Brain Neuronal Degeneration Caused by Episodic Alcohol Intoxication in Rats: Effects of Nimodipine, 6,7-Dinitro-quinoxaline-2,3-dione, and MK-801

Moderate blood alcohol and brain neurovulnerability: Selective depletion of calcium-independent phospholipase A2, omega-3 docosahexaenoic acid, and its synaptamide derivative as a potential harbinger of deficits in anti-inflammatory reserve

BACKGROUND

Repetitive, highly elevated blood alcohol (ethanol) concentrations (BACs) of 350 to 450 mg/dl over several days cause brain neurodegeneration and coincident neuroinflammation in adult rats localized in the hippocampus (HC), temporal cortex (especially the entorhinal cortex; ECX), and olfactory bulb (OB). The profuse neuroinflammation involves microgliosis, increased proinflammatory cytokines, and elevations of Ca+2 -dependent phospholipase A2 (cPLA2) and secretory PLA2 (sPLA2), which both mobilize proinflammatory ω-6 arachidonic acid (ARA). In contrast, Ca+2 -independent PLA2 (iPLA2) and anti-inflammatory ω-3 docosahexaenoic acid (DHA), a polyunsaturated fatty acid regulated primarily by iPLA2, are diminished. Furthermore, supplemented DHA exerts neuroprotection. Given uncertainties about the possible effects of lower circulating BACs that are common occurring during short- term binges, we examined how moderate BACs affected the above inflammatory events, and the impact of supplemented DHA.

METHODS AND RESULTS

Young adult male rats sustaining upper-moderate BACs (~150 mg/dl) from once-daily alcohol intubations were sacrificed with appropriate controls after 1 week. The HC, ECX and OB were quantitatively examined using immunoblotting, neurodegeneration staining, and lipidomics assays. Whereas neurodegeneration, increases in cPLA2 IVA, sPLA2 IIA, and ARA, and microglial activation were not detected, the HC and ECX regions demonstrated significantly reduced iPLA2 levels. Levels of DHA and synaptamide, its anti-inflammatory N-docosahexaenoylethanolamide derivative, also were lower in HC, and DHA supplementation prevented the iPLA2 decrements in HC. Additionally, adult mice maintaining upper-moderate BACs from limited alcohol binges had reduced midbrain iPLA2 levels.

CONCLUSIONS

The apparently selective depletion by moderate BACs of the metabolically linked anti-inflammatory triad of hippocampal iPLA2, DHA, and synaptamide, and of iPLA2 in the ECX, potentially indicates an unappreciated deficit in brain anti-inflammatory reserve that may be a harbinger of regional neurovulnerability.

Review of Orbitofrontal Cortex in Alcohol Dependence: A Disrupted Cognitive Map?

Alcoholism is a persistent worldwide problem associated with long-lasting impairments to decision making processes. Some aspects of dysfunction are thought to reflect alcohol-induced changes to relevant brain areas such as the orbitofrontal cortex (OFC). In this review, we will examine how chronic alcohol exposure alters OFC function to potentially contribute to maladaptive decision making, and explore experimental behavioral approaches that may be better suited to test whether alcohol dependence disrupts OFC's function. We argue that although past works suggest impairments in aspects of OFC function, more information may be gained by specifically targeting tasks to the broader function of OFC as put forth by the recent hypothesis of OFC as a "cognitive map" of task space. Overall, we suggest that such a focus could provide a better understanding of how OFC function changes in alcohol dependence, and could inform better assessment tools and treatment options for clinicians working with this population.

Acetate Mediates Alcohol Excitotoxicity in Dopaminergic-like PC12 Cells

Neuronal excitotoxicity is the major cause of alcohol-related brain damage, yet the underlying mechanism remains poorly understood. Using dopaminergic-like PC12 cells, we evaluated the effect of N-methyl-d-aspartate receptors (NMDAR) on acetate-induced changes in PC12 cells: cell death, cytosolic calcium, and expression levels of the pro-inflammatory cytokine tumor necrosis factor alpha (TNFα). Treatment of PC12 cells with increasing concentrations of acetate for 4 h caused a dose-dependent increase in the percentage of cells staining positive for cell death using propidium iodide (PI) exclusion and cytosolic reactive oxygen species (ROS) using cell ROX detection analyzed via flow cytometry. The EC₅₀ value for acetate was calculated and found to be 4.40 mM for PI and 1.81 mM for ROS. Ethanol up to 100 mM had no apparent changes in the percent of cells staining positive for PI or ROS. Acetate (6 mM) treatment caused an increase in cytosolic calcium measured in real-time with Fluo-4AM, which was abolished by coapplication with the NMDAR blocker memantine (10 μM). Furthermore, cells treated with acetate (6 mM) for 4 h had increased expression levels of TNFα relative to control, which was abolished by coapplication of memantine (10 μM). Co-application of acetate (6 mM) and memantine had no apparent reduction in acetate-induced cell death. These findings suggest that acetate is capable of increasing cytosolic calcium concentrations and expression levels of the pro-inflammatory cytokine TNFα through an NMDAR-dependent mechanism. Cell death from acetate was not reduced through NMDAR blockade, suggesting alternative pathways independent of NMDAR activation for excitotoxicity.

Genetic aspects of behavioral neurotoxicology

Considerable progress has been made over the past couple of decades concerning the molecular bases of neurobehavioral function and dysfunction. The field of neurobehavioral genetics is becoming mature. Genetic factors contributing to neurologic diseases such as Alzheimer's disease have been found and evidence for genetic factors contributing to other diseases such as schizophrenia and autism are likely. This genetic approach can also benefit the field of behavioral neurotoxicology. It is clear that there is substantial heterogeneity of response with behavioral impairments resulting from neurotoxicants. Many factors contribute to differential sensitivity, but it is likely that genetic variability plays a prominent role. Important discoveries concerning genetics and behavioral neurotoxicity are being made on a broad front from work with invertebrate and piscine mutant models to classic mouse knockout models and human epidemiologic studies of polymorphisms. Discovering genetic factors of susceptibility to neurobehavioral toxicity not only helps identify those at special risk, it also advances our understanding of the mechanisms by which toxicants impair neurobehavioral function in the larger population. This symposium organized by Edward Levin and Annette Kirshner, brought together researchers from the laboratories of Michael Aschner, Douglas Ruden, Ulrike Heberlein, Edward Levin and Kathleen Welsh-Bohmer conducting studies with Caenorhabditis elegans, Drosophila, fish, rodents and humans studies to determine the role of genetic factors in susceptibility to behavioral impairment from neurotoxic exposure.

Aniracetam and DNQX affect the acquisition of rapid tolerance to ethanol in mice

Several studies have emphasized the role of learning in the development of rapid tolerance and have shown that glutamate-mediated neurotransmission plays an important role in this phenomenon. Since the AMPA/kainate receptor system is directly involved in plasticity mechanisms, the influence of this receptor system on rapid tolerance induced by ethanol was studied using the rotarod. In the first experiment, mice were pretreated with aniracetam, an agonist of AMPA/kainate receptors, 30 min before ethanol (2.75 g/kg; IP) treatment, and tested on the rotarod. After 24 h, the groups were tested on the rotarod under ethanol treatment. Aniracetam facilitated the acquisition of rapid tolerance to ethanol. In the second experiment, mice received DNQX, a competitive antagonist of the AMPA receptor, 30 min before ethanol treatment (3 g/kg) and submitted to the rotarod. This dose of ethanol produced tolerance per se. Groups were tested under ethanol treatment (1.75 g/kg) after 24 h. DNQX blocked rapid tolerance to ethanol. Using a similar protocol, the third experiment showed that DNQX blocked the aniracetam-induced facilitation of rapid tolerance to ethanol. Our results show that aniracetam facilitates whereas DNQX blocks ethanol tolerance, suggesting that the non-NMDA receptors are involved in this phenomenon.

Mechanisms of neurodegeneration and regeneration in alcoholism

AIMS

This is a review of preclinical studies covering alcohol-induced brain neuronal death and loss of neurogenesis as well as abstinence-induced brain cell genesis, e.g. brain regeneration. Efforts are made to relate preclinical studies to human studies.

METHODS

The studies described are preclinical rat experiments using a 4-day binge ethanol treatment known to induce physical dependence to ethanol. Neurodegeneration and cognitive deficits following binge treatment mimic the mild degeneration and cognitive deficits found in humans. Various histological methods are used to follow brain regional degeneration and regeneration.

RESULTS

Alcohol-induced degeneration occurs due to neuronal death during alcohol intoxication. Neuronal death is related to increases in oxidative stress in brain that coincide with the induction of proinflammatory cytokines and oxidative enzymes that insult brain. Degeneration is associated with increased NF-kappaB proinflammatory transcription and decreased CREB transcription. Corticolimbic brain regions are most sensitive to binge-induced degeneration and induce relearning deficits. Drugs that block oxidative stress and NF-kappaB transcription or increase CREB transcription block binge-induced neurodegeneration, inhibition of neurogenesis and proinflammatory enzyme induction. Regeneration of brain occurs during abstinence following binge ethanol treatment. Bursts of proliferating cells occur across multiple brain regions, with many new microglia across brain after months of abstinence and many new neurons in neurogenic hippocampal dentate gyrus. Brain regeneration may be important to sustain abstinence in humans.

CONCLUSIONS

Alcohol-induced neurodegeneration occurs primarily during intoxication and is related to increased oxidative stress and proinflammatory proteins that are neurotoxic. Abstinence after binge ethanol intoxication results in brain cell genesis that could contribute to the return of brain function and structure found in abstinent humans.

Bidirectional alterations of hippocampal cannabinoid 1 receptors and their endogenous ligands in a rat model of alcohol withdrawal and dependence

BACKGROUND

The hippocampus is strongly implicated in memory processes and contains high concentrations of both cannabinoid receptors and their endogenous ligands. Chronic alcohol consumption impairs a variety of cognitive and performance tasks, including memory and learning. As the activation of cannabinoid receptors by their endogenous ligands modulates hippocampal neurotransmission, we hypothesized that the impaired memory and learning in alcoholism may be due to alterations in the hippocampal endocannabinoid system.

METHODS

We used the rat chronic intermittent ethanol (CIE) model for alcohol withdrawal and dependence which involves intermittent episodes of ethanol intoxication (60 doses) and withdrawal (approximating binge drinking episodes in humans). We measured the levels of cannabinoid 1 receptor (CB1R) protein (Western blot using a C-terminal-directed antibody), CB1R mRNA (real-time RT-PCR), CB1R localization (immunocytochemistry), tissue levels of the endocannabinoids N-arachidonoylethanolamine/anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and function (patch-clamp recordings of depolarization-induced suppression of inhibition (DSI), as well as effects of CB1R agonist WIN 55,212-2 on inhibitory currents) in the hippocampus of CIE rats and their saline-treated controls.

RESULTS

Results were obtained in saline and CIE-treated rats after 2 and 40 days of withdrawal (DW) from their respective treatments. In 2 DW CIE rats, CB1R mRNA and protein levels were decreased by 27% (p<0.05) compared with saline controls. Surprisingly, in 40 DW CIE rats, CB1R mRNA increased by 100% and protein increased by 21%, confirmed by immunohistochemistry. Hippocampal [2-AG] increased in both 2 and 40 DW CIE rats; [AEA] increased only at 40 DW. Hippocampal DSI of CIE rats was significantly reduced at 2 DW but not at 40 DW. The CB1R agonist WIN 55,212-2 (0.5 microM) produced a significantly greater decrease in the frequency of spontaneous inhibitory currents from saline-treated rats compared with CIE rats at 2 DW, but not at 40 DW.

CONCLUSIONS

These data demonstrate that CIE treatment and withdrawal transiently down-regulates hippocampal CB1 Rs followed by a long-term up-regulation, including increased levels of endogenous cannabinoids. These findings are consistent with our hypothesis and suggest that long-term up-regulation of hippocampal CB1Rs may contribute to the long-term cognitive impairments in alcoholism. The data further suggest that the effectiveness of CB1R blockade in decreasing alcohol consumption may be greater after protracted abstinence from alcohol.

Nicotine stimulation on extracellular glutamate levels in the nucleus accumbens of ethanol-withdrawn rats in vivo

BACKGROUND

Nicotine can release glutamate in the limbic system. Presynaptic activation of glutamate receptors might be relevant for the subsequent firing of excitatory postsynaptic potentials. This might be relevant in early ethanol withdrawal. The effects and differences of nicotine stimulation on glutamate response measured by microdialysis in the nucleus accumbens (NAC) between ethanol-withdrawn rats (EW group) and ethanol-naïve rats (control group) were investigated.

METHODS

Rats were ethanol-intoxicated according to a binge-drinking model: recurrent cycle of 4 days of intoxication (EW group) or 5% sucrose (control group), followed by a 3-day recovery. This was followed by a 2-day intoxication period and subsequent abstinence. After the last oral intake, microdialysis was performed in the left NAC for a 16-hour withdrawal period. At the end of the withdrawal period, a rated withdrawal score (RWS) was documented. Then, nicotine was given subcutaneously at a dose of 0.5 mg/kg and amino acid levels determined by microdialysis were followed for an additional 3 hours.

RESULTS

The RWS was not correlated to the last amount of ethanol received, but was correlated to the total amount of ethanol administered during the pretreatment period: the basal values of extracellular glutamate were found to be decreased in the EW group before withdrawal. Cessation of ethanol significantly increased glutamate levels with a peak between 4 and 10 hours after the last oral intake. Sixteen hours after ethanol withdrawal, the same level as in the control group was achieved. Nicotine significantly increased glutamate levels in the NAC of the EW group but not in ethanol-naïve rats.

CONCLUSIONS

This study showed that withdrawal of ethanol was associated with an increase in extracellular glutamate levels. Systemic administration of nicotine in vivo produced an increase in extracellular levels of glutamate in the core region of the NAC during ethanol withdrawal. This might be a relevant pathomechanism for increased craving either for alcohol or for nicotine after ethanol withdrawal.

Comparison of cannabidiol, antioxidants, and diuretics in reversing binge ethanol-induced neurotoxicity

Binge alcohol consumption in the rat induces substantial neurodegeneration in the hippocampus and entorhinal cortex. Oxidative stress and cytotoxic edema have both been shown to be involved in such neurotoxicity, whereas N-methyl-d-aspartate (NMDA) receptor activity has been implicated in alcohol withdrawal and excitoxic injury. Because the nonpsychoactive cannabinoid cannabidiol (CBD) was previously shown in vitro to prevent glutamate toxicity through its ability to reduce oxidative stress, we evaluated CBD as a neuroprotectant in a rat binge ethanol model. When administered concurrently with binge ethanol exposure, CBD protected against hippocampal and entorhinal cortical neurodegeneration in a dose-dependent manner. Similarly, the common antioxidants butylated hydroxytoluene and alpha-tocopherol also afforded significant protection. In contrast, the NMDA receptor antagonists dizocilpine (MK-801) and memantine did not prevent cell death. Of the diuretics tested, furosemide was protective, whereas the other two anion exchanger inhibitors, L-644,711 [(R)-(+)-(5,6-dichloro2,3,9,9a-tetrahydro 3-oxo-9a-propyl-1H-fluoren-7-yl)oxy acetic acid] and bumetanide, were ineffective. In vitro comparison of these diuretics indicated that furosemide is also a potent antioxidant, whereas the nonprotective diuretics are not. The lack of efficacy of L-644,711 and bumetanide suggests that the antioxidant rather than the diuretic properties of furosemide contribute most critically to its efficacy in reversing ethanol-induced neurotoxicity in vitro, in our model. This study provides the first demonstration of CBD as an in vivo neuroprotectant and shows the efficacy of lipophilic antioxidants in preventing binge ethanol-induced brain injury.

Cognitive deficits and CNS damage after a 4-day binge ethanol exposure in rats

Impairments of learning and memory are common neuropsychological sequelae of chronic alcohol abuse. Alcoholics often have impairments of anterograde memory, including spatial memory dysfunction, and a tendency toward response perseveration. This study was designed to assess the effects of binge ethanol exposure on neurodegeneration and cognitive function. Rats were given ethanol three times daily for 4 days. Silver staining revealed neurodegeneration in the olfactory bulb, piriform cortex, perirhinal cortex, entorhinal cortex, and dentate gyrus. After withdrawal, behavioral testing in the Morris water maze revealed significant differences in reversal learning between treatment groups. Ethanol-treated animals required more trials to learn the reversal task, entered the previously trained quadrant more often, and spent more time there than controls. [3H]PK-11195 binding, an index of CNS damage, was elevated in the piriform cortex of ethanol-treated animals. Thus, binge ethanol exposure resulted in neurodegeneration of a corticolimbic circuit with common excitatory inputs from the olfactory bulb and was associated with perseverative responding on a spatial learning task. These studies suggest that a single binge drinking episode could cause neurodegeneration and cognitive dysfunction in humans. The perseverative nature of the behavioral deficit could be related to both cognitive dysfunction and the behavioral components of the addiction process.

Nimodipine prevents the effects of ethanol in tests of memory

The effects of acute administration of the dihydropyridine calcium channel antagonist, nimodipine, were studied on the actions of ethanol in the radial arm maze and the object recognition test. In the former test, the effects of the drugs were examined on the performance in finding the four baited arms, after previous training in this task. Ethanol, at 1 g/kg, increased both the number of re-entries into baited arms (counted as errors of working memory) and the total number of arm choices required to complete the task. Administration of nimodipine, 10 mg/kg, with the ethanol, completely prevented the deleterious effects on memory in this task, but had no effects on the performance when given in the absence of ethanol. In the object recognition task, ethanol, 1 g/kg, significantly decreased the differences in the time spent exploring novel and familiar objects. Nimodipine, 10 mg/kg, given with the ethanol, completely prevented this effect, but nimodipine alone had no effects. The lack of changes in total exploration times indicated that the effects of ethanol in these tests were not due to loss of motor co-ordination or of alertness. The results are discussed in the light of the known actions of the drugs on brain function.

Test of the plausibility of adolescent substance use playing a causal role in developing adulthood antisocial behavior

DSM-IV antisocial personality disorder diagnosis requires that conduct disorder be exhibited before age 15. However, recent studies have reported on men and women without conduct disorder before age 15 but qualified for the adulthood antisocial personality criterion (AAB). This general-population, retrospective study investigated the plausibility of causal relationships between adolescent drug and alcohol misuse (ADAM) and AAB among subgroups who reported childhood-onset conduct problems (CP), adolescent-onset CP, or no more than one conduct problem. Data from the Epidemiological Catchment Area Study (N = 8,724) suggested that persons with childhood-onset CP are at much greater risk for AAB than persons with adolescent-onset CP. Nevertheless, large proportions of men and women with AAB had adolescent-onset CP or no CP. Regardless of CP history, being drunk by age 18 or having a drug use-related symptom before age 18 increased AAB risk, even after controlling for having a substance use-related disorder in adulthood. Mechanisms that potentially explain these associations are discussed.

Effects of nicotine on ethanol dependence and brain damage

Almost all alcoholics (80%-95%) smoke tobacco. When alcoholics binge, they achieve high, sustained blood alcohol levels, become physically dependent, and often suffer loss of cognition and other higher cortical functions. Nicotine could have a modulatory effect on ethanol drinking behavior and ethanol-induced brain damage through its cholinergic actions. To determine whether nicotine altered alcohol dependence, alcohol-induced brain damage, or both, a rat model of binge drinking was used to study the effects of nicotine on the alcohol withdrawal syndrome and its associated brain damage. After administration of the last dose of ethanol in a 4-day binge model, rats remained intoxicated for approximately 5 h, slowly returned to a neutral state, and entered a hyperexcited period, which peaked around 24 h and lasted a total of 60 h. Behavioral signs of withdrawal included splayed limbs, tremors, and seizures. Continuous transdermal nicotine did not alter the duration or severity of ethanol withdrawal. The 4-day binge ethanol treatment caused considerable brain damage in the perirhinal cortex, entorhinal cortex, ventral dentate gyrus, and olfactory bulb as visualized with amino cupric silver stain. Nicotine alone caused little or no brain damage and did not markedly alter binge ethanol-induced damage in cortical or hippocampal regions. In the olfactory bulb, nicotine reduced ethanol-induced brain damage. Although results of other studies seem to indicate that nicotine increases alcohol consumption, our findings indicate that nicotine does not markedly change the development of alcohol dependence or alcohol-induced cortical damage.