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Pintori N, Piva A, Guardiani V, Decimo I, Chiamulera C. Brief Environmental Enrichment exposure enhances contextual-induced sucrose-seeking with and without memory reactivation in rats. Behav Brain Res 2022; 416:113556. [PMID: 34474039 DOI: 10.1016/j.bbr.2021.113556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/21/2021] [Accepted: 08/23/2021] [Indexed: 12/16/2022]
Abstract
Chronic Environmental Enrichment (EE) has been shown to prevent the relapse to addictive behaviours, such as drug-taking and -seeking. Recently, acute EE was shown to reduce cue-induced sucrose-seeking, but its effects on contextual (Cx)-induced sucrose-seeking is still unknown. Here we report the effects of brief EE exposure on Cx-induced sucrose-seeking with and without prior Cx-memory reactivation. Adult male Sprague-Dawley rats were trained to sucrose self-administration associated to a specific conditioning Cx (CxA), followed by a 7-day extinction in a different Cx (CxB). Afterwards, rats were exposed for 22 h to EE, and 1 h later to either i) Cx-induced sucrose-seeking (1 h, renewal without Cx-memory reactivation), ii) or two different Cx-memory reactivations: short (2-min) and long (15-min) CxA-retrieval session (Cx-Ret). In Cx-Ret experiments, CxA-induced sucrose-seeking test (1 h) was done after a subsequent 3-day extinction phase. The assessment of molecular markers of memory reactivation/reconsolidation, Zif-268 and rpS6P, was performed 2 h after Cx-Ret. Brief EE exposure enhanced Cx-induced sucrose-seeking without and with short but not long Cx-retrieval. Moreover, EE impaired discriminative responding at test prior to long, whereas improved it with or without short Cx-retrieval. Different changes in Zif-268 and rpS6P expression induced by short vs. long Cx-Ret were correlated to behavioural data, suggesting the occurrence of different memory processes affected by EE. Our data show that brief EE exposure may differently affect subsequent appetitive relapse depending on the modality of re-exposure to conditioned context. This finding suggests caution and further studies to understand the proper conditions for the use of EE against appetitive and addiction disorders.
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Affiliation(s)
- N Pintori
- Section of Pharmacology, Dept. Diagnostic & Public Health, University of Verona, Verona, Italy.
| | - A Piva
- Section of Pharmacology, Dept. Diagnostic & Public Health, University of Verona, Verona, Italy
| | - V Guardiani
- Section of Pharmacology, Dept. Diagnostic & Public Health, University of Verona, Verona, Italy
| | - I Decimo
- Section of Pharmacology, Dept. Diagnostic & Public Health, University of Verona, Verona, Italy
| | - C Chiamulera
- Section of Pharmacology, Dept. Diagnostic & Public Health, University of Verona, Verona, Italy
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Pintori N, Piva A, Guardiani V, Marzo CM, Decimo I, Chiamulera C. The interaction between Environmental Enrichment and fluoxetine in inhibiting sucrose-seeking renewal in mice depend on social living condition. Psychopharmacology (Berl) 2022; 239:2351-2361. [PMID: 35353203 PMCID: PMC9205808 DOI: 10.1007/s00213-022-06124-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
RATIONALE Several single or combined therapeutic approaches have been developed to treat addiction, however with partial efficacy in preventing relapse. Recently, the living environment has been suggested as a critical intervening factor determining the treatment outcomes. Despite accumulating evidence confirming a role of living conditions in the vulnerability to addictive behaviours, their impact on single or integrative therapeutic strategies preventing relapse is yet to be identified. OBJECTIVES Here, we explore the possible interaction between brief Environmental Enrichment (EE) exposure and acute fluoxetine administration in inhibiting sucrose-seeking behaviours, and whether this effect could be affected by living environment. METHODS Social and isolated adult male C57BL/6 mice were trained to sucrose self-administration associated to a specific conditioning context (CxA), followed by a 7-day extinction in a different context (CxB). Afterwards, mice were exposed for 22 h to EE and then injected with fluoxetine (10 mg/kg, i.p.) 1 h before a CxA-induced sucrose-seeking test. RESULTS Brief EE exposure and acute fluoxetine administration alone inhibited context-induced sucrose-seeking in both housing conditions; however, they exhibited additive properties only in social condition. CONCLUSIONS Our data show that social environment may influence the EE/fluoxetine interaction in inhibiting relapse to sucrose. These findings suggest that setting up proper living conditions to boost the efficacy of therapeutic approaches may represent a fundamental strategy to treat addiction disorders.
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Affiliation(s)
- N. Pintori
- Section of Pharmacology, Department of Diagnostic and Public Health, Policlinico ‘GB Rossi’, P.le Scuro 10, University of Verona, 37134 Verona, Italy ,Department of Biomedical Sciences, Cittadella Universitaria Di Monserrato, University of Cagliari, S.P.8 km 0, 700-09042 Monserrato, Cagliari Italy
| | - A. Piva
- Section of Pharmacology, Department of Diagnostic and Public Health, Policlinico ‘GB Rossi’, P.le Scuro 10, University of Verona, 37134 Verona, Italy
| | - V. Guardiani
- Section of Pharmacology, Department of Diagnostic and Public Health, Policlinico ‘GB Rossi’, P.le Scuro 10, University of Verona, 37134 Verona, Italy
| | - C. M. Marzo
- Department of Biotechnology, University of Verona, Verona, Italy
| | - I. Decimo
- Section of Pharmacology, Department of Diagnostic and Public Health, Policlinico ‘GB Rossi’, P.le Scuro 10, University of Verona, 37134 Verona, Italy
| | - C. Chiamulera
- Section of Pharmacology, Department of Diagnostic and Public Health, Policlinico ‘GB Rossi’, P.le Scuro 10, University of Verona, 37134 Verona, Italy
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Piva A, Caffino L, Padovani L, Pintori N, Mottarlini F, Sferrazza G, Paolone G, Fumagalli F, Chiamulera C. The metaplastic effects of ketamine on sucrose renewal and contextual memory reconsolidation in rats. Behav Brain Res 2020; 379:112347. [DOI: 10.1016/j.bbr.2019.112347] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 12/15/2022]
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Liu W, Chen XJ, Wen YT, Winkler MH, Paul P, He YL, Wang L, Chen HX, Li YH. Memory Retrieval-Extinction Combined With Virtual Reality Reducing Drug Craving for Methamphetamine: Study Protocol for a Randomized Controlled Trial. Front Psychiatry 2020; 11:322. [PMID: 32411025 PMCID: PMC7202246 DOI: 10.3389/fpsyt.2020.00322] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/31/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Relapse, often precipitated by drug-associated cues that evoke craving, is a key problem in the treatment of methamphetamine use disorder (MUD). Drug-associated memories play a major role in the maintenance of relapse. Extinction training is a common method for decreasing drug craving by suppressing drug-associated memories. However, the effects are often not permanent, which is evident in form of spontaneous recovery or renewal of cue-elicited responses. Based on memory reconsolidation theory, the retrieval-extinction (R-E) paradigm may be more effective in decreasing spontaneous recovery or renewal responses than extinction. After the original memory reactivated to a labile state, extinction will be introduced within the reconsolidation window, thereby updating drug-associated memories. However, there are still some controversial results, which suggest that the reactivation of drug-associated memories and the 10 min-6 h of limited time window are two main elements in the R-E protocol. Virtual reality (VR) is supposed to promote memory reactivation by providing vivid drug-related stimuli when compared with movies. OBJECTIVE The aim of this study is to examine the effectiveness of R-E training combined with VR on reducing spontaneous recovery or renewal of cue-elicited responses, in comparison to extinction, R-E training provided outside the time window of 6 h and R-E training retrieved using videos, in methamphetamine abusers. METHODS The study is a parallel matched controlled study including 95 participants with MUD. Participants will be randomly assigned to either a R-10 min-E group (methamphetamine-related cues retrieval in VR followed by extinction after 10 min) or a NR-10 min-E group (neutral cues retrieval in VR followed by extinction after 10 min) or a R-6 h-E group (methamphetamine-related cues retrieval in VR followed by extinction after 6 h) or a RV-10 min-E group (methamphetamine-related cues retrieval in videos followed by extinction after 10 min). Cue-evoked craving and reactivity will be assessed at pre-test and at 1 day, 1 week, 1 month, and 6-month post-tests. DISCUSSION To our knowledge, this study will probably be the first study to examine the efficacy of R-E training combined with VR to reduce cue-evoked responses in people with MUD. This innovative non-pharmacological intervention targeting drug-associated memories may provide significant clinical implications for reducing relapse, providing the study confirms its efficacy. CLINICAL TRIAL REGISTRATION The trial is registered with Chinese Clinical Trial Registry at 17 October 2018, number: ChiCTR1800018899, URL: http://www.chictr.org.cn/showproj.aspx?proj=30854.
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Affiliation(s)
- Wang Liu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xi-Jing Chen
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Ya-Tong Wen
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Markus H Winkler
- Department of Psychology I, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Wurzburg, Wurzburg, Germany
| | - Pauli Paul
- Department of Psychology I, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Wurzburg, Wurzburg, Germany
| | - Yi-Ling He
- Center for Mental Health, Women's Drug Rehabilitation Center of Guangdong Province, Foshan, China
| | - Liang Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hong-Xian Chen
- Mental Health Institute, Second Xiangya Hospital, Central South Universit y, Changsha, China
| | - Yong-Hui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Struik RF, De Vries TJ, Peters J. Detrimental Effects of a Retrieval-Extinction Procedure on Nicotine Seeking, but Not Cocaine Seeking. Front Behav Neurosci 2019; 13:243. [PMID: 31680898 PMCID: PMC6803535 DOI: 10.3389/fnbeh.2019.00243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/27/2019] [Indexed: 01/03/2023] Open
Abstract
Retrieval-extinction memory reactivation procedures have been used to prevent the return of learned fear and drug seeking in preclinical models. These procedures first reactivate the original memory with a brief cue exposure (i.e., retrieval) session, and then disrupt memory reconsolidation by conducting extinction training within the reconsolidation window. The original memory is thought to be updated with the new information conveyed by extinction learning, resulting in a persistent therapeutic effect beyond that observed with extinction training alone (i.e., no retrieval). Here, we attempted to replicate the therapeutic effects on cocaine seeking reported by Xue et al. (2012), and extend these findings to nicotine seeking. Rats self-administered either cocaine or nicotine with contingent cues for weeks, and were then divided into two groups. The retrieval group underwent a 10-min retrieval session wherein drug cues were available, but drug was not. Ten minutes later, they were allowed to continue cue extinction training for an additional 60 min. The no retrieval group underwent a contiguous 70-min cue extinction session. These procedures continued for weeks, followed by a test for spontaneous recovery of drug seeking. No group differences were observed on any measure of cocaine seeking, although both groups exhibited extinction and spontaneous recovery. By contrast, for nicotine seeking, the retrieval group exhibited resistance to extinction, an effect that persisted on the spontaneous recovery test. These findings underscore the importance of drug type in the outcome of retrieval-extinction procedures and moreover indicate that retrieval-extinction procedures can be detrimental to nicotine seeking.
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Affiliation(s)
- Roeland F Struik
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Taco J De Vries
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Jamie Peters
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands.,Department of Anesthesiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States
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Reconsolidation of sucrose instrumental memory in rats: The role of retrieval context. Brain Res 2019; 1714:193-201. [PMID: 30853627 DOI: 10.1016/j.brainres.2019.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/21/2019] [Accepted: 03/06/2019] [Indexed: 12/11/2022]
Abstract
Memory reconsolidation enables the update of a previously consolidated memory trace after its reactivation. Although Pavlovian memory reconsolidation has been widely demonstrated, instrumental memory reconsolidation is still debated. The most critical issue on instrumental memory reconsolidation findings have mainly been linked to the presence of specific boundary conditions for reactivation, for instance contextual parameters. In this study, we investigated the role of the spatial context on molecular markers of sucrose instrumental memory reactivation. Following withdrawal, rats previously conditioned to sucrose self-administration underwent either instrumental memory retrieval or no-retrieval in the conditioned context (Context A, AA condition) or in a modified version of the conditioned context (Context B, AB condition). Two hours later, the level of GluA1 and GluN2B receptors, Zif268 and phosphorylated-rpS6 (rpS6P) was measured in key brain areas for memory reactivation. Retrieval in Context A significantly increased GluA1Rs and GluN2BRs in amygdala compared to no-retrieval, indicating that memory successfully reactivated and destabilized. Moreover, Zif268 level was significantly increased after retrieval in Context A in the nucleus accumbens shell, central and basolateral amygdala but not in the hippocampus, while retrieval in Context B significantly increased Zif268 level in all brain areas. On the other hand, rpS6P level was increased in the nucleus accumbens shell and central amygdala, but decreased in the hippocampus, after retrieval in Context A, while retrieval in Context B did not change rpS6P level in brain areas, except for a small but significant decrease in hippocampus. While the increase of Zif268 level indicated that memory reactivation has been triggered in both the conditions, the lack of change in rpS6P levels after retrieval in Context B - in particular in the central amygdala - suggests that the reconsolidation process could not occur after memory reactivation in a context different from the conditioned one.
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Chiamulera C, Marzo CM, Balfour DJK. Metabotropic glutamate receptor 5 as a potential target for smoking cessation. Psychopharmacology (Berl) 2017; 234:1357-1370. [PMID: 27847973 DOI: 10.1007/s00213-016-4487-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/07/2016] [Indexed: 12/21/2022]
Abstract
RATIONALE Most habitual smokers find it difficult to quit smoking because they are dependent upon the nicotine present in tobacco smoke. Tobacco dependence is commonly treated pharmacologically using nicotine replacement therapy or drugs, such as varenicline, that target the nicotinic receptor. Relapse rates, however, remain high, and there remains a need to develop novel non-nicotinic pharmacotherapies for the dependence that are more effective than existing treatments. OBJECTIVE The purpose of this paper is to review the evidence from preclinical and clinical studies that drugs that antagonise the metabotropic glutamate receptor 5 (mGluR5) in the brain are likely to be efficacious as treatments for tobacco dependence. RESULTS Imaging studies reveal that chronic exposure to tobacco smoke reduces the density of mGluR5s in human brain. Preclinical results demonstrate that negative allosteric modulators (NAMs) at mGluR5 attenuate both nicotine self-administration and the reinstatement of responding evoked by exposure to conditioned cues paired with nicotine delivery. They also attenuate the effects of nicotine on brain dopamine pathways implicated in addiction. CONCLUSIONS Although mGluR5 NAMs attenuate most of the key facets of nicotine dependence, they potentiate the symptoms of nicotine withdrawal. This may limit their value as smoking cessation aids. The NAMs that have been employed most widely in preclinical studies of nicotine dependence have too many "off-target" effects to be used clinically. However, newer mGluR5 NAMs have been developed for clinical use in other indications. Future studies will determine if these agents can also be used effectively and safely to treat tobacco dependence.
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Affiliation(s)
- Cristiano Chiamulera
- Neuropsychopharmacology Lab., Section Pharmacology, Department Diagnostic and Public Health, University of Verona, P.le Scuro 10, 37134, Verona, Italy.
| | - Claudio Marcello Marzo
- Neuropsychopharmacology Lab., Section Pharmacology, Department Diagnostic and Public Health, University of Verona, P.le Scuro 10, 37134, Verona, Italy
| | - David J K Balfour
- Division of Neuroscience, University of Dundee Medical School, Mailbox 6, Ninewells Hospital, Dundee, DD1 9SY, UK
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Germeroth LJ, Carpenter MJ, Baker NL, Froeliger B, LaRowe SD, Saladin ME. Effect of a Brief Memory Updating Intervention on Smoking Behavior: A Randomized Clinical Trial. JAMA Psychiatry 2017; 74:214-223. [PMID: 28146243 PMCID: PMC5930385 DOI: 10.1001/jamapsychiatry.2016.3148] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Recent research on addiction-related memory processes suggests that protracted extinction training following brief cue-elicited memory retrieval (ie, retrieval-extinction [R-E] training) can attenuate/eradicate the ability of cues to elicit learned behaviors. One study reported that cue-elicited craving among detoxified heroin addicts was substantially attenuated following R-E training and through 6-month follow-up. OBJECTIVE To build on these impressive findings by examining whether R-E training could attenuate smoking-related craving and behavior. DESIGN, SETTING, AND PARTICIPANTS This prospective, mixed-design, human laboratory randomized clinical trial took place between December 2013 and September 2015. Participants were recruited in Charleston, South Carolina. Study sessions took place at the Medical University of South Carolina. The participants were 168 screened volunteer smokers, of whom 88 were randomized; 72 of these 88 participants (81.8%) attended all the follow-up sessions through 1 month. The primary eligibility criteria were current nicotine dependence (DSM criteria), smoking 10 or more cigarettes per day, and a willingness to attempt smoking cessation. INTERVENTIONS Participants were randomly assigned to receive either smoking-related memory retrieval followed by extinction training (the R-E group) or nonsmoking-related retrieval followed by extinction training (the NR-E group). MAIN OUTCOMES AND MEASURES Primary outcomes were cue-elicited craving and physiological responding to familiar and novel cues in the R-E group vs the NR-E group over a 1-month follow-up period. Secondary outcomes were smoking-related behaviors. RESULTS A total of 44 participants were randomly assigned to the R-E group (mean age, 48.3 years; 72.7% male); a total of 44 participants were randomly assigned to the NR-E group, with 43 attending at least 1 training session (mean age, 46.7 years; 55.8% male). The mean craving response to both familiar and novel smoking cues was significantly lower for participants in the R-E group than for participants in the NR-E group at 1-month follow-up (for both cue types: t1225 = 2.1, P = .04, d = 0.44, and Δ = 0.47 [95% CI, 0.04-0.90]). The mean numbers of cigarettes smoked per day at 2 weeks and 1-month were significantly lower for the R-E group than for the NR-E group (treatment main effect: F1,68 = 5.4, P = .02, d = 0.50, and Δ = 2.4 [95% CI, 0.4-4.5]). Significant differences in physiological responses, urine cotinine level, number of days abstinent, lapse, and relapse were not observed between groups (all between P = .06 and .75). CONCLUSIONS AND RELEVANCE Retrieval-extinction training substantially attenuated craving to both familiar and novel smoking cues and reduced the number of cigarettes smoked per day by participants 1 month after treatment relative to extinction training alone. Between-group differences were not observed for physiological responses, cotinine level, number of days abstinent, relapse, or lapse. In summary, R-E training is a brief behavioral treatment that targets smoking-related memories and has the potential to enhance relapse prevention. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02154685.
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Affiliation(s)
- Lisa J. Germeroth
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; Hollings Cancer Center, Medical University of South Carolina, Charleston
| | - Nathaniel L. Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Brett Froeliger
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; Department of Neuroscience, Medical University of South Carolina, Charleston
| | - Steven D. LaRowe
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; Mental Health Service Line, Ralph H. Johnson VA Medical Center, Charleston, South Carolina
| | - Michael E. Saladin
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
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Chiamulera C, Hinnenthal I, Auber A, Cibin M. Reconsolidation of maladaptive memories as a therapeutic target: pre-clinical data and clinical approaches. Front Psychiatry 2014; 5:107. [PMID: 25191279 PMCID: PMC4137448 DOI: 10.3389/fpsyt.2014.00107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/05/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cristiano Chiamulera
- Neuropsychopharmacology Laboratory, Sezione Farmacologia, Università di Verona, Policlinico "G.B. Rossi" , Verona , Italy
| | - Ina Hinnenthal
- PhD School in Health Economics and Management, Catholic University of Sacred Heart , Rome , Italy ; Health Services Research Laboratory, University of Siena , Siena , Italy ; Healthcare System Unit 1 Imperiese , Imperia , Italy
| | - Alessia Auber
- Neuropsychopharmacology Laboratory, Sezione Farmacologia, Università di Verona, Policlinico "G.B. Rossi" , Verona , Italy
| | - Mauro Cibin
- Addictive Behaviours Department, Local Health Authority , Dolo Venice , Italy
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