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Guo F, Zhang B, Shen F, Li Q, Song Y, Li T, Zhang Y, Du W, Li Y, Liu W, Cao H, Zhou X, Zheng Y, Zhu S, Li Y, Liu Z. Sevoflurane acts as an antidepressant by suppression of GluN2D-containing NMDA receptors on interneurons. Br J Pharmacol 2024. [PMID: 38779864 DOI: 10.1111/bph.16420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND AND PURPOSE Sevoflurane, a commonly used inhaled anaesthetic known for its favourable safety profile and rapid onset and offset, has not been thoroughly investigated as a potential treatment for depression. In this study, we reveal the mechanism through which sevoflurane delivers enduring antidepressant effects. EXPERIMENTAL APPROACH To assess the antidepressant effects of sevoflurane, behavioural tests were conducted, along with in vitro and ex vivo whole-cell patch-clamp recordings, to examine the effects on GluN1-GluN2 incorporated N-methyl-d-aspartate (NMDA) receptors (NMDARs) and neuronal circuitry in the medial prefrontal cortex (mPFC). Multiple-channel electrophysiology in freely moving mice was performed to evaluate sevoflurane's effects on neuronal activity, and GluN2D knockout (grin2d-/-) mice were used to confirm the requirement of GluN2D for the antidepressant effects. KEY RESULTS Repeated exposure to subanaesthetic doses of sevoflurane produced sustained antidepressant effects lasting up to 2 weeks. Sevoflurane preferentially inhibited GluN2C- and GluN2D-containing NMDARs, causing a reduction in interneuron activity. In contrast, sevoflurane increased action potentials (AP) firing and decreased spontaneous inhibitory postsynaptic current (sIPSC) in mPFC pyramidal neurons, demonstrating a disinhibitory effect. These effects were absent in grin2d-/- mice, and both pharmacological blockade and genetic knockout of GluN2D abolished sevoflurane's antidepressant actions, suggesting that GluN2D is essential for its antidepressant effect. CONCLUSION AND IMPLICATIONS Sevoflurane directly targets GluN2D, leading to a specific decrease in interneuron activity and subsequent disinhibition of pyramidal neurons, which may underpin its antidepressant effects. Targeting the GluN2D subunit could hold promise as a potential therapeutic strategy for treating depression.
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Affiliation(s)
- Fei Guo
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Bing Zhang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fuyi Shen
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qian Li
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yingcai Song
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tianyu Li
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yongmei Zhang
- University of Chinese Academy of Sciences, Beijing, China
| | - Weijia Du
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuanxi Li
- Institute for Cognitive Neurodynamics, East China University of Science and Technology, Shanghai, China
| | - Wei Liu
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hang Cao
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xianjin Zhou
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yinli Zheng
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, China
| | - Shujia Zhu
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Yang Li
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Zhiqiang Liu
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Anesthesiology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
- Anesthesia and Brain Function Research Institute, Tongji University School of Medicine, Shanghai, China
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Falkenberg I, Bitsch F, Liu W, Matsingos A, Noor L, Vogelbacher C, Yildiz C, Kircher T. The effects of esketamine and treatment expectation in acute major depressive disorder (Expect): study protocol for a pharmacological fMRI study using a balanced placebo design. Trials 2023; 24:514. [PMID: 37568215 PMCID: PMC10416369 DOI: 10.1186/s13063-023-07556-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly prevalent (8-15%), severely disabling disorder and is associated with enormous socioeconomic impact. Antidepressant medication for the treatment of MDD has proven effective in RCTs; however, placebo response is also substantial. Given the potential benefits of modulating the placebo response in patient care and pharmacological research, understanding the mechanisms underlying placebo response is of high clinical relevance. The placebo response is mediated by treatment expectation, i.e. an individual's belief about whether and how much they will improve as a consequence of their treatment. The mechanisms and moderators of treatment expectation effects in MDD are poorly understood. Initial brain imaging studies on placebo responses in MDD point towards the relevance of the lateral prefrontal cortex and the rostral anterior cingulate cortex (rACC). In this project, we will investigate the neural mechanisms underlying the antidepressant effects of treatment expectation associated with the fast-acting antidepressant esketamine in patients with MDD. Esketamine is an NMDA receptor antagonist inducing antidepressant effects within hours. METHODS We will employ a fully balanced placebo design with the factors "treatment" (i.v. esketamine / placebo) and verbally induced "expectation" (high / low) combined with fMRI (resting state, emotion and reward processing paradigms) to investigate the psychological and neural mechanisms underlying the antidepressant effects of expectation, and how these interact with the pharmacological effects of esketamine. DISCUSSION The insights gained by this project promise fundamental implications for clinical treatment and future drug trials. Unraveling the mechanisms underlying expectation effects on antidepressant treatment may inform (1) strategies to modulate these effects and thus improve assay sensitivity in RCTs and (2) novel treatment regiments aiming to maximize the synergistic effects of expectation and pharmacological treatment in the clinical care of patients with MDD. TRIAL REGISTRATION This trial has been prospectively registered with the EU Clinical Trials Register: EudraCT-No.: 2020-000784-23 (November 17, 2020).
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Affiliation(s)
- Irina Falkenberg
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany.
| | - Florian Bitsch
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
| | - Wei Liu
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
| | - Alexandros Matsingos
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
| | - Laila Noor
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
| | - Christoph Vogelbacher
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
- Department of Clinical Psychology, University of Marburg, Schulstr. 12, 35037, Marburg, Germany
| | - Cüneyt Yildiz
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
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3
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Horacek J, Janda R, Görnerova N, Jajcay L, Andrashko V. Several reasons why ketamine as a neuroplastic agent may have failed to prevent postoperative delirium: Implications for future protocols. Neurosci Lett 2023; 798:137095. [PMID: 36693556 DOI: 10.1016/j.neulet.2023.137095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 12/14/2021] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
Ketamine exerts anti-inflammatory, neuroprotective and neuroplastic activity, therefore it may counteract the neurotoxic processes underlying postoperative delirium. However, the majority of studies in this field failed. We identified several pharmacological reasons why these studies may have failed, together with suggestions of how to remediate them. Among them, the interaction with intravenous general anesthetics exerting the opposite effect on GABA interneurons than ketamine may be of principal importance. We suggest biomarkers which may elucidate the influence of this interaction on the different steps of neuroplastic pathways. We hypothesize that administering ketamine before or after general anesthesia could both prevent the interactions and strengthen the effect of ketamine by timing surgery within the climax of ketamine-induced neuroplastic changes or by stabilizing AMPA receptors. It is vital to deal with these questions because the protocols of ongoing studies are based again on the administration of ketamine during general anesthesia (the major identified pitfall).
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Affiliation(s)
- Jiri Horacek
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Robert Janda
- Intensive Care Unit, Karlovy Vary Regional Hospital, K. Vary, Czech Republic
| | - Natalie Görnerova
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lucia Jajcay
- National Institute of Mental Health, Klecany, Czech Republic; Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Veronika Andrashko
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
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4
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Tham JCW, Do A, Fridfinnson J, Rafizadeh R, Siu JTP, Budd GP, Lam RW. Repeated subcutaneous racemic ketamine in treatment-resistant depression: case series. Int Clin Psychopharmacol 2022; 37:206-214. [PMID: 35695279 DOI: 10.1097/yic.0000000000000409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Interest in the use of parenteral ketamine has been increasing over the last 2 decades for the management of treatment-resistant depression (TRD). While intravenous (IV) ketamine has been the most common parenteral route of administration, subcutaneous (SC) and intramuscular options have been described. We developed a clinical treatment protocol for the use of repeated SC racemic ketamine (maximum six treatments, twice per week) in an inpatient psychiatric care setting with inclusion/exclusion criteria, dosing schedule, and description of treatment, assessment, and monitoring procedures. Results from the first 10 consecutive patients demonstrated the effectiveness of SC racemic ketamine in relieving symptoms of TRD as measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) and Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR 16 ). Response (≥50% reduction in scores from baseline to endpoint) was achieved in 8/10 cases on the MADRS and 6/10 on the QIDS-SR 16 . Remission was achieved in 8/10 (based on MADRS ≤10) and 5/10 (based on QIDS-SR 16 ≤6). Patients tolerated the treatments well with only transient blood pressure changes and dissociative side effects. Repeated SC ketamine treatments could be a safe, feasible, and effective alternative to IV ketamine infusions for patients with TRD.
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Affiliation(s)
- Joseph C W Tham
- BC Neuropsychiatry Program, University of British Columbia
- VGH/UBC Neurostimulation Program, University of British Columbia, Vancouver
| | - André Do
- Department of Psychiatry, Université de Montréal, Montreal
| | - Jason Fridfinnson
- Department of Anesthesiology and Perioperative Care (VGH and UBC), University of British Columbia
| | - Reza Rafizadeh
- BC Mental Health & Substance Use Services, Lower Mainland Pharmacy Services
| | - Jacky T P Siu
- Tertiary Mental Health & Substance Use, Lower Mainland Pharmacy Services, University of British Columbia
| | - George P Budd
- Mental Health and Substance Use Services, Vancouver Coastal Health
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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5
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Wolf DH, Zheng D, Kohler C, Turetsky BI, Ruparel K, Satterthwaite TD, Elliott MA, March ME, Cross AJ, Smith MA, Zukin SR, Gur RC, Gur RE. Effect of mGluR2 positive allosteric modulation on frontostriatal working memory activation in schizophrenia. Mol Psychiatry 2022; 27:1226-1232. [PMID: 34667261 PMCID: PMC9018886 DOI: 10.1038/s41380-021-01320-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 09/09/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023]
Abstract
Negative symptoms and cognitive deficits contribute strongly to disability in schizophrenia, and are resistant to existing medications. Recent drug development has targeted enhanced NMDA function by increasing mGluR2/3 signaling. However, the clinical utility of such agents remains uncertain, and markers of brain circuit function are critical for clarifying mechanisms and understanding individual differences in efficacy. We conducted a double-blind, placebo-controlled, randomized cross-over (14 day washout) pilot study evaluating adjunctive use of the mGluR2 positive allosteric modulator AZD8529 (80 mg daily for 3 days), in chronic stable patients with schizophrenia (n = 26 analyzed). We focused on 3 T fMRI response in frontostriatal regions during an n-back working memory task, testing the hypothesis that AZD8529 produces fMRI changes that correlate with improvement in negative symptoms and cognition. We found that AZD8529 did not produce significant group-average effects on symptoms or cognitive accuracy. However, AZD8529 did increase n-back fMRI activation in striatum (p < 0.0001) and anterior cingulate/paracingulate (p = 0.002). Greater drug-versus-placebo effects on caudate activation significantly correlated with greater reductions in PANSS negative symptom scores (r = -0.42, p = 0.031), and exploratory correlations suggested broader effects across multiple symptom domains and regions of interest. These findings demonstrate that fMRI responses to mGluR2 positive modulation relate to individual differences in symptom reduction, and could be pursued for future biomarker development. Negative clinical results at the group level should not lead to premature termination of investigation of this mechanism, which may benefit an important subset of individuals with schizophrenia. Imaging biomarkers may reveal therapeutic mechanisms, and help guide treatment toward specific populations.
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Affiliation(s)
- Daniel H. Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - David Zheng
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Christian Kohler
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Bruce I. Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | | | - Mark A. Elliott
- Department of Radiology, University of Pennsylvania, Philadelphia PA 19104
| | - Mary E. March
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104
| | - Alan J. Cross
- AstraZeneca Pharmaceuticals LP, Wilmington DE, 19850.,Present affiliations: Psy Therapeutics, Thornton PA 19373
| | - Mark A. Smith
- AstraZeneca Pharmaceuticals LP, Wilmington DE, 19850.,Vistagen Therapeutics, South San Francisco CA 94080;,Medical College of Georgia, Augusta, GA 30912
| | - Stephen R. Zukin
- AstraZeneca Pharmaceuticals LP, Wilmington DE, 19850.,PRA Health Sciences, Blue Bell PA 19422
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104.,Department of Radiology, University of Pennsylvania, Philadelphia PA 19104
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104.,Department of Radiology, University of Pennsylvania, Philadelphia PA 19104
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6
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Zhuo C, Ji F, Tian H, Wang L, Jia F, Jiang D, Chen C, Zhou C, Lin X, Zhu J. Transient effects of multi-infusion ketamine augmentation on treatment-resistant depressive symptoms in patients with treatment-resistant bipolar depression - An open-label three-week pilot study. Brain Behav 2020; 10:e01674. [PMID: 32621379 PMCID: PMC7428494 DOI: 10.1002/brb3.1674] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/29/2020] [Accepted: 05/08/2020] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION While the psychiatric benefits of ketamine have been verified through clinical trials, there is limited information about ketamine augmentation in patients with treatment-resistant bipolar depression (TRBPD). Hence, in the present study, we investigate the therapeutic efficacy and functional brain alterations associated with multi-infusion ketamine augmentation in patients with TRBPD. METHODS The present three-week study included 38 patients with TRBPD, all of whom received a series of nine ketamine injections over the study period. The Hamilton Depression Rating Scale (HAMD) was used to assess the effects of multi-infusion ketamine combined with mood stabilizers. Brain function was evaluated by global functional connectivity density (gFCD). RESULTS Adjunctive treatment with multiple infusions of ketamine, when combined with a mood stabilizer, could effectively alleviate depressive symptoms for one week, yet the symptoms began to relapse during the second week. Functional brain alterations were detected via gFCD. Specifically, gFCD reductions were mainly found in the bilateral insula, right caudate nucleus, and bilateral inferior frontal gyrus, while increased gFCD was mainly located in the bilateral postcentral gyrus, subgenual anterior cingulate cortex, bilateral thalamus, and cerebellum. Although gFCD alterations were sustained for up to three weeks after the first ketamine infusion, the antidepressant effects of ketamine augmentation sharply declined from the end of the second week of treatment. CONCLUSIONS Multi-infusion ketamine augmentation can rapidly alleviate depressive symptoms in patients with TRBPD. The clinical effects were primarily visible in the first week after treatment and partially sustained for two weeks; however, the therapeutic effects and related functional brain alterations sharply decreased from the end of the second week. Based on these findings, we demonstrated that the clinical efficacy and functional brain alterations induced by ketamine augmentation are transient.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China.,Department of Psychiatry and Imaging-Genetics and Co-morbidity (PNGC-Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China.,Department of Psychiatry Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Feng Ji
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Hongjun Tian
- Department of Psychiatry and Imaging-Genetics and Co-morbidity (PNGC-Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Lina Wang
- Department of Psychiatry and Imaging-Genetics and Co-morbidity (PNGC-Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Feng Jia
- Department of Psychiatry and Imaging-Genetics and Co-morbidity (PNGC-Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Deguo Jiang
- Department of Psychiatry Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Ce Chen
- Department of Psychiatry Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Chunhua Zhou
- Department of Pharmacy, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaodong Lin
- Department of Psychiatry Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Psychiatry Wenzhou Seventh People's Hospital, Wenzhou, China
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7
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McMillan R, Muthukumaraswamy SD. The neurophysiology of ketamine: an integrative review. Rev Neurosci 2020; 31:457-503. [DOI: 10.1515/revneuro-2019-0090] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/26/2020] [Indexed: 12/13/2022]
Abstract
AbstractThe drug ketamine has been extensively studied due to its use in anaesthesia, as a model of psychosis and, most recently, its antidepressant properties. Understanding the physiology of ketamine is complex due to its rich pharmacology with multiple potential sites at clinically relevant doses. In this review of the neurophysiology of ketamine, we focus on the acute effects of ketamine in the resting brain. We ascend through spatial scales starting with a complete review of the pharmacology of ketamine and then cover its effects on in vitro and in vivo electrophysiology. We then summarise and critically evaluate studies using EEG/MEG and neuroimaging measures (MRI and PET), integrating across scales where possible. While a complicated and, at times, confusing picture of ketamine’s effects are revealed, we stress that much of this might be caused by use of different species, doses, and analytical methodologies and suggest strategies that future work could use to answer these problems.
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Affiliation(s)
- Rebecca McMillan
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Suresh D. Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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8
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Kovacs-Balint Z, Feczko E, Pincus M, Earl E, Miranda-Dominguez O, Howell B, Morin E, Maltbie E, Li L, Steele J, Styner M, Bachevalier J, Fair D, Sanchez M. Early Developmental Trajectories of Functional Connectivity Along the Visual Pathways in Rhesus Monkeys. Cereb Cortex 2020; 29:3514-3526. [PMID: 30272135 DOI: 10.1093/cercor/bhy222] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 07/23/2018] [Accepted: 08/19/2018] [Indexed: 12/30/2022] Open
Abstract
Early social interactions shape the development of social behavior, although the critical periods or the underlying neurodevelopmental processes are not completely understood. Here, we studied the developmental changes in neural pathways underlying visual social engagement in the translational rhesus monkey model. Changes in functional connectivity (FC) along the ventral object and motion pathways and the dorsal attention/visuo-spatial pathways were studied longitudinally using resting-state functional MRI in infant rhesus monkeys, from birth through early weaning (3 months), given the socioemotional changes experienced during this period. Our results revealed that (1) maturation along the visual pathways proceeds in a caudo-rostral progression with primary visual areas (V1-V3) showing strong FC as early as 2 weeks of age, whereas higher-order visual and attentional areas (e.g., MT-AST, LIP-FEF) show weak FC; (2) functional changes were pathway-specific (e.g., robust FC increases detected in the most anterior aspect of the object pathway (TE-AMY), but FC remained weak in the other pathways (e.g., AST-AMY)); (3) FC matures similarly in both right and left hemispheres. Our findings suggest that visual pathways in infant macaques undergo selective remodeling during the first 3 months of life, likely regulated by early social interactions and supporting the transition to independence from the mother.
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Affiliation(s)
- Z Kovacs-Balint
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - E Feczko
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.,Department of Psychiatry & Behavioral Science, Emory University, Atlanta, GA, USA.,Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland OR, USA
| | - M Pincus
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - E Earl
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - O Miranda-Dominguez
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - B Howell
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.,Department of Psychiatry & Behavioral Science, Emory University, Atlanta, GA, USA
| | - E Morin
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.,Department of Psychiatry & Behavioral Science, Emory University, Atlanta, GA, USA
| | - E Maltbie
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - L Li
- Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - J Steele
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - M Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - J Bachevalier
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.,Department of Psychology, Emory University, Atlanta, GA, USA
| | - D Fair
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - M Sanchez
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.,Department of Psychiatry & Behavioral Science, Emory University, Atlanta, GA, USA
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9
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Examining fMRI time-series entropy as a marker for brain E/I balance with pharmacological neuromodulation in a non-human primate translational model. Neurosci Lett 2020; 728:134984. [PMID: 32315710 DOI: 10.1016/j.neulet.2020.134984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 11/23/2022]
Abstract
Recently, there has been a lot of interest in the neuroimaging community in exploring fMRI time-series measures of local neuronal activity and excitation/inhibition (E/I) balance in the brain. In this preliminary study we probed the sensitivity of widely used sample entropy (SE) measure at multiple scales to controlled alteration of the brain's E/I balance in non-human primates (NHPs) with a well-characterized sub-anesthetic ketamine infusion fMRI model. We found that SE failed to detect the expected changes in E/I balance induced by ketamine. Subsequently, noticing that the complexity in the time series contributing SE could be dominated by non-neuronal noise in this experimental setting, we developed a new time-series measure called restricted sample entropy (RSE) by restricting SE estimations to regular portions of the fMRI time-series. RSE was able to adequately reflect the increased excitatory activity engendered by disinhibition of glutamergic neurons, through sub-anesthetic ketamine infusion. These results show that RSE is potentially a powerful tool for examining local neural activity, E/I balance, and alterations in brain state.
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Zhuo C, Lin X, Tian H, Liu S, Bian H, Chen C. Adjunct ketamine treatment of depression in treatment-resistant schizophrenia patients is unsatisfactory in pilot and secondary follow-up studies. Brain Behav 2020; 10:e01600. [PMID: 32174025 PMCID: PMC7218248 DOI: 10.1002/brb3.1600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/07/2020] [Accepted: 02/25/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To investigate the effects of adjunct ketamine treatment on chronic treatment-resistant schizophrenia patients with treatment-resistant depressive symptoms (CTRS-TRD patients), including alterations in brain function. METHODS Intravenous ketamine (0.5 mg/kg body weight) was administered to CTRS-TRD patients over a 1-hr period on days 1, 4, 7, 10, 13, 16, 19, 22, and 25 of our initial pilot study. This treatment method was subsequently repeated 58 days after the start of the pilot study for a secondary follow-up study. Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), and regional homogeneity (ReHo) results were used to assess treatment effects and alterations in brain function throughout the entire duration of our studies. RESULTS Between day 7 and day 14 of the first treatment, CDSS scores were reduced by 63.8% and PANSS scores were reduced by 30.04%. In addition, ReHo values increased in the frontal, temporal, and parietal lobes. However, by day 21, depressive symptoms relapsed. During the second treatment period, CDSS and PANSS scores exhibited no significant differences compared to baseline between day 58 and day 86. On day 65, ReHo values were higher in the temporal, frontal, and parietal lobes. However, on day 79, the increase in ReHo values completely disappeared. CONCLUSIONS Depressive symptoms in CTRS-TRD patients were alleviated with adjunct ketamine treatment for only 1 week during the first treatment period. Moreover, after 1 month, the antidepressant effects of ketamine on CTRS-TRD patients completely disappeared. Correspondingly, ReHo alterations induced by ketamine in the CTRS-TRD patients were not maintained for more than 3 weeks. These pilot findings indicate that adjunct ketamine treatment is not satisfactory for CTRS-TRD patients.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China.,Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, China.,PNGC-Lab, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Hongjun Tian
- PNGC-Lab, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Sha Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Tainyuan, China
| | - Haiman Bian
- Department of Radiology, The Fourth Centre Hospital of Tianjin, Tianjin Medical University Affiliated Fourth Centre Hospital, Tianijn, China
| | - Ce Chen
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, China
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Kim D, Moussa‐Tooks AB, Bolbecker AR, Apthorp D, Newman SD, O'Donnell BF, Hetrick WP. Cerebellar-cortical dysconnectivity in resting-state associated with sensorimotor tasks in schizophrenia. Hum Brain Mapp 2020; 41:3119-3132. [PMID: 32250008 PMCID: PMC7336143 DOI: 10.1002/hbm.25002] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/15/2020] [Accepted: 03/25/2020] [Indexed: 12/11/2022] Open
Abstract
Abnormalities of cerebellar function have been implicated in the pathophysiology of schizophrenia. Since the cerebellum has afferent and efferent projections to diverse brain regions, abnormalities in cerebellar lobules could affect functional connectivity with multiple functional systems in the brain. Prior studies, however, have not examined the relationship of individual cerebellar lobules with motor and nonmotor resting‐state functional networks. We evaluated these relationships using resting‐state fMRI in 30 patients with a schizophrenia‐spectrum disorder and 37 healthy comparison participants. For connectivity analyses, the cerebellum was parcellated into 18 lobular and vermal regions, and functional connectivity of each lobule to 10 major functional networks in the cerebrum was evaluated. The relationship between functional connectivity measures and behavioral performance on sensorimotor tasks (i.e., finger‐tapping and postural sway) was also examined. We found cerebellar–cortical hyperconnectivity in schizophrenia, which was predominantly associated with Crus I, Crus II, lobule IX, and lobule X. Specifically, abnormal cerebellar connectivity was found to the cerebral ventral attention, motor, and auditory networks. This cerebellar–cortical connectivity in the resting‐state was differentially associated with sensorimotor task‐based behavioral measures in schizophrenia and healthy comparison participants—that is, dissociation with motor network and association with nonmotor network in schizophrenia. These findings suggest that functional association between individual cerebellar lobules and the ventral attentional, motor, and auditory networks is particularly affected in schizophrenia. They are also consistent with dysconnectivity models of schizophrenia suggesting cerebellar contributions to a broad range of sensorimotor and cognitive operations.
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Affiliation(s)
- Dae‐Jin Kim
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
| | - Alexandra B. Moussa‐Tooks
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
- Program in NeuroscienceIndiana UniversityBloomingtonIndianaUSA
| | - Amanda R. Bolbecker
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Deborah Apthorp
- School of Psychology, Faculty of Medicine and HealthUniversity of New EnglandArmidaleNew South WalesAustralia
- Research School of Computer Science, College of Engineering and Computer ScienceAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Sharlene D. Newman
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
- Program in NeuroscienceIndiana UniversityBloomingtonIndianaUSA
| | - Brian F. O'Donnell
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
- Program in NeuroscienceIndiana UniversityBloomingtonIndianaUSA
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - William P. Hetrick
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
- Program in NeuroscienceIndiana UniversityBloomingtonIndianaUSA
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
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Matrov D, Imbeault S, Kanarik M, Shkolnaya M, Schikorra P, Miljan E, Shimmo R, Harro J. Comprehensive mapping of cytochrome c oxidase activity in the rat brain after sub-chronic ketamine administration. Acta Histochem 2020; 122:151531. [PMID: 32131979 DOI: 10.1016/j.acthis.2020.151531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
Ketamine is a noncompetitive antagonist of glutamatergic N-methyl-d-aspartate receptors. Its acute effects on healthy volunteers and schizophrenia patients mimic some acute psychotic, but also cognitive and negative symptoms of schizophrenia, and subchronic treatment with ketamine has been used as an animal model of psychotic disorders. Glutamatergic neurotransmission is tightly coupled to oxidative metabolism in the brain. Quantitative histochemical mapping of cytochrome c oxidase (COX) activity, which reflect long-term energy metabolism, was carried out in rats that received a daily subanaesthetic dose (30 mg/kg) of ketamine for 10 days. In total, COX activity was measured in 190 brain regions to map out metabolic adaptations to the subchronic administration of ketamine. Ketamine treatment was associated with elevated COX activity in nine brain sub-regions in sensory thalamus, basal ganglia, cortical areas, hippocampus and superior colliculi. Changes in pairwise correlations between brain regions were studied with differential correlation analysis. Ketamine treatment was associated with the reduction of positive association between brain regions in 66 % of the significant comparisons. Different layers of the superior colliculi showed the strongest effects. Changes in other visual and auditory brain centres were also of note. The locus coeruleus showed opposite pattern of increased coupling to mainly limbic brain regions in ketamine-treated rats. Our study replicated commonly observed activating effects of ketamine in the hippocampus, cingulate cortex, and basal ganglia. The current study is the first to extensively map the oxidative metabolism in the CNS in the ketamine model of schizophrenia. It shows that ketamine treatment leads to the re-organization of activity in sensory and memory-related brain circuits.
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Affiliation(s)
- Denis Matrov
- Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Division of Neuropsychopharmacology, Department of Psychology, University of Tartu, Tartu, Estonia
| | - Sophie Imbeault
- Tallinn University Centre of Excellence in Neural and Behavioural Sciences, School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Margus Kanarik
- Division of Neuropsychopharmacology, Department of Psychology, University of Tartu, Tartu, Estonia
| | - Marianna Shkolnaya
- Tallinn University Centre of Excellence in Neural and Behavioural Sciences, School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Patricia Schikorra
- Tallinn University Centre of Excellence in Neural and Behavioural Sciences, School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Ergo Miljan
- Tallinn University Centre of Excellence in Neural and Behavioural Sciences, School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Ruth Shimmo
- Tallinn University Centre of Excellence in Neural and Behavioural Sciences, School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Jaanus Harro
- Tallinn University Centre of Excellence in Neural and Behavioural Sciences, School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia; Division of Neuropsychopharmacology, Department of Psychology, University of Tartu, Tartu, Estonia.
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Ye J, Lin X, Jiang D, Chen M, Zhang Y, Tian H, Li J, Zhuo C, Zhao Y. Adjunct ketamine treatment effects on treatment-resistant depressive symptoms in chronic treatment-resistant schizophrenia patients are short-term and disassociated from regional homogeneity changes in key brain regions – a pilot study. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1699726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Jiaen Ye
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People’s Hospital, Wenzhou, People’s Republic of China
| | - Xiaodong Lin
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People’s Hospital, Wenzhou, People’s Republic of China
| | - Deguo Jiang
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People’s Hospital, Wenzhou, People’s Republic of China
| | - Min Chen
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, People’s Republic of China
| | - Yanchi Zhang
- Department of Psychiatry, Changchun Sixth People’s Hospital, Changchun, People’s Republic of China
| | - Hongjun Tian
- PNGC-Lab, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, People’s Republic of China
| | - Jie Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, Tainyuan, People’s Republic of China
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People’s Hospital, Wenzhou, People’s Republic of China
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, People’s Republic of China
- Department of Psychiatry, Changchun Sixth People’s Hospital, Changchun, People’s Republic of China
- PNGC-Lab, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, People’s Republic of China
| | - Yanling Zhao
- Department of Psychiatry, Qingdao Mental Health Centre, Qingdao, People’s Republic of China
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Resting-state brain functional connectivity in patients with chronic pain who responded to subanesthetic-dose ketamine. Sci Rep 2019; 9:12912. [PMID: 31501482 PMCID: PMC6733873 DOI: 10.1038/s41598-019-49360-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/23/2019] [Indexed: 11/30/2022] Open
Abstract
Ketamine has been used to treat chronic pain; however, it is still unknown as to what types of chronic pain is ketamine effective against. To identify the effect of administration of subanesthetic-dose ketamine in patients with chronic pain and to clarify the mechanism of the effect, we retrospectively investigated brain functional connectivity using resting-state functional magnetic resonance imaging (rs-fMRI). Patients were divided into responders (Group R: ≥50% improvement on Numerical Rating Scale) and non-responders (Group NR). We compared the differences in terms of brain functional connectivity by seed-to-voxel correlation analysis. Two-sample t-test revealed significant lower connectivity between the medial prefrontal cortex (mPFC) and precuneus in Group R. We also found a significant negative correlation between the improvement rate and functional connectivity strength between the mPFC and precuneus. These findings suggest that subanesthetic-dose ketamine is effective in patients with chronic pain whose brain functional connectivity between the mPFC and precuneus is low. We believe that the current study explored for the first time the correlation between brain functional connectivity and the effect of subanesthetic-dose ketamine for chronic pain and indicated the possibility of use of the predictive marker in pharmacological treatment of chronic pain.
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Krajcovic B, Fajnerova I, Horacek J, Kelemen E, Kubik S, Svoboda J, Stuchlik A. Neural and neuronal discoordination in schizophrenia: From ensembles through networks to symptoms. Acta Physiol (Oxf) 2019; 226:e13282. [PMID: 31002202 DOI: 10.1111/apha.13282] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/27/2019] [Accepted: 04/12/2019] [Indexed: 12/22/2022]
Abstract
Despite the substantial knowledge accumulated by past research, the exact mechanisms of the pathogenesis of schizophrenia and causal treatments still remain unclear. Deficits of cognition and information processing in schizophrenia are today often viewed as the primary and core symptoms of this devastating disorder. These deficits likely result from disruptions in the coordination of neuronal and neural activity. The aim of this review is to bring together convergent evidence of discoordinated brain circuits in schizophrenia at multiple levels of resolution, ranging from principal cells and interneurons, neuronal ensembles and local circuits, to large-scale brain networks. We show how these aberrations could underlie deficits in cognitive control and other higher order cognitive-behavioural functions. Converging evidence from both animal models and patients with schizophrenia is presented in an effort to gain insight into common features of deficits in the brain information processing in this disorder, marked by disruption of several neurotransmitter and signalling systems and severe behavioural outcomes.
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Affiliation(s)
- Branislav Krajcovic
- Department of Neurophysiology of Memory Institute of Physiology of the Czech Academy of Sciences Prague Czech Republic
- Third Faculty of Medicine Charles University Prague Czech Republic
| | - Iveta Fajnerova
- Department of Neurophysiology of Memory Institute of Physiology of the Czech Academy of Sciences Prague Czech Republic
- Research Programme 3 - Applied Neurosciences and Brain Imaging National Institute of Mental Health Klecany Czech Republic
| | - Jiri Horacek
- Third Faculty of Medicine Charles University Prague Czech Republic
- Research Programme 3 - Applied Neurosciences and Brain Imaging National Institute of Mental Health Klecany Czech Republic
| | - Eduard Kelemen
- Research Programme 1 - Experimental Neurobiology National Institute of Mental Health Klecany Czech Republic
| | - Stepan Kubik
- Department of Neurophysiology of Memory Institute of Physiology of the Czech Academy of Sciences Prague Czech Republic
| | - Jan Svoboda
- Department of Neurophysiology of Memory Institute of Physiology of the Czech Academy of Sciences Prague Czech Republic
| | - Ales Stuchlik
- Department of Neurophysiology of Memory Institute of Physiology of the Czech Academy of Sciences Prague Czech Republic
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Maltbie EA, Gopinath KS, Howell LL. Effects of ketamine treatment on cocaine-induced reinstatement and disruption of functional connectivity in unanesthetized rhesus monkeys. Psychopharmacology (Berl) 2019; 236:2105-2118. [PMID: 30879118 DOI: 10.1007/s00213-019-05204-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 02/18/2019] [Indexed: 01/28/2023]
Abstract
RATIONALE Substance use disorders are characterized by a loss of executive control over reward-based decision-making, and disruption of fronto-striatal connectivity has been implicated in this process. Sub-anesthetic ketamine has recently been shown to bolster fronto-striatal connectivity in drug-naïve subjects. OBJECTIVES The influence of ketamine treatment was examined on the disruptive effects of cocaine on functional connectivity (FC) and on cocaine-seeking behavior in female rhesus monkeys. METHODS Three female rhesus were trained for unanesthetized MRI scanning. Each received three drug-naïve/abstinent pharmacological MRI scans with acute injections of saline, cocaine (0.3 mg/kg i.v.), and cocaine (0.3 mg/kg i.v.) 48-h after a ketamine treatment (low dose = 0.345 mg/kg bolus + 0.256 mg/kg/h for 1 h; i.v.), and a fourth scan with saline injection following 2 months of daily cocaine self-administration. A separate cohort of five rhesus (4 female), all with extensive histories of cocaine exposure, underwent reinstatement testing 48 h after ketamine (or vehicle) treatment. Two sub-anesthetic doses were tested: low dose and high dose = 0.69 mg/kg + 0.512 mg/kg/h for 1 h. RESULTS Ketamine treatment attenuated the effects of cocaine on both global and fronto-striatal FC in drug-naïve/abstinent subjects. Two months of daily cocaine self-administration led to prolonged disruption of both global and fronto-striatal FC. Cocaine-seeking behavior during reinstatement was reduced following ketamine treatment at the low dose, but not high dose. CONCLUSION These findings illustrate the disruptive effects of cocaine on functional connectivity and provide evidence for the potential efficacy of ketamine as a treatment for stimulant use disorder.
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Affiliation(s)
- Eric A Maltbie
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd NE, Atlanta, GA, 30329, USA
| | - Kaundinya S Gopinath
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd NE, Atlanta, GA, 30329, USA.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, 30329, USA
| | - Leonard L Howell
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd NE, Atlanta, GA, 30329, USA. .,Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30329, USA.
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Mueller F, Musso F, London M, de Boer P, Zacharias N, Winterer G. Pharmacological fMRI: Effects of subanesthetic ketamine on resting-state functional connectivity in the default mode network, salience network, dorsal attention network and executive control network. NEUROIMAGE-CLINICAL 2018; 19:745-757. [PMID: 30003027 PMCID: PMC6040604 DOI: 10.1016/j.nicl.2018.05.037] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/13/2018] [Accepted: 05/30/2018] [Indexed: 11/26/2022]
Abstract
Background Subanesthetic dosages of the NMDAR antagonist, S-Ketamine, can cause changes in behavior in healthy subjects, which are similar to the state acute psychosis and are relevant in translational schizophrenia research. Functional magnetic resonance imaging (fMRI) can be used for non-hypothesis-driven analysis of brain connectivity. The correlation between clinical behavioral scores and neuroimaging can help to characterize ketamine effects on healthy brains in resting state. Method seventeen healthy, male subjects (mean: 27.42 years, SD: 4.42) were administered an infusion with S-Ketamine (initial bolus 1 mg/kg and continuous infusion of 0.015625 mg/kg/min with dosage reduction −10%/10 min) or saline in a randomized, double-blind, cross-over study. During infusion, resting state connectivity was measured and analyzed with a seed-to-voxel fMRI analysis approach. The seed regions were located in the posterior cingulate cortex, intraparietal sulcus, dorsolateral prefrontal cortex and fronto-insular cortex. Receiver operating characteristics (ROC) were calculated to assess the accuracy of the ketamine-induced functional connectivity changes. Bivariate Pearson correlation was used for correlation testing of functional connectivity changes with changes of clinical scores (PANSS, 5D-ASC). Results In the executive network (ECN), ketamine significantly increases the functional connectivity with parts of the anterior cingulum and superior frontal gyrus, but no significant correlations with clinical symptoms were found. Decreased connectivity between the salience network (SN) and the calcarine fissure was found, which is significantly correlated with negative symptoms (PANSS) (R2 > 0.4). Conclusion Decreased ketamine-induced functional connectivity in the salience network may qualify as accurate and highly predictive biomarkers for ketamine induced negative symptoms. All seed regions showed ketamine induced changes of functional connectivity Signficant changes of functional connectivity were found in the salience and executive control network PANSS and 5D-ASC scores are highly sensitive and specific to differentiate between placebo and ketamine condition A significant correlation between salience network- visual cortex connectivity and negative symptom scores was found
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Affiliation(s)
- Felix Mueller
- Experimental and Clinical Research Center (ECRC), Dept. of Anesthesiology and Intensive Care Medicine, Charité - University Medicine Berlin, Germany.
| | - Francesco Musso
- Department of Psychiatry, Heinrich-Heine University, Düsseldorf, Germany
| | - Markus London
- Janssen-Cilag GmbH, Early Development and Clinical Pharmacology, Neuss, Germany
| | - Peter de Boer
- Janssen Pharmaceutica, Johnson & Johnson Pharmaceutical Research and Development, Beerse, Belgium
| | - Norman Zacharias
- Experimental and Clinical Research Center (ECRC), Dept. of Anesthesiology and Intensive Care Medicine, Charité - University Medicine Berlin, Germany
| | - Georg Winterer
- Experimental and Clinical Research Center (ECRC), Dept. of Anesthesiology and Intensive Care Medicine, Charité - University Medicine Berlin, Germany; Pharmaimage Biomarker Solutions GmbH, Berlin, Germany; Pharmaimage Biomarker Solutions Inc., Boston, USA
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18
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Sleigh J. Can nitric oxide tame the ketamine tiger? Br J Anaesth 2018; 120:890-891. [DOI: 10.1016/j.bja.2018.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/14/2018] [Indexed: 11/15/2022] Open
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Artigas F, Celada P, Bortolozzi A. Can we increase the speed and efficacy of antidepressant treatments? Part II. Glutamatergic and RNA interference strategies. Eur Neuropsychopharmacol 2018. [PMID: 29525411 DOI: 10.1016/j.euroneuro.2018.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the second part we focus on two treatment strategies that may overcome the main limitations of current antidepressant drugs. First, we review the experimental and clinical evidence supporting the use of glutamatergic drugs as fast-acting antidepressants. Secondly, we review the involvement of microRNAs (miRNAs) in the pathophysiology of major depressive disorder (MDD) and the use of small RNAs (e.g.., small interfering RNAs or siRNAs) to knockdown genes in monoaminergic and non-monoaminergic neurons and induce antidepressant-like responses in experimental animals. The development of glutamatergic agents is a promising venue for antidepressant drug development, given the antidepressant properties of the non-competitive NMDA receptor antagonist ketamine. Its unique properties appear to result from the activation of AMPA receptors by a metabolite [(2S,6S;2R,6R)-hydroxynorketamine (HNK)] and mTOR signaling. These effects increase synaptogenesis in prefrontal cortical pyramidal neurons and enhance serotonergic neurotransmission via descending inputs to the raphe nuclei. This view is supported by the cancellation of ketamine's antidepressant-like effects by inhibition of serotonin synthesis. We also review existing evidence supporting the involvement of miRNAs in MDD and the preclinical use of RNA interference (RNAi) strategies to target genes involved in antidepressant response. Many miRNAs have been associated to MDD, some of which e.g., miR-135 targets genes involved in antidepressant actions. Likewise, SSRI-conjugated siRNA evokes faster and/or more effective antidepressant-like responses. Intranasal application of sertraline-conjugated siRNAs directed to 5-HT1A receptors and SERT evoked much faster changes of pre- and postsynaptic antidepressant markers than those produced by fluoxetine.
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Affiliation(s)
- F Artigas
- Department of Neurochemistry and Neuropharmacology, Institut d'Investigacions Biomèdiques de Barcelona, Consejo Superior de Investigaciones Científicas (CSIC), Spain; CIBERSAM (Centro de Investigació Biomédica en Red de Salud Mental), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.
| | - P Celada
- Department of Neurochemistry and Neuropharmacology, Institut d'Investigacions Biomèdiques de Barcelona, Consejo Superior de Investigaciones Científicas (CSIC), Spain; CIBERSAM (Centro de Investigació Biomédica en Red de Salud Mental), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - A Bortolozzi
- Department of Neurochemistry and Neuropharmacology, Institut d'Investigacions Biomèdiques de Barcelona, Consejo Superior de Investigaciones Científicas (CSIC), Spain; CIBERSAM (Centro de Investigació Biomédica en Red de Salud Mental), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
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