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Konjevod M, Rešetar M, Matošić A, Čičin-Šain L, Štefulj J. Association of Functional Polymorphism in TPH2 Gene with Alcohol Dependence and Personality Traits: Study in Cloninger's Type I and Type II Alcohol-Dependent Inpatients. Genes (Basel) 2023; 14:413. [PMID: 36833340 PMCID: PMC9956211 DOI: 10.3390/genes14020413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/09/2023] Open
Abstract
Alcohol dependence (AD) is a complex disorder with a poorly understood etiology. In this study, we investigated the relationship between genetic variation in the TPH2 gene, which encodes the enzyme responsible for serotonin synthesis in the brain, and both AD and personality traits, with attention to Cloninger's types of AD. The study included 373 healthy control subjects, 206 inpatients with type I AD, and 110 inpatients with type II AD. All subjects were genotyped for the functional polymorphism rs4290270 in the TPH2 gene, and AD patients completed the Tridimensional Personality Questionnaire (TPQ). The AA genotype and the A allele of the rs4290270 polymorphism were more frequent in both patient groups compared with the control group. In addition, a negative association was found between the number of A alleles and TPQ scores for harm avoidance in patients with type II, but not type I, AD. These results support the involvement of genetic variations of the serotonergic system in the pathogenesis of AD, especially type II AD. They also suggest that in a subset of patients, genetic variation of TPH2 could potentially influence the development of AD by affecting the personality trait of harm avoidance.
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Affiliation(s)
- Marcela Konjevod
- Division of Molecular Biology, Ruđer Bošković Institute, HR-10000 Zagreb, Croatia
| | - Mirta Rešetar
- Division of Pharmacognosy, University of Vienna, AT-1090 Vienna, Austria
| | - Ana Matošić
- Clinical Department of Psychiatry, Sestre Milosrdnice University Hospital Center, HR-10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, HR-10000 Zagreb, Croatia
| | - Lipa Čičin-Šain
- Division of Molecular Biology, Ruđer Bošković Institute, HR-10000 Zagreb, Croatia
| | - Jasminka Štefulj
- Division of Molecular Biology, Ruđer Bošković Institute, HR-10000 Zagreb, Croatia
- Department of Psychology, Catholic University of Croatia, HR-10000 Zagreb, Croatia
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Quijano Cardé NA, Perez EE, Feinn R, Kranzler HR, De Biasi M. Antagonism of GluK1-containing kainate receptors reduces ethanol consumption by modulating ethanol reward and withdrawal. Neuropharmacology 2021; 199:108783. [PMID: 34509497 PMCID: PMC8572579 DOI: 10.1016/j.neuropharm.2021.108783] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/18/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
Alcohol use disorder (AUD) is a neuropsychiatric condition affecting millions of people worldwide. Topiramate (TPM) is an antiepileptic drug that has been shown to reduce ethanol drinking in humans. However, TPM is associated with a variety of adverse effects due to its interaction with many receptor systems and intracellular pathways. GluK1-containing kainate receptors (GluK1*KARs) are non-selectively inhibited by TPM, and genetic association studies suggest that this receptor system could be targeted to reduce drinking in AUD patients. We examined the efficacy of LY466195, a selective inhibitor of GluK1*KAR, in reducing ethanol consumption in the intermittent two-bottle choice paradigm in mice. The effect of LY466195 on various ethanol-related phenotypes was investigated by quantification of alcohol intake, physical signs of withdrawal, conditioned place preference (CPP) and in vivo microdialysis in the nucleus accumbens. Selective GluK1*KAR inhibition reduced ethanol intake and preference in a dose-dependent manner. LY466195 treatment attenuated the physical manifestations of ethanol withdrawal and influenced the rewarding properties of ethanol. Interestingly, LY466195 injection also normalized changes in dopamine levels in response to acute ethanol in ethanol-dependent mice, but had no effect in ethanol-naïve mice, suggesting ethanol state-dependent effects. The data point to GluK1*KARs as an attractive pharmacological target for the treatment of AUD.
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Affiliation(s)
- Natalia A Quijano Cardé
- Pharmacology Graduate Group, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Erika E Perez
- Department of Neuroscience, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Richard Feinn
- Department of Medical Sciences, Frank H Netter School of Medicine, Quinnipiac University, CTl Sciences, USA
| | - Henry R Kranzler
- Center for Studies of Addiction, Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania and VISN 4 MIRECC, Crescenz VAMC, Philadelphia, PA, 19104, USA; Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, USA
| | - Mariella De Biasi
- Pharmacology Graduate Group, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, USA.
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Smith LC, Kimbrough A. Leveraging Neural Networks in Preclinical Alcohol Research. Brain Sci 2020; 10:E578. [PMID: 32825739 PMCID: PMC7565429 DOI: 10.3390/brainsci10090578] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/25/2022] Open
Abstract
Alcohol use disorder is a pervasive healthcare issue with significant socioeconomic consequences. There is a plethora of neural imaging techniques available at the clinical and preclinical level, including magnetic resonance imaging and three-dimensional (3D) tissue imaging techniques. Network-based approaches can be applied to imaging data to create neural networks that model the functional and structural connectivity of the brain. These networks can be used to changes to brain-wide neural signaling caused by brain states associated with alcohol use. Neural networks can be further used to identify key brain regions or neural "hubs" involved in alcohol drinking. Here, we briefly review the current imaging and neurocircuit manipulation methods. Then, we discuss clinical and preclinical studies using network-based approaches related to substance use disorders and alcohol drinking. Finally, we discuss how preclinical 3D imaging in combination with network approaches can be applied alone and in combination with other approaches to better understand alcohol drinking.
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Affiliation(s)
- Lauren C. Smith
- Department of Psychiatry, School of Medicine, University of California San Diego, MC 0667, La Jolla, CA 92093, USA;
| | - Adam Kimbrough
- Department of Psychiatry, School of Medicine, University of California San Diego, MC 0667, La Jolla, CA 92093, USA;
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, IN 47907, USA
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Hesselbrock MN, Hesselbrock VM, Chan G, Del Boca F, Chartier K. Subtypes of Alcohol Dependence and 36-Year Mortality. Alcohol Clin Exp Res 2020; 44:1658-1665. [PMID: 32701168 PMCID: PMC8221267 DOI: 10.1111/acer.14398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/11/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Chronic, heavy alcohol use is associated with multiple health problems, including premature death. Further, the clinical presentation of alcohol dependence may differentially affect and predict the long-term health consequences of affected individuals. Subtypes of alcohol dependence based upon treatment intake information can help identify homogenous groups of patients for treatment purposes, but have not been used to predict long-term outcomes. The current study examined mortality in a 36-year posttreatment interval among 4 subtypes of alcohol-dependent patients based upon their initial intake data. METHODS Extensive baseline data were collected from n = 316 male and female patients receiving inpatient treatment for alcohol dependence between 1980 and 1982. Four alcohol dependent subtypes (Del Boca & Hesselbrock, Alcohol Health Res World, 20:56, 1996) derived from the baseline data were used to examine the 1-year posttreatment drinking status and the risk of death 36 years postdischarge. Public records were used to determine patient deaths in the 36 years since discharge. RESULTS At the 36-year follow-up interval since discharge, 68.4% of the sample had died. The 4 subtypes were found to be associated with different rates of resumption of regular drinking in the first year posttreatment and a differential risk of mortality. An increased risk for returning to regular drinking (once a week or more) and early death were associated with subtypes defined, in part, by conduct problems and externalizing disorders. Regardless of subtype membership, women had the highest risk of death following treatment. CONCLUSIONS This study demonstrates the clinical usefulness of subtypes of alcohol dependence for examining different alcohol use outcomes, including predicting mortality. The increased risks for returning to regular drinking once a week or more and early death posttreatment among subtypes associated with conduct problems and externalizing disorders suggest the need for continued monitoring and possible additional intervention postdischarge.
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Affiliation(s)
- Michie N Hesselbrock
- From the, Department of Psychiatry MC-2103, (MNH, VMH, GC), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Victor M Hesselbrock
- From the, Department of Psychiatry MC-2103, (MNH, VMH, GC), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Grace Chan
- From the, Department of Psychiatry MC-2103, (MNH, VMH, GC), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Frances Del Boca
- Department of Public Health Sciences MC-6325, (FDB), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Karen Chartier
- School of Social Work, (KC), Virginia Commonwealth University, Richmond, Virginia, USA
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Kimbrough A, Kononoff J, Simpson S, Kallupi M, Sedighim S, Palomino K, Conlisk D, Momper JD, de Guglielmo G, George O. Oxycodone self-administration and withdrawal behaviors in male and female Wistar rats. Psychopharmacology (Berl) 2020; 237:1545-1555. [PMID: 32114633 PMCID: PMC7269712 DOI: 10.1007/s00213-020-05479-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 02/06/2020] [Indexed: 12/22/2022]
Abstract
RATIONALE Over the last decade, oxycodone has become one of the most widely abused drugs in the USA. Oxycodone use disorder (OUD) is a serious health problem that has prompted a need to develop animal models of OUD that have both face and predictive validity. Oxycodone use in humans is more prevalent in women and leads to pronounced hyperalgesia and irritability during withdrawal. However, unclear is whether current animal models of oxycodone self-administration recapitulate these characteristics in humans. OBJECTIVES We assessed the face validity of a model of extended-access oxycodone self-administration in rats by examining the escalation of oxycodone intake and behavioral symptoms of withdrawal, including irritability-like behavior and mechanical nociception, in male and female Wistar rats. RESULTS Both male and female rats escalated their oxycodone intake over fourteen 12-h self-administration sessions. After escalation, female rats administered more drug than male rats. No differences in plasma oxycodone levels were identified, but males had a significantly higher level of oxycodone in the brain at 30 min. Extended access to oxycodone significantly decreased aggressive-like behavior and increased defensive-like behaviors when tested immediately after a 12-h self-administration session, followed by a rebound increase in aggressive-like behavior 12 h into withdrawal. Tests of mechanical nociception thresholds during withdrawal indicated pronounced hyperalgesia. No sex differences in irritability-like behavior or pain sensitivity were observed. CONCLUSIONS The present study demonstrated the face validity of the extended access model of oxycodone self-administration by identifying sex differences in the escalation of oxycodone intake and pronounced changes in pain and affective states.
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Affiliation(s)
- Adam Kimbrough
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Jenni Kononoff
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Sierra Simpson
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA,Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Marsida Kallupi
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Sharona Sedighim
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Kenia Palomino
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Dana Conlisk
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Jeremiah D. Momper
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Giordano de Guglielmo
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Olivier George
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA, 92093-0737, USA.
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Brain-wide functional architecture remodeling by alcohol dependence and abstinence. Proc Natl Acad Sci U S A 2020; 117:2149-2159. [PMID: 31937658 DOI: 10.1073/pnas.1909915117] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Alcohol abuse and alcohol dependence are key factors in the development of alcohol use disorder, which is a pervasive societal problem with substantial economic, medical, and psychiatric consequences. Although our understanding of the neurocircuitry that underlies alcohol use has improved, novel brain regions that are involved in alcohol use and novel biomarkers of alcohol use need to be identified. The present study used a single-cell whole-brain imaging approach to 1) assess whether abstinence from alcohol in an animal model of alcohol dependence alters the functional architecture of brain activity and modularity, 2) validate our current knowledge of the neurocircuitry of alcohol abstinence, and 3) discover brain regions that may be involved in alcohol use. Alcohol abstinence resulted in the whole-brain reorganization of functional architecture in mice and a pronounced decrease in modularity that was not observed in nondependent moderate drinkers. Structuring of the alcohol abstinence network revealed three major brain modules: 1) extended amygdala module, 2) midbrain striatal module, and 3) cortico-hippocampo-thalamic module, reminiscent of the three-stage theory. Many hub brain regions that control this network were identified, including several that have been previously overlooked in alcohol research. These results identify brain targets for future research and demonstrate that alcohol use and dependence remodel brain-wide functional architecture to decrease modularity. Further studies are needed to determine whether the changes in coactivation and modularity that are associated with alcohol abstinence are causal features of alcohol dependence or a consequence of excessive drinking and alcohol exposure.
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Long EC, Ohlsson H, Sundquist J, Sundquist K, Kendler KS. Different Characteristics and Heritabilities of Alcohol Use Disorder Classes: A Population-Based Swedish Study. Alcohol Alcohol 2019; 54:647-655. [PMID: 31556919 DOI: 10.1093/alcalc/agz069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/23/2019] [Accepted: 07/14/2019] [Indexed: 11/13/2022] Open
Abstract
AIMS The aims of the present study are to identify alcohol use disorder (AUD) classes among a population-based Swedish sample, determine if these classes differ by variables known to be associated with AUD and determine whether some AUD classes have stronger genetic influences than others. METHODS A latent class analysis (LCA), based on types of registrations, was conducted on Swedish individuals with an AUD registration born between 1960 and 1990 (N = 184,770). These classes were then validated using demographics; patterns of comorbidity with drug abuse, psychiatric disorders and criminal behavior; and neighborhood-level factors, i.e. peer AUD and neighborhood deprivation. The degree of genetic and environmental influence was also investigated. RESULTS The best-fit LCA had four classes: (a) outpatient/prescription, characterized by a mix of outpatient medical and prescription registrations, (b) low-frequency inpatient, characterized entirely by inpatient medical registrations, with the majority of individuals having one AUD registration, (c) high-frequency mixed, characterized by a mix of all four registration types, with the majority having four or more registrations and (d) crime, characterized almost entirely by criminal registrations. The highest heritability for both males and females was found for Class 3 (61% and 65%, respectively) and the lowest for Class 1 (20% for both), with shared environmental influences accounting for 10% or less of the variance in all Classes. CONCLUSIONS Using comprehensive, nationwide registry data, we showed evidence for four distinct, meaningful classes of AUD with varying degrees of heritability.
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Affiliation(s)
- E C Long
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, USA
| | - H Ohlsson
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Box 50332, 202 13 Malmö, Sweden
| | - J Sundquist
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Box 50332, 202 13 Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl., New York, NY 10029, USA
| | - K Sundquist
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Box 50332, 202 13 Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl., New York, NY 10029, USA
| | - K S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E. Leigh St., Biotech One, Suite 100, Richmond, VA 23219, USA.,Department of Psychiatry, Virginia Commonwealth University, 1200 East Broad St., P.O. Box 980710, Richmond, VA 23298, USA.,Department of Human and Molecular Genetics, Virginia Commonwealth University, 1101 East Marshall St., Box 980033, Richmond, VA 23298, USA
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Sidhu H, Kreifeldt M, Contet C. Affective Disturbances During Withdrawal from Chronic Intermittent Ethanol Inhalation in C57BL/6J and DBA/2J Male Mice. Alcohol Clin Exp Res 2018; 42:1281-1290. [PMID: 29687895 PMCID: PMC6028290 DOI: 10.1111/acer.13760] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/16/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND Alcohol use disorders are characterized by a complex behavioral symptomatology, which includes the loss of control over alcohol consumption and the emergence of a negative affective state when alcohol is not consumed. Some of these symptoms can be recapitulated in rodent models, for instance following chronic intermittent ethanol (EtOH; CIE) vapor inhalation. However, the detection of negative affect in mice withdrawn from CIE has proven challenging and variable between strains. This study aimed to detect reliable indices of negative emotionality in CIE-exposed C57BL/6J (C57) and DBA/2J (DBA) mice. Males were used because they are known to escalate their voluntary EtOH consumption upon CIE exposure, which is hypothesized to be driven by negative reinforcement (relief from negative affect). METHODS Adult male mice were exposed to 4 to 6 weeks of CIE and were evaluated 3 to 10 days into withdrawal in the social approach, novelty-suppressed feeding, digging, marble burying, and bottle brush tests. RESULTS Withdrawal from CIE decreased sociability in DBA mice but not in C57 mice. Conversely, hyponeophagia was exacerbated by CIE in C57 mice but not in DBA mice. Withdrawal from CIE robustly increased digging activity in both strains, even in the absence of marbles. Aggressive responses to bottle brush attacks were elevated in both C57 and DBA mice following CIE exposure, but CIE had an opposite effect on defensive responses in the 2 strains (increase in C57 vs. decrease in DBA). CONCLUSIONS Our results indicate that withdrawal from CIE elicits negative emotionality in both C57 and DBA mice, but different tests need to be used to measure the anxiogenic-like effects of withdrawal in each strain. Increased digging activity and irritability-like behavior represent novel indices of affective dysfunction associated with withdrawal from CIE in both mouse strains. Our findings enrich the characterization of the affective symptomatology of protracted withdrawal from CIE in mice.
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Affiliation(s)
- Harpreet Sidhu
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
| | - Max Kreifeldt
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
| | - Candice Contet
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
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Oreland L, Lagravinese G, Toffoletto S, Nilsson KW, Harro J, Robert Cloninger C, Comasco E. Personality as an intermediate phenotype for genetic dissection of alcohol use disorder. J Neural Transm (Vienna) 2018; 125:107-130. [PMID: 28054193 PMCID: PMC5754455 DOI: 10.1007/s00702-016-1672-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/23/2016] [Indexed: 01/16/2023]
Abstract
Genetic and environmental interactive influences on predisposition to develop alcohol use disorder (AUD) account for the high heterogeneity among AUD patients and make research on the risk and resiliency factors complicated. Several attempts have been made to identify the genetic basis of AUD; however, only few genetic polymorphisms have consistently been associated with AUD. Intermediate phenotypes are expected to be in-between proxies of basic neuronal biological processes and nosological symptoms of AUD. Personality is likely to be a top candidate intermediate phenotype for the dissection of the genetic underpinnings of different subtypes of AUD. To date, 38 studies have investigated personality traits, commonly assessed by the Cloninger's Tridimensional Personality Questionnaire (TPQ) or Temperament and Character Inventory (TCI), in relation to polymorphisms of candidate genes of neurotransmitter systems in alcohol-dependent patients. Particular attention has been given to the functional polymorphism of the serotonin transporter gene (5-HTTLPR), however, leading to contradictory results, whereas results with polymorphisms in other candidate monoaminergic genes (e.g., tryptophan hydroxylase, serotonin receptors, monoamine oxidases, dopamine receptors and transporter) are sparse. Only one genome-wide association study has been performed so far and identified the ABLIM1 gene of relevance for novelty seeking, harm avoidance and reward dependence in alcohol-dependent patients. Studies investigating genetic factors together with personality could help to define more homogenous subgroups of AUD patients and facilitate treatment strategies. This review also urges the scientific community to combine genetic data with psychobiological and environmental data to further dissect the link between personality and AUD.
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Affiliation(s)
- Lars Oreland
- Department of Neuroscience, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Gianvito Lagravinese
- Department of Neuroscience, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Simone Toffoletto
- Department of Neuroscience, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Kent W Nilsson
- Centre for Clinical Research, Uppsala University, Västmanland County Counci, Västerås, Sweden
| | - Jaanus Harro
- Division of Neuropsychopharmacology, Department of Psychology, University of Tartu, Tartu, Estonia
- Psychiatry Clinic, North Estonia Medical Centre, Tallinn, Estonia
| | - C Robert Cloninger
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO, USA
| | - Erika Comasco
- Department of Neuroscience, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden.
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Paulino S, Pombo S, Ismail F, Figueira ML, Lesch O. The role of affective temperament as a predictor of relapse in alcohol dependence. Personal Ment Health 2017; 11:278-289. [PMID: 28660681 DOI: 10.1002/pmh.1373] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/13/2017] [Accepted: 03/20/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND Personality traits have been proposed as relapse risk factors in alcohol use disorders. So far, no study has assessed the association between affective temperamental traits and the prospective relapse risk. METHODS This was a 3-month prospective naturalistic study, designed to assess the impact of affective temperaments in relapse. A sample of 61 alcohol-dependent patients was collected from an ambulatory clinical setting. Socio-demographic information, drinking and substance use habits, drinking status, craving and affective temperament traits were assessed. RESULTS Age, age of onset of alcohol abuse and dependence and drug consumption correlate with drinking status. Male alcohol-dependent patients who relapsed presented higher scores on cyclothymic temperament than patients with an alcohol dependence diagnosis who remain sober. Hierarchical logistic regression indicates that cyclothymic temperament predicted relapse in a 3-month follow-up. However, the coefficient was marginally significant after controlling for all potential confounding predictors. CONCLUSIONS Our results provide new insights about the role of affective temperaments in alcohol use disorders, specifically in predicting short-term relapse in detoxified male alcohol-dependent patients. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sofia Paulino
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Samuel Pombo
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Fátima Ismail
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Maria Luísa Figueira
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Otto Lesch
- Department for Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Hwa LS, Nathanson AJ, Shimamoto A, Tayeh JK, Wilens AR, Holly EN, Newman EL, DeBold JF, Miczek KA. Aggression and increased glutamate in the mPFC during withdrawal from intermittent alcohol in outbred mice. Psychopharmacology (Berl) 2015; 232:2889-902. [PMID: 25899790 PMCID: PMC4515187 DOI: 10.1007/s00213-015-3925-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/20/2015] [Indexed: 12/14/2022]
Abstract
RATIONALE Disrupted social behavior, including occasional aggressive outbursts, is characteristic of withdrawal from long-term alcohol (EtOH) use. Heavy EtOH use and exaggerated responses during withdrawal may be treated using glutamatergic N-methyl-D-aspartate receptor (NMDAR) antagonists. OBJECTIVES The current experiments explore aggression and medial prefrontal cortex (mPFC) glutamate as consequences of withdrawal from intermittent access to EtOH and changes in aggression and mPFC glutamate caused by NMDAR antagonists memantine and ketamine. METHODS Swiss male mice underwent withdrawal following 1-8 weeks of intermittent access to 20 % EtOH. Aggressive and nonaggressive behaviors with a conspecific were measured 6-8 h into EtOH withdrawal after memantine or ketamine (0-30 mg/kg, i.p.) administration. In separate mice, extracellular mPFC glutamate after memantine was measured during withdrawal using in vivo microdialysis. RESULTS At 6-8 h withdrawal from EtOH, mice exhibited more convulsions and aggression and decreased social contact compared to age-matched water controls. Memantine, but not ketamine, increased withdrawal aggression at the 5-mg/kg dose in mice with a history of 8 weeks of EtOH but not 1 or 4 weeks of EtOH or in water drinkers. Tonic mPFC glutamate was higher during withdrawal after 8 weeks of EtOH compared to 1 week of EtOH or 8 weeks of water. Five milligrams per kilogram of memantine increased glutamate in 8-week EtOH mice, but also in 1-week EtOH and water drinkers. CONCLUSIONS These studies reveal aggressive behavior as a novel symptom of EtOH withdrawal in outbred mice and confirm a role of NMDARs during withdrawal aggression and for disrupted social behavior.
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Affiliation(s)
- Lara S. Hwa
- Tufts University Department of Psychology, Medford, MA 02155
| | | | - Akiko Shimamoto
- Tufts University Department of Psychology, Medford, MA 02155
| | | | | | | | - Emily L. Newman
- Tufts University Department of Psychology, Medford, MA 02155
| | | | - Klaus A. Miczek
- Tufts University Department of Psychology, Medford, MA 02155
- Tufts University Department of Neuroscience, Boston, MA 02111
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Pombo S, da Costa NF, Figueira ML, Ismail F, Lesch OM. Multidimensional alcoholism typologies: could they guide clinical practice? Results from a 3-month prospective study. Int J Psychiatry Clin Pract 2015; 19:137-47. [PMID: 25666860 DOI: 10.3109/13651501.2015.1016972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The current nosological classifications may describe a syndrome of "alcoholism" that is too heterogeneous to produce prognostic models for clinical management. Multidimensional alcoholism typologies (ATs) could represent a valuable paradigm in the search for targeted treatment. The main goal of this study was to evaluate the clinical implications of 3 empirically-validated ATs, focusing on various measures of clinical performance. METHOD This was a 3-month naturalistic study in which drinking status, and participation in the clinical protocol and group psychotherapy were recorded and used as indicators of treatment performance. The clinical profiles of the subtypes were also compared and graphically presented. Alcohol-dependent outpatients were classified according to the Cloninger, Lesch, and NETER typologies. RESULTS The results showed that the type II (Cloninger), type IV (Lesch), and sociopathic and addictopathic (NETER) subgroups showed a worse outcome in terms of abstinence rates and clinical healthcare resource use. CONCLUSIONS Our findings point to the need to differentiate multidimensional alcoholism subtypes before planning the clinical management of alcohol use disorders.
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Affiliation(s)
- Samuel Pombo
- Department of Neuroscience, Psychiatric Service and Medical Psychology, Santa Maria University Hospital , Lisbon , Portugal
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Bi J, Gelernter J, Sun J, Kranzler HR. Comparing the utility of homogeneous subtypes of cocaine use and related behaviors with DSM-IV cocaine dependence as traits for genetic association analysis. Am J Med Genet B Neuropsychiatr Genet 2014; 165B:148-56. [PMID: 24339190 PMCID: PMC4152729 DOI: 10.1002/ajmg.b.32216] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 11/20/2013] [Indexed: 11/08/2022]
Abstract
Because DSM-IV cocaine dependence (CD) is heterogeneous, it is not an optimal phenotype to identify genetic variation contributing to risk for cocaine use and related behaviors (CRBs). We used a cluster analytic method to differentiate homogeneous, highly heritable subtypes of CRBs and to compare their utility with that of the DSM-IV CD as traits for genetic association analysis. Clinical features of CRBs and co-occurring disorders were obtained via a poly-diagnostic interview administered to 9,965 participants in genetic studies of substance dependence. A subsample of subjects (N = 3,443) were genotyped for 1,350 single nucleotide polymorphisms (SNPs) selected from 130 candidate genes related to addiction. Cluster analysis of clinical features of the sample yielded five subgroups, two of which were characterized by heavy cocaine use and high heritability: a heavy cocaine use, infrequent intravenous injection group and an early-onset, heavy cocaine use, high comorbidity group. The utility of these traits was compared with the CD diagnosis through association testing of 2,320 affected subjects and 480 cocaine-exposed controls. Analyses examined both single SNP (main) and SNP-SNP interaction (epistatic) effects, separately for African-Americans and European-Americans. The two derived subtypes showed more significant P values for 6 of 8 main effects and 7 of 8 epistatic effects. Variants in the CLOCK gene were significantly associated with the heavy cocaine use, infrequent intravenous injection group, but not with the DSM-IV diagnosis of CD. These results support the utility of subtypes based on CRBs to detect risk variants for cocaine addiction.
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Affiliation(s)
- Jinbo Bi
- Department of Computer Science and Engineering, School of Engineering, University of Connecticut, Storrs, Connecticut
| | - Joel Gelernter
- Departments of Psychiatry, Genetics, and Neurobiology, Yale University School of Medicine, New Haven, Connecticut,Department of Psychiatry, VA CT Healthcare Center, West Haven, Connecticut
| | - Jiangwen Sun
- Department of Computer Science and Engineering, School of Engineering, University of Connecticut, Storrs, Connecticut
| | - Henry R. Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania,VISN 4 Mental Illness Research, Education, and Clinical Center, Philadelphia, Pennsylvania,Correspondence to: Henry R. Kranzler, M.D., Department of Psychiatry, Treatment Research Center, University of Pennsylvania Perelman School of Medicine, 3900 Chestnut Street, Philadelphia, PA 19104-6178.
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Pombo S, Figueira ML, da Costa NF, Ismail F, Yang G, Akiskal K, Akiskal H. The burden of cyclothymia on alcohol dependence. J Affect Disord 2013; 151:1090-6. [PMID: 24091304 DOI: 10.1016/j.jad.2013.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/03/2013] [Accepted: 09/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The relationship between cyclothymic temperament and alcoholism remains insufficiently explored. METHODS A sample of 125 alcohol-dependent patients diagnosed according to DSM-IV-TR criteria (APA, 2000) was recruited from a clinical setting. Cyclothymic temperament was diagnosed according to the Portuguese version of the Akiskal and Akiskal (2005) temperament scale. RESULTS Alcohol dependent patients who score positive (above mean) for CT present to some extent a more severe profile of alcohol-related problems. LIMITATIONS Correlational study CONCLUSIONS CT traits in alcohol dependents seems to influence whether subjects engage earlier in pathological alcohol use and present particular alcohol-related problems, in particular Cloninger type II alcoholism phenotype.
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Affiliation(s)
- Samuel Pombo
- Psychiatric Service and Medical Psychology from Santa Maria Universitary Hospital of Lisbon, Portugal.
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15
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Casey M, Adamson G, Stringer M. Empirical derived AUD sub types in the US general population: a latent class analysis. Addict Behav 2013; 38:2782-6. [PMID: 23954945 DOI: 10.1016/j.addbeh.2013.06.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 05/23/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
Abstract
AIMS This study examined the homogenous expression of DSM-5-based alcohol use disorder (AUD) latent subtypes. METHOD Using data from the National Epidemiologic Survey of Alcohol and Related Conditions Wave 2 (n = 22,177) the typology was established utilising latent class analysis and the model was further validated by multivariate regression on a range of covariates. RESULTS Three AUD classes based on a severity gradient and one non-problematic class were the most parsimonious description of the data. These classes displayed both quantitative and qualitative differences on the covariates. CONCLUSIONS The resulting typology has high clinical utility, enhances AUD classification and adds to our understanding of AUD trajectories, prevention and treatment.
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Levola J, Kaskela T, Holopainen A, Sabariego C, Tourunen J, Cieza A, Pitkänen T. Psychosocial difficulties in alcohol dependence: a systematic review of activity limitations and participation restrictions. Disabil Rehabil 2013; 36:1227-39. [DOI: 10.3109/09638288.2013.837104] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Skala K, Walter H. Adolescence and Alcohol: a review of the literature. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2013; 27:202-11. [PMID: 23839238 DOI: 10.1007/s40211-013-0066-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 04/20/2013] [Indexed: 01/01/2023]
Abstract
Up to two thirds of adolescents consume alcohol and about a quarter engage in abusive behavior at some point. Many users begin alcohol use at young ages, and binge drinking is a dominant pattern for a proportion of youth. Because neurogenesis is inhibited by ethanol, consequences of adolescent alcohol abuse include changes in brain development and impairment of neurocognitive performance. A variety of mental and psychosocial problems are also often witnessed in alcohol abusing youth. Apart from the influence exerted by genetic and psychosocial factors, the chance of developing problematic alcohol consumption is increased by consumption in a binge drinking manner and by first contact with alcohol at a young age. Discrimination of alcohol consumption within the frames of normal adolescent behavior from problematic use is still a challenging issue. Different prevention programs provide treatment either directly to the adolescent, in the context of the school, or within the frame of the adolescent's family. Although some of these efforts have been shown to be effective in reducing alcohol misuse in youth, hardly any intervention reveals satisfactory outcomes in a long-term prospect. Successful prevention strategies would need to comprise treatment of current neuropsychological impairment as well as of comorbid mental health problems and concurrent other substance misuse.
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Affiliation(s)
- Katrin Skala
- Department of Child- and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Aguiar P, Neto D, Lambaz R, Chick J, Ferrinho P. Prognostic Factors During Outpatient Treatment for Alcohol Dependence: Cohort Study with 6 months of Treatment Follow-up. Alcohol Alcohol 2012; 47:702-10. [DOI: 10.1093/alcalc/ags097] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chen YC, Prescott CA, Walsh D, Patterson DG, Riley BP, Kendler KS, Kuo PH. Different phenotypic and genotypic presentations in alcohol dependence: age at onset matters. J Stud Alcohol Drugs 2012; 72:752-62. [PMID: 21906503 DOI: 10.15288/jsad.2011.72.752] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Several theoretical typology models have been proposed to classify alcoholism into more homogeneous subtypes using various criteria, for which age at onset of alcohol dependence is shared across many models. We investigated the evidence for the distinction between early- versus late-onset alcoholism by examining relevant phenotypic and genotypic variables. METHOD Data are from 1,248 individuals with alcohol dependence, who were interviewed to collect detailed clinical information. Early versus late onset of alcohol dependence was defined by the age at onset of 22 years. Odds ratio (OR) and Cohen's d were calculated as effect size for comparisons of clinical features between the two groups. We adjusted interviewed age and gender in logistic regression models. Case-control genetic analyses were conducted for the association between HTR1B, SLC6A4, DRD2, and OPRμ1 genes and subgroups of alcohol dependence using a sample of 530 controls screened for alcohol problems. RESULTS Early-onset alcoholism exhibited significantly (p < .01) different clinical characteristics from late-onset alcoholism, including higher severity in alcohol dependence symptoms (d = 0.22) and maximum drinking quantity within 24 hours (d = 0.40), more rapid progression from regular drinking to meet alcohol dependence diagnosis (d = 1.73), higher expectancies for alcohol (d = 0.22-0.47), more comorbidity with externalizing disorders (ORs = 2.8-2.9), and greater prevalence of family alcohol use problems (d = 0.26-0.43). In addition, markers in the HTR1B and OPRμ1 genes showed genetic associations with subgroups of alcohol dependence (ORs = 1.5-2.4). CONCLUSIONS Our findings support that subgroups of alcohol dependence defined by onset age have phenotypic and genetic differences. The early-onset subgroup had more severe features for almost every aspect we examined. Coupled with genetic association findings, age at onset of alcohol dependence may serve as a simple but important clinical marker with implications for future etiological research and intervention.
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Affiliation(s)
- Yu-Chu Chen
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan
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Comasco E, Berglund K, Oreland L, Nilsson KW. Why do adolescents drink? Motivational patterns related to alcohol consumption and alcohol-related problems. Subst Use Misuse 2010; 45:1589-604. [PMID: 20590377 DOI: 10.3109/10826081003690159] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The present study was designed to investigate motivational patterns for drinking alcohol and their relation about alcohol consumption and problems related to alcohol consumption. Data were collected by semistructured interviews and questionnaires, containing questions about reasons for drinking, alcohol consumption, and problems related to alcohol consumption during the years 2001, 2004, and 2005. Three independent population samples from two different counties of central Sweden were included. A total of 11,167 adolescents participated. Data on reasons for drinking were analyzed by factor analysis to extract components explaining drinking motives. Relationships between motivational patterns and alcohol use were examined with correlation analysis. Three drinking motives emerged (social-enhancement, coping, and dominance motives) and related to alcohol consumption and problems related to alcohol consumption. Limitations of the study are noted and discussed.
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Affiliation(s)
- Erika Comasco
- Center for Clinical Research, Uppsala University, Central Hospital Västerås, Sweden.
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Sintov ND, Kendler KS, Young-Wolff KC, Walsh D, Patterson DG, Prescott CA. Empirically defined subtypes of alcohol dependence in an Irish family sample. Drug Alcohol Depend 2010; 107:230-6. [PMID: 20022183 PMCID: PMC2822051 DOI: 10.1016/j.drugalcdep.2009.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 10/06/2009] [Accepted: 11/04/2009] [Indexed: 10/20/2022]
Abstract
Alcohol dependence (AD) is clinically and etiologically heterogeneous. The goal of this study was to explore AD subtypes among a sample of 1221 participants in the Irish Affected Sib Pair Study of Alcohol Dependence, all of whom met DSM-IV criteria for AD. Variables used to identify the subtypes included major depressive disorder, antisocial personality disorder, illicit drug dependence (cannabis, sedatives, stimulants, cocaine, opioids, and hallucinogens), nicotine dependence, the personality traits of neuroticism and novelty seeking, and early alcohol use. Using latent class analysis, a 3-class solution was identified as the most parsimonious description of the data. Individuals in a Mild class were least likely to have comorbid psychopathology, whereas a severe class had highest probabilities of all comorbid psychopathology. The third class was characterized by high probabilities of major depression and higher neuroticism scores, but lower likelihood of other comorbid disorders than seen in the severe class. Overall, sibling pair resemblance for class was stronger within than between classes, and was greatest for siblings within the severe class, suggesting a stronger familial etiology for this class. These findings are consistent with the affective regulation and behavioral disinhibition subtypes of alcoholism, and are in line with prior work suggesting familial influences on subtype etiology.
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Affiliation(s)
- Nicole D Sintov
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
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Typologies of Alcohol Dependence. From Jellinek to Genetics and Beyond. Neuropsychol Rev 2009; 19:115-29. [DOI: 10.1007/s11065-008-9080-z] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Accepted: 11/25/2008] [Indexed: 10/21/2022]
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23
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Pombo S, Lesch OM. The Alcoholic Phenotypes among Different Multidimensional Typologies: Similarities and Their Classification Procedures. Alcohol Alcohol 2008; 44:46-54. [DOI: 10.1093/alcalc/agn080] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pombo S, Levy P, Bicho M, Ismail F, Cardoso JMN. Neuropsychological function and platelet monoamine oxidase activity levels in type I alcoholic patients. Alcohol Alcohol 2008; 43:423-30. [PMID: 18408241 DOI: 10.1093/alcalc/agn021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To explore neuropsychological function in two differentiated patterns of platelet monoamine oxidase B (MAO B) activity in alcoholic patients. METHODS Neuropsychological examination and platelet MAO B activity extracted from blood were collected from 42 alcohol-dependent patients recruited in the alcoholism unit (NETER) of the Psychiatric Service of Santa Maria University Hospital. RESULTS Alcoholics presented significantly low levels of platelet MAO B activity, when compared with control subjects; platelet MAO B activity in alcoholics classified as "under average subgroup" showed significant lower scores in the Raven Progressive Matrix and higher scores in hostility dimension, when compared with platelet MAO B activity in "above average subgroup." CONCLUSIONS Results suggested platelet MAO B as a trait marker also to type I alcohol-dependent patients and the two observed associations between platelet MAO B activity with neurocognitive measures of executive functions (nonverbal reasoning) and psychopathological dimension such as hostility may support the notion about the effect of platelet MAO B activity in the further development of an impulsive cognitive style.
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Affiliation(s)
- Samuel Pombo
- Psychiatric Service of Santa Maria General Hospital, Núcleo de Estudos e Tratamento do Etilo-Risco (NETER), Lisbon, Portugal.
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Abstract
The immediate early gene, activity-regulated cytoskeleton-associated protein (Arc), has been implicated in synaptic plasticity. However, the role of Arc in alcoholism is unknown. Here, we report that the anxiolytic effects of acute ethanol were associated with increased brain-derived neurotrophic factor (BDNF) and tyrosine kinase B (trkB) expression, increased phosphorylation of extracellular signal-regulated kinases 1/2 (Erk1/2), Elk-1, and cAMP responsive element-binding protein (CREB), increased Arc expression, and increased dendritic spine density (DSD) in both the central amygdala (CeA) and medial amygdala (MeA) but not in the basolateral amygdala (BLA) of rats. Conversely, the anxiogenic effects of withdrawal after long-term ethanol exposure were associated with decreased BDNF and trkB expression, decreased phosphorylation of Erk1/2, Elk-1, and CREB, decreased Arc expression, and decreased DSD in both the CeA and MeA but not in the BLA of rats. We also showed that BDNF infusion into the CeA normalized phosphorylation of Erk1/2, Elk-1, and CREB, and normalized Arc expression, thereby protecting against the onset of ethanol withdrawal-related anxiety. We further demonstrated that arresting Arc expression in the CeA decreased DSD, thereby increasing anxiety-like and alcohol-drinking behaviors in control rats. These results revealed that BDNF-Arc signaling and the associated DSD in the CeA, and possibly in the MeA, may be involved in the molecular processes of alcohol dependence and comorbidity of anxiety and alcohol-drinking behaviors.
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Davis MI. Ethanol-BDNF interactions: still more questions than answers. Pharmacol Ther 2008; 118:36-57. [PMID: 18394710 DOI: 10.1016/j.pharmthera.2008.01.003] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Accepted: 01/08/2008] [Indexed: 01/02/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) has emerged as a regulator of development, plasticity and, recently, addiction. Decreased neurotrophic activity may be involved in ethanol-induced neurodegeneration in the adult brain and in the etiology of alcohol-related neurodevelopmental disorders. This can occur through decreased expression of BDNF or through inability of the receptor to transduce signals in the presence of ethanol. In contrast, recent studies implicate region-specific up-regulation of BDNF and associated signaling pathways in anxiety, addiction and homeostasis after ethanol exposure. Anxiety and depression are precipitating factors for substance abuse and these disorders also involve region-specific changes in BDNF in both pathogenesis and response to pharmacotherapy. Polymorphisms in the genes coding for BDNF and its receptor TrkB are linked to affective, substance abuse and appetitive disorders and therefore may play a role in the development of alcoholism. This review summarizes historical and pre-clinical data on BDNF and TrkB as it relates to ethanol toxicity and addiction. Many unresolved questions about region-specific changes in BDNF expression and the precise role of BDNF in neuropsychiatric disorders and addiction remain to be elucidated. Resolution of these questions will require significant integration of the literature on addiction and comorbid psychiatric disorders that contribute to the development of alcoholism.
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Affiliation(s)
- Margaret I Davis
- Section on Synaptic Pharmacology, Laboratory for Integrative Neuroscience, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA.
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Pombo S, Reizinho R, Ismail F, Barbosa A, Figueira ML, Cardoso JMN, Lesch OM. NETER 1 alcoholic 5 subtypes: Validity with Lesch four evolutionary subtypes. Int J Psychiatry Clin Pract 2008; 12:55-64. [PMID: 24916498 DOI: 10.1080/13651500701493953] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective. To validate NAT (NETER's alcoholic typology), taking into account the differentiated distribution of the measures used as external criteria in alcohol-dependent sub-groups and its relationship with Lesch's alcoholic typology (LAT). Method. A sample of 133 alcohol-dependent patients integrated in the alcoholism unit of the Psychiatric Service of Santa Maria University Hospital were included in the study. Results and Conclusions. Convergent validity was assured by the agreement between the subtypes of the two typologies (NAT and Lesch), considering the same underlying model of alcoholism development: anxiopathic subtype of NAT and Type II (model of anxiety, alcohol as conflict solution) of Lesch and the tymopathic subtype of NAT and type III (model of depression, alcohol as antidepressant) of Lesch. Discriminant analysis (external criteria) showed significant differences between the subtypes in the following variables: gender; tobacco; beer and whisky consumption; daily average of drinks; clinical conditions such as delirium tremens, alcoholic blackouts and seizures; severity of alcohol-related problems; psychological dimensions such as psychological maturity and extroversion; and suicidal ideation during the alcohol consumption period. A more exhaustive description of alcoholic sub-groups may improve genetic studies of alcoholism and provide the alcoholic patient with an adequate specific therapeutic protocol.
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Affiliation(s)
- Samuel Pombo
- Psychiatric Service of Santa Maria University Hospital, Av. Professor Egas Moniz, 1649-028, Lisboa, Portugal
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Babor TF, Caetano R. Subtypes of substance dependence and abuse: implications for diagnostic classification and empirical research. Addiction 2006; 101 Suppl 1:104-10. [PMID: 16930166 DOI: 10.1111/j.1360-0443.2006.01595.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the relevance of a form of diagnostic classification called clinical subtyping in relation to possible revisions in the diagnostic criteria for substance abuse and dependence in psychiatric classification systems. METHODS A general rationale for subtyping is presented. To explore the implications for diagnostic classification, recent research on a variety of subtyping schemes is reviewed in terms of the development of new subtypes and the validation of established theories. RESULTS Subtypes of alcoholism and other psychiatric disorders have been proposed since the beginning of modern psychiatry. Recent subtyping research suggests that no consensus has emerged about the nature, much less the number, of subtypes that could be used to characterize the clinical heterogeneity assumed to be present in groups of people with substance use disorders. Although several relatively simple binary typologies have been developed (e.g. Cloninger's type I and type II; Babor et al.'s type A and type B), validation research has produced mixed results in terms of the construct, concurrent and predictive validity of these classifications. CONCLUSIONS The adoption of a subtyping scheme in the major psychiatric classification systems is not recommended until further international research is conducted.
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Affiliation(s)
- Thomas F Babor
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT, USA.
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Abstract
BACKGROUND Little work has been done in India on the personality factors of alcoholics. These personality factors have a significant effect on treatment outcome. AIM To study the personality characteristics, stressful life events and diagnostic utility of the Michigan Alcoholism Screening Test (MAST) and CAGE (Cutting down, Annoyance by criticism, Guilty feeling, and Eye-opener) Questionnaire in service personnel with alcohol dependence. METHODS Psychological assessment of 100 consecutive male inpatients meeting the DSM-IV criteria for alcohol dependence, and an equal number of controls matched for age, sex, occupation and regional background was carried out utilizing the MAST, CAGE Questionnaire, State-Trait Anxiety Inventory, Hamilton Rating Scale for Depression, Multiphasic Personality Questionnaire, Maudsley Personality Inventory, Toronto Alexithymia Scale, Self-esteem Inventory and Presumptive Stressful Life Events scale. RESULTS The MAST and CAGE were of limited value in the diagnosis of alcohol dependence. Alcoholics obtained significantly higher scores on state and trait anxiety, depression, mania scale, paranoia scale, schizophrenia scale, psychopathic deviance, neuroticism, extroversion, and the Presumptive Stressful Life Events scale. Alcohol-dependent individuals had significantly lower self-esteem compared with control subjects, and significantly more alcoholics were identified as alexithymic. CONCLUSION Alcohol-dependent individuals show significantly high neuroticism, extroversion, anxiety, depression, psychopathic deviation, stressful life events and significantly low self-esteem as compared with normal control subjects. Significantly more alcoholics were found to be alexithymic compared with normal controls.
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Affiliation(s)
| | - S.K. Das
- Consultant Psychiatrist Bhubaneshwar
| | - B. Ukil
- Psychiatrist No. 3 CRPF Base Hospital, Guwahati
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