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Kraus C, Castrén E, Kasper S, Lanzenberger R. Serotonin and neuroplasticity - Links between molecular, functional and structural pathophysiology in depression. Neurosci Biobehav Rev 2017; 77:317-326. [PMID: 28342763 DOI: 10.1016/j.neubiorev.2017.03.007] [Citation(s) in RCA: 254] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 02/23/2017] [Accepted: 03/12/2017] [Indexed: 12/26/2022]
Abstract
Serotonin modulates neuroplasticity, especially during early life, and dysfunctions in both systems likewise contribute to pathophysiology of depression. Recent findings demonstrate that serotonin reuptake inhibitors trigger reactivation of juvenile-like neuroplasticity. How these findings translate to clinical antidepressant treatment in major depressive disorder remains unclear. With this review, we link preclinical with clinical work on serotonin and neuroplasticity to bring two pathophysiologic models in clinical depression closer together. Dysfunctional developmental plasticity impacts on later-life cognitive and emotional functions, changes of synaptic serotonin levels and receptor levels are coupled with altered synaptic plasticity and neurogenesis. Structural magnetic resonance imaging in patients reveals disease-state-specific reductions of gray matter, a marker of neuroplasticity, and reversibility upon selective serotonin reuptake inhibitor treatment. Translational evidence from magnetic resonance imaging in animals support that reduced densities and sizes of neurons and reduced hippocampal volumes in depressive patients could be attributable to changes of serotonergic neuroplasticity. Since ketamine, physical exercise or learning enhance neuroplasticity, combinatory paradigms with selective serotonin reuptake inhibitors could enhance clinical treatment of depression.
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Affiliation(s)
- Christoph Kraus
- NEUROIMAGING LABs (NIL) - PET & MRI & EEG & Chemical Lab Department of Psychiatry and Psychotherapy Medical University of Vienna
| | - Eero Castrén
- Neuroscience Center, University of Helsinki, Helsinki, Finland
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria(1)
| | - Rupert Lanzenberger
- NEUROIMAGING LABs (NIL) - PET & MRI & EEG & Chemical Lab Department of Psychiatry and Psychotherapy Medical University of Vienna.
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2
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Richardson GA, Goldschmidt L, Larkby C, Day NL. Effects of prenatal cocaine exposure on child behavior and growth at 10 years of age. Neurotoxicol Teratol 2013; 40:1-8. [PMID: 23981277 DOI: 10.1016/j.ntt.2013.08.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/12/2013] [Accepted: 08/13/2013] [Indexed: 10/26/2022]
Abstract
We examined physical growth and behavioral outcomes in 226 10-year-old children who were participants in a longitudinal study of prenatal cocaine exposure (PCE), while controlling for other factors that affect development. During the first trimester, 42% of the women used cocaine, with use declining across pregnancy. At the 10-year follow-up, the caregivers were 37years old, had 12.8years of education, and 50% were African American. First trimester cocaine exposure predicted decreased weight, height, and head circumference at 10years. First trimester cocaine use also predicted maternal ratings of less sociability on the EAS Temperament Survey and more withdrawn behavior problems on the Child Behavior Checklist, more anxious/depressed behaviors on the Teacher Report Form, and more self-reported depressive symptoms on the Children's Depression Inventory. In addition, exposure to violence mediated the effect of PCE on child and teacher reports of depressive symptoms, but not of maternal reports of sociability and withdrawn behaviors. These behaviors may be precursors of later psychiatric problems.
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Affiliation(s)
- Gale A Richardson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, United States.
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3
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Harrington RA, Lee LC, Crum RM, Zimmerman AW, Hertz-Picciotto I. Serotonin Hypothesis of Autism: Implications for Selective Serotonin Reuptake Inhibitor Use during Pregnancy. Autism Res 2013; 6:149-68. [DOI: 10.1002/aur.1288] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 02/15/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Rebecca A. Harrington
- Department of Epidemiology; Johns Hopkins Bloomberg School of Public Health; Baltimore; Maryland
| | - Li-Ching Lee
- Department of Epidemiology; Johns Hopkins Bloomberg School of Public Health; Baltimore; Maryland
| | - Rosa M. Crum
- Departments of Epidemiology, Psychiatry, and Mental Health; Johns Hopkins Medical Institutions; Baltimore; Maryland
| | - Andrew W. Zimmerman
- Lurie Center for Autism; Massachusetts General Hospital for Children; Lexington; Massachusetts
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences and the M.I.N.D. Institute; MS1C; University of California, Davis; Davis; California
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Abstract
Prenatal substance abuse continues to be a significant problem in this country and poses important health risks for the developing fetus. The primary care pediatrician's role in addressing prenatal substance exposure includes prevention, identification of exposure, recognition of medical issues for the exposed newborn infant, protection of the infant, and follow-up of the exposed infant. This report will provide information for the most common drugs involved in prenatal exposure: nicotine, alcohol, marijuana, opiates, cocaine, and methamphetamine.
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Roussotte F, Soderberg L, Sowell E. Structural, metabolic, and functional brain abnormalities as a result of prenatal exposure to drugs of abuse: evidence from neuroimaging. Neuropsychol Rev 2010; 20:376-97. [PMID: 20978945 PMCID: PMC2988996 DOI: 10.1007/s11065-010-9150-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 10/06/2010] [Indexed: 12/28/2022]
Abstract
Prenatal exposure to alcohol and stimulants negatively affects the developing trajectory of the central nervous system in many ways. Recent advances in neuroimaging methods have allowed researchers to study the structural, metabolic, and functional abnormalities resulting from prenatal exposure to drugs of abuse in living human subjects. Here we review the neuroimaging literature of prenatal exposure to alcohol, cocaine, and methamphetamine. Neuroimaging studies of prenatal alcohol exposure have reported differences in the structure and metabolism of many brain systems, including in frontal, parietal, and temporal regions, in the cerebellum and basal ganglia, as well as in the white matter tracts that connect these brain regions. Functional imaging studies have identified significant differences in brain activation related to various cognitive domains as a result of prenatal alcohol exposure. The published literature of prenatal exposure to cocaine and methamphetamine is much smaller, but evidence is beginning to emerge suggesting that exposure to stimulant drugs in utero may be particularly toxic to dopamine-rich basal ganglia regions. Although the interpretation of such findings is somewhat limited by the problem of polysubstance abuse and by the difficulty of obtaining precise exposure histories in retrospective studies, such investigations provide important insights into the effects of drugs of abuse on the structure, function, and metabolism of the developing human brain. These insights may ultimately help clinicians develop better diagnostic tools and devise appropriate therapeutic interventions to improve the condition of children with prenatal exposure to drugs of abuse.
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Affiliation(s)
- Florence Roussotte
- Developmental Cognitive Neuroimaging Group, Department of Neurology, University of California, Los Angeles, CA USA
- Interdepartmental Ph.D. Program for Neuroscience, University of California, Los Angeles, CA USA
| | - Lindsay Soderberg
- Developmental Cognitive Neuroimaging Group, Department of Neurology, University of California, Los Angeles, CA USA
| | - Elizabeth Sowell
- Developmental Cognitive Neuroimaging Group, Department of Neurology, University of California, Los Angeles, CA USA
- Interdepartmental Ph.D. Program for Neuroscience, University of California, Los Angeles, CA USA
- Developmental Cognitive Neuroimaging Group, Laboratory of Neuro Imaging, University of California, Los Angeles, 710 Westwood Plaza, Room 1-138, Los Angeles, CA 90095-7332 USA
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Richardson GA, Goldschmidt L, Willford J. Continued effects of prenatal cocaine use: preschool development. Neurotoxicol Teratol 2009; 31:325-33. [PMID: 19695324 PMCID: PMC2765398 DOI: 10.1016/j.ntt.2009.08.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 08/07/2009] [Accepted: 08/08/2009] [Indexed: 11/24/2022]
Abstract
The relationship between prenatal cocaine use and preschooler's physical and cognitive development and behavioral characteristics was examined, controlling for other influences on child development. On average, children were 38.5 months old, women were 29.4 years old, had 12.3 years of education, and 47% were African American. During the first trimester, 18% of the women were frequent cocaine users (> or = 1 line/day). First trimester cocaine exposure predicted decreased head circumference at 3 years and lower scores on the short-term memory subscale of the Stanford-Binet Intelligence Scale (SBIS) [74]. There was no significant relationship between prenatal cocaine use and the other SBIS scales. First trimester cocaine use also predicted more total, internalizing, and externalizing behavior problems on the Child Behavior Checklist [3] and higher scores on the fussy/difficult scale of the Infant Characteristics Questionnaire [6]. Children who were exposed to cocaine throughout pregnancy had more behavior problems and were more fussy compared to children of women who never used cocaine prenatally. A repeated measures analysis showed that children of first trimester cocaine users became more fussy over time. These detrimental effects on growth and behavior are consistent with other reports in the literature and with the hypothesis that prenatal cocaine exposure affects development through changes in neurotransmitter systems.
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Affiliation(s)
- Gale A Richardson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Pawluski JL, Galea LAM, Brain U, Papsdorf M, Oberlander TF. Neonatal S100B protein levels after prenatal exposure to selective serotonin reuptake inhibitors. Pediatrics 2009; 124:e662-70. [PMID: 19786426 DOI: 10.1542/peds.2009-0442] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study investigated neonatal S100B levels as a biomarker of prenatal selective serotonin reuptake inhibitor (SSRI) exposure. METHODS Maternal (delivery; N = 53) and neonatal (cord; N = 52) serum S100B levels were compared between prenatally SSRI-exposed (maternal, N = 36; neonatal, N = 37; duration: 230 +/- 71 days) and nonexposed (maternal, N = 17; neonatal, N = 15) groups. Measures of maternal depression and anxiety symptoms were assessed during the third trimester (33-36 weeks), and neonatal outcomes, including Apgar scores, birth weight, gestational age at birth, and symptoms of poor neonatal adaptation, were recorded. RESULTS S100B levels were significantly lower in prenatally SSRI-exposed neonates than in nonexposed neonates, controlling for gestational age and third-trimester maternal mood (P = .036). In contrast, SSRI-exposed mothers had significantly higher maternal serum S100B levels, compared with nonexposed mothers (P = .014), even controlling for maternal mood in the third trimester. S100B levels were not associated with maternal or neonatal drug levels, duration of prenatal exposure, demographic variables, or risk for poor neonatal adaptation. CONCLUSIONS Prenatal SSRI exposure was associated with decreased neonatal serum S100B levels, controlling for prenatal maternal mood. Neonatal S100B levels did not reflect neonatal behavioral outcomes and were not related to pharmacologic indices. These findings are consistent with prenatal alcohol and cocaine exposures, which also alter central serotonin levels.
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Affiliation(s)
- Jodi L Pawluski
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Richardson GA, Goldschmidt L, Willford J. The effects of prenatal cocaine use on infant development. Neurotoxicol Teratol 2008; 30:96-106. [PMID: 18243651 PMCID: PMC2275897 DOI: 10.1016/j.ntt.2007.12.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 12/19/2007] [Accepted: 12/19/2007] [Indexed: 11/28/2022]
Abstract
This study examined the effect of prenatal cocaine use on infant physical, cognitive, and motor development, and temperamental characteristics, controlling for other factors that affect infant development. Women were, on average, 26.8 years old, had 12 years of education, and 46% were African American. During the first trimester, 18% were frequent users of cocaine (> or =1 line/day). The infants were, on average, 14.6 months old at this follow-up phase. Women who used cocaine during pregnancy rated their infants as more fussy/difficult and unadaptable than did women who did not use cocaine. Cocaine use in the second trimester was associated with significantly lower motor scores on the Bayley Scales of Infant Development (BSID) [N. Bayley, Manual for the Bayley Scales of Infant Development, Psychological Corporation, New York, 1969.]. There was no effect of prenatal cocaine use on BSID mental performance or on growth. These findings are consistent with other reports in the literature and with the hypothesis that prenatal cocaine exposure affects development through changes in neurotransmitter systems.
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Affiliation(s)
- Gale A Richardson
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Warner TD, Behnke M, Eyler FD, Padgett K, Leonard C, Hou W, Garvan CW, Schmalfuss IM, Blackband SJ. Diffusion tensor imaging of frontal white matter and executive functioning in cocaine-exposed children. Pediatrics 2006; 118:2014-24. [PMID: 17079574 PMCID: PMC3166953 DOI: 10.1542/peds.2006-0003] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Although animal studies have demonstrated frontal white matter and behavioral changes resulting from prenatal cocaine exposure, no human studies have associated neuropsychological deficits in attention and inhibition with brain structure. We used diffusion tensor imaging to investigate frontal white matter integrity and executive functioning in cocaine-exposed children. METHODS Six direction diffusion tensor images were acquired using a Siemens 3T scanner with a spin-echo echo-planar imaging pulse sequence on right-handed cocaine-exposed (n = 28) and sociodemographically similar non-exposed children (n = 25; mean age: 10.6 years) drawn from a prospective, longitudinal study. Average diffusion and fractional anisotropy were measured in the left and right frontal callosal and frontal projection fibers. Executive functioning was assessed using two well-validated neuropsychological tests (Stroop color-word test and Trail Making Test). RESULTS Cocaine-exposed children showed significantly higher average diffusion in the left frontal callosal and right frontal projection fibers. Cocaine-exposed children were also significantly slower on a visual-motor set-shifting task with a trend toward lower scores on a verbal inhibition task. Controlling for gender and intelligence, average diffusion in the left frontal callosal fibers was related to prenatal exposure to alcohol and marijuana and an interaction between cocaine and marijuana exposure. Performance on the visual-motor set-shifting task was related to prenatal cocaine exposure and an interaction between cocaine and tobacco exposure. Significant correlations were found between test performance and fractional anisotropy in areas of the frontal white matter. CONCLUSIONS Prenatal cocaine exposure, alone and in combination with exposure to other drugs, is associated with slightly poorer executive functioning and subtle microstructural changes suggesting less mature development of frontal white matter pathways. The relative contribution of postnatal environmental factors, including characteristics of the caregiving environment and stressors associated with poverty and out-of-home placement, on brain development and behavioral functioning in polydrug-exposed children awaits further research.
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Affiliation(s)
- Tamara Duckworth Warner
- University of Florida, College of Medicine, Department of Pediatrics, PO Box 100296, Gainesville, FL 32610-0296, USA.
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Van den Hove DLA, Steinbusch HWM, Bruschettini M, Gazzolo D, Frulio R, Scheepens A, Prickaerts J, Blanco CE. Prenatal stress reduces S100B in the neonatal rat hippocampus. Neuroreport 2006; 17:1077-80. [PMID: 16791107 DOI: 10.1097/01.wnr.0000223391.74575.c9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Prenatal stress has been shown to disturb neonatal rat brain development. The astroglial-specific neurotrophic factor S100B is known to play an important role in normal brain development. In the present study, we investigated the effects of prenatal stress on S100B concentrations in the hippocampus of 1-day-old Fischer 344 rats. Overall, prenatal stress resulted in a 25% reduction in hippocampal S100B content. Further, male hippocampal S100B content was negatively correlated with plasma corticosterone levels. Positive correlations were found between female S100B levels and fetal growth, and hippocampal brain-derived neurotrophic factor content. In conclusion, the observed reduction in neonatal hippocampal S100B levels, as a consequence of prenatal stress, may be involved in affecting postnatal brain development.
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Affiliation(s)
- Daniël L A Van den Hove
- Department of Pediatrics, Faculty of Medicine, Maastricht University, Maastricht, The Netherlands.
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Van den Hove DLA, Lauder JM, Scheepens A, Prickaerts J, Blanco CE, Steinbusch HWM. Prenatal stress in the rat alters 5-HT1A receptor binding in the ventral hippocampus. Brain Res 2006; 1090:29-34. [PMID: 16677618 DOI: 10.1016/j.brainres.2006.03.057] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2005] [Revised: 02/21/2006] [Accepted: 03/07/2006] [Indexed: 11/29/2022]
Abstract
Exposure of a pregnant woman to physical and/or psychological stress might affect her offspring by promoting the development of various learning, behavioral and/or mood disorders in later life. The 5-HT1A and 5-HT2A receptors are prominently implicated in the modulation of anxiety and mood-related behaviors. Using a semi-quantitative radiolabel immunocytochemical analysis (immunobinding), we studied the effect of prenatal stress on binding of these two receptor subtypes in the hippocampus of 4-week-old male and female Fischer 344 rats. Levels of 5-HT1A immunobinding in the ventral hippocampus, which is primarily implicated in emotional processing, were significantly decreased in male offspring after prenatal stress. A trend towards a decrease was observed in the ventral hippocampus of females. In contrast, 5-HT1A immunobinding within the dorsal hippocampus, which is mainly related to learning and memory, was not affected by prenatal stress in offspring of either gender. Likewise, no significant differences between control and prenatally stressed rats were observed for levels of 5-HT2A immunobinding in either part of the hippocampus or gender. The observed reduction in hippocampal 5-HT1A receptor binding in male offspring after prenatal stress may have important consequences for adult anxiety- and depressive-like behavior.
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Affiliation(s)
- D L A Van den Hove
- Department of Pediatrics, Research Institute Growth and Development (GROW), Faculty of Medicine, Maastricht University, 6202 AZ Maastricht, The Netherlands.
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Chen Z, Tetzlaff J, Sripathirathan K, Carrasco GA, Shankaran M, Van De Kar LD, Muma NA, Battaglia G. Paroxetine is effective in desensitizing 5-HT1A receptor function in adult offspring exposed prenatally to cocaine. Psychopharmacology (Berl) 2005; 180:316-26. [PMID: 15864558 DOI: 10.1007/s00213-005-2249-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2004] [Accepted: 12/11/2004] [Indexed: 10/25/2022]
Abstract
RATIONALE Desensitization of postsynaptic 5-HT(1A) receptors may be responsible for the therapeutic effectiveness of serotonin selective uptake inhibitors (SSRIs). As prenatal cocaine exposure produces long-term deficits in 5-HT neurons in offspring, it may alter the ability of postsynaptic 5-HT(1A) receptors to be desensitized by chronic paroxetine. OBJECTIVES The aim of the study is to determine (1) prenatal cocaine-induced changes in 5-HT(1A) receptor function and (2) the effectiveness of chronic treatment with paroxetine to produce 5-HT(1A) receptor desensitization in adult offspring exposed to cocaine in utero. METHODS Pregnant rats received saline or (-)cocaine (15 mg/kg, s.c.) twice daily from gestational days 13 through 20. Adult male offspring from each of prenatal groups were treated with saline or paroxetine (10 mg/kg/day; i.p.) for 14 days. Eighteen hours post-treatment, rats were challenged with saline or the 5-HT(1A) receptor agonist (+)8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT, 0.04 or 0.2 mg/kg, s.c.). Plasma oxytocin, adrenocorticotropic hormone (ACTH), corticosterone, renin and prolactin were determined. RESULTS Prenatal cocaine exposure did not alter 5-HT(1A) receptor-mediated neuroendocrine responses. Paroxetine treatment desensitized 5-HT(1A) receptor-mediated increases in oxytocin, ACTH and corticosterone to a comparable extent in all offspring and reduced the E(max) for ACTH only in prenatal cocaine-exposed offspring. Cortical [(3)H]-8-OH-DPAT- or [(3)H]-WAY100635-labeled 5-HT(1A) receptors were unaltered by prenatal cocaine or subsequent paroxetine treatment. CONCLUSIONS Postsynaptic 5-HT(1A) receptor function is unaltered by prenatal cocaine exposure and paroxetine can effectively desensitize 5-HT(1A) receptor function in adult cocaine-exposed offspring. These data suggest that paroxetine may be clinically effective in treating mood disorders in adults exposed in utero to cocaine.
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Affiliation(s)
- Zhuo Chen
- Department of Pharmacology and Center for Serotonin Disorders Research, Stritch School of Medicine, Loyola University of Chicago, 2160 South First Avenue, Maywood, IL 60153, USA
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13
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Abstract
BACKGROUND Alcohol and drug use by pregnant women are harmful to the developing embryo and fetus. Teasing apart the specific contributions of each substance to adverse child outcome, however, proves difficult in practice. The risks to the neonate include intra-uterine growth retardation, birth defects, altered neurobehavior, and withdrawal symptoms. Subsequent behavior, development, and neurologic function may also be impaired. REVIEW SUMMARY Maternal cigarette smoking carries the greatest risk of impaired fetal growth of any of the substances discussed herein and has been linked to subsequent externalizing behaviors. Alcohol is a well-established teratogen. Heavy exposure to alcohol in a subset of infants is associated with fetal alcohol syndrome (FAS). Mental retardation is one of the main sequelae of alcohol exposure in utero. Fetal marijuana exposure has no consistent effect on outcome. Prenatal cocaine exposure has not been shown to have any detrimental effect on cognition, except as mediated through cocaine effects on head size. Although fetal cocaine exposure has been linked to numerous abnormalities in arousal, attention, and neurologic and neurophysiological function, most such effects appear to be self-limited and restricted to early infancy and childhood. Opiate exposure elicits a well-described withdrawal syndrome affecting central nervous, autonomic, and gastrointestinal systems, which is most severe among methadone-exposed infants. CONCLUSION Most adverse effects of prenatal drug exposure are self-limited, with catch-up growth and resolution of withdrawal and of prior neurobehavioral abnormalities noted over time. The exception is alcohol, which is linked to life-long impairments (i.e., mental retardation and microcephaly) and possibly cigarette-related behavioral effects. The absence of tangible evidence of detrimental long-term cocaine effects may reflect limitations in the methodology used to identify children at greatest risk for adverse outcome.
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Affiliation(s)
- Claudia A Chiriboga
- Department of Neurology, Division of Pediatric Neurology, College of Physicians and Surgeons, Columbia University, and Harlem Hospital Center, New York, NY 10032, USA.
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Bartzokis G, Beckson M, Lu PH, Edwards N, Bridge P, Mintz J. Brain maturation may be arrested in chronic cocaine addicts. Biol Psychiatry 2002; 51:605-11. [PMID: 11955460 DOI: 10.1016/s0006-3223(02)01315-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Animal and human newborn studies suggest that exposure to cocaine in utero delays glial maturation and white matter myelination. Postmortem data show that in the frontal and temporal lobes, white matter myelination continues into middle age. Recent magnetic resonance imaging (MRI) data have confirmed continued white matter volume increase in these regions, reaching a maximum at age 47. METHODS Thirty-seven male cocaine dependent (CD) and 52 normal control subjects between ages 19 and 47 were evaluated with MRI. Coronal images focused on the frontal and temporal lobes were acquired using pulse sequences that maximized gray/white matter contrast. RESULTS Highly significant positive correlations between white matter volume and age were observed in both the frontal and temporal lobes of the control group (r =.52, p =.0001 and r =.54, p =.0001, respectively); however, CD subjects did not demonstrate any age-related increase in white matter volume of the frontal (r = -.001; p =.99) and temporal (r = -.07; p =.67) lobes in this age range. CONCLUSIONS The age-related expansion in white matter volume occurring in normal control subjects was absent in CD subjects. The findings suggest that in adults, cocaine dependence may arrest normal white matter maturation in the frontal and temporal lobes of addicts who continue using cocaine.
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Affiliation(s)
- George Bartzokis
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
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Oberlander TF, Eckstein Grunau R, Fitzgerald C, Ellwood AL, Misri S, Rurak D, Riggs KW. Prolonged prenatal psychotropic medication exposure alters neonatal acute pain response. Pediatr Res 2002; 51:443-53. [PMID: 11919328 DOI: 10.1203/00006450-200204000-00008] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are frequently used to treat maternal depression during pregnancy, however the effect of increased serotonin (5HT) and gamma-amino-butyric acid (GABA) agonists in the fetal human brain remains unknown. 5HT and GABA are active during fetal neurologic growth and play early roles in pain modulation, therefore, if prolonged prenatal exposure alters neurodevelopment this may become evident in altered neonatal pain responses. To examine biologic and behavioral effects of prenatal exposure, neonatal responses to acute pain (phenylketonuria heel lance) in infants with prolonged prenatal exposure were examined. Facial action (Neonatal Facial Coding System) and cardiac autonomic reactivity derived from the relationship between respiratory activity and short term variations of heart rate (HRV) were compared between 22 infants with SSRI exposure (SE) [fluoxetine (n = 7), paroxetine (n = 11), sertraline (n = 4)]; 16 infants exposed to SSRIs and clonazepam (SE+) [paroxetine (n = 14), fluoxetine (n = 2)]; and 23 nonexposed infants during baseline, lance, and recovery periods of a heel lance. Length of maternal SSRI use did not vary significantly between exposure groups-[mean (range)] SE:SE+ 183 (31-281):141 (54-282) d (p > 0.05). Infants exposed to SE and SE+ displayed significantly less facial activity to heel lance than control infants. Mean HR increased with lance, but was significantly lower in SE infants during recovery. Using measures of HRV and the transfer relationship between heart rate and respiration, SSRI infants had a greater return of parasympathetic cardiac modulation in the recovery period, whereas a sustained sympathetic response continued in the control group. Prolonged prenatal SSRI exposure appears to be associated with reduced behavioral pain responses and increased parasympathetic cardiac modulation in recovery following an acute neonatal noxious event. Possible 5HT-mediated pain inhibition, pharmacologic factors and the developmental course remain to be studied.
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Affiliation(s)
- Tim F Oberlander
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
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16
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Stanwood GD, Washington RA, Shumsky JS, Levitt P. Prenatal cocaine exposure produces consistent developmental alterations in dopamine-rich regions of the cerebral cortex. Neuroscience 2002; 106:5-14. [PMID: 11564412 DOI: 10.1016/s0306-4522(01)00256-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Administration of cocaine to pregnant rabbits produces robust and long-lasting anatomical alterations in the dopamine-rich anterior cingulate cortex of offspring. These effects include increased length and decreased bundling of layer III and V pyramidal neuron dendrites, increases in parvalbumin expression in the dendrites of interneurons, and increases in detectable GABAergic neurons. We have now examined multiple cortical regions with varying degrees of catecholaminergic innervation to investigate regional variations in the ability of prenatal cocaine exposure to elicit these permanent changes. All regions containing a high density of tyrosine hydroxylase-immunoreactive fibers, indicative of prominent dopaminergic input, exhibited alterations in GABA and parvalbumin expression by interneurons and microtubule-associated protein-2 labeling of apical dendrites of pyramidal neurons. These regions included the medial prefrontal, entorhinal, and piriform cortices. In contrast, primary somatosensory, auditory and motor cortices exhibited little tyrosine hydroxylase staining and no measurable cocaine-induced changes in cortical structure. From these data we suggest that the presence of dopaminergic afferents contributes to the marked specificity of the altered development of excitatory pyramidal neurons and inhibitory interneurons induced by low dose i.v. administration of cocaine in utero.
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Affiliation(s)
- G D Stanwood
- Department of Neurobiology, University of Pittsburgh School of Medicine, E1440 Biomedical Science Tower, Pittsburgh, PA 15261, USA.
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Abstract
Serotonin is known to play a role in brain development prior to the time it assumes its role as a neurotransmitter in the mature brain. Serotonin regulates both the development of serotonergic neurons (termed autoregulation of development) and the development of target tissues. In both cases, the astroglial-derived protein, S-100beta plays a role. Disruption of serotonergic development can leave permanent alterations in brain function and behavior. This may be the case in such human developmental illnesses as autism and Down Syndrome.
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Affiliation(s)
- P M Whitaker-Azmitia
- Program in Biopsychology, Department of Psychology, SUNY at Stony Brook, 11794-2500, USA.
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18
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Whitaker-Azmitia P, Zhou F, Hobin J, Borella A. Isolation-rearing of rats produces deficits as adults in the serotonergic innervation of hippocampus. Peptides 2000; 21:1755-9. [PMID: 11090932 DOI: 10.1016/s0196-9781(00)00327-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Isolation-rearing of rats causes a variety of behavioral changes, including anxiety, learning deficits and sensory changes related to schizophrenia. Similar changes are seen following loss of serotonin during development. Thus, the effects of isolation-rearing on behavior may be due to changes in serotonin. Sprague-Dawley rats were raised in groups of four (social animals) or in isolation, from postnatal day 22 until postnatal day 64. The hippocampi were examined immunochemically for changes in serotonin. Our findings show that serotonin terminals are lost throughout the CA regions of hippocampus, where there is also an associated loss of dendrites, but not in the molecular layer of the dentate gyrus. Thus, some of the brain and behavioral changes seen in isolation-reared animals could be due to loss of serotonin.
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Affiliation(s)
- P Whitaker-Azmitia
- Program in Biopsychology, Department of Psychology, SUNY at Stony Brook, 11794, Stony Brook, NY, USA.
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19
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Delaney-Black V, Covington C, Templin T, Ager J, Nordstrom-Klee B, Martier S, Leddick L, Czerwinski RH, Sokol RJ. Teacher-assessed behavior of children prenatally exposed to cocaine. Pediatrics 2000; 106:782-91. [PMID: 11015523 DOI: 10.1542/peds.106.4.782] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Prenatal cocaine exposure has been associated with alterations in neonatal behavior and more recently a dose-response relationship has been identified. However, few data are available to address the long-term behavioral effects of prenatal exposures in humans. The specific aim of this report is to evaluate the school-age behavior of children prenatally exposed to cocaine. METHODS All black non-human immunodeficiency virus-positive participants in a larger pregnancy outcomes study who delivered singleton live born infants between September 1, 1989 and August 31, 1991 were eligible for study participation. Staff members of the larger study extensively screened study participants during pregnancy for cocaine, alcohol, cigarettes, and other illicit drugs. Prenatal drug exposure was defined by maternal history elicited by structured interviews with maternal and infant drug testing as clinically indicated. Cocaine exposure was considered positive if either history or laboratory results were positive. Six years later, 665 families were contacted; 94% agreed to participate. The child, primary caretaker (parent), and, when available, the biologic mothers were tested in our research facilities. Permission was elicited to obtain blinded teacher assessments of child behavior with the Achenbach Teacher's Report Form (TRF). Drug use since the child's birth was assessed by trained researchers using a structured interview. RESULTS Complete laboratory and teacher data were available for 499 parent-child dyads, with a final sample size for all analyses of 471 (201 cocaine-exposed) after the elimination of mentally retarded subjects. A comparison of relative Externalizing (Aggressive, Delinquent) to Internalizing (Anxious/Depressed, Withdrawn, Somatic Complaints) behaviors of the offspring was computed for the TRF by taking the difference between the 2 subscales to create an Externalizing-Internalizing Difference (T. M. Achenbach, personal communication, 1998). Univariate comparisons revealed that boys were significantly more likely to score in the clinically significant range on total TRF, Externalizing-Internalizing, and Aggressive Behaviors than were girls. Children prenatally exposed to cocaine had higher Externalizing-Internalizing Differences compared with controls but did not have significantly higher scores on any of the other TRF variables. Additionally, boys prenatally exposed to cocaine were twice as likely as controls to have clinically significant scores for externalizing (25% vs 13%) and delinquent behavior (22% vs 11%). Gender, prenatal exposures (cocaine and alcohol), and postnatal risk factors (custody changes, current drug use in the home, child's report of violence exposure) were all related to problem behaviors. Even after controlling for gender, other prenatal substance exposures, and home environment variables, cocaine-exposed children had higher Externalizing-Internalizing Difference scores. Prenatal exposure to alcohol was associated with higher total score, increased attention problems, and more delinquent behaviors. Prenatal exposure to cigarettes was not significantly related to the total TRF score or any of the TRF subscales. Postnatal factors associated with problem behaviors included both changes in custody status and current drug use in the home. Change in custody status of the cocaine-exposed children, but not of the controls, was related to higher total scores on the TRF and more externalizing and aggressive behaviors. Current drug use in the home was associated with higher scores on the externalizing and aggressive subscales. CONCLUSIONS Results of this study suggest gender-specific behavioral effects related to prenatal cocaine exposure. Prenatal alcohol exposure also had a significant impact on the TRF. Postnatal exposures, including current drug use in the home and the child's report of violence exposure, had an independent effect on teacher-assessed child behavioral problems. (ABSTRACT TRUNCATE
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Affiliation(s)
- V Delaney-Black
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, Michigan, USA.
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20
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Darmani NA, Ahmad B. Early postnatal cocaine exposure causes sequential, dose-dependent, enduring but reversible supersensitivity in 5-HT2A receptor-mediated function during development in male mice. Neurotoxicol Teratol 2000; 22:61-9. [PMID: 10642115 DOI: 10.1016/s0892-0362(99)00054-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This report investigated whether postnatal exposure to cocaine affects the index of 5-HT2A receptor function during development by utilizing the ability of the 5-HT2A/C agonist DOI to induce the head-twitch response (HTR) in mice. Thus, several groups of mice litters were treated with varying doses of cocaine (0, 0.5, 1, 5, and 10 mg/kg, IP) twice daily from postnatal days 5 to 14. Then, different groups of cocaine-exposed male mice pups along with their corresponding age-matched vehicle-exposed control groups were HTR tested once during development on the following postnatal test days: 15, 16, 18, 20, 30, 45, and 60. The HTR testing involved administration of DOI (0.5 mg/kg, IP) and counting the frequency of the behavior for the next 20 min. Cocaine exposure caused bell-shaped, dose-dependent, enduring but reversible increase in DOI-induced HTR frequency (mean +/- SEM) during development. The developing pups were most sensitive to low and intermediate doses of cocaine (0.5-5 mg/kg). The greatest degree of increase in HTR frequency in response to DOI challenge occurred in the 1 mg/kg cocaine-exposure group on most test days. The onset of HTR supersensitivity varied from 48 h (5 mg/kg) to 144 h (0.5 mg/kg) following the termination of chronic cocaine exposure. Moreover, maximal supersensitivity for the latter doses of cocaine occurred 96 and 384 h postcocaine treatment, respectively. Other cocaine exposure groups attained their maxima sometime between the latter time periods. The duration of persistence of 5-HT2A receptor supersensitivity varied with different doses of cocaine: the 10-mg/kg group was supersensitive up to 384 h postcocaine treatment, the 1- and 5-mg/kg groups up to 744 h; and the 0.5-mg/kg group up to 1104 h. Although developmentally cocaine-exposed pups exhibit some similarities (i.e., exquisite sensitivity and bell-shaped dose-response) in 5-HT2A receptor adaptation to mature adult mice exposed to cocaine, they also differ from mature adult cocaine-exposed mice in the onset of appearance as well as the enduring persistence of the induced supersensitivity.
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Affiliation(s)
- N A Darmani
- Department of Pharmacology, Kirksville College of Osteopathic Medicine, MO 63501, USA.
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Lajard AM, Bou C, Monteau R, Hilaire G. Serotonin levels are abnormally elevated in the fetus of the monoamine oxidase-A-deficient transgenic mouse. Neurosci Lett 1999; 261:41-4. [PMID: 10081922 DOI: 10.1016/s0304-3940(98)01012-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Developmental changes in levels of serotonin, L-tryptophan and 5-hydroxyindol acetic acid (5-HIAA) were measured by high pressure liquid chromatography (HPLC) in the forebrain, brainstem and cervical cord of fetal, neonatal and adult mice from the wild strain C3H and the transgenic strain Tg8, created from the C3H line by the disruption of the gene encoding monoamine oxidase A. The results indicated that the absence of monoamine oxidase A activity in Tg8 mice results in abnormally high 5-hydroxytryptamine (5-HT) levels in all the central nervous structures and at all the studied developmental ages. Since serotonin levels were 4-5 times larger in Tg8 than in C3H mice at gestational day 20, comparing the central network function at birth of C3H and Tg8 neonates should shed some light on the role of serotonin in prenatal network maturation.
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Affiliation(s)
- A M Lajard
- UPRESA CNRS 6034, Fac. St. Jérôme, Marseille, France
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