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Nagamatsu ST, Pietrzak RH, Xu K, Krystal JH, Gelernter J, Montalvo-Ortiz JL. Dissecting the epigenomic differences between smoking and nicotine dependence in a veteran cohort. Addict Biol 2023; 28:e13259. [PMID: 36577721 DOI: 10.1111/adb.13259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/26/2022] [Accepted: 11/10/2022] [Indexed: 12/02/2022]
Abstract
Smoking is a serious public health issue linked to more than 8 million deaths per year worldwide and may lead to nicotine dependence (ND). Although the epigenomic literature on smoking is well established, studies evaluating the role of epigenetics in ND are limited. In this study, we examined the epigenomic signatures of ND and how these differ from smoking exposure to identify biomarkers specific to ND. We investigated the peripheral epigenetic profile of smoking status (SS) and ND in a US male veteran cohort. DNA from saliva was collected from 1135 European American (EA) male US military veterans. DNAm was assessed using the Illumina Infinium Human MethylationEPIC BeadChip array. SS was evaluated as current smokers (n = 137; 12.1%) and non-current smokers (never and former; n = 998; 87.9%). NDFTND was assessed as a continuous variable using the Fagerström Test for ND (FTND; n = 1135; mean = 2.54 ± 2.29). Epigenome-wide association studies (EWAS) and co-methylation analyses were conducted for SS and NDFTND . A total of 450 and 22 genome-wide significant differentially methylated sites (DMS) were associated with SS and NDFTND , respectively (15 overlapped DMS). We identified 97 DMS (43 genes) in SS-EWAS previously reported in the literature, including AHRR and F2RL3 genes (p-value: 1.95 × 10-83 to 4.55 × 10-33 ). NDFTND novel DMS mapped to NEUROG1, ANPEP, and SLC29A1. Co-methylation analysis identified 386 modules (11 SS-related and 19 NDFTND -related). SS-related modules showed enrichment for alcoholism, while NDFTND -related modules were enriched for nicotine addiction. This study confirms previous findings associated with SS and identifies novel and-potentially specific-epigenetic biomarkers of ND that may inform prognosis and novel treatment strategies.
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Affiliation(s)
- Sheila Tiemi Nagamatsu
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- VA CT Healthcare Center, West Haven, Connecticut, USA
| | - Robert H Pietrzak
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- VA CT Healthcare Center, West Haven, Connecticut, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center of Posttraumatic Stress Disorder, West Haven, Connecticut, USA
| | - Ke Xu
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- VA CT Healthcare Center, West Haven, Connecticut, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center of Posttraumatic Stress Disorder, West Haven, Connecticut, USA
| | - John H Krystal
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- VA CT Healthcare Center, West Haven, Connecticut, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center of Posttraumatic Stress Disorder, West Haven, Connecticut, USA
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- VA CT Healthcare Center, West Haven, Connecticut, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center of Posttraumatic Stress Disorder, West Haven, Connecticut, USA
| | - Janitza Liz Montalvo-Ortiz
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- VA CT Healthcare Center, West Haven, Connecticut, USA
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center of Posttraumatic Stress Disorder, West Haven, Connecticut, USA
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2
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Gibson BC, Claus ED, Sanguinetti J, Witkiewitz K, Clark VP. A review of functional brain differences predicting relapse in substance use disorder: Actionable targets for new methods of noninvasive brain stimulation. Neurosci Biobehav Rev 2022; 141:104821. [PMID: 35970417 DOI: 10.1016/j.neubiorev.2022.104821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/17/2022]
Abstract
Neuroimaging studies have identified a variety of brain regions whose activity predicts substance use (i.e., relapse) in patients with substance use disorder (SUD), suggesting that malfunctioning brain networks may exacerbate relapse. However, this knowledge has not yet led to a marked improvement in treatment outcomes. Noninvasive brain stimulation (NIBS) has shown some potential for treating SUDs, and a new generation of NIBS technologies offers the possibility of selectively altering activity in both superficial and deep brain structures implicated in SUDs. The goal of the current review was to identify deeper brain structures involved in relapse to SUD and give an account of innovative methods of NIBS that might be used to target them. Included studies measured fMRI in currently abstinent SUD patients and tracked treatment outcomes, and fMRI results were organized with the framework of the Addictions Neuroclinical Assessment (ANA). Four brain structures were consistently implicated: the anterior and posterior cingulate cortices, ventral striatum and insula. These four deeper brain structures may be appropriate future targets for the treatment of SUD using these innovative NIBS technologies.
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Affiliation(s)
- Benjamin C Gibson
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA
| | - Eric D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jay Sanguinetti
- The Center for Consciousness Studies, University of Arizona, Tucson, AZ 85719, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Vincent P Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA.
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3
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Smart K, Worhunsky PD, Scheinost D, Angarita GA, Esterlis I, Carson RE, Krystal JH, O'Malley SS, Cosgrove KP, Hillmer AT. Multimodal neuroimaging of metabotropic glutamate 5 receptors and functional connectivity in alcohol use disorder. Alcohol Clin Exp Res 2022; 46:770-782. [PMID: 35342968 PMCID: PMC9117461 DOI: 10.1111/acer.14816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/15/2022] [Accepted: 03/19/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND People recovering from alcohol use disorder (AUD) show altered resting brain connectivity. The metabotropic glutamate 5 (mGlu5) receptor is an important regulator of synaptic plasticity potentially linked with synchronized brain activity and a target of interest in treating AUD. The goal of this work was to assess potential relationships of brain connectivity at rest with mGlu5 receptor availability in people with AUD at two time points early in abstinence. METHODS Forty-eight image data sets were acquired with a multimodal neuroimaging battery that included resting-state functional magnetic resonance imaging (fMRI) and mGlu5 receptor positron emission tomography (PET) with the radiotracer [18 F]FPEB. Participants with AUD (n = 14) were scanned twice, at approximately 1 and 4 weeks after beginning supervised abstinence. [18 F]FPEB PET results were published previously. Primary comparisons of fMRI outcomes were performed between the AUD group and healthy controls (HCs; n = 23) and assessed changes over time within the AUD group. Relationships between resting-state connectivity measures and mGlu5 receptor availability were explored within groups. RESULTS Compared to HCs, global functional connectivity of the orbitofrontal cortex was higher in the AUD group at 4 weeks of abstinence (p = 0.003), while network-level functional connectivity within the default mode network (DMN) was lower (p < 0.04). Exploratory multimodal analyses showed that mGlu5 receptor availability was correlated with global connectivity across all brain regions (HCs, r = 0.41; AUD group at 1 week of abstinence, r = 0.50 and at 4 weeks, r = 0.46; all p < 0.0001). Furthermore, a component of cortical and striatal mGlu5 availability was correlated with connectivity between the DMN and salience networks in HCs (r = 0.60, p = 0.003) but not in the AUD group (p > 0.3). CONCLUSIONS These preliminary findings of altered global and network connectivity during the first month of abstinence from drinking may reflect the loss of efficient network function, while exploratory relationships with mGlu5 receptor availability suggest a potential glutamatergic relationship with network coherence.
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Affiliation(s)
- Kelly Smart
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Patrick D Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
| | - Gustavo A Angarita
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Richard E Carson
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Kelly P Cosgrove
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ansel T Hillmer
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
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4
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Longitudinal imaging of metabotropic glutamate 5 receptors during early and extended alcohol abstinence. Neuropsychopharmacology 2021; 46:380-385. [PMID: 32919411 PMCID: PMC7852514 DOI: 10.1038/s41386-020-00856-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/10/2020] [Accepted: 08/27/2020] [Indexed: 01/22/2023]
Abstract
Chronic alcohol use has important effects on the glutamate system. The metabotropic glutamate 5 (mGlu5) receptor has shown promise in preclinical models as a target to reduce drinking-related behaviors and cue-induced reinstatement, motivating human studies of mGlu5 receptor negative allosteric modulators. The goal of this work was to measure levels of mGlu5 receptor availability with positron emission tomography (PET) imaging using the mGlu5 receptor-specific radiotracer [18F]FPEB during early and extended alcohol abstinence. Subjects who met DSM-5 criteria for alcohol use disorder (AUD; n = 17) were admitted inpatient for the study duration. [18F]FPEB PET scans were acquired first during early abstinence (6 ± 4 days after last drink) and a second time during extended abstinence (n = 13; 27 ± 6 days after last drink). A single scan was acquired in healthy controls matched for sex and smoking status (n = 20). [18F]FPEB total volumes of distribution (VT) corrected for partial volume effects were measured using equilibrium analysis throughout the brain. A linear mixed model controlling for smoking status and sex identified significantly higher [18F]FPEB VT in AUD subjects at early abstinence compared to controls (F(1,32) = 7.23, p = 0.011). Post-hoc analyses revealed this effect to occur in cortical brain regions. No evidence for significant changes in [18F]FPEB VT over time were established. These findings provide human evidence consistent with a robust preclinical literature supporting mGlu5 receptor drugs as pharmacotherapies for AUD.
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5
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Patterson F, Grandner MA, Malone SK, Rizzo A, Davey A, Edwards DG. Sleep as a Target for Optimized Response to Smoking Cessation Treatment. Nicotine Tob Res 2020; 21:139-148. [PMID: 29069464 DOI: 10.1093/ntr/ntx236] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 10/19/2017] [Indexed: 12/23/2022]
Abstract
Declining national rates of current tobacco use to an all-time low of 15.1% represents a public health victory. Undermining this progress, however, are smoking rates of up to 50% among high-risk, low-income populations. Current FDA-approved treatments for nicotine dependence are ineffective with between 70-95% of treatment-seekers relapsing within the first year of attempted abstinence. Thus, identification of novel intervention targets to optimize response to currently available treatments for nicotine dependence is a critical next step. One such target may be sleep insomnia. Insomnia is a clinically verified nicotine withdrawal symptom but, to date, addressing insomnia or other sleep disturbance symptoms as an adjunctive smoking cessation therapy has yet to be fully considered. To this end, this manuscript presents a narrative review of: (1) sleep continuity and architecture in smokers versus nonsmokers; (2) effects of nicotine abstinence on sleep; (3) possible mechanisms linking sleep with smoking cessation outcomes; (4) plausible adjunctive sleep therapies to promote smoking cessation; (5) possible treatments for unhealthy sleep in smokers; and (6) directions for future research. Taken together, this will provide conceptual support for sleep therapy as an adjunctive treatment for smoking cessation. Implications This narrative literature review presents a comprehensive discussion of the relationship between habitual sleep and cigarette smoking. The extent to which unhealthy sleep in smokers may be a viable intervention target for promoting response to smoking cessation treatment is considered. Ultimately, this review provides conceptual support for sleep therapy as an adjunctive treatment for smoking cessation.
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Affiliation(s)
- Freda Patterson
- College of Health Sciences, University of Delaware, Newark, DE
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ
| | - Susan K Malone
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Albert Rizzo
- Christiana Care Health System, Pulmonary and Critical Care Medicine, Newark, DE
| | - Adam Davey
- College of Health Sciences, University of Delaware, Newark, DE
| | - David G Edwards
- College of Health Sciences, University of Delaware, Newark, DE
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6
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Ozbay N, Shevorykin A, Smith P, Sheffer CE. The association between gender roles and smoking initiation among women and adolescent girls. JOURNAL OF GENDER STUDIES 2019; 29:664-684. [PMID: 33414576 PMCID: PMC7787365 DOI: 10.1080/09589236.2019.1693985] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 11/11/2019] [Indexed: 06/12/2023]
Abstract
Smoking cigarettes is a leading global cause of preventable death and disease. Men historically smoke more than women, but the prevalence of smoking among women in low and middle-income countries is increasing at an alarming rate. Understanding the factors that influence smoking initiation among women and girls is needed to address the growing epidemic of women smokers and the looming impact on women's health worldwide. We assume that smoking initiation is embedded in socio-culturally influenced gendered context and use a social cognitive model with a gendered lens as a framework for organizing and synthesizing the research. Guided by this framework, we identified gaps in the literature and make recommendations for future research in this review paper. The results suggest that psychological and environmental determinants are rooted in fluctuating cultural influences and values, but few research studies provide a gendered analysis or systematically examine these factors in the context of gender and culture. Sex/gender is a significant construct through which women and girls experience the psychological, environmental, and other influences on smoking initiation. Much more research is needed to understand the psychological and environmental influences as well as the intersection of gender roles and other social categories on female smoking initiation.
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Affiliation(s)
- Nurbanu Ozbay
- Department of Psychology, The City College of New York, NY
| | - Alina Shevorykin
- Department of Mental Health Counseling and Psychology, Pace University, Pleasantville, NY
| | - Philip Smith
- City University of New York School of Medicine, New York, NY
- Department of Kinesiology and Health, Miami University, Oxford, OH
| | - Christine E. Sheffer
- City University of New York School of Medicine, New York, NY
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY
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7
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Sliedrecht W, de Waart R, Witkiewitz K, Roozen HG. Alcohol use disorder relapse factors: A systematic review. Psychiatry Res 2019; 278:97-115. [PMID: 31174033 DOI: 10.1016/j.psychres.2019.05.038] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 12/12/2022]
Abstract
A relapsing-remitting course is very common in patients with an Alcohol Use Disorder (AUD). Understanding the determinants associated with alcohol resumption remains a formidable task. This paper examines relapse determinants based on a systematic review of recent alcohol literature (2000-2019). Relevant databases were consulted for articles that contained information about specific relapse determinants and reported statistical significance of each relapse determinant in predicting relapse. Relapse was broadly defined based on the characterization in the included articles. From the initial identified 4613 papers, a total of 321 articles were included. Results encompass multiple relapse determinants, which were ordered according to biopsychosocial and spiritual categories, and presented, using a descriptive methodology. Psychiatric co-morbidity, AUD severity, craving, use of other substances, health and social factors were consistently significantly associated with AUD relapse. Conversely, supportive social network factors, self efficacy, and factors related to purpose and meaning in life, were protective against AUD relapse. Despite heterogeneity in different methods, measures, and sample characteristics, these findings may contribute to a better therapeutic understanding in which specific factors are associated with relapse and those that prevent relapse. Such factors may have a role in a personalized medicine framework to improve patient outcomes.
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Affiliation(s)
- Wilco Sliedrecht
- De Hoop GGZ, Provincialeweg 70, 3329 KP Dordrecht, the Netherlands.
| | - Ranne de Waart
- Mentrum/Arkin, Wisselwerking 46-48, 1112 XR Diemen, the Netherlands.
| | - Katie Witkiewitz
- The University of New Mexico (UNM), MSC 03-2220, Univ of New Mexico, Albuquerque, NM 87131, USA.
| | - Hendrik G Roozen
- The University of New Mexico (UNM), Center on Alcoholism, Substance Abuse, and Addictions (CASAA), MSC 11 6280, 1 Univ of New Mexico, Albuquerque, NM 87106, USA.
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8
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Clark L, Boileau I, Zack M. Neuroimaging of reward mechanisms in Gambling disorder: an integrative review. Mol Psychiatry 2019; 24:674-693. [PMID: 30214041 DOI: 10.1038/s41380-018-0230-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 12/14/2022]
Abstract
Gambling disorder (GD) was reclassified as a behavioral addiction in the DSM-5 and shares clinical and behavioral features with substance use disorders (SUDs). Neuroimaging studies of GD hold promise in isolating core features of the addiction syndrome, avoiding confounding effects of drug neurotoxicity. At the same time, a neurobiologically-grounded theory of how behaviors like gambling can become addictive remains lacking, posing a significant hurdle for ongoing decisions in addiction nosology. This article integrates research on reward-related brain activity (functional MRI) and neurotransmitter function (PET) in GD, alongside the consideration of structural MRI data as to whether these signals more likely reflect pre-existing vulnerability or neuroadaptive change. Where possible, we point to qualitative similarities and differences with established markers for SUDs. Structural MRI studies indicate modest changes in regional gray matter volume and diffuse reductions in white matter integrity in GD, contrasting with clear structural deterioration in SUDs. Functional MRI studies consistently identify dysregulation in reward-related circuitry (primarily ventral striatum and medial prefrontal cortex), but evidence is mixed as to the direction of these effects. The need for further parsing of reward sub-processes is emphasized, including anticipation vs outcome, gains vs. losses, and disorder-relevant cues vs natural rewards. Neurotransmitter PET studies indicate amplified dopamine (DA) release in GD, in the context of minimal differences in baseline DA D2 receptor binding, highlighting a distinct profile from SUDs. Preliminary work has investigated further contributions of opioids, GABA and serotonin. Neuroimaging data increasingly highlight divergent profiles in GD vs. SUDs. The ability of gambling to perpetually activate DA (via maximal uncertainty) may contribute to neuroimaging similarities between GD and SUDs, whereas the supra-physiological DA effects of drugs may partly explain differences in the neuroimaging profile of the two syndromes. Coupled with consistent observations of correlations with gambling severity and related clinical variables within GD samples, the overall pattern of effects is interpreted as a likely combination of shared vulnerability markers across GD and SUDs, but with further experience-dependent neuroadaptive processes in GD.
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Affiliation(s)
- Luke Clark
- Centre for Gambling Research, University of British Columbia (UBC), Vancouver, BC, Canada.,Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Isabelle Boileau
- Addiction Imaging Research Group, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,Vivian M. Rakoff PET Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Schizophrenia Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Martin Zack
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Clinical Neuroscience Program, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada. .,Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada.
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9
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Frye CCJ, Rung JM, Nall RW, Galizio A, Haynes JM, Odum AL. Continuous nicotine exposure does not affect resurgence of alcohol seeking in rats. PLoS One 2018; 13:e0202230. [PMID: 30110388 PMCID: PMC6093676 DOI: 10.1371/journal.pone.0202230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/29/2018] [Indexed: 11/19/2022] Open
Abstract
Alcohol is the most commonly used drug in the United States and alcohol abuse can lead to alcohol use disorder. Alcohol use disorder is a persistent condition and relapse rates following successful remission are high. Many factors have been associated with relapse for alcohol use disorder, but identification of these factors has not been well translated into preventative utility. One potentially important factor, concurrent nicotine use, has not been well investigated as a causal factor in relapse for alcohol use disorder. Nicotine increases the value of other stimuli in the environment and may increase the value of alcohol. If nicotine increases the value of alcohol, then nicotine use during and after treatment may make relapse more probable. In the current study, we investigated the effect of continuous nicotine exposure (using osmotic minipumps to deliver nicotine or saline, depending on group, at a constant rate for 28 days) on resurgence of alcohol seeking in rats. Resurgence is a type of relapse preparation that consists of three phases: Baseline, Alternative Reinforcement, and Resurgence Testing. During Baseline, target responses produced a dipper of alcohol. During Alternative Reinforcement, target responses were extinguished and responses on a chain produced a chocolate pellet. During Resurgence Testing, responses on the chain were also extinguished and a return to responding on the target lever was indicative of resurgence. Multilevel modeling was used to analyze the effect of nicotine on resurgence. Both the nicotine and saline group showed resurgence of alcohol seeking, but there was no difference in the degree of resurgence across groups. Future directions could involve testing alternative drug delivery techniques.
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Affiliation(s)
- Charles C. J. Frye
- Department of Psychology, Utah State University, Logan, Utah, United States of America
| | - Jillian M. Rung
- Department of Psychology, Utah State University, Logan, Utah, United States of America
| | - Rusty W. Nall
- Department of Psychology, Utah State University, Logan, Utah, United States of America
| | - Ann Galizio
- Department of Psychology, Utah State University, Logan, Utah, United States of America
| | - Jeremy M. Haynes
- Department of Psychology, Utah State University, Logan, Utah, United States of America
| | - Amy L. Odum
- Department of Psychology, Utah State University, Logan, Utah, United States of America
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10
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Petrakis IL, Ralevski E, Gueorguieva R, O’Malley SS, Arias A, Sevarino KA, Jane JS, O’Brien E, Krystal JH. Mecamylamine treatment for alcohol dependence: a randomized controlled trial. Addiction 2018; 113:6-14. [PMID: 28710873 PMCID: PMC5725262 DOI: 10.1111/add.13943] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 03/08/2017] [Accepted: 07/12/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS The nicotinic acetylcholine receptor antagonist, mecamylamine, is a potential novel pharmacotherapy for alcohol use disorder. The aims were to compare alcohol consumption between mecamylamine and placebo and test if smoking status modified treatment effects. DESIGN Out-patient, randomized, double-blind clinical trial for 12 weeks of treatment with mecamylamine (10 mg) (n = 65) versus placebo (n = 63). SETTING Connecticut, USA. PARTICIPANTS Individuals had current alcohol dependence (n = 128), had an average age of 48.5 [standard deviation (SD) = 9.4], 110 (85.9%) were men, and included 74 smokers (57.8%) and 54 non-smokers (42.2%). Participants were randomized to mecamylamine 10 mg per day or placebo. All subjects also received medical management therapy administered by trained research personnel. MEASUREMENTS Primary outcome was percentage of heavy drinking days during the last month of treatment; other outcomes included drinking days, drinks per drinking days, alcohol craving, smoking, symptoms of nicotine withdrawal and side effects. FINDINGS There were no significant differences in the percentage of heavy drinking days at 3 months between the mecamylamine (mean = 18.4, SD = 29.0) and placebo treatment groups (mean = 20.4, SD = 29.2) [F1, 100 = 1.3, P = 0.25; effect size d = 0.07; mean difference = 2.06, 95% confidence interval (CI) = -8.96 to 13.08]. There were no significant differences in percentage of drinking days or in drinks per drinking day at month 3 between the mecamylamine and placebo groups; there were no significant interactions. CONCLUSIONS Mecamylamine 10 mg per day did not reduce alcohol consumption significantly in treatment-seeking smokers and non-smokers with alcohol use disorder.
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Affiliation(s)
- Ismene L. Petrakis
- VISN I Mental Illness Research Education Clinical Center (MIRECC)
- VA Connecticut Healthcare System
- Yale University School of Medicine, Department of Psychiatry
| | - Elizabeth Ralevski
- VISN I Mental Illness Research Education Clinical Center (MIRECC)
- VA Connecticut Healthcare System
- Yale University School of Medicine, Department of Psychiatry
| | - Ralitza Gueorguieva
- Yale University School of Medicine, Department of Psychiatry
- Yale University School of Public Health, Department of Biostatistics
| | | | - Albert Arias
- VISN I Mental Illness Research Education Clinical Center (MIRECC)
- VA Connecticut Healthcare System
- Yale University School of Medicine, Department of Psychiatry
| | - Kevin A. Sevarino
- VISN I Mental Illness Research Education Clinical Center (MIRECC)
- VA Connecticut Healthcare System
- Yale University School of Medicine, Department of Psychiatry
| | - Jane S. Jane
- VISN I Mental Illness Research Education Clinical Center (MIRECC)
- VA Connecticut Healthcare System
- Yale University School of Medicine, Department of Psychiatry
| | - Erin O’Brien
- VISN I Mental Illness Research Education Clinical Center (MIRECC)
- VA Connecticut Healthcare System
- Yale University School of Medicine, Department of Psychiatry
| | - John H. Krystal
- VA Connecticut Healthcare System
- Yale University School of Medicine, Department of Psychiatry
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11
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Abreu-Villaça Y, Manhães AC, Krahe TE, Filgueiras CC, Ribeiro-Carvalho A. Tobacco and alcohol use during adolescence: Interactive mechanisms in animal models. Biochem Pharmacol 2017; 144:1-17. [DOI: 10.1016/j.bcp.2017.06.113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/05/2017] [Indexed: 12/13/2022]
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12
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Meyerhoff DJ. Time for Cigarette Smoke Exposure Chambers? Alcohol Clin Exp Res 2016; 40:936-8. [PMID: 26990486 PMCID: PMC4844762 DOI: 10.1111/acer.13040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Dieter J Meyerhoff
- Veterans Administration Medical Center (DJM), University of California San Francisco; and Center for Imaging of Neurodegenerative Diseases (CIND) (DJM), San Francisco, California
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13
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Hillmer AT, Kloczynski T, Sandiego CM, Pittman B, Anderson JM, Labaree D, Gao H, Huang Y, Deluliis G, O'Malley SS, Carson RE, Cosgrove KP. Nicotine and Nicotine Abstinence Do Not Interfere with GABAA Receptor Neuroadaptations During Alcohol Abstinence. Alcohol Clin Exp Res 2016; 40:698-705. [PMID: 26971694 DOI: 10.1111/acer.12997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 12/28/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol dependence and tobacco smoking are highly comorbid, and treating both conditions simultaneously is controversial. Previously, we showed that tobacco smoking interferes with GABAA receptor neuroadaptations during alcohol withdrawal in humans, while this effect did not occur with continued nicotine use during alcohol abstinence in nonhuman primates. Here, we extend our previous work by measuring GABAA receptor availability with positron emission tomography (PET) during drug abstinence in nonhuman primates exposed to alcohol alone, nicotine and alcohol together, and alcohol abstinence with continued nicotine exposure. METHODS Twenty-four adolescent male rhesus macaques orally self-administered alcohol and nicotine, available separately in water and saccharin, over 20 weeks. The groups included alcohol alone (n = 8); nicotine and alcohol with simultaneous abstinence (n = 8); nicotine and alcohol with alcohol abstinence while nicotine was still available (n = 8); and a pilot group of animals consuming nicotine alone (n = 6). Animals were imaged with [(11)C]flumazenil PET to measure binding potential (BPND), an index of GABAA receptor availability. Imaging occurred at baseline (drug-naíve), and following alcohol and/or nicotine cessation at 1 day, 8 days, and 12 weeks of abstinence. Generalized linear mixed models were used to examine the time course of [(11)C]flumazenil BPND during alcohol abstinence across groups. RESULTS Animals consumed 3.95 ± 1.22 g/kg/d alcohol and 55.4 ± 35.1 mg/kg/d nicotine. No significant group effects were observed in [(11)C]flumazenil BPND during alcohol abstinence; however, a main effect of time was detected. Post hoc analyses indicated that all groups abstaining from alcohol exhibited significantly increased GABAA receptor availability at 1 day and 8 days (but not 12 weeks) of abstinence relative to baseline, while no changes in [(11)C]flumazenil BPND during nicotine abstinence alone were observed. CONCLUSIONS These data indicate that neither nicotine nor nicotine abstinence interferes with GABAA receptor neuroadaptations during alcohol withdrawal. This conclusion is consistent with our previous study and does not contradict the use of nicotine replacement therapies or non-nicotinic-acting pharmaceuticals to quit smoking during alcohol withdrawal from a GABAergic perspective.
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Affiliation(s)
- Ansel T Hillmer
- Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut.,Yale PET Center, Yale University School of Medicine, New Haven, Connecticut
| | - Tracy Kloczynski
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Christine M Sandiego
- Yale PET Center, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Jon M Anderson
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - David Labaree
- Yale PET Center, Yale University School of Medicine, New Haven, Connecticut
| | - Hong Gao
- Yale PET Center, Yale University School of Medicine, New Haven, Connecticut
| | - Yiyun Huang
- Yale PET Center, Yale University School of Medicine, New Haven, Connecticut
| | - Giuseppe Deluliis
- Department of Pulmonology, Yale University School of Medicine, New Haven, Connecticut
| | - Stephanie S O'Malley
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Richard E Carson
- Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut.,Yale PET Center, Yale University School of Medicine, New Haven, Connecticut
| | - Kelly P Cosgrove
- Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut.,Yale PET Center, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut
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14
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Van Skike CE, Maggio SE, Reynolds AR, Casey EM, Bardo MT, Dwoskin LP, Prendergast MA, Nixon K. Critical needs in drug discovery for cessation of alcohol and nicotine polysubstance abuse. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:269-87. [PMID: 26582145 PMCID: PMC4679525 DOI: 10.1016/j.pnpbp.2015.11.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 01/29/2023]
Abstract
Polysubstance abuse of alcohol and nicotine has been overlooked in our understanding of the neurobiology of addiction and especially in the development of novel therapeutics for its treatment. Estimates show that as many as 92% of people with alcohol use disorders also smoke tobacco. The health risks associated with both excessive alcohol consumption and tobacco smoking create an urgent biomedical need for the discovery of effective cessation treatments, as opposed to current approaches that attempt to independently treat each abused agent. The lack of treatment approaches for alcohol and nicotine abuse/dependence mirrors a similar lack of research in the neurobiology of polysubstance abuse. This review discusses three critical needs in medications development for alcohol and nicotine co-abuse: (1) the need for a better understanding of the clinical condition (i.e. alcohol and nicotine polysubstance abuse), (2) the need to better understand how these drugs interact in order to identify new targets for therapeutic development and (3) the need for animal models that better mimic this human condition. Current and emerging treatments available for the cessation of each drug and their mechanisms of action are discussed within this context followed by what is known about the pharmacological interactions of alcohol and nicotine. Much has been and will continue to be gained from studying comorbid alcohol and nicotine exposure.
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Affiliation(s)
- C E Van Skike
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, United States
| | - S E Maggio
- Department of Psychology, University of Kentucky, Lexington, KY 40536, United States
| | - A R Reynolds
- Department of Psychology, University of Kentucky, Lexington, KY 40536, United States
| | - E M Casey
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, United States
| | - M T Bardo
- Department of Psychology, University of Kentucky, Lexington, KY 40536, United States; Center for Drug Abuse and Research Translation, University of Kentucky, Lexington, KY 40536, United States; Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY 40536, United States
| | - L P Dwoskin
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, United States; Center for Drug Abuse and Research Translation, University of Kentucky, Lexington, KY 40536, United States
| | - M A Prendergast
- Department of Psychology, University of Kentucky, Lexington, KY 40536, United States; Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY 40536, United States
| | - K Nixon
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, United States; Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY 40536, United States.
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15
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Moeller SJ, London ED, Northoff G. Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: Relationships to resting-state functional connectivity. Neurosci Biobehav Rev 2016; 61:35-52. [PMID: 26657968 PMCID: PMC4731270 DOI: 10.1016/j.neubiorev.2015.11.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/05/2015] [Accepted: 11/21/2015] [Indexed: 12/29/2022]
Abstract
Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications.
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Affiliation(s)
- Scott J Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Edythe D London
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Georg Northoff
- Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, Ottawa, Canada.
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16
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Hillmer AT, Mason GF, Fucito LM, O'Malley SS, Cosgrove KP. How Imaging Glutamate, γ-Aminobutyric Acid, and Dopamine Can Inform the Clinical Treatment of Alcohol Dependence and Withdrawal. Alcohol Clin Exp Res 2015; 39:2268-82. [PMID: 26510169 DOI: 10.1111/acer.12893] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 08/29/2015] [Indexed: 12/29/2022]
Abstract
Neuroimaging studies have dramatically advanced our understanding of the neurochemical basis of alcohol dependence, a major public health issue. In this paper, we review the research generated from neurochemical specific imaging modalities including magnetic resonance spectroscopy, positron emission tomography, and single-photon emission computed tomography in studies of alcohol dependence and withdrawal. We focus on studies interrogating γ-aminobutyric acid (GABA), glutamate, and dopamine, as these are prominent neurotransmitter systems implicated in alcohol dependence. Highlighted findings include diminished dopaminergic functioning and modulation of the GABA system by tobacco smoking during alcohol withdrawal. Then, we consider how these findings impact the clinical treatment of alcohol dependence and discuss directions for future experiments to address existing gaps in the literature, for example, sex differences and smoking comorbidity. These and other considerations provide opportunities to build upon the current neurochemistry imaging literature of alcohol dependence and withdrawal, which may usher in improved therapeutic and relapse prevention strategies.
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Affiliation(s)
- Ansel T Hillmer
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Graeme F Mason
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Lisa M Fucito
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Stephanie S O'Malley
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Kelly P Cosgrove
- Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
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Shi W, Ding Y, Yu A, Wang Q, Zhang Z, Zhang LC. BDNF/TRK/KCC2 pathway in nicotine withdrawal-induced hyperalgesia. Transl Neurosci 2015; 6:208-213. [PMID: 28123805 PMCID: PMC4936630 DOI: 10.1515/tnsci-2015-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/09/2015] [Indexed: 01/19/2023] Open
Abstract
Purpose To investigate the effect of brain-derived neurotrophic factor (BDNF)/tropomyosin receptor kinase (Trk) on potassium chloride cotransporter 2 (KCC2) in rats following nicotine withdrawal and the roles played by BDNF/Trk/KCC2 pathway in nicotine withdrawal-induced hyperalgesia. Methods Seventy-eight rats were randomly assigned to five groups: control group (n = 12) without any treatment, normal saline group (NS group, n = 12) and nicotine withdrawal group (NW group, n = 30) receiving a subcutaneous injection of saline or nicotine for 7 days, respectively. The NW + dimethyl sulfoxide (DMSO) (n = 12) and NW+ Trk antagonist K252a groups (n = 12) received an intrathecal injection of DMSO (10 μl) and K252a (10 μg/10 μl) for 3 days after nicotine withdrawal, respectively. Nicotine withdrawal was precipitated by subcutaneous injection of nonselective and noncompetitive antagonist of nicotinic acetylcholine receptors mecamylamine. Pain was tested using thermal withdrawal latency (TWL). A Western blot was used to examine the expression of BDNF and KCC2. Results The TWL was significantly decreased in NW group relative to control and NS groups (P < 0.01). Compared with the NW group, the NW+K252a group manifested a significantly higher latency (P < 0.01). The BDNF expression was increased and KCC2 was decreased in NW group compared with the control group (P < 0.01). K252a reduced KCC2 downregulation. Conclusion BDNF/Trk signaling may contribute to nicotine withdrawal-induced hyperalgesia via downregulation of KCC2.
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Affiliation(s)
- Wenhui Shi
- Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou, Jiangsu 221000, P. R. China
| | - Yonghong Ding
- Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou, Jiangsu 221000, P. R. China
| | - Ailan Yu
- Department of Anesthesiology, Laocheng People’s Hospital, Liaocheng, Shandong 252000, P. R. China
| | - Qinghe Wang
- Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou, Jiangsu 221000, P. R. China
| | - Zongwang Zhang
- Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou, Jiangsu 221000, P. R. China
- Department of Anesthesiology, Laocheng People’s Hospital, Liaocheng, Shandong 252000, P. R. China
- E-mail:
| | - Li-Cai Zhang
- Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou, Jiangsu 221000, P. R. China
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