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Bojesen KB, Rostrup E, Sigvard AK, Mikkelsen M, Edden RAE, Ebdrup BH, Glenthøj B. The Trajectory of Prefrontal GABA levels in Initially Antipsychotic-Naïve Patients with Psychosis during Two Years Treatment and associations with Striatal Cerebral Blood Flow and Outcome. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023:S2451-9022(23)00339-7. [PMID: 38145706 DOI: 10.1016/j.bpsc.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/03/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Gamma-aminobutyric acid (GABA)-ergic function in the prefrontal cortex seems dysfunctional in first-episode patients with psychosis, but the impact of longer-term treatment and relation to clinical outcomes as well as striatal activity are unknown. METHODS Longitudinal study of 39 antipsychotic-naïve and benzodiazepine-free patients with psychosis (22.4 ± 5.4 years, 64% females) and 54 matched healthy controls (HCs) (22.2 ± 4.3 years, 61% females) followed-up after six weeks (28 patients, 51 HCs), six months (17 patients, 47 HCs), and two years (21 patients, 43 HCs). GABA levels in dorsal anterior cingulate cortex (dACC) and striatal resting cerebral blood flow (rCBF) were assessed on a 3T MR scanner at all visits. RESULTS GABA levels in dACC were significantly lower in patients at baseline and after six weeks, but not after six months and two years. Analyses of groups separately revealed decreased GABA levels after two years in HCs but stable levels in patients. Treatment increased striatal rCBF after six weeks and six months but not after two years. GABA levels were negatively associated with striatal rCBF in both groups at all visits. Last, lower baseline GABA levels in patients were related to less functional improvement after two years. CONCLUSIONS The findings suggest a different trajectory of GABA levels and striatal perfusion in first-episode patients over two years of antipsychotic treatment compared with HCs and indicate a downregulatory role of prefrontal GABAergic function on striatum. Moreover, abnormally low prefrontal GABA level at illness onset may be a marker for a more severe prognosis.
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Affiliation(s)
- Kirsten Borup Bojesen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark.
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, University of Copenhagen, Denmark
| | - Anne Korning Sigvard
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Mark Mikkelsen
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Baltimore, MD, USA
| | - Bjørn Hylsebeck Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark
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Bojesen KB, Glenthøj BY, Sigvard AK, Tangmose K, Raghava JM, Ebdrup BH, Rostrup E. Cerebral blood flow in striatum is increased by partial dopamine agonism in initially antipsychotic-naïve patients with psychosis. Psychol Med 2023; 53:1-11. [PMID: 36754993 PMCID: PMC10600821 DOI: 10.1017/s0033291723000144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Resting cerebral blood flow (rCBF) in striatum and thalamus is increased in medicated patients with psychosis, but whether this is caused by treatment or illness pathology is unclear. Specifically, effects of partial dopamine agonism, sex, and clinical correlates on rCBF are sparsely investigated. We therefore assessed rCBF in antipsychotic-naïve psychosis patients before and after aripiprazole monotherapy and related findings to sex and symptom improvement. METHODS We assessed rCBF with the pseudo-Continuous Arterial Spin Labeling (PCASL) sequence in 49 first-episode patients (22.6 ± 5.2 years, 58% females) and 50 healthy controls (HCs) (22.3 ± 4.4 years, 63% females) at baseline and in 29 patients and 49 HCs after six weeks. RCBF in striatum and thalamus was estimated with a region-of-interest (ROI) approach. Psychopathology was assessed with the positive and negative syndrome scale. RESULTS Baseline rCBF in striatum and thalamus was not altered in the combined patient group compared with HCs, but female patients had lower striatal rCBF compared with male patients (p = 0.009). Treatment with a partial dopamine agonist increased rCBF significantly in striatum (p = 0.006) in the whole patient group, but not significantly in thalamus. Baseline rCBF in nucleus accumbens was negatively associated with improvement in positive symptoms (p = 0.046), but baseline perfusion in whole striatum and thalamus was not related to treatment outcome. CONCLUSIONS The findings suggest that striatal perfusion is increased by partial dopamine agonism and decreased in female patients prior to first treatment. This underlines the importance of treatment effects and sex differences when investigating the neurobiology of psychosis.
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Affiliation(s)
- Kirsten Borup Bojesen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Birte Yding Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Korning Sigvard
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karen Tangmose
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jayachandra Mitta Raghava
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Glostrup, Denmark
| | - Bjørn Hylsebeck Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
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3
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Hernandez‐Garcia L, Aramendía‐Vidaurreta V, Bolar DS, Dai W, Fernández‐Seara MA, Guo J, Madhuranthakam AJ, Mutsaerts H, Petr J, Qin Q, Schollenberger J, Suzuki Y, Taso M, Thomas DL, van Osch MJP, Woods J, Zhao MY, Yan L, Wang Z, Zhao L, Okell TW. Recent Technical Developments in ASL: A Review of the State of the Art. Magn Reson Med 2022; 88:2021-2042. [PMID: 35983963 PMCID: PMC9420802 DOI: 10.1002/mrm.29381] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/31/2022] [Accepted: 06/18/2022] [Indexed: 12/11/2022]
Abstract
This review article provides an overview of a range of recent technical developments in advanced arterial spin labeling (ASL) methods that have been developed or adopted by the community since the publication of a previous ASL consensus paper by Alsop et al. It is part of a series of review/recommendation papers from the International Society for Magnetic Resonance in Medicine Perfusion Study Group. Here, we focus on advancements in readouts and trajectories, image reconstruction, noise reduction, partial volume correction, quantification of nonperfusion parameters, fMRI, fingerprinting, vessel selective ASL, angiography, deep learning, and ultrahigh field ASL. We aim to provide a high level of understanding of these new approaches and some guidance for their implementation, with the goal of facilitating the adoption of such advances by research groups and by MRI vendors. Topics outside the scope of this article that are reviewed at length in separate articles include velocity selective ASL, multiple-timepoint ASL, body ASL, and clinical ASL recommendations.
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Affiliation(s)
| | | | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of California at San DiegoSan DiegoCaliforniaUSA
| | - Weiying Dai
- Department of Computer ScienceState University of New York at BinghamtonBinghamtonNYUSA
| | | | - Jia Guo
- Department of BioengineeringUniversity of California RiversideRiversideCaliforniaUSA
| | | | - Henk Mutsaerts
- Department of Radiology & Nuclear MedicineAmsterdam University Medical Center, Amsterdam NeuroscienceAmsterdamThe Netherlands
| | - Jan Petr
- Helmholtz‐Zentrum Dresden‐RossendorfInstitute of Radiopharmaceutical Cancer ResearchDresdenGermany
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Yuriko Suzuki
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Manuel Taso
- Division of MRI research, RadiologyBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMassachusettsUSA
| | - David L. Thomas
- Department of Brain Repair and RehabilitationUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Matthias J. P. van Osch
- C.J. Gorter Center for high field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Joseph Woods
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Department of RadiologyUniversity of CaliforniaLa JollaCaliforniaUSA
| | - Moss Y. Zhao
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Lirong Yan
- Department of Radiology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Ze Wang
- Department of Diagnostic Radiology and Nuclear MedicineUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Li Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument ScienceZhejiang UniversityZhejiangPeople's Republic of China
| | - Thomas W. Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
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4
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Juurlink DN. Antiemetics, stroke, and the limits of observational epidemiology. BMJ 2022; 377:o924. [PMID: 35396322 DOI: 10.1136/bmj.o924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- David N Juurlink
- Clinical Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
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5
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Bénard-Laribière A, Hucteau E, Debette S, Kirchgesner J, Bezin J, Pariente A. Risk of first ischaemic stroke and use of antidopaminergic antiemetics: nationwide case-time-control study. BMJ 2022; 376:e066192. [PMID: 35321876 PMCID: PMC8941665 DOI: 10.1136/bmj-2021-066192] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To estimate the risk of ischaemic stroke associated with antidopaminergic antiemetic (ADA) use. DESIGN Case-time-control study. SETTING Data from the nationwide French reimbursement healthcare system database Système National des Données de Santé (SNDS). PARTICIPANTS Eligible participants were ≥18 years with a first ischaemic stroke between 2012 and 2016 and at least one reimbursement for any ADA in the 70 days before stroke. Frequencies of ADA reimbursements were compared for a risk period (days -14 to -1 before stroke) and three matched reference periods (days -70 to -57, -56 to -43, and -42 to -29) for each patient. Time trend of ADA use was controlled by using a control group of 21 859 randomly selected people free of the event who were individually matched to patients with stroke according to age, sex, and risk factors of ischaemic stroke. MAIN OUTCOME MEASURES Association between ADA use and risk of ischaemic stroke was assessed by estimating the ratio of the odds ratios of exposure evaluated in patients with stroke and in controls. Analyses were adjusted for time varying confounders (anticoagulants, antiplatelets, and prothrombotic or vasoconstrictive drugs). RESULTS Among the 2612 patients identified with incident stroke, 1250 received an ADA in the risk period and 1060 in the reference periods. The comparison with the 5128 and 13 165 controls who received an ADA in the same periods yielded a ratio of adjusted odds ratios of 3.12 (95% confidence interval 2.85 to 3.42). Analyses stratified by age, sex, and history of dementia showed similar results. Ratio of adjusted odds ratios for analyses stratified by ADA was 2.51 (2.18 to 2.88) for domperidone, 3.62 (3.11 to 4.23) for metopimazine, and 3.53 (2.62 to 4.76) for metoclopramide. Sensitivity analyses suggested the risk would be higher in the first days of use. CONCLUSIONS Using French nationwide exhaustive reimbursement data, this self-controlled study reported an increased risk of ischaemic stroke with recent ADA use. The highest increase was found for metopimazine and metoclopramide.
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Affiliation(s)
| | - Emilie Hucteau
- Univ. Bordeaux, INSERM, BPH, team Pharmacoepidemiology, U1219, Bordeaux, France
| | - Stéphanie Debette
- Univ. Bordeaux, INSERM, BPH, team Vascular and neurological diseases: integrative and genetic epidemiology-VINTAGE, U1219, Bordeaux, France
- CHU de Bordeaux, Department of Neurology, Bordeaux, France
| | - Julien Kirchgesner
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Department of Gastroenterology, Hôpital Saint-Antoine, Paris, France
| | - Julien Bezin
- Univ. Bordeaux, INSERM, BPH, team Pharmacoepidemiology, U1219, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, Bordeaux, France
| | - Antoine Pariente
- Univ. Bordeaux, INSERM, BPH, team Pharmacoepidemiology, U1219, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, Bordeaux, France
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6
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Martens M, McConnell FK, Filippini N, Mackay CE, Harrison PJ, Tunbridge EM. Dopaminergic modulation of regional cerebral blood flow: An arterial spin labelling study of genetic and pharmacological manipulation of COMT activity. Neuroimage 2021; 234:117999. [PMID: 33789133 DOI: 10.1016/j.neuroimage.2021.117999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022] Open
Abstract
Dopamine has direct and complex vasoactive effects on cerebral circulation. Catechol-O-methyltransferase (COMT) regulates cortical dopamine, and its activity can be influenced both genetically and pharmacologically. COMT activity influences the functional connectivity of the PFC at rest, as well as its activity during task performance, determined using blood oxygen level-dependent (BOLD) fMRI. However, its effects on cerebral perfusion have been relatively unexplored. Here, 76 healthy males, homozygous for the functional COMT Val158Met polymorphism, were administered either the COMT inhibitor tolcapone or placebo in a double-blind, randomised design. We then assessed regional cerebral blood flow at rest using pulsed arterial spin labelling. Perfusion was affected by both genotype and drug. COMT genotype affected frontal regions (Val158 > Met158), whilst tolcapone influenced parietal and temporal regions (placebo > tolcapone). There was no genotype by drug interaction. Our data demonstrate that lower COMT activity is associated with lower cerebral blood flow, although the regions affected differ between those affected by genotype compared with those altered by acute pharmacological inhibition. The results extend the evidence for dopaminergic modulation of cerebral blood flow. Our findings also highlight the importance of considering vascular effects in functional neuroimaging studies, and of exercising caution in ascribing group differences in BOLD signal solely to altered neuronal activity if information about regional perfusion is not available.
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Affiliation(s)
- Mag Martens
- Oxford Health NHS Foundation Trust, Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK.
| | - Fa Kennedy McConnell
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK
| | - N Filippini
- Oxford Health NHS Foundation Trust, Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK; IRCCS San Camillo Hospital, Venice, Italy
| | - C E Mackay
- Oxford Health NHS Foundation Trust, Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - P J Harrison
- Oxford Health NHS Foundation Trust, Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - E M Tunbridge
- Oxford Health NHS Foundation Trust, Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK
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Hawkins PCT, Zelaya FO, O'Daly O, Holiga S, Dukart J, Umbricht D, Mehta MA. The effect of risperidone on reward-related brain activity is robust to drug-induced vascular changes. Hum Brain Mapp 2021; 42:2766-2777. [PMID: 33666305 PMCID: PMC8127149 DOI: 10.1002/hbm.25400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/22/2021] [Accepted: 02/16/2021] [Indexed: 12/20/2022] Open
Abstract
Dopamine (DA) mediated brain activity is intimately linked to reward‐driven cerebral responses, while aberrant reward processing has been implicated in several psychiatric disorders. fMRI has been a valuable tool in understanding the mechanism by which DA modulators alter reward‐driven responses and how they may exert their therapeutic effect. However, the potential effects of a pharmacological compound on aspects of neurovascular coupling may cloud the interpretability of the BOLD contrast. Here, we assess the effects of risperidone on reward driven BOLD signals produced by reward anticipation and outcome, while attempting to control for potential drug effects on regional cerebral blood flow (CBF) and cerebrovascular reactivity (CVR). Healthy male volunteers (n = 21) each received a single oral dose of either 0.5 mg, 2 mg of risperidone or placebo in a double‐blind, placebo‐controlled, randomised, three‐period cross‐over study design. Participants underwent fMRI scanning while performing the widely used Monetary Incentive Delay (MID) task to assess drug impact on reward function. Measures of CBF (Arterial Spin Labelling) and breath‐hold challenge induced BOLD signal changes (as a proxy for CVR) were also acquired and included as covariates. Risperidone produced divergent, dose‐dependent effects on separate phases of reward processing, even after controlling for potential nonneuronal influences on the BOLD signal. These data suggest the D2 antagonist risperidone has a wide‐ranging influence on DA‐mediated reward function independent of nonneuronal factors. We also illustrate that assessment of potential vascular confounds on the BOLD signal may be advantageous when investigating CNS drug action and advocate for the inclusion of these additional measures into future study designs.
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Affiliation(s)
- Peter C T Hawkins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fernando O Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stefan Holiga
- Roche Pharma Research and Early Development, Roche Innovation Centre Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Juergen Dukart
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Daniel Umbricht
- Roche Pharma Research and Early Development, Roche Innovation Centre Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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8
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Coupling of cerebral blood flow and functional connectivity is decreased in healthy aging. Brain Imaging Behav 2021; 14:436-450. [PMID: 31250268 DOI: 10.1007/s11682-019-00157-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Aging leads to cerebral perfusion and functional connectivity changes that have been assessed using various neuroimaging techniques. In addition, a link between these two parameters has been demonstrated in healthy young adults. In this work, we employed arterial spin labeling (ASL) fMRI to measure global and voxel-wise differences in cerebral blood flow (CBF) and intrinsic connectivity contrast (ICC) in the resting state in a group of cognitively normal elderly subjects and a group of cognitively normal young subjects, in order to assess the effects of aging on CBF-ICC coupling, which had not been previously evaluated. Our results showed age-related global and regional CBF decreases in prefrontal mesial areas, lateral frontal regions, insular cortex, lateral parietal areas, precuneus and occipital regions. Subcortically, perfusion was reduced in the medial thalamus and caudate nucleus. ICC was also found reduced with age in prefrontal cortical areas and insular cortex, affecting key nodes of the default mode and salience networks. Areas of ICC and CBF decrease partially overlapped, however, the CBF reduction was more extensive and encompassed more areas. This dissociation was accompanied by a decrease in CBF-ICC coupling. These results suggest that aging leads to a disruption in the relationship between CBF and intrinsic functional connectivity that could be due to neurovascular dysregulation.
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Turkheimer FE, Selvaggi P, Mehta MA, Veronese M, Zelaya F, Dazzan P, Vernon AC. Normalizing the Abnormal: Do Antipsychotic Drugs Push the Cortex Into an Unsustainable Metabolic Envelope? Schizophr Bull 2020; 46:484-495. [PMID: 31755955 PMCID: PMC7147598 DOI: 10.1093/schbul/sbz119] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The use of antipsychotic medication to manage psychosis, principally in those with a diagnosis of schizophrenia or bipolar disorder, is well established. Antipsychotics are effective in normalizing positive symptoms of psychosis in the short term (delusions, hallucinations and disordered thought). Their long-term use is, however, associated with side effects, including several types of movement (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac disorders. Furthermore, higher lifetime antipsychotic dose-years may be associated with poorer cognitive performance and blunted affect, although the mechanisms driving the latter associations are not well understood. In this article, we propose a novel model of the long-term effects of antipsychotic administration focusing on the changes in brain metabolic homeostasis induced by the medication. We propose here that the brain metabolic normalization, that occurs in parallel to the normalization of psychotic symptoms following antipsychotic treatment, may not ultimately be sustainable by the cerebral tissue of some patients; these patients may be characterized by already reduced oxidative metabolic capacity and this may push the brain into an unsustainable metabolic envelope resulting in tissue remodeling. To support this perspective, we will review the existing data on the brain metabolic trajectories of patients with a diagnosis of schizophrenia as indexed using available neuroimaging tools before and after use of medication. We will also consider data from pre-clinical studies to provide mechanistic support for our model.
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Affiliation(s)
- Federico E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, UK
| | - Pierluigi Selvaggi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Anthony C Vernon
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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10
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Wolke SA, Mehta MA, O'Daly O, Zelaya F, Zahreddine N, Keren H, O'Callaghan G, Young AH, Leibenluft E, Pine DS, Stringaris A. Modulation of anterior cingulate cortex reward and penalty signalling in medication-naive young-adult subjects with depressive symptoms following acute dose lurasidone. Psychol Med 2019; 49:1365-1377. [PMID: 30606271 PMCID: PMC6518385 DOI: 10.1017/s0033291718003306] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/08/2018] [Accepted: 10/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Aberrations in reward and penalty processing are implicated in depression and putatively reflect altered dopamine signalling. This study exploits the advantages of a placebo-controlled design to examine how a novel D2 antagonist with adjunctive antidepressant properties modifies activity in the brain's reward network in depression. METHODS We recruited 43 medication-naïve subjects across the range of depression severity (Beck's Depression Inventory-II score range: 0-43), including healthy volunteers, as well as people meeting full-criteria for major depressive disorder. In a double-blind placebo-controlled cross-over design, all subjects received either placebo or lurasidone (20 mg) across two visits separated by 1 week. Functional magnetic resonance imaging with the Monetary Incentive Delay (MID) task assessed reward functions via neural responses during anticipation and receipt of gains and losses. Arterial spin labelling measured cerebral blood flow (CBF) at rest. RESULTS Lurasidone altered fronto-striatal activity during anticipation and outcome phases of the MID task. A significant three-way Medication-by-Depression severity-by-Outcome interaction emerged in the anterior cingulate cortex (ACC) after correction for multiple comparisons. Follow-up analyses revealed significantly higher ACC activation to losses in high- v. low depression participants in the placebo condition, with a normalisation by lurasidone. This effect could not be accounted for by shifts in resting CBF. CONCLUSIONS Lurasidone acutely normalises reward processing signals in individuals with depressive symptoms. Lurasidone's antidepressant effects may arise from reducing responses to penalty outcomes in individuals with depressive symptoms.
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Affiliation(s)
- Selina A. Wolke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Mood Brain and Development Unit, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, USA
| | - Mitul A. Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Nada Zahreddine
- Department of Psychiatry, Saint-Joseph University, Beirut, Lebanon
| | - Hanna Keren
- Mood Brain and Development Unit, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, USA
| | - Georgia O'Callaghan
- Mood Brain and Development Unit, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, USA
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Ellen Leibenluft
- Section on Mood Dysregulation and Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, USA
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, MD, USA
| | - Argyris Stringaris
- Mood Brain and Development Unit, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, USA
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11
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Selvaggi P, Hawkins PC, Dipasquale O, Rizzo G, Bertolino A, Dukart J, Sambataro F, Pergola G, Williams SC, Turkheimer F, Zelaya F, Veronese M, Mehta MA. Increased cerebral blood flow after single dose of antipsychotics in healthy volunteers depends on dopamine D2 receptor density profiles. Neuroimage 2019; 188:774-784. [DOI: 10.1016/j.neuroimage.2018.12.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 12/05/2018] [Accepted: 12/12/2018] [Indexed: 12/11/2022] Open
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12
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Ghai S, Ghai I. Role of Sonification and Rhythmic Auditory Cueing for Enhancing Gait Associated Deficits Induced by Neurotoxic Cancer Therapies: A Perspective on Auditory Neuroprosthetics. Front Neurol 2019; 10:21. [PMID: 30761065 PMCID: PMC6361827 DOI: 10.3389/fneur.2019.00021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 01/08/2019] [Indexed: 01/01/2023] Open
Abstract
Patients undergoing chemotherapy, radiotherapy, and immunotherapy experience neurotoxic changes in the central and peripheral nervous system. These neurotoxic changes adversely affect functioning in the sensory, motor, and cognitive domains. Thereby, considerably affecting autonomic activities like gait and posture. Recent evidence from a range of systematic reviews and meta-analyses have suggested the beneficial influence of music-based external auditory stimulations i.e., rhythmic auditory cueing and real-time auditory feedback (sonification) on gait and postural stability in population groups will balance disorders. This perspective explores the conjunct implications of auditory stimulations during cancer treatment to simultaneously reduce gait and posture related deficits. Underlying neurophysiological mechanisms by which auditory stimulations might influence motor performance have been discussed. Prompt recognition of this sensorimotor training strategy in future studies can have a widespread impact on patient care in all areas of oncology.
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Affiliation(s)
- Shashank Ghai
- Institute of Sports Science, Leibniz University Hannover, Hanover, Germany
| | - Ishan Ghai
- Consultation Division, Program Management Discovery Sciences, RSGBIOGEN, New Delhi, India
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13
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Trujillo P, van Wouwe NC, Lin YC, Stark AJ, Petersen KJ, Kang H, Zald DH, Donahue MJ, Claassen DO. Dopamine effects on frontal cortical blood flow and motor inhibition in Parkinson's disease. Cortex 2019; 115:99-111. [PMID: 30776736 DOI: 10.1016/j.cortex.2019.01.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/15/2018] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
Abstract
Parkinson's disease (PD) is characterized by dysfunction in frontal cortical and striatal networks that regulate action control. We investigated the pharmacological effect of dopamine agonist replacement therapy on frontal cortical activity and motor inhibition. Using Arterial Spin Labeling MRI, we examined 26 PD patients in the off- and on-dopamine agonist medication states to assess the effect of dopamine agonists on frontal cortical regional cerebral blood flow. Motor inhibition was measured by the Simon task in both medication states. We applied the dual process activation suppression model to dissociate fast response impulses from motor inhibition of incorrect responses. General linear regression model analyses determined the medication effect on regional cerebral blood flow and motor inhibition, and the relationship between regional cerebral blood flow and motor inhibitory proficiency. We show that dopamine agonist administration increases frontal cerebral blood flow, particularly in the pre-supplementary motor area (pre-SMA) and the dorsolateral prefrontal cortex (DLPFC). Higher regional blood flow in the pre-SMA, DLPFC and motor cortex was associated with better inhibitory control, suggesting that treatments which improve frontal cortical activity could ameliorate motor inhibition deficiency in PD patients.
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Affiliation(s)
- Paula Trujillo
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Ya-Chen Lin
- Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam J Stark
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kalen J Petersen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David H Zald
- Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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14
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Tournier N, Bauer M, Pichler V, Nics L, Klebermass EM, Bamminger K, Matzneller P, Weber M, Karch R, Caillé F, Auvity S, Marie S, Jäger W, Wadsak W, Hacker M, Zeitlinger M, Langer O. Impact of P-Glycoprotein Function on the Brain Kinetics of the Weak Substrate 11C-Metoclopramide Assessed with PET Imaging in Humans. J Nucl Med 2019; 60:985-991. [PMID: 30630940 DOI: 10.2967/jnumed.118.219972] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/28/2018] [Indexed: 02/07/2023] Open
Abstract
PET with avid substrates of P-glycoprotein (ABCB1) provided evidence of the role of this efflux transporter in effectively restricting the brain penetration of its substrates across the human blood-brain barrier (BBB). This may not reflect the situation for weak ABCB1 substrates including several antidepressants, antiepileptic drugs, and neuroleptics, which exert central nervous system effects despite being transported by ABCB1. We performed PET with the weak ABCB1 substrate 11C-metoclopramide in humans to elucidate the impact of ABCB1 function on its brain kinetics. Methods: Ten healthy male subjects underwent 2 consecutive 11C-metoclopramide PET scans without and with ABCB1 inhibition using cyclosporine A (CsA). Pharmacokinetic modeling was performed to estimate the total volume of distribution (V T) and the influx (K 1) and efflux (k 2) rate constants between plasma and selected brain regions. Furthermore, 11C-metoclopramide washout from the brain was estimated by determining the elimination slope (k E,brain) of the brain time-activity curves. Results: In baseline scans, 11C-metoclopramide showed appreciable brain distribution (V T = 2.11 ± 0.33 mL/cm3). During CsA infusion, whole-brain gray matter V T and K 1 were increased by 29% ± 17% and 9% ± 12%, respectively. K 2 was decreased by 15% ± 5%, consistent with a decrease in k E,brain (-32% ± 18%). The impact of CsA on outcome parameters was significant and similar across brain regions except for the pituitary gland, which is not protected by the BBB. Conclusion: Our results show for the first time that ABCB1 does not solely account for the "barrier" property of the BBB but also acts as a detoxifying system to limit the overall brain exposure to its substrates at the human blood-brain interface.
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Affiliation(s)
- Nicolas Tournier
- UMR 1023 IMIV, Service Hospitalier Frédéric Joliot, CEA, Inserm, Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Martin Bauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Verena Pichler
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Lukas Nics
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Eva-Maria Klebermass
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Karsten Bamminger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Peter Matzneller
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Maria Weber
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Rudolf Karch
- Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Fabien Caillé
- UMR 1023 IMIV, Service Hospitalier Frédéric Joliot, CEA, Inserm, Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Sylvain Auvity
- UMR 1023 IMIV, Service Hospitalier Frédéric Joliot, CEA, Inserm, Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Solène Marie
- UMR 1023 IMIV, Service Hospitalier Frédéric Joliot, CEA, Inserm, Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Walter Jäger
- Department of Clinical Pharmacy and Diagnostics, University of Vienna, Vienna, Austria
| | - Wolfgang Wadsak
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.,Center for Biomarker Research in Medicine-CBmed GmbH, Graz, Austria; and
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Markus Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Oliver Langer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.,Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
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15
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Evaluation of drug effects on cerebral blood flow and glucose uptake in un-anesthetized and un-stimulated rats: application of free-moving apparatus enabling to keep rats free during PET/SPECT tracer injection and uptake. Nucl Med Commun 2018; 39:753-760. [PMID: 29771718 PMCID: PMC6075887 DOI: 10.1097/mnm.0000000000000863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives The purpose of this study is the development of novel fluorine-18-fluorodeoxyglucose (18F-FDG)-PET and 99mTc-hexamethylpropylene amine oxime (HMPAO) SPECT methods with free-moving apparatus on conscious rats to investigate brain activity without the effects of anesthesia and tactual stimulation. We also assessed the sensitivity of the experimental system by an intervention study using fluoxetine as a reference drug. Materials and methods A catheter was inserted into the femoral vein and connected to a free-moving cannula system. After fluoxetine administration, the rats were given an injection of 18F-FDG or 99mTc-HMPAO via the intravenous cannula and released into a free-moving cage. After the tracer was trapped in the brain, the rats were anesthetized and scanned with PET or SPECT scanners. Then a volume of interest analysis and statistical parametric mapping were performed. Results We could inject the tracer without touching the rats, while keeping them conscious until the tracers were distributed and trapped in the brain using the developed system. The effects of fluoxetine on glucose uptake and cerebral blood flow were perceptively detected by volume of interest and statistical parametric mapping analysis. Conclusion We successfully developed free-moving 18F-FDG-PET and 99mTc-HMPAO-SPECT imaging systems and detected detailed glucose uptake and cerebral blood flow changes in the conscious rat brain with fluoxetine administration. This system is expected to be useful to assess brain activity without the effects of anesthesia and tactual stimulation to evaluate drug effect or animal brain function.
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16
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McQueen G, Lally J, Collier T, Zelaya F, Lythgoe DJ, Barker GJ, Stone JM, McGuire P, MacCabe JH, Egerton A. Effects of N-acetylcysteine on brain glutamate levels and resting perfusion in schizophrenia. Psychopharmacology (Berl) 2018; 235:3045-3054. [PMID: 30141055 PMCID: PMC6182588 DOI: 10.1007/s00213-018-4997-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/06/2018] [Indexed: 01/16/2023]
Abstract
RATIONALE N-Acetylcysteine (NAC) is currently under investigation as an adjunctive treatment for schizophrenia. The therapeutic potential of NAC may involve modulation of brain glutamate function, but its effects on brain glutamate levels in schizophrenia have not been evaluated. OBJECTIVES The aim of this study was to examine whether a single dose of NAC can alter brain glutamate levels. A secondary aim was to characterise its effects on regional brain perfusion. METHODS In a double-blind placebo-controlled crossover study, 19 patients with a diagnosis of schizophrenia underwent two MRI scans, following oral administration of 2400 mg NAC or matching placebo. Proton magnetic resonance spectroscopy was used to investigate the effect of NAC on glutamate and Glx (glutamate plus glutamine) levels scaled to creatine (Cr) in the anterior cingulate cortex (ACC) and in the right caudate nucleus. Pulsed continuous arterial spin labelling was used to assess the effects of NAC on resting cerebral blood flow (rCBF) in the same regions. RESULTS Relative to the placebo condition, the NAC condition was associated with lower levels of Glx/Cr, in the ACC (P < 0.05), but not in the caudate nucleus. There were no significant differences in CBF in the NAC compared to placebo condition. CONCLUSIONS These data provide preliminary evidence that NAC can modulate ACC glutamate in patients with schizophrenia. In contrast, physiological effects of NAC on the brain were not detectable as between session changes in rCBF. Future studies assessing the effects of a course of treatment with NAC on glutamate metabolites in schizophrenia are indicated.
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Affiliation(s)
- Grant McQueen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK.
| | - John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tracy Collier
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - David J Lythgoe
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - Gareth J Barker
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - James M Stone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
- Experimental Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - James H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
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17
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Dukart J, Holiga Š, Chatham C, Hawkins P, Forsyth A, McMillan R, Myers J, Lingford-Hughes AR, Nutt DJ, Merlo-Pich E, Risterucci C, Boak L, Umbricht D, Schobel S, Liu T, Mehta MA, Zelaya FO, Williams SC, Brown G, Paulus M, Honey GD, Muthukumaraswamy S, Hipp J, Bertolino A, Sambataro F. Cerebral blood flow predicts differential neurotransmitter activity. Sci Rep 2018; 8:4074. [PMID: 29511260 PMCID: PMC5840131 DOI: 10.1038/s41598-018-22444-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/23/2018] [Indexed: 12/13/2022] Open
Abstract
Application of metabolic magnetic resonance imaging measures such as cerebral blood flow in translational medicine is limited by the unknown link of observed alterations to specific neurophysiological processes. In particular, the sensitivity of cerebral blood flow to activity changes in specific neurotransmitter systems remains unclear. We address this question by probing cerebral blood flow in healthy volunteers using seven established drugs with known dopaminergic, serotonergic, glutamatergic and GABAergic mechanisms of action. We use a novel framework aimed at disentangling the observed effects to contribution from underlying neurotransmitter systems. We find for all evaluated compounds a reliable spatial link of respective cerebral blood flow changes with underlying neurotransmitter receptor densities corresponding to their primary mechanisms of action. The strength of these associations with receptor density is mediated by respective drug affinities. These findings suggest that cerebral blood flow is a sensitive brain-wide in-vivo assay of metabolic demands across a variety of neurotransmitter systems in humans.
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Affiliation(s)
- Juergen Dukart
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland.
| | - Štefan Holiga
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Christopher Chatham
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Peter Hawkins
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Anna Forsyth
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rebecca McMillan
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jim Myers
- Neuropsychopharmacology Unit, Imperial College London, London, United Kingdom
| | | | - David J Nutt
- Veterans Affairs San Diego Healthcare System, San Diego, USA
| | - Emilio Merlo-Pich
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Celine Risterucci
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Lauren Boak
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Daniel Umbricht
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Scott Schobel
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Thomas Liu
- Center for Functional MRI, University of California San Diego, 9500 Gilman Drive MC 0677, La Jolla, CA 92093, United States
- Departments of Radiology, Psychiatry and Bioengineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Fernando O Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Steve C Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Gregory Brown
- University of California, San Diego, La Jolla, USA
- Veterans Affairs San Diego Healthcare System, San Diego, USA
| | - Martin Paulus
- University of California, San Diego, La Jolla, USA
- Veterans Affairs San Diego Healthcare System, San Diego, USA
| | - Garry D Honey
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Suresh Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Joerg Hipp
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | - Alessandro Bertolino
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
- Institute Of Psychiatry, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Fabio Sambataro
- F. Hoffmann-La Roche, pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Udine, Italy
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18
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Li Y, Mao D, Li Z, Schär M, Pillai JJ, Pipe JG, Lu H. Cardiac-triggered pseudo-continuous arterial-spin-labeling: A cost-effective scheme to further enhance the reliability of arterial-spin-labeling MRI. Magn Reson Med 2018; 80:969-975. [PMID: 29369422 DOI: 10.1002/mrm.27090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/04/2017] [Accepted: 12/27/2017] [Indexed: 01/01/2023]
Affiliation(s)
- Yang Li
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Deng Mao
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Zhiqiang Li
- Imaging Research, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Michael Schär
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay J Pillai
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - James G Pipe
- Imaging Research, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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19
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Hawkins PCT, Wood TC, Vernon AC, Bertolino A, Sambataro F, Dukart J, Merlo-Pich E, Risterucci C, Silber-Baumann H, Walsh E, Mazibuko N, Zelaya FO, Mehta MA. An investigation of regional cerebral blood flow and tissue structure changes after acute administration of antipsychotics in healthy male volunteers. Hum Brain Mapp 2017; 39:319-331. [PMID: 29058358 DOI: 10.1002/hbm.23844] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/13/2017] [Accepted: 10/02/2017] [Indexed: 01/05/2023] Open
Abstract
Chronic administration of antipsychotic drugs has been linked to structural brain changes observed in patients with schizophrenia. Recent MRI studies have shown rapid changes in regional brain volume following just a single dose of these drugs. However, it is not clear if these changes represent real volume changes or are artefacts ("apparent" volume changes) due to drug-induced physiological changes, such as increased cerebral blood flow (CBF). To address this, we examined the effects of a single, clinical dose of three commonly prescribed antipsychotics on quantitative measures of T1 and regional blood flow of the healthy human brain. Males (n = 42) were randomly assigned to one of two parallel groups in a double-blind, placebo-controlled, randomized, three-period cross-over study design. One group received a single oral dose of either 0.5 or 2 mg of risperidone or placebo during each visit. The other received olanzapine (7.5 mg), haloperidol (3 mg), or placebo. MR measures of quantitative T1, CBF, and T1-weighted images were acquired at the estimated peak plasma concentration of the drug. All three drugs caused localized increases in striatal blood flow, although drug and region specific effects were also apparent. In contrast, all assessments of T1 and brain volume remained stable across sessions, even in those areas experiencing large changes in CBF. This illustrates that a single clinically relevant oral dose of an antipsychotic has no detectable acute effect on T1 in healthy volunteers. We further provide a methodology for applying quantitative imaging methods to assess the acute effects of other compounds on structural MRI metrics. Hum Brain Mapp 39:319-331, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Peter C T Hawkins
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tobias C Wood
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Anthony C Vernon
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari BA, Italy
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - Juergen Dukart
- Translational Medicine Neuroscience and Biomarkers, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Emilio Merlo-Pich
- CNS Therapeutic Area Unit, Takeda Development Centre Europe, London, United Kingdom
| | - Celine Risterucci
- Pharma Research and Early Development, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Hanna Silber-Baumann
- Pharma Research and Early Development, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Eamonn Walsh
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ndabezinhle Mazibuko
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Fernando O Zelaya
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mitul A Mehta
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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20
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Liemburg EJ, van Es F, Knegtering H, Aleman A. Effects of aripiprazole versus risperidone on brain activation during planning and social-emotional evaluation in schizophrenia: A single-blind randomized exploratory study. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:112-119. [PMID: 28558941 DOI: 10.1016/j.pnpbp.2017.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/28/2017] [Accepted: 05/26/2017] [Indexed: 12/28/2022]
Abstract
Impaired function of prefrontal brain networks may be the source of both negative symptoms and neurocognitive problems in psychotic disorders. Whereas most antipsychotics may decrease prefrontal activation, the partial dopamine D2-receptor agonist aripiprazole is hypothesized to improve prefrontal function. This study investigated whether patients with a psychotic disorder would show stronger activation of prefrontal areas and associated regions after treatment with aripiprazole compared to risperidone treatment. In this exploratory pharmacological neuroimaging study, 24 patients were randomly assigned to either aripiprazole or risperidone. At baseline and after nine weeks treatment they underwent an interview and MRI session. Here we report on brain activation (measured with arterial spin labeling) during performance of two tasks, the Tower of London and the Wall of Faces. Aripiprazole treatment decreased activation of the middle frontal, superior frontal and occipital gyrus (ToL) and medial temporal and inferior frontal gyrus, putamen and cuneus (WoF), while activation increased after risperidone. Activation increased in the ventral anterior cingulate and posterior insula (ToL), and superior frontal, superior temporal and precentral gyrus (WoF) after aripiprazole treatment and decreased after risperidone. Both treatment groups had increased ventral insula activation (ToL) and middle temporal gyrus (WoF), and decreased occipital cortex, precuneus and caudate head activation (ToL) activation. In conclusion, patients treated with aripiprazole may need less frontal resources for planning performance and may show increased frontotemporal and frontostriatal reactivity to emotional stimuli. More research is needed to corroborate and extend these preliminary findings.
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Affiliation(s)
- Edith J Liemburg
- BCN Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Frank van Es
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; University Center Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Henderikus Knegtering
- BCN Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Lentis Research, Center for Mental Health, Groningen, The Netherlands.
| | - André Aleman
- BCN Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Psychology, University of Groningen, Groningen, The Netherlands.
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Presynaptic Dopamine Synthesis Capacity in Schizophrenia and Striatal Blood Flow Change During Antipsychotic Treatment and Medication-Free Conditions. Neuropsychopharmacology 2017; 42:2232-2241. [PMID: 28387222 PMCID: PMC5603816 DOI: 10.1038/npp.2017.67] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 02/03/2023]
Abstract
Standard-of-care biological treatment of schizophrenia remains dependent upon antipsychotic medications, which demonstrate D2 receptor affinity and elicit variable, partial clinical responses via neural mechanisms that are not entirely understood. In the striatum, where D2 receptors are abundant, antipsychotic medications may affect neural function in studies of animals, healthy volunteers, and patients, yet the relevance of this to pharmacotherapeutic actions remains unresolved. In this same brain region, some individuals with schizophrenia may demonstrate phenotypes consistent with exaggerated dopaminergic signaling, including alterations in dopamine synthesis capacity; however, the hypothesis that dopamine system characteristics underlie variance in medication-induced regional blood flow changes has not been directly tested. We therefore studied a cohort of 30 individuals with schizophrenia using longitudinal, multi-session [15O]-water and [18F]-FDOPA positron emission tomography to determine striatal blood flow during active atypical antipsychotic medication treatment and after at least 3 weeks of placebo treatment, along with presynaptic dopamine synthesis capacity (ie, DOPA decarboxylase activity). Regional striatal blood flow was significantly higher during active treatment than during the placebo condition. Furthermore, medication-related increases in ventral striatal blood flow were associated with more robust amelioration of excited factor symptoms during active medication and with higher dopamine synthesis capacity. These data indicate that atypical medications enact measureable physiological alterations in limbic striatal circuitry that vary as a function of dopaminergic tone and may have relevance to aspects of therapeutic responses.
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22
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Neural response to catecholamine depletion in remitted bulimia nervosa: Relation to depression and relapse. Eur Neuropsychopharmacol 2017; 27:633-646. [PMID: 28502528 DOI: 10.1016/j.euroneuro.2017.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 04/13/2017] [Accepted: 04/18/2017] [Indexed: 01/05/2023]
Abstract
Bulimia nervosa has been associated with a dysregulated catecholamine system. Nevertheless, the influence of this dysregulation on bulimic symptoms, on neural activity, and on the course of the illness is not clear yet. An instructive paradigm for directly investigating the relationship between catecholaminergic functioning and bulimia nervosa has involved the behavioral and neural responses to experimental catecholamine depletion. The purpose of this study was to examine the neural substrate of catecholaminergic dysfunction in bulimia nervosa and its relationship to relapse. In a randomized, double-blind and crossover study design, catecholamine depletion was achieved by using the oral administration of alpha-methyl-paratyrosine (AMPT) over 24 h in 18 remitted bulimic (rBN) and 22 healthy (HC) female participants. Cerebral blood flow (CBF) was measured using a pseudo continuous arterial spin labeling (pCASL) sequence. In a follow-up telephone interview, bulimic relapse was assessed. Following AMPT, rBN participants revealed an increased vigor reduction and CBF decreases in the pallidum and posterior midcingulate cortex (pMCC) relative to HC participants showing no CBF changes in these regions. These results indicated that the pallidum and the pMCC are the functional neural correlates of the dysregulated catecholamine system in bulimia nervosa. Bulimic relapse was associated with increased depressive symptoms and CBF reduction in the hippocampus/parahippocampal gyrus following catecholamine depletion. AMPT-induced increased CBF in this region predicted staying in remission. These findings demonstrated the importance of depressive symptoms and the stress system in the course of bulimia nervosa.
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23
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Khalili-Mahani N, Rombouts SARB, van Osch MJP, Duff EP, Carbonell F, Nickerson LD, Becerra L, Dahan A, Evans AC, Soucy JP, Wise R, Zijdenbos AP, van Gerven JM. Biomarkers, designs, and interpretations of resting-state fMRI in translational pharmacological research: A review of state-of-the-Art, challenges, and opportunities for studying brain chemistry. Hum Brain Mapp 2017; 38:2276-2325. [PMID: 28145075 DOI: 10.1002/hbm.23516] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 11/21/2016] [Accepted: 01/04/2017] [Indexed: 12/11/2022] Open
Abstract
A decade of research and development in resting-state functional MRI (RSfMRI) has opened new translational and clinical research frontiers. This review aims to bridge between technical and clinical researchers who seek reliable neuroimaging biomarkers for studying drug interactions with the brain. About 85 pharma-RSfMRI studies using BOLD signal (75% of all) or arterial spin labeling (ASL) were surveyed to investigate the acute effects of psychoactive drugs. Experimental designs and objectives include drug fingerprinting dose-response evaluation, biomarker validation and calibration, and translational studies. Common biomarkers in these studies include functional connectivity, graph metrics, cerebral blood flow and the amplitude and spectrum of BOLD fluctuations. Overall, RSfMRI-derived biomarkers seem to be sensitive to spatiotemporal dynamics of drug interactions with the brain. However, drugs cause both central and peripheral effects, thus exacerbate difficulties related to biological confounds, structured noise from motion and physiological confounds, as well as modeling and inference testing. Currently, these issues are not well explored, and heterogeneities in experimental design, data acquisition and preprocessing make comparative or meta-analysis of existing reports impossible. A unifying collaborative framework for data-sharing and data-mining is thus necessary for investigating the commonalities and differences in biomarker sensitivity and specificity, and establishing guidelines. Multimodal datasets including sham-placebo or active control sessions and repeated measurements of various psychometric, physiological, metabolic and neuroimaging phenotypes are essential for pharmacokinetic/pharmacodynamic modeling and interpretation of the findings. We provide a list of basic minimum and advanced options that can be considered in design and analyses of future pharma-RSfMRI studies. Hum Brain Mapp 38:2276-2325, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Najmeh Khalili-Mahani
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Institute of Psychology and Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | | | - Eugene P Duff
- Institute of Psychology and Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Oxford Centre for Functional MRI of the Brain, Oxford University, Oxford, United Kingdom
| | | | - Lisa D Nickerson
- McLean Hospital, Belmont, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School & Boston Children's Hospital, Boston, Massachusetts
| | - Albert Dahan
- Department of Anesthesiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Jean-Paul Soucy
- PERFORM Centre, Concordia University, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Richard Wise
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Alex P Zijdenbos
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada.,Biospective Inc, Montreal, Quebec, Canada
| | - Joop M van Gerven
- Centre for Human Drug Research, Leiden University Medical Centre, Leiden, The Netherlands
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24
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Michels L, Scherpiet S, Stämpfli P, Herwig U, Brühl AB. Baseline Perfusion Alterations Due to Acute Application of Quetiapine and Pramipexole in Healthy Adults. Int J Neuropsychopharmacol 2016; 19:pyw067. [PMID: 27466220 PMCID: PMC5137281 DOI: 10.1093/ijnp/pyw067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 07/01/2016] [Accepted: 07/22/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The dopaminergic system is implicated in many mental processes and neuropsychiatric disorders. Pharmacologically, drugs with dopamine receptor antagonistic and agonistic effects are used, but their effects on functional brain metabolism are not well known. METHODS In this randomized crossover, placebo-controlled, and rater-blinded study, 25 healthy adults received an acute dose placebo substance (starch), quetiapine (dopamine receptor antagonist), or pramipexole (dopamine agonist of the nonergoline class) 1 hour before the experiment. Background-suppressed 2D pseudo-continuous arterial spin labeling was used to examine whole-brain baseline cerebral blood flow differences induced by the 3 substances. RESULTS We found that quetiapine reduced perfusion in the occipital (early visual areas) and bilateral cerebellar cortex relative to placebo. In contrast, quetiapine enhanced cerebral blood flow (relative to placebo) in the striatal system (putamen and caudate nucleus) but also in the supplementary motor area, insular-, prefrontal- as well as in the pre- and postcentral cortex. Pramipexole increased cerebral blood flow compared with placebo in the caudate nucleus, putamen, middle frontal, supplementary motor area, and brainstem (substantia nigra), but reduced cerebral blood flow in the posterior thalamus, cerebellum, and visual areas. Pramipexole administration resulted in stronger cerebral blood flow relative to quetiapine in the hypothalamus, cerebellum, and substantia nigra. CONCLUSIONS Our results indicate that quetiapine and pramipexole differentially modulate regional baseline cerebral blood flow. Both substances act on the dopaminergic system, although they affect distinct regions. Quetiapine altered dopaminergic function in frontal, striatal, and motor regions. In contrast, pramipexole affected cerebral blood flow of the nigrostriatal (striatum and substantia nigra) dopaminergic, but less the fronto-insular system.
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Affiliation(s)
- Lars Michels
- Institute of Neuroradiology, University Hospital Zurich, Zurich, Switzerland (Dr Michels); MR-Center, University Children's Hospital Zurich, Zurich, Switzerland (Dr Michels); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland (Drs Scherpiet, Stämpfli, Herwig, and Brühl); Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK (Dr Brühl). .,L.M. and S.S. are shared first authors.
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25
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Abstract
Arterial spin labeling (ASL) is an increasingly established magnetic resonance imaging (MRI) technique that is finding broader applications in studying the healthy and diseased brain. This review addresses the use of ASL to assess brain function in the resting state. Following a brief technical description, we discuss the use of ASL in the following main categories: (1) resting-state functional connectivity (FC) measurement: the use of ASL-based cerebral blood flow (CBF) measurements as an alternative to the blood oxygen level-dependent (BOLD) technique to assess resting-state FC; (2) the link between network CBF and FC measurements: the use of network CBF as a surrogate of the metabolic activity within corresponding networks; and (3) the study of resting-state dynamic CBF-BOLD coupling and cerebral metabolism: the use of dynamic CBF information obtained using ASL to assess dynamic CBF-BOLD coupling and oxidative metabolism in the resting state. In addition, we summarize some future challenges and interesting research directions for ASL, including slice-accelerated (multiband) imaging as well as the effects of motion and other physiological confounds on perfusion-based FC measurement. In summary, this work reviews the state-of-the-art of ASL and establishes it as an increasingly viable MRI technique with high translational value in studying resting-state brain function.
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Affiliation(s)
- J. Jean Chen
- Rotman Research Institute, Baycrest Centre for Geriatric Care, Toronto, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Kay Jann
- Laboratory of Functional MRI Technology, Department of Neurology, University of California Los Angeles, Los Angeles, California
| | - Danny J.J. Wang
- Laboratory of Functional MRI Technology, Department of Neurology, University of California Los Angeles, Los Angeles, California
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26
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Jonckers E, Shah D, Hamaide J, Verhoye M, Van der Linden A. The power of using functional fMRI on small rodents to study brain pharmacology and disease. Front Pharmacol 2015; 6:231. [PMID: 26539115 PMCID: PMC4612660 DOI: 10.3389/fphar.2015.00231] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/28/2015] [Indexed: 12/23/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) is an excellent tool to study the effect of pharmacological modulations on brain function in a non-invasive and longitudinal manner. We introduce several blood oxygenation level dependent (BOLD) fMRI techniques, including resting state (rsfMRI), stimulus-evoked (st-fMRI), and pharmacological MRI (phMRI). Respectively, these techniques permit the assessment of functional connectivity during rest as well as brain activation triggered by sensory stimulation and/or a pharmacological challenge. The first part of this review describes the physiological basis of BOLD fMRI and the hemodynamic response on which the MRI contrast is based. Specific emphasis goes to possible effects of anesthesia and the animal’s physiological conditions on neural activity and the hemodynamic response. The second part of this review describes applications of the aforementioned techniques in pharmacologically induced, as well as in traumatic and transgenic disease models and illustrates how multiple fMRI methods can be applied successfully to evaluate different aspects of a specific disorder. For example, fMRI techniques can be used to pinpoint the neural substrate of a disease beyond previously defined hypothesis-driven regions-of-interest. In addition, fMRI techniques allow one to dissect how specific modifications (e.g., treatment, lesion etc.) modulate the functioning of specific brain areas (st-fMRI, phMRI) and how functional connectivity (rsfMRI) between several brain regions is affected, both in acute and extended time frames. Furthermore, fMRI techniques can be used to assess/explore the efficacy of novel treatments in depth, both in fundamental research as well as in preclinical settings. In conclusion, by describing several exemplary studies, we aim to highlight the advantages of functional MRI in exploring the acute and long-term effects of pharmacological substances and/or pathology on brain functioning along with several methodological considerations.
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Affiliation(s)
- Elisabeth Jonckers
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp Antwerp, Belgium
| | - Disha Shah
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp Antwerp, Belgium
| | - Julie Hamaide
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp Antwerp, Belgium
| | - Marleen Verhoye
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp Antwerp, Belgium
| | - Annemie Van der Linden
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp Antwerp, Belgium
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27
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Arrondo G, Aznárez-Sanado M, Fernández-Seara MA, Goñi J, Loayza FR, Salamon-Klobut E, Heukamp FH, Pastor MA. Dopaminergic modulation of the trade-off between probability and time in economic decision-making. Eur Neuropsychopharmacol 2015; 25:817-27. [PMID: 25840742 DOI: 10.1016/j.euroneuro.2015.02.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 10/16/2014] [Accepted: 02/25/2015] [Indexed: 11/28/2022]
Abstract
Studies on animals and humans have demonstrated the importance of dopamine in modulating decision-making processes. In this work, we have tested dopaminergic modulation of economic decision-making and its neural correlates by administering either placebo or metoclopramide, a dopamine D2-receptor antagonist, to healthy subjects, during a functional MRI study. The decision-making task combined probability and time delay with a fixed monetary reward. For individual behavioral characterization, we used the Probability Time Trade-off (PTT) economic model, which integrates the traditional trade-offs of reward magnitude-time and reward magnitude-probability into a single measurement, thereby quantifying the subjective value of a delayed and probabilistic outcome. A regression analysis between BOLD signal and the PTT model index permitted to identify the neural substrate encoding the subjective reward-value. Behaviorally, medication reduced the rate of temporal discounting over probability, reflected in medicated subjects being more prone to postpone the reward in order to increase the outcome probability. In addition, medicated subjects showed less activity during the task in the postcentral gyrus as well as frontomedian areas, whereas there were no differences in the ventromedial orbitofrontal cortex (VMOFC) between groups when coding the subjective value. The present study demonstrates by means of behavior and imaging that dopamine modulation alters the probability-time trade-off in human economic decision-making.
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Affiliation(s)
- Gonzalo Arrondo
- Functional Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain; Managerial Decision Sciences, IESE Business School, University of Navarra, 08034 Barcelona, Spain; Psychiatry Department, University of Cambridge, United Kingdom
| | - Maite Aznárez-Sanado
- Functional Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Maria A Fernández-Seara
- Functional Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Joaquín Goñi
- Functional Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Francis R Loayza
- Functional Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Ewa Salamon-Klobut
- Managerial Decision Sciences, IESE Business School, University of Navarra, 08034 Barcelona, Spain
| | - Franz H Heukamp
- Managerial Decision Sciences, IESE Business School, University of Navarra, 08034 Barcelona, Spain
| | - Maria A Pastor
- Functional Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain.
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28
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Fernández-Seara MA, Mengual E, Vidorreta M, Castellanos G, Irigoyen J, Erro E, Pastor MA. Resting state functional connectivity of the subthalamic nucleus in Parkinson's disease assessed using arterial spin-labeled perfusion fMRI. Hum Brain Mapp 2015; 36:1937-50. [PMID: 25641065 DOI: 10.1002/hbm.22747] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 12/02/2014] [Accepted: 01/13/2015] [Indexed: 12/24/2022] Open
Abstract
Neurophysiological changes within the cortico-basal ganglia-thalamocortical circuits appear to be a characteristic of Parkinson's disease (PD) pathophysiology. The subthalamic nucleus (STN) is one of the basal ganglia components showing pathological neural activity patterns in PD. In this study, perfusion imaging data, acquired noninvasively using arterial spin-labeled (ASL) perfusion MRI, were used to assess the resting state functional connectivity (FC) of the STN in 24 early-to-moderate PD patients and 34 age-matched healthy controls, to determine whether altered FC in the very low frequency range of the perfusion time signal occurs as a result of the disease. Our results showed that the healthy STN was functionally connected with other nuclei of the basal ganglia and the thalamus, as well as with discrete cortical areas including the insular cortex and the hippocampus. In PD patients, connectivity of the STN was increased with two cortical areas involved in motor and cognitive processes. These findings suggest that hyperconnectivity of the STN could underlie some of the motor and cognitive deficits often present even at early stages of the disease. The FC measures provided good discrimination between controls and patients, suggesting that ASL-derived FC metrics could be a putative PD biomarker.
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Affiliation(s)
- María A Fernández-Seara
- Neuroimaging Laboratory, Division of Neuroscience, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain; CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain
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29
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Viviani R, Lehmann ML, Stingl JC. Use of magnetic resonance imaging in pharmacogenomics. Br J Clin Pharmacol 2014; 77:684-94. [PMID: 23802603 PMCID: PMC3971984 DOI: 10.1111/bcp.12197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/18/2013] [Indexed: 01/11/2023] Open
Abstract
Because of the large variation in the response to psychoactive medication, many studies have attempted to uncover genetic factors that determine response. While considerable knowledge exists on the large effects of genetic polymorphisms on pharmacokinetics and plasma concentrations of drugs, effects of the concentration at the target site and pharmacodynamic effects on brain functions in disease are much less known. This article reviews the role of magnetic resonance imaging (MRI) to visualize response to medication in brain behaviour circuits in vivo in humans and assess the influence of pharmacogenetic factors. Two types of studies have been used to characterize effects of medication and genetic variation. In task-related activation studies the focus is on changes in the activity of a neural circuit associated with a specific psychological process. The second type of study investigates resting state perfusion. These studies provide an assessment of vascular changes associated with bioavailability of drugs in the brain, but may also assess changes in neural activity after binding of centrally active agents. Task-related pharmacogenetic studies of cognitive function have characterized the effects in the prefrontal cortex of genetic polymorphisms of dopamine receptors (DRD2), metabolic enzymes (COMT) and in the post-synaptic signalling cascade under the administration of dopamine agonists and antagonists. In contrast, pharmacogenetic imaging with resting state perfusion is still in its infancy. However, the quantitative nature of perfusion imaging, its non-invasive character and its repeatability might be crucial assets in visualizing the effects of medication in vivo in man during therapy.
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Affiliation(s)
- Roberto Viviani
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany; Institute of Psychology, University of Innsbruck, Innsbruck, Austria
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30
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Goozée R, Handley R, Kempton MJ, Dazzan P. A systematic review and meta-analysis of the effects of antipsychotic medications on regional cerebral blood flow (rCBF) in schizophrenia: association with response to treatment. Neurosci Biobehav Rev 2014; 43:118-36. [PMID: 24690578 DOI: 10.1016/j.neubiorev.2014.03.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/27/2014] [Accepted: 03/20/2014] [Indexed: 11/25/2022]
Abstract
Evaluating the short- and long-term effects of antipsychotics on brain physiology is a key factor in advancing our understanding of neurophysiological changes in psychosis and improving prediction of treatment response. Understanding the nature of such changes is crucial to the interpretation of neuroimaging findings in patients with schizophrenia and psychoses in general. This review has systematically appraised existing evidence on resting cerebral blood flow (rCBF) in schizophrenia, before and after antipsychotic treatment, relating the findings to symptom severity. The review shows that antipsychotics exert regional effects on rCBF, particularly in frontal and basal ganglia regions, and that different antipsychotic generations have differential effects on rCBF. These findings are supported by an exploratory meta-analysis of a subset of studies. The review also highlights the relative lack of studies that use a priori definitions of treatment response, which is an important step in identifying testable hypotheses and ensuring clinical relevance of remission criteria. Finally, the review highlights important considerations for future psychopharmacological studies investigating the potential for rCBF to predict symptomatic improvement, which could inform the management of treatment in schizophrenia.
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Affiliation(s)
- Rhianna Goozée
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK.
| | - Rowena Handley
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
| | - Matthew J Kempton
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
| | - Paola Dazzan
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Kings College London, London, UK
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31
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Abbott CC, Jaramillo A, Wilcox CE, Hamilton DA. Antipsychotic drug effects in schizophrenia: a review of longitudinal FMRI investigations and neural interpretations. Curr Med Chem 2014; 20:428-37. [PMID: 23157635 DOI: 10.2174/0929867311320030014] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 09/10/2012] [Accepted: 09/26/2012] [Indexed: 12/11/2022]
Abstract
The evidence that antipsychotics improve brain function and reduce symptoms in schizophrenia is unmistakable, but how antipsychotics change brain function is poorly understood, especially within neuronal systems. In this review, we investigated the hypothesized normalization of the functional magnetic resonance imaging (fMRI) blood oxygen level dependent signal in the context of antipsychotic treatment. First, we conducted a systematic PubMed search to identify eight fMRI investigations that met the following inclusion criteria: case-control, longitudinal design; pre- and post-treatment contrasts with a healthy comparison group; and antipsychotic-free or antipsychotic-naive patients with schizophrenia at the start of the investigation. We hypothesized that aberrant activation patterns or connectivity between patients with schizophrenia and healthy comparisons at the first imaging assessment would no longer be apparent or "normalize" at the second imaging assessment. The included studies differed by analysis method and fMRI task but demonstrated normalization of fMRI activation or connectivity during the treatment interval. Second, we reviewed putative mechanisms from animal studies that support normalization of the BOLD signal in schizophrenia. We provided several neuronal-based interpretations of these changes of the BOLD signal that may be attributable to long-term antipsychotic administration.
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Affiliation(s)
- C C Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
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32
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Effects of amisulpride on human resting cerebral perfusion. Psychopharmacology (Berl) 2013; 229:95-103. [PMID: 23584671 DOI: 10.1007/s00213-013-3091-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 03/22/2013] [Indexed: 12/12/2022]
Abstract
RATIONALE Quantitative neuroimaging studies show that different neuroleptics have similar effects on resting metabolism/perfusion in the basal ganglia, but vary in their effect on the cortex, especially in the prefrontal and temporal lobes. These differences may represent signatures of the action of medication on distinctive receptor combinations. OBJECTIVES This study seeks to determine the effect on cerebral perfusion at rest of low-dose amisulpride, a neuroleptic with a receptor profile relatively selective to dopaminergic D2-receptors and both antidepressant and antipsychotic efficacy. METHODS Continuous arterial spin labelling in a placebo-controlled, double blind, crossover study at steady state of N = 20 healthy male adults. RESULTS Relative to placebo, amisulpride was associated with extensive and significant cortical decrements in resting perfusion levels, particularly in the prefrontal lobes (p = 0.01, corrected). Decrements spared the basal ganglia, where perfusion was slightly increased. CONCLUSIONS In contrast to earlier reports on other neuroleptics, amisulpride was associated with intense cortical perfusion decrements at rest. These results are consistent with an existing model in which dopaminergic blockade is associated not only with metabolism/perfusion increases in the basal ganglia, but also with decreases in the cerebral cortex that in most neuroleptics are compensated by action on other receptor systems. The selective receptor profile of amisulpride may explain the extensive cortical decrements.
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Lam SCB, Wang Z, Li Y, Franklin T, O’Brien C, Magland J, Childress AR. Wavelet-transformed temporal cerebral blood flow signals during attempted inhibition of cue-induced cocaine craving distinguish prognostic phenotypes. Drug Alcohol Depend 2013; 128:140-7. [PMID: 22981242 PMCID: PMC4380328 DOI: 10.1016/j.drugalcdep.2012.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 07/31/2012] [Accepted: 08/19/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cocaine addicted patients with positive cocaine urine status at treatment entry are far less likely to have a successful treatment outcome. This work aims to identify brain substrates that can distinguish this group of patients from their cocaine-negative counterparts in order to better understand this clinical phenotype. Going a step beyond conventional functional connectivity, we used wavelet transform coherence (WTC) to determine in which ways the temporal pattern of fMRI cerebral blood flow (CBF) signals during attempted inhibition of cue-induced cocaine craving may differ between these two groups. METHODS Using a critical node in motivational circuitry, amygdala, as a seed, whole brain correlations for the entire sample revealed a functional connection with the dorsal cingulate. Next, WTC maps of CBF were constructed for each individual, characterizing the temporal patterns between these two regions during craving inhibition. RESULTS As revealed by WTC, during attempted craving inhibition, the cocaine-negative subjects had significantly stronger and longer negative coherence between the amygdala and the dorsal cingulate, as compared to the cocaine-positive subjects. This relationship was neither evident in the resting state nor between two regions unrelated to inhibition processes. CONCLUSIONS The duration and strength of negative coherence calculated from wavelet-transformed CBF provide an objective and well-defined way to characterize brain responses during attempted inhibition of cue-induced craving, at the level of the individual. The stronger and sustained negative coherence in CBF between motivational (amygdala) and modulatory (dorsal cingulate) regions in cocaine-negative subjects may be a critical brain strength that fosters improved craving inhibition and thus, better clinical outcome.
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Affiliation(s)
- Shing Chun Benny Lam
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ze Wang
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yin Li
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Teresa Franklin
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Charles O’Brien
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jeremy Magland
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Anna Rose Childress
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA,Corresponding author. Tel.: +1 215 222 3200; fax: +1 215 386 6770. (A.R. Childress)
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Loggia ML, Kim J, Gollub RL, Vangel MG, Kirsch I, Kong J, Wasan AD, Napadow V. Default mode network connectivity encodes clinical pain: an arterial spin labeling study. Pain 2012; 154:24-33. [PMID: 23111164 DOI: 10.1016/j.pain.2012.07.029] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 06/19/2012] [Accepted: 07/26/2012] [Indexed: 11/29/2022]
Abstract
Neuroimaging studies have suggested the presence of alterations in the anatomo-functional properties of the brain of patients with chronic pain. However, investigation of the brain circuitry supporting the perception of clinical pain presents significant challenges, particularly when using traditional neuroimaging approaches. While potential neuroimaging markers for clinical pain have included resting brain connectivity, these cross-sectional studies have not examined sensitivity to within-subject exacerbation of pain. We used the dual regression probabilistic Independent Component Analysis approach to investigate resting-state connectivity on arterial spin labeling data. Brain connectivity was compared between patients with chronic low back pain (cLBP) and healthy controls, before and after the performance of maneuvers aimed at exacerbating clinical pain levels in the patients. Our analyses identified multiple resting state networks, including the default mode network (DMN). At baseline, patients demonstrated stronger DMN connectivity to the pregenual anterior cingulate cortex (pgACC), left inferior parietal lobule, and right insula (rINS). Patients' baseline clinical pain correlated positively with connectivity strength between the DMN and right insula (DMN-rINS). The performance of calibrated physical maneuvers induced changes in pain, which were paralleled by changes in DMN-rINS connectivity. Maneuvers also disrupted the DMN-pgACC connectivity, which at baseline was anticorrelated with pain. Finally, baseline DMN connectivity predicted maneuver-induced changes in both pain and DMN-rINS connectivity. Our results support the use of arterial spin labeling to evaluate clinical pain, and the use of resting DMN connectivity as a potential neuroimaging biomarker for chronic pain perception.
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Affiliation(s)
- Marco L Loggia
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School (HMS), Boston, MA, USA Department of Psychiatry, Massachusetts General Hospital, HMS, Boston, MA, USA MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA Program in Placebo Studies & the Therapeutic Encounter, Beth Israel Deaconess Medical Center, HMS, Boston, MA, USA Department of Psychiatry, Brigham and Women's Hospital, HMS, Boston, MA, USA
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Handley R, Zelaya FO, Reinders AATS, Marques TR, Mehta MA, O'Gorman R, Alsop DC, Taylor H, Johnston A, Williams S, McGuire P, Pariante CM, Kapur S, Dazzan P. Acute effects of single-dose aripiprazole and haloperidol on resting cerebral blood flow (rCBF) in the human brain. Hum Brain Mapp 2012; 34:272-82. [PMID: 22451196 DOI: 10.1002/hbm.21436] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 06/22/2011] [Accepted: 07/25/2011] [Indexed: 11/07/2022] Open
Abstract
Antipsychotic drugs act on the dopaminergic system (first-generation antipsychotics, FGA), but some also directly affect serotonergic function (second-generation antipsychotics, SGA) in the brain. Short and long-term effects of these drugs on brain physiology remain poorly understood. Moreover, it remains unclear whether any physiological effect in the brain may be different for FGAs and SGAs. Immediate (+3.30 h) and different effects of single-dose FGA (haloperidol, 3 mg) and a SGA (aripiprazole, 10 mg) on resting cerebral blood flow (rCBF) were explored in the same 20 healthy volunteers using a pulsed continuous arterial spin labeling (pCASL) sequence (1.5T) in a placebo-controlled, repeated measures design. Both antipsychotics increased striatal rCBF but the effect was greater after haloperidol. Both decreased frontal rCBF, and opposite effects of the drugs were observed in the temporal cortex (haloperidol decreased, aripiprazole increased rCBF) and in the posterior cingulate (haloperidol increased, aripiprazole decreased rCBF). Further increases were evident in the insula, hippocampus, and anterior cingulate after both antipsychotics, in the motor cortex following haloperidol and in the occipital lobe the claustrum and the cerebellum after aripiprazole. Further decreases were observed in the parietal and occipital cortices after aripiprazole. This study suggests that early and different rCBF changes are evident following a single-dose of FGA and SGA. The effects occur in healthy volunteers, thus may be independent from any underlying pathology, and in the same regions identified as structurally and functionally altered in schizophrenia, suggesting a possible relationship between antipsychotic-induced rCBF changes and brain alterations in schizophrenia.
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Affiliation(s)
- Rowena Handley
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, United Kingdom.
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Detre JA, Rao H, Wang DJJ, Chen YF, Wang Z. Applications of arterial spin labeled MRI in the brain. J Magn Reson Imaging 2012; 35:1026-37. [PMID: 22246782 DOI: 10.1002/jmri.23581] [Citation(s) in RCA: 223] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 12/15/2011] [Indexed: 01/18/2023] Open
Abstract
Perfusion provides oxygen and nutrients to tissues and is closely tied to tissue function while disorders of perfusion are major sources of medical morbidity and mortality. It has been almost two decades since the use of arterial spin labeling (ASL) for noninvasive perfusion imaging was first reported. While initial ASL magnetic resonance imaging (MRI) studies focused primarily on technological development and validation, a number of robust ASL implementations have emerged, and ASL MRI is now also available commercially on several platforms. As a result, basic science and clinical applications of ASL MRI have begun to proliferate. Although ASL MRI can be carried out in any organ, most studies to date have focused on the brain. This review covers selected research and clinical applications of ASL MRI in the brain to illustrate its potential in both neuroscience research and clinical care.
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Affiliation(s)
- John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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The response to rapid infusion of fentanyl in the human brain measured using pulsed arterial spin labelling. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2011; 25:163-75. [PMID: 22113518 DOI: 10.1007/s10334-011-0293-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 09/17/2011] [Accepted: 10/21/2011] [Indexed: 10/15/2022]
Abstract
OBJECTIVE We evaluated the sensitivity of pulsed Arterial Spin Labelling (pASL) for the detection of changes in regional cerebral blood perfusion (CBP) during and after intra-venous (i.v.) infusion of an opioid agonist (fentanyl) and an opioid antagonist (naloxone). MATERIALS AND METHODS Twenty-three subjects were scanned four times, receiving i.v. infusion of fentanyl, naloxone, placebo and a second fentanyl administration, in four separate scanning sessions in randomised order. End-tidal CO(2), respiration rate and heart rate were recorded continuously throughout each scan. pASL time series were collected using single shot EPI for 15 min (including 5 min of baseline prior to infusion). RESULTS Significant increases in CBP were detected during and after administration of fentanyl, (when compared to placebo and naloxone), in most areas of high concentration of mu-opioid receptors (thalamus, lingual gyrus, para-hippocampal gyrus, and insula); near-significant increases were also observed in the insula. No increases in perfusion were observed during or after naloxone infusion. No correlation was found between regional rCBF changes and end-tidal CO(2), respiration rate or heart rate. Good reliability was found between the first and second fentanyl sessions but the regions of high reliability did not overlap completely with those of highest perfusion change. CONCLUSION pASL is a suitable method for examining rapid, dynamic effects of opioid administration on brain physiology.
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Wang DJJ, Chen Y, Fernández-Seara MA, Detre JA. Potentials and challenges for arterial spin labeling in pharmacological magnetic resonance imaging. J Pharmacol Exp Ther 2011; 337:359-66. [PMID: 21317356 DOI: 10.1124/jpet.110.172577] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Pharmacological magnetic resonance imaging (phMRI) is increasingly being used in drug discovery and development to speed the translation from the laboratory to the clinic. The two primary methods in phMRI include blood-oxygen-level-dependent (BOLD) contrast and arterial spin-labeled (ASL) perfusion MRI. BOLD contrast has been widely applied in existing phMRI studies. However, because of the lack of absolute quantification and poor reproducibility over time scales longer than hours or across scanning sessions, BOLD fMRI may not be suitable to track oral and other long-term drug effects on baseline brain function. As an alternative method, ASL provides noninvasive, absolute quantification of cerebral blood flow both at rest and during task activation. ASL perfusion measurements have been shown to be highly reproducible over minutes and hours to days and weeks. These two characteristics make ASL an ideal tool for phMRI for studying both intravenous and oral drug action as well as understanding drug effects on baseline brain function and brain activation to cognitive or sensory processing. When ASL is combined with BOLD fMRI, drug-induced changes in cerebral metabolic rate of oxygen may also be inferred. Representative phMRI studies using ASL perfusion MRI on caffeine, remifentanil, and metoclopramide (dopamine antagonist) are reviewed here, with an emphasis on the methodologies used to control for potentially confounding vascular and systemic effects. Both the potentials and limitations of using ASL as an imaging marker of drug action are discussed.
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Affiliation(s)
- Danny J J Wang
- Ahmanson-Lovelace Brain Mapping Center, University of California Department of Neurology, 660 Charles E Young Dr South, Los Angeles, CA 90095, USA.
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