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Palagini L, Bianchini C. Pharmacotherapeutic management of insomnia and effects on sleep processes, neural plasticity, and brain systems modulating stress: A narrative review. Front Neurosci 2022; 16:893015. [PMID: 35968380 PMCID: PMC9374363 DOI: 10.3389/fnins.2022.893015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionInsomnia is a stress-related sleep disorder, may favor a state of allostatic overload impairing brain neuroplasticity, stress immune and endocrine pathways, and may contribute to mental and physical disorders. In this framework, assessing and targeting insomnia is of importance.AimSince maladaptive neuroplasticity and allostatic overload are hypothesized to be related to GABAergic alterations, compounds targeting GABA may play a key role. Accordingly, the aim of this review was to discuss the effect of GABAA receptor agonists, short-medium acting hypnotic benzodiazepines and the so called Z-drugs, at a molecular level.MethodLiterature searches were done according to PRISMA guidelines. Several combinations of terms were used such as “hypnotic benzodiazepines” or “brotizolam,” or “lormetazepam” or “temazepam” or “triazolam” or “zolpidem” or “zopiclone” or “zaleplon” or “eszopiclone” and “insomnia” and “effects on sleep” and “effect on brain plasticity” and “effect on stress system”. Given the complexity and heterogeneity of existing literature, we ended up with a narrative review.ResultsAmong short-medium acting compounds, triazolam has been the most studied and may regulate the stress system at central and peripheral levels. Among Z-drugs eszopiclone may regulate the stress system. Some compounds may produce more “physiological” sleep such as brotizolam, triazolam, and eszopiclone and probably may not impair sleep processes and related neural plasticity. In particular, triazolam, eszopiclone, and zaleplon studied in vivo in animal models did not alter neuroplasticity.ConclusionCurrent models of insomnia may lead us to revise the way in which we use hypnotic compounds in clinical practice. Specifically, compounds should target sleep processes, the stress system, and sustain neural plasticity. In this framework, among the short/medium acting hypnotic benzodiazepines, triazolam has been the most studied compound while among the Z-drugs eszopiclone has demonstrated interesting effects. Both offer potential new insight for treating insomnia.
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Affiliation(s)
- Laura Palagini
- Psychiatry Division, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Laura Palagini,
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Casasola-Castro C, Weissmann-Sánchez L, Calixto-González E, Aguayo-Del Castillo A, Velázquez-Martínez DN. Short-term and long-term effects of diazepam on the memory for discrimination and generalization of scopolamine. Psychopharmacology (Berl) 2017; 234:3083-3090. [PMID: 28735367 DOI: 10.1007/s00213-017-4692-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/05/2017] [Indexed: 01/01/2023]
Abstract
Benzodiazepines are among the most widely prescribed and misused psychopharmaceutical drugs. Although they are well-tolerated, they are also capable of producing amnestic effects similar to those observed after pharmacological or organic cholinergic dysfunction. To date, the effect of benzodiazepine diazepam on the memory for discrimination of anticholinergic drugs has not been reported. The aim of the present study was to analyze the immediate and long-term effects of diazepam on a drug discrimination task with scopolamine. Male Wistar rats were trained to discriminate between scopolamine and saline administration using a two-lever discrimination task. Once discrimination was acquired, the subjects were divided into three independent groups, (1) control, (2) diazepam, and (3) diazepam chronic administration (10 days). Subsequently, generalization curves for scopolamine were obtained. Additionally, the diazepam and control groups were revaluated after 90 days without having been given any other treatment. The results showed that diazepam produced a significant reduction in the generalization gradient for scopolamine, indicating an impairment of discrimination. The negative effect of diazepam persisted even 90 days after drug had been administered. Meanwhile, the previous administration of diazepam for 10 days totally abated the generalization curve and the general performance of the subjects. The results suggest that diazepam affects memory for the stimulus discrimination of anticholinergic drugs and does so persistently, which could be an important consideration during the treatment of amnesic patients with benzodiazepines.
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Affiliation(s)
- C Casasola-Castro
- Departamento de Psicobiología y Neurociencias, Facultad de Psicología, Universidad Nacional Autónoma de México (UNAM), Av. Universidad 3004, Col. Copilco-Universidad, 04510, Mexico City, Mexico.
| | - L Weissmann-Sánchez
- Departamento de Psicobiología y Neurociencias, Facultad de Psicología, Universidad Nacional Autónoma de México (UNAM), Av. Universidad 3004, Col. Copilco-Universidad, 04510, Mexico City, Mexico
| | - E Calixto-González
- Departamento de Psicobiología y Neurociencias, Facultad de Psicología, Universidad Nacional Autónoma de México (UNAM), Av. Universidad 3004, Col. Copilco-Universidad, 04510, Mexico City, Mexico.,Departamento de Neurobiología, Dirección de Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente, México City, Mexico
| | - A Aguayo-Del Castillo
- Departamento de Psicobiología y Neurociencias, Facultad de Psicología, Universidad Nacional Autónoma de México (UNAM), Av. Universidad 3004, Col. Copilco-Universidad, 04510, Mexico City, Mexico
| | - D N Velázquez-Martínez
- Departamento de Psicobiología y Neurociencias, Facultad de Psicología, Universidad Nacional Autónoma de México (UNAM), Av. Universidad 3004, Col. Copilco-Universidad, 04510, Mexico City, Mexico
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Vashchinkina E, Panhelainen A, Aitta-Aho T, Korpi ER. GABAA receptor drugs and neuronal plasticity in reward and aversion: focus on the ventral tegmental area. Front Pharmacol 2014; 5:256. [PMID: 25505414 PMCID: PMC4243505 DOI: 10.3389/fphar.2014.00256] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 11/03/2014] [Indexed: 12/13/2022] Open
Abstract
GABAA receptors are the main fast inhibitory neurotransmitter receptors in the mammalian brain, and targets for many clinically important drugs widely used in the treatment of anxiety disorders, insomnia and in anesthesia. Nonetheless, there are significant risks associated with the long-term use of these drugs particularly related to development of tolerance and addiction. Addictive mechanisms of GABAA receptor drugs are poorly known, but recent findings suggest that those drugs may induce aberrant neuroadaptations in the brain reward circuitry. Recently, benzodiazepines, acting on synaptic GABAA receptors, and modulators of extrasynaptic GABAA receptors (THIP and neurosteroids) have been found to induce plasticity in the ventral tegmental area (VTA) dopamine neurons and their main target projections. Furthermore, depending whether synaptic or extrasynaptic GABAA receptor populations are activated, the behavioral outcome of repeated administration seems to correlate with rewarding or aversive behavioral responses, respectively. The VTA dopamine neurons project to forebrain centers such as the nucleus accumbens and medial prefrontal cortex, and receive afferent projections from these brain regions and especially from the extended amygdala and lateral habenula, forming the major part of the reward and aversion circuitry. Both synaptic and extrasynaptic GABAA drugs inhibit the VTA GABAergic interneurons, thus activating the VTA DA neurons by disinhibition and this way inducing glutamatergic synaptic plasticity. However, the GABAA drugs failed to alter synaptic spine numbers as studied from Golgi-Cox-stained VTA dendrites. Since the GABAergic drugs are known to depress the brain metabolism and gene expression, their likely way of inducing neuroplasticity in mature neurons is by disinhibiting the principal neurons, which remains to be rigorously tested for a number of clinically important anxiolytics, sedatives and anesthetics in different parts of the circuitry.
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Affiliation(s)
- Elena Vashchinkina
- Department of Pharmacology, Institute of Biomedicine, University of Helsinki Helsinki, Finland
| | - Anne Panhelainen
- Institute of Biotechnology, University of Helsinki Helsinki, Finland
| | - Teemu Aitta-Aho
- Department of Pharmacology, Institute of Biomedicine, University of Helsinki Helsinki, Finland ; Department of Pharmacology, University of Cambridge Cambridge, UK
| | - Esa R Korpi
- Department of Pharmacology, Institute of Biomedicine, University of Helsinki Helsinki, Finland ; Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, Neurobiology and Ageing Programme, Life Sciences Institute, National University of Singapore, and SINAPSE, Singapore Institute for Neurotechnology Singapore, Singapore
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Licata SC, Shinday NM, Huizenga MN, Darnell SB, Sangrey GR, Rudolph U, Rowlett JK, Sadri-Vakili G. Alterations in brain-derived neurotrophic factor in the mouse hippocampus following acute but not repeated benzodiazepine treatment. PLoS One 2013; 8:e84806. [PMID: 24367698 PMCID: PMC3868703 DOI: 10.1371/journal.pone.0084806] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 11/19/2013] [Indexed: 12/24/2022] Open
Abstract
Benzodiazepines (BZs) are safe drugs for treating anxiety, sleep, and seizure disorders, but their use also results in unwanted effects including memory impairment, abuse, and dependence. The present study aimed to reveal the molecular mechanisms that may contribute to the effects of BZs in the hippocampus (HIP), an area involved in drug-related plasticity, by investigating the regulation of immediate early genes following BZ administration. Previous studies have demonstrated that both brain derived neurotrophic factor (BDNF) and c-Fos contribute to memory- and abuse-related processes that occur within the HIP, and their expression is altered in response to BZ exposure. In the current study, mice received acute or repeated administration of BZs and HIP tissue was analyzed for alterations in BDNF and c-Fos expression. Although no significant changes in BDNF or c-Fos were observed in response to twice-daily intraperitoneal (i.p.) injections of diazepam (10 mg/kg + 5 mg/kg) or zolpidem (ZP; 2.5 mg/kg + 2.5 mg/kg), acute i.p. administration of both triazolam (0.03 mg/kg) and ZP (1.0 mg/kg) decreased BDNF protein levels within the HIP relative to vehicle, without any effect on c-Fos. ZP specifically reduced exon IV-containing BDNF transcripts with a concomitant increase in the association of methyl-CpG binding protein 2 (MeCP2) with BDNF promoter IV, suggesting that MeCP2 activity at this promoter may represent a ZP-specific mechanism for reducing BDNF expression. ZP also increased the association of phosphorylated cAMP response element binding protein (pCREB) with BDNF promoter I. Future work should examine the interaction between ZP and DNA as the cause for altered gene expression in the HIP, given that BZs can enter the nucleus and intercalate into DNA directly.
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Affiliation(s)
- Stephanie C. Licata
- McLean Hospital, Belmont, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Nina M. Shinday
- New England Primate Research Center, Southborough, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Megan N. Huizenga
- Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Shayna B. Darnell
- Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gavin R. Sangrey
- Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Uwe Rudolph
- McLean Hospital, Belmont, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - James K. Rowlett
- New England Primate Research Center, Southborough, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ghazaleh Sadri-Vakili
- Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- *
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Mednick SC, Cai DJ, Shuman T, Anagnostaras S, Wixted JT. An opportunistic theory of cellular and systems consolidation. Trends Neurosci 2011; 34:504-14. [PMID: 21742389 DOI: 10.1016/j.tins.2011.06.003] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 04/15/2011] [Accepted: 06/01/2011] [Indexed: 11/16/2022]
Abstract
Memories are often classified as hippocampus dependent or independent, and sleep has been found to facilitate both, but in different ways. In this Opinion, we explore the optimal neural state for cellular and systems consolidation of hippocampus-dependent memories that benefit from sleep. We suggest that these two kinds of consolidation, which are ordinarily treated separately, overlap in time and jointly benefit from a period of reduced interference (during which no new memories are formed). Conditions that result in reduced interference include slow wave sleep (SWS), NMDA receptor antagonists, benzodiazepines, alcohol and acetylcholine antagonists. We hypothesize that the consolidation of hippocampal-dependent memories might not depend on SWS per se. Instead, the brain opportunistically consolidates previously encoded memories whenever the hippocampus is not otherwise occupied by the task of encoding new memories.
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Affiliation(s)
- Sara C Mednick
- University of California, San Diego, Department of Psychiatry 9116a, 3350 La Jolla Village Drive, San Diego, CA 92116, USA.
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Takamatsu I, Sekiguchi M, Yonamine R, Wada K, Kazama T. The effect of a new water-soluble sedative-hypnotic drug, JM-1232(-), on long-term potentiation in the CA1 region of the mouse hippocampus. Anesth Analg 2011; 113:1043-9. [PMID: 21788318 DOI: 10.1213/ane.0b013e3182291782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND JM-1232(-) {(-)-3-[2-(4-methyl-1-piperazinyl)-2-oxoethyl]-2-phenyl-3,5,6,7-tetrahydrocyclopenta[f]isoindol-1(2H)-one} is a new water-soluble sedative-hypnotic drug with affinity for the benzodiazepine binding site on γ-aminobutyric acid A receptors. The effects of JM-1232(-) on synaptic transmission in the brain are not known. In the present study, we investigated the effects of JM-1232(-) on synaptic transmission, synaptic plasticity (i.e., long-term potentiation [LTP] and paired-pulse facilitation), and excitatory/inhibitory postsynaptic currents (EPSCs/IPSCs) of pyramidal neurons in the CA1 region of mouse hippocampal slices. METHODS We recorded Schaffer collateral-evoked field excitatory postsynaptic potentials and EPSCs and IPSCs of pyramidal neurons using whole-cell patch-clamp techniques in the CA1 region of mouse hippocampal slices. RESULTS JM-1232(-) had no significant effect on the field excitatory postsynaptic potentials. Application of JM-1232(-) for 20 minutes before theta-burst stimulation dose dependently impaired LTP. JM-1232(-) impaired paired-pulse facilitation. The benzodiazepine antagonist flumazenil abolished the inhibitory effect of JM-1232(-) on LTP and paired-pulse facilitation. JM-1232(-) had no effect on Schaffer collateral stimulation-evoked EPSCs, whereas it potentiated the amplitude and prolonged the decay of evoked IPSCs in CA1 pyramidal neurons. Flumazenil blocked the effect of JM-1232(-) on the amplitude and decay of evoked IPSCs. JM-1232(-) suppressed the action potential discharge in the CA1 pyramidal neurons during theta-burst stimulation, which was reversed by flumazenil. CONCLUSION JM-1232(-) enhances synaptic inhibition and impairs LTP and paired-pulse facilitation in area CA1 of the mouse hippocampus. These effects were mediated by benzodiazepine binding sites on γ-aminobutyric acid A receptors.
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Affiliation(s)
- Isao Takamatsu
- Department of Anesthesiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
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Erdi P, Huhn Z, Kiss T. Hippocampal theta rhythms from a computational perspective: code generation, mood regulation and navigation. Neural Netw 2005; 18:1202-11. [PMID: 16198540 DOI: 10.1016/j.neunet.2005.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this paper three computer models are summarized discussing different functions of the cortico-hippocampal system. Mood regulation, rhythm and code generation and navigation are integrated into a coherent conceptual framework around the concepts of structural hierarchy and circular causality. First, a model of spatio-temporal code generation is reviewed in which the hippocampal population theta rhythm plays an important role. Next, generation and pharmcological modulation of this rhythm is examined using a computer model of multiple cell populations forming a feed-back loop within the hippocampus and between the septum and the hippocampus. Last, an abstract, but biologically motivated model of navigation is described which achieves a near optimal mode of navigation by composing hierarchical levels of the cortico-hippocampal system. The connections among the different hierarchical structures of the cortico-hippocampal organization and their functional roles are discussed.
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Affiliation(s)
- Péter Erdi
- Center for Complex Systems Studies, Kalamazoo College, Kalamazoo, Michigan Kalamazoo, MI 49006, USA.
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