Magnetic Resonance Spectroscopy Studies. Int J Mol Sci 2022; 23:ijms23168974. [PMID: 36012234 PMCID: PMC9409038 DOI: 10.3390/ijms23168974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/26/2022] Open
Abstract
The exact neurobiological mechanisms of bipolar disorder (BD) remain unknown. However, some neurometabolites could be implicated, including Glutamate (Glu), Glutamine (Gln), Glx, and N-acetylaspartate (NAA). Proton Magnetic Resonance Spectroscopy (1H-MRS) allows one to quantify these metabolites in the human brain. Thus, we conducted a systematic review and meta-analysis of the literature to compare their levels between BD patients and healthy controls (HC). The main inclusion criteria for inclusion were 1H-MRS studies comparing levels of Glu, Gln, Glx, and NAA in the prefrontal cortex (PFC), anterior cingulate cortex (ACC), and hippocampi between patients with BD in clinical remission or a major depressive episode and HC. Thirty-three studies were included. NAA levels were significantly lower in the left white matter PFC (wmPFC) of depressive and remitted BD patients compared to controls and were also significantly higher in the left dorsolateral PFC (dlPFC) of depressive BD patients compared to HC. Gln levels were significantly higher in the ACC of remitted BD patients compared to in HC. The decreased levels of NAA of BD patients may be related to the alterations in neuroplasticity and synaptic plasticity found in BD patients and may explain the deep white matter hyperintensities frequently observed via magnetic resonance imagery.
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Affiliation(s)
- Jonathan Chabert
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
- Correspondence: (J.C.); (L.S.); Tel.: +33-4-73-752-124 (J.C. & L.S.)
| | - Etienne Allauze
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, Université Clermont Auvergne, 7 Place Henri Dunant, 63000 Clermont-Ferrand, France
| | - Carine Chassain
- Imaging Department, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, Clermont Auvergne INP, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Ingrid De Chazeron
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Jean-Yves Rotgé
- Service de Psychiatrie Adulte, Pitié-Salpêtrière Hospital, CNRS UMR 7593, 47-83 Bd de l’Hôpital, 75651 Paris, France
| | - Philippe Fossati
- Service de Psychiatrie Adulte, Pitié-Salpêtrière Hospital, CNRS UMR 7593, 47-83 Bd de l’Hôpital, 75651 Paris, France
| | - Pierre-Michel Llorca
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Ludovic Samalin
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
- Correspondence: (J.C.); (L.S.); Tel.: +33-4-73-752-124 (J.C. & L.S.)
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6
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Kirkland AE, Browning BD, Green R, Leggio L, Meyerhoff DJ, Squeglia LM. Brain metabolite alterations related to alcohol use: a meta-analysis of proton magnetic resonance spectroscopy studies. Mol Psychiatry 2022; 27:3223-3236. [PMID: 35508628 PMCID: PMC10578135 DOI: 10.1038/s41380-022-01594-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 11/08/2022]
Abstract
Alcohol misuse and alcohol use disorder (AlUD) have neurobiological consequences. This meta-analysis of proton magnetic resonance spectroscopy (MRS) studies aimed to assess the differences in brain metabolite levels in alcohol misuse and AUD relative to controls (PROSPERO registration: CRD42020209890). Hedge's g with random-effects modeling was used. Sub-group and meta-regression techniques explored potential sources of demographic and MRS parameter heterogeneity. A comprehensive literature review identified 43 studies, resulting in 69 models across gray and white matter (GM, WM). Lower N-acetylaspartate levels were found in frontal, anterior cingulate cortex (ACC), hippocampal, and cerebellar GM, and frontal and parietal WM, suggesting decreased neuronal and axonal viability. Lower choline-containing metabolite levels (all metabolites contributing to choline peak) were found in frontal, temporal, thalamic, and cerebellar GM, and frontal and parietal WM, suggesting membrane alterations related to alcohol misuse. Lower creatine-containing metabolite levels (Cr; all metabolites contributing to Cr peak) were found in temporal and occipital cortical GM, while higher levels were noted in midbrain/brainstem GM; this finding may have implications for using Cr as an internal reference. The lack of significant group differences in glutamate-related levels is possibly related to biological and methodological complexities. The few studies reporting on GABA found lower levels restricted to the ACC. Confounding variables were age, abstinence duration, treatment status, and MRS parameters (echo time, quantification type, data quality). This first meta-analysis of proton MRS studies consolidates the numerous individual studies to identify neurometabolite alterations within alcohol misuse and AUD. Future studies can leverage this new formalized information to investigate treatments that might effectively target the observed disturbances.
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Affiliation(s)
- Anna E Kirkland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Brittney D Browning
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - ReJoyce Green
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Lorenzo Leggio
- National Institutes of Health, NIDA and NIAAA, Baltimore, MD, USA
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California San Francisco and VA Medical Center, San Francisco, CA, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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7
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Tretyak V, Kirsch DE, Le V, Fromme K, Strakowski SM, Lippard ET. Coping drinking motives, neural functional coupling during emotion processing, and alcohol use in young adults with bipolar disorder. Alcohol Clin Exp Res 2022; 46:1482-1496. [PMID: 35702929 PMCID: PMC9478569 DOI: 10.1111/acer.14885] [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] [Received: 04/30/2021] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rates of alcohol use disorders in individuals with bipolar disorder are 3 to 5 times greater than in the general population and exceed rates of alcohol use disorders reported in other affective and anxiety disorders. Despite this high rate of comorbidity, our understanding of the psychosocial and neural mechanisms that underlie the initiation of alcohol misuse in young adults with bipolar disorder remains limited. Prior work suggests that individuals with bipolar disorder may misuse alcohol as a coping mechanism, yet the neural correlates of coping drinking motives and associated alcohol use have not been previously investigated in this population. METHODS Forty-eight young adults (22 bipolar disorder type I, 26 typically developing; 71% women; average age ± standard deviation = 22 ± 2 years) completed the Drinking Motives and Daily Drinking Questionnaires, and a Continuous Performance Functional magnetic resonance imaging (fMRI) Task with Emotional and Neutral Distracters. We calculated the relative difference in anterior cingulate cortex (ACC) functional coupling with the anterior insula and amygdala in response to emotional distracters compared with neutral stimuli and investigated the relations with coping drinking motives and alcohol use. RESULTS Across all participants, coping drinking motives were associated with greater quantity of recent alcohol use. In individuals with bipolar disorder, greater ACC-anterior insula functional coupling was associated with greater coping drinking motives, and greater quantity and frequency of recent alcohol use. The relative difference in ACC-anterior insula functional coupling was not associated with coping drinking motives or alcohol use in the typically developing group. Greater ACC-anterior insula functional coupling in individuals with bipolar disorder was also associated with greater anxiety symptoms and recent perceived psychological stress. Exploratory analyses suggest that the relations between ACC-anterior insula functional coupling and coping drinking motives may be confounded by anticonvulsant use. CONCLUSION Results suggest that a difference in ACC-anterior insula functional coupling during emotion processing may underlie alcohol use as a maladaptive coping mechanism in young adults with bipolar disorder.
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Affiliation(s)
- Valeria Tretyak
- Department of Psychiatry and Behavioral Sciences,
University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX,
USA,Waggoner Center for Alcohol and Addiction Research,
University of Texas, Austin, TX, USA
| | - Dylan E. Kirsch
- Department of Psychiatry and Behavioral Sciences,
University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research,
University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin,
TX, USA
| | - Vanessa Le
- Department of Psychiatry and Behavioral Sciences,
University of Texas, Austin, TX, USA
| | - Kim Fromme
- Department of Psychology, University of Texas, Austin, TX,
USA,Waggoner Center for Alcohol and Addiction Research,
University of Texas, Austin, TX, USA
| | - Stephen M. Strakowski
- Department of Psychiatry and Behavioral Sciences,
University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX,
USA,Waggoner Center for Alcohol and Addiction Research,
University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin,
TX, USA
| | - Elizabeth T.C. Lippard
- Department of Psychiatry and Behavioral Sciences,
University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX,
USA,Waggoner Center for Alcohol and Addiction Research,
University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin,
TX, USA,Institute of Early Life Adversity Research, University of
Texas, Austin, TX, USA
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Shyu C, Chavez S, Boileau I, Foll BL. Quantifying GABA in Addiction: A Review of Proton Magnetic Resonance Spectroscopy Studies. Brain Sci 2022; 12:918. [PMID: 35884725 PMCID: PMC9316447 DOI: 10.3390/brainsci12070918] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 02/04/2023] Open
Abstract
Gamma-aminobutyric acid (GABA) signaling plays a crucial role in drug reward and the development of addiction. Historically, GABA neurochemistry in humans has been difficult to study due to methodological limitations. In recent years, proton magnetic resonance spectroscopy (1H-MRS, MRS) has emerged as a non-invasive imaging technique that can detect and quantify human brain metabolites in vivo. Novel sequencing and spectral editing methods have since been developed to allow for quantification of GABA. This review outlines the clinical research utilization of 1H-MRS in understanding GABA neurochemistry in addiction and summarizes current literature that reports GABA measurements by MRS in addiction. Research on alcohol, nicotine, cocaine, and cannabis addiction all suggest medications that modulate GABA signaling may be effective in reducing withdrawal, craving, and other addictive behaviors. Thus, we discuss how improvements in current MRS techniques and design can optimize GABA quantification in future studies and explore how monitoring changes to brain GABA could help identify risk factors, improve treatment efficacy, further characterize the nature of addiction, and provide crucial insights for future pharmacological development.
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Affiliation(s)
- Claire Shyu
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada;
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (S.C.); (I.B.)
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Sofia Chavez
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (S.C.); (I.B.)
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, Division of Brain and Therapeutics, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Isabelle Boileau
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (S.C.); (I.B.)
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, Division of Brain and Therapeutics, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada;
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (S.C.); (I.B.)
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, Division of Brain and Therapeutics, University of Toronto, Toronto, ON M5T 1R8, Canada
- Centre for Addiction and Mental Health, Concurrent Outpatient Medical & Psychosocial Addiction Support Services, Toronto, ON M6J 1H4, Canada
- Centre for Addiction and Mental Health, Acute Care Program, Toronto, ON M6J 1H3, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Waypoint Centre for Mental Health Care, Waypoint Research Institute, 500 Church Street, Penetanguishene, ON L9M 1G3, Canada
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9
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Marinkovic K, Alderson Myers AB, Arienzo D, Sereno MI, Mason GF. Cortical GABA levels are reduced in young adult binge drinkers: Association with recent alcohol consumption and sex. Neuroimage Clin 2022; 35:103091. [PMID: 35753236 PMCID: PMC9240858 DOI: 10.1016/j.nicl.2022.103091] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/10/2022] [Accepted: 06/18/2022] [Indexed: 01/12/2023]
Abstract
Binge drinking refers to a pattern of alcohol intake that raises blood alcohol concentration to or above legal intoxication levels. It is common among young adults and is associated with health risks that scale up with alcohol intake. Acute intoxication depresses neural activity via complex signaling mechanisms by enhancing inhibition mediated by gamma-amino butyric acid (GABA), and by decreasing excitatory glutamatergic effects. Evidence primarily rooted in animal research indicates that the brain compensates for the acute depressant effects under the conditions of habitual heavy use. These neuroadaptive changes are reflected in neural hyperexcitability via downregulated inhibitory signaling, which becomes apparent as withdrawal symptoms. However, human evidence on the compensatory reduction in GABA signaling is scant. The neurochemical aspect of this mechanistic model was evaluated in the present study with proton magnetic resonance spectroscopy (1H-MRS) which is sensitive to GABA plus macromolecule signal (GABA + ). Furthermore, we examined sex differences in GABA + levels as a function of a recent history of binge drinking, given interactions between endogenous neurosteroids, GABA signaling, and alcohol. The study recruited young adult women and men (22.2 ± 2.8 years of age) who were classified as binge drinkers (BDs, N = 52) if they reported ≥ 5 binge episodes in the previous six months. Light drinkers (LDs, N = 49) reported drinking regularly, but not exceeding ≤ 2 binge episodes in the past six months. GABA-edited 1H-MR spectra were acquired from the occipital cortex at 3 T with the MEGA-PRESS sequence. GABA + signal was analyzed relative to water and total creatine (Cr) levels as a function of binge drinking history and sex. Controlling for within-voxel tissue composition, both GABA + indices showed decreased GABA + levels in BDs relative to LDs. The reduced GABA + concentration was associated with occasional high-intensity drinking in the BD group. This evidence is consistent with compensatory GABA downregulation that accompanies alcohol misuse, tipping the excitation/inhibition balance towards hyperexcitability. Analysis of the time course of GABA + neuroplasticity indicated that GABA + was lowest when measured one day after the last drinking occasion in BDs. While the BD vs LD differences were primarily driven by LD women, there was no interaction between Sex and a history of binge drinking. GABA + was higher in LD women compared to LD men. Aligned with the allostasis model, the mechanistic compensatory GABA downregulation observed in young emerging adults engaging in occasional binge drinking complements direct neural measures of hyperexcitability in BDs. Notably, these results suggest that neuroadaptation to alcohol is detectable at the levels of consumption that are within a normative range, and may contribute to adverse health outcomes.
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Affiliation(s)
- Ksenija Marinkovic
- Department of Psychology, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA; Department of Radiology, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA.
| | - Austin B Alderson Myers
- Department of Psychology, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA.
| | - Donatello Arienzo
- Department of Psychology, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Martin I Sereno
- Department of Psychology, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA.
| | - Graeme F Mason
- Department of Radiology and Biomedical Imaging, Department of Psychiatry, Department of Biomedical Engineering, Yale University, N-141 TAC-MRRC, 300 Cedar Street, New Haven, CT 06520, USA.
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10
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Prisciandaro JJ, Mellick W, Squeglia LM, Hix S, Arnold L, Tolliver BK. Results from a randomized, double-blind, placebo-controlled, crossover, multimodal-MRI pilot study of gabapentin for co-occurring bipolar and cannabis use disorders. Addict Biol 2022; 27:e13085. [PMID: 34390300 PMCID: PMC9104469 DOI: 10.1111/adb.13085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/29/2021] [Accepted: 07/23/2021] [Indexed: 01/03/2023]
Abstract
Disrupted brain gamma-aminobutyric acid (GABA)/glutamate homeostasis is a promising target for pharmacological intervention in co-occurring bipolar disorder (BD) and cannabis use disorder (CUD). Gabapentin is a safe and well-tolerated medication, FDA-approved to treat other neurological diseases, that restores GABA/glutamate homeostasis, with treatment studies supporting efficacy in treating CUD, as well as anxiety and sleep disorders that are common to both BD and CUD. The present manuscript represents the primary report of a randomized, double-blind, placebo-controlled, crossover (1-week/condition), multimodal-MRI (proton-MR spectroscopy, functional MRI) pilot study of gabapentin (1200 mg/day) in BD + CUD (n = 22). Primary analyses revealed that (1) gabapentin was well tolerated and adherence and retention were high, (2) gabapentin increased dorsal anterior cingulate cortex (dACC) and right basal ganglia (rBG) glutamate levels and (3) gabapentin increased activation to visual cannabis cues in the posterior midcingulate cortex (pMCC, a region involved in response inhibition to rewarding stimuli). Exploratory evaluation of clinical outcomes further found that in participants taking gabapentin versus placebo, (1) elevations of dACC GABA levels were associated with lower manic/mixed and depressive symptoms and (2) elevations of rBG glutamate levels and pMCC activation to cannabis cues were associated with lower cannabis use. Though promising, the findings from this study should be interpreted with caution due to observed randomization order effects on dACC glutamate levels and identification of statistical moderators that differed by randomization order (i.e. cigarette-smoking status on rBG glutamate levels and pMCC cue activation). Nonetheless, they provide the necessary foundation for a more robustly designed (urn-randomized, parallel-group) future study of adjuvant gabapentin for BD + CUD.
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Affiliation(s)
- James J Prisciandaro
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - William Mellick
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lindsay M Squeglia
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sara Hix
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lauren Arnold
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Bryan K Tolliver
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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11
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Chen T, Tan H, Lei H, Li X, Wu Q, Xu X, Ye Y, Zhong N, Du J, Jiang H, Su H, Zhao M. Nature of glutamate alterations in substance dependence: A systematic review and meta-analysis of proton magnetic resonance spectroscopy studies. Psychiatry Res Neuroimaging 2021; 315:111329. [PMID: 34271295 DOI: 10.1016/j.pscychresns.2021.111329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/19/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Animal studies have reported the brain glutamatergic dysfunction in substance dependence. However, proton magnetic resonance spectroscopy (1H-MRS) studies of glutamate in substance-dependent patients published contradicting results. In order to investigate the characteristics of brain glutamatergic alterations in substance-dependent patients, we conducted systematic reviews and meta-analyses of 1H-MRS studies that have investigated the glutamate, glutamine, and Glx (glutamate + glutamine) concentration in substance-dependent patients. Multiple databases were searched until Sep 10, 2020. Twenty-nine studies comprising 982 patients and 787 controls were included. There was significantly decreased glutamate level in dorsolateral prefrontal cortex in patients compared with controls. Higher glutamate levels in medial prefrontal cortex and basal ganglia region were also demonstrated in patients compared with controls. Subgroup analyses based on the substance type and abstinence period (short vs medium-term abstinence period) were performed. The results revealed Glx and glutamate concentrations in all investigated brain regions were not different in patients with any types of substance dependence compared with controls. The abstinence period had no effect on the glutamate levels. In summary, substance dependence is associated with glutamatergic dysfunction of prefrontal cortex and basal ganglia. Present findings partially support the hypothesis that addiction is associated with abnormal brain glutamatergic neurotransmission.
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Affiliation(s)
- Tianzhen Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Haoye Tan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Huiting Lei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Xiaotong Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Qianying Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Xiaomin Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Yujian Ye
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China.
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12
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Prisciandaro JJ, Hoffman M, Brown TR, Voronin K, Book S, Bristol E, Anton RF. Effects of Gabapentin on Dorsal Anterior Cingulate Cortex GABA and Glutamate Levels and Their Associations With Abstinence in Alcohol Use Disorder: A Randomized Clinical Trial. Am J Psychiatry 2021; 178:829-837. [PMID: 34256607 PMCID: PMC9161238 DOI: 10.1176/appi.ajp.2021.20121757] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although gabapentin has demonstrated efficacy in mitigating alcohol withdrawal symptoms and preventing relapse drinking in individuals with alcohol use disorder (AUD), the neurobiological mechanisms of action underlying these therapeutic effects remain unknown. The present study evaluated changes in GABA and glutamate levels in the dorsal anterior cingulate cortex (dACC) as candidate mechanisms of action. METHODS In a 16-week randomized clinical trial, 68 adults with AUD, including a history of alcohol withdrawal syndrome, received 1,200 mg/day of gabapentin (N=37) or placebo (N=31) and nine medical management visits after ≥72 hours of abstinence. Proton MR spectroscopy (1H-MRS) estimates of dACC levels of GABA (N=67) and glutamate (N=64) were acquired before start of treatment and again approximately 14 days after randomization. Percent days abstinent was reported via timeline followback interview. RESULTS The effects of gabapentin on GABA and glutamate levels were significantly associated with participants' percent days abstinent during early treatment. Specifically, gabapentin was associated with greater increases in glutamate and greater decreases in GABA levels in participants who remained mostly or entirely abstinent, and yet the opposite in participants who drank on more than half of the days preceding the second scan. Furthermore, gabapentin-treated participants with greater increases in glutamate levels during early treatment had significantly more percent days abstinent across the remainder of the study, relative to placebo-treated participants. CONCLUSIONS In addition to providing insight into the mechanisms through which gabapentin may promote abstinence in individuals with AUD, this study also provides evidence for a biomarker of efficacious treatment that may be used to evaluate other glutamatergic or GABAergic medications for AUD and related conditions.
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Affiliation(s)
- James J. Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC, Corresponding author,
| | - Michaela Hoffman
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Truman R. Brown
- Department of Radiology, Medical University of SC, Charleston, SC
| | - Konstantin Voronin
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Sarah Book
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Emily Bristol
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
| | - Raymond F. Anton
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of SC, Charleston, SC
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13
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Jiménez-Balado J, Eich TS. GABAergic dysfunction, neural network hyperactivity and memory impairments in human aging and Alzheimer's disease. Semin Cell Dev Biol 2021; 116:146-159. [PMID: 33573856 PMCID: PMC8292162 DOI: 10.1016/j.semcdb.2021.01.005] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/25/2021] [Accepted: 01/30/2021] [Indexed: 02/07/2023]
Abstract
In this review, we focus on the potential role of the γ-aminobutyric acidergic (GABAergic) system in age-related episodic memory impairments in humans, with a particular focus on Alzheimer's disease (AD). Well-established animal models have shown that GABA plays a central role in regulating and synchronizing neuronal signaling in the hippocampus, a brain area critical for episodic memory that undergoes early and significant morphologic and functional changes in the course of AD. Neuroimaging research in humans has documented hyperactivity in the hippocampus and losses of resting state functional connectivity in the Default Mode Network, a network that itself prominently includes the hippocampus-presaging episodic memory decline in individuals at-risk for AD. Apolipoprotein ε4, the highest genetic risk factor for AD, is associated with GABAergic dysfunction in animal models, and episodic memory impairments in humans. In combination, these findings suggest that GABA may be the linchpin in a complex system of factors that eventually leads to the principal clinical hallmark of AD: episodic memory loss. Here, we will review the current state of literature supporting this hypothesis. First, we will focus on the molecular and cellular basis of the GABAergic system and its role in memory and cognition. Next, we report the evidence of GABA dysregulations in AD and normal aging, both in animal models and human studies. Finally, we outline a model of GABAergic dysfunction based on the results of functional neuroimaging studies in humans, which have shown hippocampal hyperactivity to episodic memory tasks concurrent with and even preceding AD diagnosis, along with factors that may modulate this association.
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Affiliation(s)
- Joan Jiménez-Balado
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Teal S Eich
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA.
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14
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Yang D, Chen J, Cheng X, Cao B, Chang H, Li X, Yang C, Wu Q, Sun J, Manry D, Pan Y, Dong Y, Li J, Xu T, Cao L. SERINC2 increases the risk of bipolar disorder in the Chinese population. Depress Anxiety 2021; 38:985-995. [PMID: 34288243 DOI: 10.1002/da.23186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/28/2021] [Accepted: 05/22/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although common variants in a large collection of patients are associated with increased risk for bipolar disorder (BD), studies have only been able to predict 25%-45% of risks, suggesting that lots of variants that contribute to the risk for BD haven't been identified. Our study aims to identify novel BD risk genes. METHODS We performed whole-exome sequencing of 27 individuals from 6 BD multi-affected Chinese families to identify candidate variants. Targeted sequencing of one of the novel risk genes, SERINC2, in additional sporadic 717 BD patients and 312 healthy controls (HC) validated the association. Magnetic resonance imaging (MRI) were performed to evaluate the effect of the variant to brain structures from 213 subjects (4 BD subjects from a multi-affected family, 130 sporadic BD subjects and 79 HC control). RESULTS BD pedigrees had an increased burden of uncommon variants in extracellular matrix (ECM) and calcium ion binding. By large-scale sequencing we identified a novel recessive BD risk gene, SERINC2, which plays a role in synthesis of sphingolipid and phosphatidylserine (PS). MRI image results show the homozygous nonsense variant in SERINC2 affects the volume of white matter in cerebellum. CONCLUSIONS Our study identified SERINC2 as a risk gene of BD in the Chinese population.
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Affiliation(s)
- Dong Yang
- Team for Growth Control and Size Innovative Research, Westlake University, Hangzhou, Zhejiang, China.,Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
| | - Jianshan Chen
- Guangzhou Huiai Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiongchao Cheng
- Department of Clinical Psychology, Nanning Fifth People's Hospital, Nanning, Guangxi, China
| | - Bo Cao
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Hao Chang
- Howard Hughes Medical Institute, Department of Genetics, Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Xuan Li
- Guangzhou Huiai Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chanjuan Yang
- Guangzhou Huiai Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qiuxia Wu
- Guangzhou Huiai Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiaqi Sun
- Guangzhou Huiai Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Diane Manry
- Howard Hughes Medical Institute, Department of Genetics, Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yukun Pan
- Howard Hughes Medical Institute, Department of Genetics, Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA.,Yeda Research Institute of Gene and Cell Therapy, Taizhou, Zhejiang, China
| | - Yongli Dong
- Howard Hughes Medical Institute, Department of Genetics, Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jiaojiao Li
- Team for Growth Control and Size Innovative Research, Westlake University, Hangzhou, Zhejiang, China.,Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
| | - Tian Xu
- Team for Growth Control and Size Innovative Research, Westlake University, Hangzhou, Zhejiang, China.,Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.,Howard Hughes Medical Institute, Department of Genetics, Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Liping Cao
- Guangzhou Huiai Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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15
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Grecco GG, Chumin EJ, Dzemidzic M, Cheng H, Finn P, Newman S, Dydak U, Yoder KK. Anterior cingulate cortex metabolites and white matter microstructure: a multimodal study of emergent alcohol use disorder. Brain Imaging Behav 2021; 15:2436-2444. [PMID: 34097282 DOI: 10.1007/s11682-020-00443-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/17/2020] [Accepted: 12/28/2020] [Indexed: 12/27/2022]
Abstract
Multimodal imaging is increasingly used to address neuropathology associated with alcohol use disorder (AUD). Few studies have investigated relationships between metabolite concentrations and white matter (WM) integrity; currently, there are no such data in AUD. In this preliminary study, we used complementary neuroimaging techniques, magnetic resonance spectroscopy (MRS), and diffusion weighted imaging (DWI), to study AUD neurophysiology. We tested for relationships between metabolites in the dorsal anterior cingulate cortex (dACC) and adjacent WM microstructure in young adult AUD and control (CON) subjects. Sixteen AUD and fourteen CON underwent whole-brain DWI and MRS of the dACC. Outcomes were dACC metabolites, and diffusion tensor metrics of dACC-adjacent WM. Multiple linear regression terms included WM region, group, and region × group for prediction of dACC metabolites. dACC myo-inositol was positively correlated with axial diffusivity in the left anterior corona radiata (p < 0.0001) in CON but not AUD (group effect: p < 0.001; region × group: p < 0.001; Bonferroni-corrected). In the bilateral anterior corona radiata and right genu of the corpus callosum, glutamate was negatively related to mean diffusivity in AUD, but not CON subjects (all model terms: p < 0.05, uncorrected). In AUD subjects, dACC glutamate was negatively correlated with AUD symptom severity. This is likely the first integrative study of cortical metabolites and WM integrity in young individuals with AUD. Differential relationships between dACC metabolites and adjacent WM tract integrity in AUD could represent early consequences of hazardous drinking, and/or novel biomarkers of early-stage AUD. Additional studies are required to replicate these findings, and to determine the behavioral relevance of these results.
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Affiliation(s)
- Gregory G Grecco
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.,Medical Scientist Training Program, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Evgeny J Chumin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.,Indiana University Network Science Institute, Bloomington, IN, USA
| | - Mario Dzemidzic
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hu Cheng
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Peter Finn
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Sharlene Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Ulrike Dydak
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA.,School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Karmen K Yoder
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 West 16th Street, GH 4100, Indianapolis, IN, 46202, USA. .,Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA. .,Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
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16
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Anterior cingulate cortex neurometabolites in bipolar disorder are influenced by mood state and medication: A meta-analysis of 1H-MRS studies. Eur Neuropsychopharmacol 2021; 47:62-73. [PMID: 33581932 DOI: 10.1016/j.euroneuro.2021.01.096] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022]
Abstract
The anterior cingulate cortex (ACC), a brain region that mediates affect and cognition by connecting the frontal cortex to limbic structures, has been consistently implicated in the neurobiology of Bipolar Disorder (BD). Proton magnetic resonance spectroscopy (1H-MRS) studies have extensively compared in vivo neurometabolite levels of BD patients and healthy controls (HC) in the ACC. However, these studies have not been analyzed in a systematic review or meta-analysis and nor has the influence of mood state and medication on neurometabolites been examined in this cortical region. A systematic review and a meta-analysis of 1H-MRS studies comparing ACC neurometabolite profiles of adult BD patients and HC subjects was conducted, retrieving 27 articles published between 2000 and 2018. Overall increased ACC levels of Glx [glutamine (Gln) + glutamate)/Creatine], Gln, choline (Cho) and Cho/Creatine were found in BD compared to HC. Bipolar depression was associated with higher Cho levels, while euthymia correlated with higher glutamine (Gln) and Cho. Mood stabilizers appeared to affect ACC Glu and Gln metabolites. Increased ACC Cho observed in euthymia, depression and in medication-free groups could be considered a trait marker in BD and attributed to increased cell membrane phospholipid turnover. Overall increased ACC Glx was associated with elevated Gln levels, particularly influenced by euthymia, but no abnormality in Glu was detected. Further 1H-MRS studies, on other voxels, should assess more homogeneous (mood state-specific), larger BD samples and account for medication status using more sensitive 1H-MRS techniques.
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17
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Bart CP, Titone MK, Ng TH, Nusslock R, Alloy LB. Neural reward circuit dysfunction as a risk factor for bipolar spectrum disorders and substance use disorders: A review and integration. Clin Psychol Rev 2021; 87:102035. [PMID: 34020138 DOI: 10.1016/j.cpr.2021.102035] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/13/2021] [Accepted: 04/28/2021] [Indexed: 01/08/2023]
Abstract
Bipolar spectrum disorders (BSDs) and substance use disorders (SUDs) are associated with neural reward dysfunction. However, it is unclear what pattern of neural reward function underlies pre-existing vulnerability to BSDs and SUDs, or whether neural reward function explains their high co-occurrence. The current paper provides an overview of the separate literatures on neural reward sensitivity in BSDs and SUDs. We provide a systematic review of 35 studies relevant to identifying neural reward function vulnerability to BSDs and SUDs. These studies include those examining neural reward processing on a monetary reward task with prospective designs predicting initial onset of SUDs, familial risk studies that examine unaffected offspring or first-degree relatives of family members with BSDs or SUDs, and studies that examine individuals with BSDs or SUDs who are not currently in an episode of the disorder. Findings from the review highlight that aberrant responding and connectivity across neural regions associated with reward and cognitive control confers risk for the development of BSDs and SUDs. Discussion focuses on limitations of the extant literature. We conclude with an integration and theoretical model for understanding how aberrant neural reward responding may constitute a vulnerability to the development of both BSDs and SUDs.
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Affiliation(s)
- Corinne P Bart
- Department of Psychology, Temple University, Philadelphia, PA, United States of America
| | - Madison K Titone
- Department of Psychology, Temple University, Philadelphia, PA, United States of America
| | - Tommy H Ng
- Department of Psychology, Temple University, Philadelphia, PA, United States of America
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, IL, United States of America
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, PA, United States of America.
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18
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ACC Glu/GABA ratio is decreased in euthymic bipolar disorder I patients: possible in vivo neurometabolite explanation for mood stabilization. Eur Arch Psychiatry Clin Neurosci 2021; 271:537-547. [PMID: 31993746 DOI: 10.1007/s00406-020-01096-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 01/13/2020] [Indexed: 12/19/2022]
Abstract
Bipolar disorder (BD) is characterized by unstable mood states ranging from mania to depression. Although there is some evidence that mood instability may result from an imbalance between excitatory glutamatergic and inhibitory GABA-ergic neurotransmission, few proton magnetic resonance spectroscopy (1H-MRS) studies have measured these two neurometabolites simultaneously in BD. The enzyme glutamic acid decarboxylase (GAD1) catalyzes the decarboxylation of glutamate (Glu) to GABA, and its single nucleotide polymorphisms (SNPs) might influence Glu/GABA ratio. Thus, we investigated Glu/GABA ratio in the dorsal anterior cingulate cortex (dACC) of euthymic BD type I patients and healthy controls (HC), and assessed the influence of both mood stabilizers and GAD1 SNPs on this ratio. Eighty-eight subjects (50 euthymic BD type I patients and 38 HC) underwent 3T 1H-MRS in the dACC (2 × 2 × 4.5 cm3) using a two-dimensional JPRESS sequence and all subjects were genotyped for 4 SNPs in the GAD1 gene. BD patients had lower dACC Glu/GABA ratio compared to HC, where this was influenced by anticonvulsant and antipsychotic medications, but not lithium. The presence of GAD1 rs1978340 allele A was associated with higher Glu/GABA ratio in BD, while patients without this allele taking mood stabilizers had a lower Glu/GABA ratio. The lowering of dACC Glu/GABA could be one explanation for the mood stabilizing action of anticonvulsants and antipsychotics in BD type I euthymia. Therefore, this putative role of Glu/GABA ratio and the influence of GAD1 genotype interacting with mood stabilization medication should be confirmed by further studies involving larger samples and other mood states.ClincalTrials.gov registration: NCT01237158.
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Yang S, Lim KH, Kim SH, Joo JY. Molecular landscape of long noncoding RNAs in brain disorders. Mol Psychiatry 2021; 26:1060-1074. [PMID: 33173194 DOI: 10.1038/s41380-020-00947-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/28/2020] [Accepted: 10/27/2020] [Indexed: 02/08/2023]
Abstract
According to current paradigms, various risk factors, such as genetic mutations, oxidative stress, neural network dysfunction, and abnormal protein degradation, contribute to the progression of brain disorders. Through the cooperation of gene transcripts in biological processes, the study of noncoding RNAs can lead to insights into the cause and treatment of brain disorders. Recently, long noncoding RNAs (lncRNAs) which are longer than 200 nucleotides in length have been suggested as key factors in various brain disorders. Accumulating evidence suggests the potential of lncRNAs as diagnostic or prognostic biomarkers and therapeutic targets. High-throughput screening-based sequencing has been instrumental in identification of lncRNAs that demand new approaches to understanding the progression of brain disorders. In this review, we discuss the recent progress in the study of lncRNAs, and addresses the pathogenesis of brain disorders that involve lncRNAs and describes the associations of lncRNAs with neurodegenerative disorders such as Alzheimer disease (AD), Parkinson disease (PD), and neurodevelopmental disorders. We also discuss potential targets of lncRNAs and their promise as novel therapeutics and biomarkers in brain disorders.
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Affiliation(s)
- Sumin Yang
- Neurodegenerative Disease Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Key-Hwan Lim
- Neurodegenerative Disease Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Sung-Hyun Kim
- Neurodegenerative Disease Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Jae-Yeol Joo
- Neurodegenerative Disease Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea.
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20
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Tretyak V, Kirsch DE, Radpour S, Weber WA, Fromme K, Strakowski SM, Lippard ET. Subjective response to alcohol: Associated alcohol use and orbitofrontal gray matter volume in bipolar disorder. J Affect Disord 2021; 279:671-679. [PMID: 33190118 PMCID: PMC7812664 DOI: 10.1016/j.jad.2020.10.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/13/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Alcohol use disorders (AUDs) are highly prevalent in bipolar disorder, however the developmental etiology of this comorbidity remains unknown. Structural differences in the orbitofrontal cortex (OFC) have been linked to problematic drinking in bipolar disorder and typically developing youth, with evidence implicating variations in OFC in differential subjective response to alcohol in typical development. METHODS Subjective response to alcohol, recent alcohol use, impulsivity, and variation in OFC gray matter volume were investigated in 48 emerging adults (24 with bipolar disorder, 24 typically developing). On average 1.5 years later, drinking patterns were reassessed and relations between subjective response and changes in alcohol use were explored. RESULTS Groups did not differ in baseline alcohol use or subjective response. At baseline, decreased subjective response to alcohol was associated with increased alcohol use in both groups. Lower gray matter volume in medial OFC in bipolar disorder was associated with increased subjective response to alcohol, whereas lower gray matter volume in OFC in typically developing participants was associated with decreased subjective response to alcohol. Increase in alcohol use (baseline to follow-up) was associated with increased baseline subjective response to alcohol in bipolar disorder, and decreased baseline subjective response in the typically developing group. LIMITATIONS Preliminary study with a small sample size. CONCLUSION Underlying OFC biology may contribute to differences in alcohol sensitivity in bipolar disorder which may also relate to prospective changes in alcohol use patterns. Future studies are needed to examine how these factors prospectively relate to development of AUDs in bipolar disorder.
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Affiliation(s)
- Valeria Tretyak
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA
| | - Dylan E. Kirsch
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA
| | - Sepeadeh Radpour
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Wade A. Weber
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Kim Fromme
- Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA
| | - Stephen M. Strakowski
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA
| | - Elizabeth T.C. Lippard
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA,Institute of Early Life Adversity Research, University of Texas, Austin, TX, USA
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21
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Diederichs C, DeMayo MM, Cole J, Yatham LN, Harris AD, McGirr A. Intermittent Theta-Burst Stimulation Transcranial Magnetic Stimulation Increases GABA in the Medial Prefrontal Cortex: A Preliminary Sham-Controlled Magnetic Resonance Spectroscopy Study in Acute Bipolar Depression. Front Psychiatry 2021; 12:665402. [PMID: 34045983 PMCID: PMC8144302 DOI: 10.3389/fpsyt.2021.665402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/12/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Magnetic resonance spectroscopy (MRS) has been used to identify gamma-aminobutyric acid (GABA) alterations in mood disorders, particularly in the medial prefrontal cortex (mPFC) where decreased concentrations have been associated with anhedonia. In major depressive disorder (MDD), prior work suggests that repetitive transcranial magnetic stimulation (rTMS) increases mPFC GABA concentrations proportional to antidepressant response. To our knowledge, this has not been examined in acute bipolar depression. Methods: As part of a multicentre 4-week randomized, double-blind, sham-controlled trial using intermittent theta-burst stimulation (iTBS) of the left dorsolateral prefrontal cortex (DLPFC) in individuals with acute bipolar depression, we quantified mPFC GABA and Glx (glutamate+glutamine) concentrations using a 3T MRS scan at baseline and after the intervention. Depressive symptoms were measured using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale-17 (HRDS-17), and anhedonia was measured using the Snaith-Hamilton Pleasure Scale (SHAPS). Results: The trial was terminated for futility and magnetic resonance spectroscopy data was acquired for 18 participants. At baseline, there were no associations between GABA or Glx concentrations and anhedonia, however GABA was negative correlated with depressive symptom severity on the HRDS-17. Compared to the sham-iTBS group, participants receiving active-iTBS had a significant increase in mPFC GABA concentrations. This was unrelated to antidepressant outcomes or improvements in anhedonia. Conclusion: Our data suggests that iTBS targeting the DLPFC is associated with physiological changes in the mPFC. In acute bipolar depression, our preliminary data suggests that mPFC GABA is dissociated from antidepressant iTBS treatment outcomes and anhedonia.
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Affiliation(s)
- Chad Diederichs
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Marilena M DeMayo
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.,Department of Radiology, University of Calgary, Calgary, AB, Canada.,Child and Adolescent Imaging Research Program, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jaeden Cole
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Ashley D Harris
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Department of Radiology, University of Calgary, Calgary, AB, Canada.,Child and Adolescent Imaging Research Program, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Alexander McGirr
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
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22
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Mellick W, Prisciandaro JJ, Brenner H, Brown D, Tolliver BK. A Multimethod Examination of Sensitivity to Reward and Sensitivity to Punishment in Bipolar Disorder and Alcohol Dependence: Results from a 2 × 2 Factorial Design. Psychopathology 2021; 54:70-77. [PMID: 33596587 PMCID: PMC8058164 DOI: 10.1159/000512661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/28/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Shared neurobehavioral characteristics of bipolar disorder (BD) and alcohol dependence (AD), including heightened sensitivity to reward (SR), may account for high rates of BD and AD co-occurrence (BD + AD). However, empirical research is lacking. The present multimethod investigation examined SR and sensitivity to punishment (SP) among these patient groups using a reliable and well-validated self-report questionnaire of SR and SP along with a laboratory task specifically designed to distinguish SR and SP activation. METHODS One-hundred participants formed 4 groups: BD + AD (n = 40), BD (n = 18), AD (n = 25), and healthy controls (n = 17). Clinical interviews were administered, and participants completed the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSR-Q) and the Point Score Reaction Test behavioral task. Pearson correlations, hierarchical linear regression, and 2 × 2 factorial general linear modeling with Bonferroni-corrected pairwise comparisons were performed. RESULTS BD and AD main effects were significant on self-reported SR and SP; however, BD × AD interactions were not. BD + AD individuals were significantly higher on self-reported SR than BD and AD individuals, yet all clinical groups were similar on SP. Behavioral response times did not distinguish groups nor did they associate with self-report data. DISCUSSION/CONCLUSION BD and AD had additive, rather than interactive, effects on self-reported SR and SP. The methods employed, paired with their application to the present sample, may account for a lack of positive findings with behavioral data.
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Affiliation(s)
- William Mellick
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - James J Prisciandaro
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA,
| | - Helena Brenner
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Delisa Brown
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Bryan K Tolliver
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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23
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Murley AG, Rouse MA, Jones PS, Ye R, Hezemans FH, O’Callaghan C, Frangou P, Kourtzi Z, Rua C, Carpenter TA, Rodgers CT, Rowe JB. GABA and glutamate deficits from frontotemporal lobar degeneration are associated with disinhibition. Brain 2020; 143:3449-3462. [PMID: 33141154 PMCID: PMC7719029 DOI: 10.1093/brain/awaa305] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/11/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022] Open
Abstract
Behavioural disinhibition is a common feature of the syndromes associated with frontotemporal lobar degeneration (FTLD). It is associated with high morbidity and lacks proven symptomatic treatments. A potential therapeutic strategy is to correct the neurotransmitter deficits associated with FTLD, thereby improving behaviour. Reductions in the neurotransmitters glutamate and GABA correlate with impulsive behaviour in several neuropsychiatric diseases and there is post-mortem evidence of their deficit in FTLD. Here, we tested the hypothesis that prefrontal glutamate and GABA levels are reduced by FTLD in vivo, and that their deficit is associated with impaired response inhibition. Thirty-three participants with a syndrome associated with FTLD (15 patients with behavioural variant frontotemporal dementia and 18 with progressive supranuclear palsy, including both Richardson's syndrome and progressive supranuclear palsy-frontal subtypes) and 20 healthy control subjects were included. Participants undertook ultra-high field (7 T) magnetic resonance spectroscopy and a stop-signal task of response inhibition. We measured glutamate and GABA levels using semi-LASER magnetic resonance spectroscopy in the right inferior frontal gyrus, because of its strong association with response inhibition, and in the primary visual cortex, as a control region. The stop-signal reaction time was calculated using an ex-Gaussian Bayesian model. Participants with frontotemporal dementia and progressive supranuclear palsy had impaired response inhibition, with longer stop-signal reaction times compared with controls. GABA concentration was reduced in patients versus controls in the right inferior frontal gyrus, but not the occipital lobe. There was no group-wise difference in partial volume corrected glutamate concentration between patients and controls. Both GABA and glutamate concentrations in the inferior frontal gyrus correlated inversely with stop-signal reaction time, indicating greater impulsivity in proportion to the loss of each neurotransmitter. We conclude that the glutamatergic and GABAergic deficits in the frontal lobe are potential targets for symptomatic drug treatment of frontotemporal dementia and progressive supranuclear palsy.
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Affiliation(s)
- Alexander G Murley
- Department of Clinical Neurosciences, University of Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - Matthew A Rouse
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - P Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Rong Ye
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Frank H Hezemans
- Department of Clinical Neurosciences, University of Cambridge, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | | | - Zoe Kourtzi
- Department of Psychology, University of Cambridge, UK
| | - Catarina Rua
- Wolfson Brain Imaging Centre, University of Cambridge, UK
| | | | | | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
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24
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Younis S, Hougaard A, Christensen CE, Vestergaard MB, Petersen ET, Boer VO, Paulson OB, Ashina M, Marsman A, Larsson HBW. Feasibility of Glutamate and GABA Detection in Pons and Thalamus at 3T and 7T by Proton Magnetic Resonance Spectroscopy. Front Neurosci 2020; 14:559314. [PMID: 33192247 PMCID: PMC7645149 DOI: 10.3389/fnins.2020.559314] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/09/2020] [Indexed: 01/03/2023] Open
Abstract
Glutamate detection in pons and thalamus using proton magnetic resonance spectroscopy (1H-MRS) after an intervention is of interest for studying various brain disorders. However, 1H-MRS in these brain regions is challenging and time-consuming, especially in longitudinal study designs. 1H-MRS of more cortical structures at the ultrahigh magnetic field strength of 7T yields an improved spectral output, including separation of the glutamate signal from the glutamine signal, in a shorter and more feasible scan time, as compared to conventional clinical field strengths. For this purpose, we compared the feasibility of 1H-MRS at 3T and 7T in pons and thalamus by applying a longitudinal study design of repeated measures on same day and three separate days at both field strength in five healthy participants. Total 1H-MRS acquisition time was reduced by a factor 3.75 for pons and by a factor 3 for thalamus at 7T as compared to 3T. We found higher spectral signal-to-noise ratio (SNR) (p < 0.001), lower linewidth (p = 0.001) and lower Cramér-Rao lower bounds (CRLB) (p < 0.001) for the combined glutamate and glutamine signal (Glx) in thalamus at 7T as compared to 3T. In pons, CRLB of Glx and SNR were lower at 7T (p = 0.002 and p = 0.006), with no differences in linewidth compared to 3T. Mean within-subject variability of Glx concentration estimates was lower at 7T compared to 3T for both pons and thalamus. At 7T, it was possible to assess glutamate and γ-aminobutyric acid (GABA) simultaneously in pons and thalamus. In conclusion, 1H-MRS at 7T resulted in improved spectral quality while allowing shorter scan times than at 3T as well as estimation of the pure glutamate signal in pons and thalamus. This opens up the opportunity for multimodal study designs and multiregional subcortical 1H-MRS research. Glutamate and GABA measurement at 7T in pons and thalamus is advantageous for future investigations of excitatory-inhibitory mechanisms in brain disorders.
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Affiliation(s)
- Samaira Younis
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Anders Hougaard
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Casper E. Christensen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Mark B. Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Esben T. Petersen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Center for Magnetic Resonance, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Vincent O. Boer
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Olaf B. Paulson
- Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Anouk Marsman
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Henrik B. W. Larsson
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
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Orsolini L, Pompili S, Volpe U. The ‘collateral side’ of mood stabilizers: safety and evidence-based strategies for managing side effects. Expert Opin Drug Saf 2020; 19:1461-1495. [DOI: 10.1080/14740338.2020.1820984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Simone Pompili
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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26
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Mellick W, Tolliver BK, Brenner H, Prisciandaro JJ. Delay discounting and reward sensitivity in a 2 × 2 study of bipolar disorder and alcohol dependence. Addiction 2019; 114:1369-1378. [PMID: 30927381 PMCID: PMC6626565 DOI: 10.1111/add.14625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 03/14/2019] [Accepted: 03/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Separate studies have shown increased delay discounting in people with bipolar disorder (BD) and people with alcohol dependence (AD) relative to people without mental health problems. Delay discounting was compared in people with no mental health problems, AD, BD and AD plus BD. Associations of delay discounting with self-reported impulsivity and reward sensitivity were also assessed. DESIGN The study was a two-by-two factorial comparative observational design. SETTING Data were collected at baseline diagnostic visits as part of a neuroimaging study at a medical university in South Carolina, USA. PARTICIPANTS Twenty-two BD + AD, 33 BD, 28 AD and 27 people without mental health problems participated. MEASUREMENTS Diagnostic and clinician-rated symptom measures, self-report questionnaires and a computerized delay discounting task were administered. Two-by-two general linear univariate models were tested to examine between-group differences on discounting rates, and bivariate correlations and hierarchical regression analyses were performed to examine associations between discounting rates and self-reported reward sensitivity and impulsivity. FINDINGS There was a significant main effect of AD (P = 0.006, η2 = 0.068). The main effect of BD and the BD × AD interaction terms were non-significant (P ≥ 0.293, η2 ≤ 0.010). Reward sensitivity and impulsivity were not significantly associated with discounting rates after adjustment for the other (P ≥ 0.089). CONCLUSIONS People with alcohol dependence appear to have higher delay discounting, while previously found associations between bipolar disorder and delay discounting may be secondary to alcohol use disorder.
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Affiliation(s)
- William Mellick
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, SC, USA
| | - Bryan K Tolliver
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, SC, USA
| | - Helena Brenner
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, SC, USA
| | - James J Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, SC, USA
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27
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Prisciandaro JJ, Mellick W, Mitaro E, Tolliver BK. An evaluation of the impact of co-occurring anxiety and substance use disorder on bipolar disorder illness outcomes in STEP-BD. J Affect Disord 2019; 246:794-799. [PMID: 30623826 PMCID: PMC6563327 DOI: 10.1016/j.jad.2018.12.070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/01/2018] [Accepted: 12/23/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Anxiety disorder (AD) and substance use disorder (SUD) highly co-occur with bipolar disorder (BD). AD and/or SUD co-occurrence is associated with poorer clinical outcomes in BD. However, respective associations between AD and/or SUD diagnoses and BD outcomes require clarification. Baseline data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were therefore utilized to investigate independent and simultaneous contributions of ADs and SUDs on clinical variables in BD. METHODS Two latent factors, "pathological anxiety" and "substance use problems," were derived from presence/absence of lifetime AD and SUD diagnoses. Latent dimensions' associations with clinical variables, obtained from the Affective Disorders Evaluation, Mini-International Neuropsychiatric Interview and Range of Impaired Functioning, were estimated via structural equation modeling (SEM). RESULTS Modeled independently, pathological anxiety and substance use problems were significantly associated with several variables. Yet when modeled simultaneously, pathological anxiety's associations with functional impairment, past-year rapid cycling, and past-year %time spent anxious and depressed remained while most variables' associations with substance use problems became non-significant. The only significant latent-factor interaction evidenced was for age of BD onset. LIMITATIONS Analyses were limited to lifetime diagnoses and causality may not be inferred given cross-sectional data. CONCLUSIONS ADs and SUDs impact on BD was mostly additive rather than synergistic. Findings highlight the potentially understated importance of treating inter-episodic anxiety in BD as it may exacerbate mood symptoms, increasing functional impairment and risk for subsequent mood episodes.
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Affiliation(s)
- James J Prisciandaro
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Charleston, SC 29425, United States.
| | - William Mellick
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Charleston, SC 29425, United States
| | - Emily Mitaro
- University of Georgia, Department of Psychology, Athens, GA 30602, United States
| | - Bryan K Tolliver
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Charleston, SC 29425, United States
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28
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Hillemacher T, Frieling H. Pharmacotherapeutic options for co-morbid depression and alcohol dependence. Expert Opin Pharmacother 2019; 20:547-569. [DOI: 10.1080/14656566.2018.1561870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Thomas Hillemacher
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University, Nuremberg, Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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29
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Lu Q, Lai J, Lu H, Ng C, Huang T, Zhang H, Ding K, Wang Z, Jiang J, Hu J, Lu J, Lu S, Mou T, Wang D, Du Y, Xi C, Lyu H, Chen J, Xu Y, Liu Z, Hu S. Gut Microbiota in Bipolar Depression and Its Relationship to Brain Function: An Advanced Exploration. Front Psychiatry 2019; 10:784. [PMID: 31736803 PMCID: PMC6828946 DOI: 10.3389/fpsyt.2019.00784] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022] Open
Abstract
The mechanism of bipolar disorder is unclear. Growing evidence indicates that gut microbiota plays a pivotal role in mental disorders. This study aimed to find out changes in the gut microbiota in bipolar depression (BD) subjects following treatment with quetiapine and evaluate their correlations with the brain and immune function. Totally 36 subjects with BD and 27 healthy controls (HCs) were recruited. The severity of depression was evaluated with the Montgomery-Asberg depression rating scale (MADRS). At baseline, fecal samples were collected and analyzed by quantitative polymerase chain reaction (qPCR). T lymphocyte subsets were measured to examine immune function. Near-infrared spectroscopy (NIRS) was used to assess brain function. All BD subjects received quetiapine treatment (300 mg/d) for four weeks, following which the fecal microbiota and immune profiles were reexamined. Here, we first put forward the new concept of brain-gut coefficient of balance (B-GCB), which referred to the ratio of [oxygenated hemoglobin]/(Bifidobacteria to Enterobacteriaceae ratio), to analyze the linkage between the gut microbiota and brain function. At baseline, the CD3+ T cell proportion was positively correlated with log10 Enterobacter spp count, whereas the correlativity between the other bacteria and immune profiles were negative. Log10 B-GCB was positively correlated with CD3+ T cell proportion. In subjects with BD, counts of Faecalibacterium prausnitzii, Bacteroides-Prevotella group, Atopobium Cluster, Enterobacter spp, and Clostridium Cluster IV were higher, whereas the log10 (B/E) were lower than HCs (B/E refers to Bifidobacteria to Enterobacteriaceae ratio and represents microbial colonization resistance). After treatment, MADRS scores were reduced, whereas the levels of Eubacterium rectale, Bifidobacteria, and B/E increased. The composition of the gut microbiota and its relationship to brain function were altered in BD subjects. Quetiapine treatment was effective for depression and influenced the composition of gut microbiota in patients. Clinical Trial Registration: http://www.chictr.org.cn/index.aspx, identifier ChiCTR-COC-17011401, URL: http://www.chictr.org.cn/listbycreater.aspx.
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Affiliation(s)
- Qiaoqiao Lu
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Jianbo Lai
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Haifeng Lu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chee Ng
- The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Tingting Huang
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hua Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaijing Ding
- Department of Children and Adolescents' Psychology, Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Zheng Wang
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Jiajun Jiang
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jianbo Hu
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Jing Lu
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Shaojia Lu
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Tingting Mou
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Dandan Wang
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Yanli Du
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Caixi Xi
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hailong Lyu
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Jingkai Chen
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Yi Xu
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
| | - Zhuhua Liu
- Center of Mental Health, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Shaohua Hu
- Department of Psychiatry, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China
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30
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Gómez-Coronado N, Sethi R, Bortolasci CC, Arancini L, Berk M, Dodd S. A review of the neurobiological underpinning of comorbid substance use and mood disorders. J Affect Disord 2018; 241:388-401. [PMID: 30145509 DOI: 10.1016/j.jad.2018.08.041] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/09/2018] [Accepted: 08/10/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND There is evidence that substance use disorders and other mental disorders may have shared biological mechanisms. However, the neurobiological basis of this comorbidity remains only partially explained. This review describes the historical evolution of the dual disorders concept and approach, and reviews the existing literature on neurobiological findings specifically regarding comorbid substance use and mood disorders. METHODS Searches were conducted using PubMed and Scopus in December 2017. A Boolean search was performed using combinations of "dual diagnosis" or "dual disorder" or "depression" or "bipolar" or "affective disorder" or "mood disorder" and "substance use" or "substance abuse" and "neurobiology" or "functional neuroimaging" or "genetics" or "neurotransmitters" or "neuroendocrinology" in the title or abstract, or as keywords, using no language restriction. RESULTS 32 studies met the inclusion criteria. We found robust evidence for involvement of the neurotransmitters dopamine, GABA and glutamate and their receptors, as well as by the central corticotrophin-releasing hormone, hypothalamic-pituitary-adrenal axis activation, oxidative stress and inflammation. Recent studies focusing on neuroimaging and genetics have not shown consistent results. LIMITATIONS Only two search tools were used; most identified studies excluded the population of interest (comorbid mood and substance abuse disorders). CONCLUSIONS The neurobiological relevance for the occurrence of comorbid mood and substance abuse disorders has not been fully elucidated. Considering the high levels of individuals who experience comorbidity in these areas as well as the negative associated outcomes, this is clearly an area that requires further in-depth investigation. Furthermore, findings from this area can help to inform drug abuse prevention and intervention efforts, and especially how they relate to populations with psychiatric symptoms.
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Affiliation(s)
- Nieves Gómez-Coronado
- Unidad de Gestión Clínica Salud Mental, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Department of Psychiatry, Hospital San Agustín ORL, Dos Hermanas, Sevilla, Spain
| | - Rickinder Sethi
- London Health Sciences Centre, Western University, London, Canada
| | - Chiara Cristina Bortolasci
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Lauren Arancini
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia; University Hospital Geelong, Barwon Health, Geelong VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, VIC, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Seetal Dodd
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia; University Hospital Geelong, Barwon Health, Geelong VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen, The National Centre for Excellence in Youth Mental Health, Parkville, VIC, Australia.
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31
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Abstract
OBJECTIVE Addiction co-occurs with distinct pathological personality traits, other psychiatric disorders or symptoms and cognitive impairment, which are known as dual disorders or co-occurring disorders. This symptomatic high concurrency suggests that both conditions are in some ways causally linked. Research is ongoing to identify distinctive neurobehavioral mechanisms and endophenotypes that predispose individuals to compulsive drug use and other mental disorders. Research is also providing new revelations about the diverse effects of substances on individuals, including differences according to sex. Today we know that the same substance may give rise to different behavioral, affective, cognitive, and sensory effects across different individuals. METHODS This state-of the art review tends to address the concept of precision psychiatry and dual disorders. The PubMed database was searched for the last 15 years to identify those articles that reported neurobiological perspectives on dual disorders, addiction and other mental disorders, precision medicine, and precision psychiatry. RESULTS There has been considerable progress made in recent years in relation to the study of addiction and dual disorders. The concept of dual disorders attempts to capture not only the persistence of substance use and substance seeking but also the evident vulnerability of specific subpopulations to switch from controlled to compulsive drug use. Precision medicine is focused on identifying this individual vulnerability to illness as much as the individual response to treatment. Psychiatry is fully committed to this goal. Regarding addiction, essential precision medicine advances will be possible if concerted efforts are made in the discovery of biological variations and environmental factors that contribute to individual vulnerability to addictive disorders and dual disorders, together with the identification of moderators of treatment response. CONCLUSIONS Here we survey the discoveries, future research directions, and translational relevance of the concept of precision psychiatry for dual disorders. The review may offer new perspectives on this issue and highlight a new way to see and to think about dual disorders.
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Affiliation(s)
- Nestor Szerman
- a Servicio de Psiquiatría , Hospital Universitario Gregorio Marañon , Madrid , Spain
| | - Lola Peris
- b Research Unit and Dual Disorders Program, Centre Neuchâtelois de Psychiatrie (CNP) , Neuchâtel , Switzerland
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32
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Vanle B, Olcott W, Jimenez J, Bashmi L, Danovitch I, IsHak WW. NMDA antagonists for treating the non-motor symptoms in Parkinson's disease. Transl Psychiatry 2018; 8:117. [PMID: 29907742 PMCID: PMC6003962 DOI: 10.1038/s41398-018-0162-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/13/2018] [Accepted: 04/21/2018] [Indexed: 12/02/2022] Open
Abstract
Among patients with Parkinson's disease (PD), depression is prevalent and disabling, impacting both health outcomes and quality of life. There is a critical need for alternative pharmacological methods to treat PD depression, as mainstream antidepressant drugs are largely ineffective in this population. Currently, there are no recommendations for the optimal treatment of PD neuropsychiatric symptoms. Given the dual antidepressant and anti-dyskinetic effects of ketamine and other N-methyl-D-aspartate (NMDA) antagonists for PD, this review aims to examine the current evidence of NMDA antagonists for treating neuropsychiatric symptoms, including memantine, amantadine, ketamine, dizoclopine, and d-cycloserine. A comprehensive literature search was conducted using the PubMed database. We also searched the following databases up to March 1, 2018: Ovid MEDLINE, PsycINFO, CINAHL, Google Scholar, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. The following keywords were used: NMDA antagonist and Parkinson's disease. Two authors independently reviewed the articles identified from the search using specific selection criteria, focusing on studies of mood, psychiatric condition, depression, cognition, and quality of life, and the consensus was reached on the 20 studies included. There is a preliminary evidence that NMDA antagonists may modulate psychiatric symptoms in PD. However, current evidence of psychiatric symptom-modifying effects is inconclusive and requires that further trials be conducted in PD. The repurposing of old NMDA antagonists, such as ketamine for depression and newer therapies, such as rapastinel, suggests that there is an emerging place for modulating the glutamatergic system for treating non-motor symptoms in PD.
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Affiliation(s)
- Brigitte Vanle
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Medical College of Wisconsin, Wausau, WI, USA.
| | - William Olcott
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jaime Jimenez
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Luma Bashmi
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Itai Danovitch
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Waguih William IsHak
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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33
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García-Martín E, Ramos MI, Cornejo-García JA, Galván S, Perkins JR, Rodríguez-Santos L, Alonso-Navarro H, Jiménez-Jiménez FJ, Agúndez JAG. Missense Gamma-Aminobutyric Acid Receptor Polymorphisms Are Associated with Reaction Time, Motor Time, and Ethanol Effects in Vivo. Front Cell Neurosci 2018; 12:10. [PMID: 29445327 PMCID: PMC5797743 DOI: 10.3389/fncel.2018.00010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/08/2018] [Indexed: 01/15/2023] Open
Abstract
Background: The Gamma-aminobutyric acid type A receptor (GABA-A receptor) is affected by ethanol concentrations equivalent to those reached during social drinking. At these concentrations, ethanol usually causes impairment in reaction and motor times in most, but not all, individuals. Objectives: To study the effect of GABA-A receptor variability in motor and reaction times, and the effect of low ethanol doses. Methods: Two hundred and fifty healthy subjects received one single dose of 0.5 g/Kg ethanol per os. Reaction and motor times were determined before ethanol challenge (basal), and when participants reached peak ethanol concentrations. We analyzed all common missense polymorphisms described in the 19 genes coding for the GABA-A receptor subunits by using TaqMan probes. Results: The GABRA6 rs4454083 T/C polymorphisms were related to motor times, with individuals carrying the C/C genotype having faster motor times, both, at basal and at peak ethanol concentrations. The GABRA4 rs2229940 T/T genotype was associated to faster reaction times and with lower ethanol effects, determined as the difference between basal reaction time and reaction time at peak concentrations. All these associations remained significant after correction for multiple comparisons. No significant associations were observed for the common missense SNPs GABRB3 rs12910925, GABRG2 rs211035, GABRE rs1139916, GABRP rs1063310, GABRQ rs3810651, GABRR1 rs12200969 or rs1186902, GABRR2 rs282129, and GABRR3 rs832032. Conclusions: This study provides novel information supporting a role of missense GABA-A receptor polymorphisms in reaction time, motor time and effects of low ethanol doses in vivo.
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Affiliation(s)
- Elena García-Martín
- Department of Pharmacology, Universidad de Extremadura, Cáceres, Spain.,ARADyAL Network, Instituto de Salud Carlos III, Madrid, Spain
| | - María I Ramos
- Department of Psychiatry, Universidad de Extremadura, Badajoz, Spain
| | - José A Cornejo-García
- ARADyAL Network, Instituto de Salud Carlos III, Madrid, Spain.,Research Laboratory, Instituto de Investigación Biomédica de Málaga, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - Segismundo Galván
- Department of Pharmacology, Universidad de Extremadura, Cáceres, Spain
| | - James R Perkins
- ARADyAL Network, Instituto de Salud Carlos III, Madrid, Spain.,Research Laboratory, Instituto de Investigación Biomédica de Málaga, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | | | | | | | - José A G Agúndez
- Department of Pharmacology, Universidad de Extremadura, Cáceres, Spain.,ARADyAL Network, Instituto de Salud Carlos III, Madrid, Spain
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