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Chang CJ, Fan YH, Chiu YC, Cheng WM. Cold hypersensitivity in the hands and feet is associated with erectile dysfunction in young Taiwanese men. Sci Rep 2024; 14:10577. [PMID: 38719920 PMCID: PMC11078973 DOI: 10.1038/s41598-024-60260-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/20/2024] [Indexed: 05/12/2024] Open
Abstract
Cold hypersensitivity in the hands and feet (CHHF) is a protective or predisposing factor for many diseases; however, the relationship between CHHF and erectile dysfunction (ED) remains unclear. We aimed to investigate associations between CHHF and ED among young men of Southeast Asian origin. In this cross-sectional study, sexually active Taiwanese men aged 20-40 years were enrolled via an online questionnaire comprising general demographic information, comorbidities, subjective thermal sensations of their hands and feet in the past 6 months, and their erectile function using the International Index of Erectile Function-5 (IIEF-5). Participants who reported cold sensation of hands and feet were classified to have CHHF; those with IIEF-5 score ≤ 21 were considered to have ED. Total 54.2% and 27.9% of participants had ED and CHHF, respectively. Men with CHHF were significantly younger, had lower body mass index and IIEF-5 scores (p < 0.001), and a lower prevalence of diabetes mellitus (p = 0.033) along with higher prevalence of ED, psychiatric disorders, and insomnia (p < 0.001). After adjusting for predisposing factors of ED, CHHF (odds ratio 1.410, 95% confidence interval 1.159-1.714; p = 0.001) remained an independent predictor of ED. Thus, CHHF is independently associated with ED, affecting more than a quarter of young Taiwanese men. Autonomic dysregulation and subclinical endothelial dysfunction may be common pathophysiologies of CHHF and ED.
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Affiliation(s)
- Che-Jui Chang
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
| | - Yu-Hua Fan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Chun Chiu
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan
| | - Wei-Ming Cheng
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan.
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Podvalny E, Sanchez-Romero R, Cole MW. Functionality of arousal-regulating brain circuitry at rest predicts human cognitive abilities. Cereb Cortex 2024; 34:bhae192. [PMID: 38745558 DOI: 10.1093/cercor/bhae192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 05/16/2024] Open
Abstract
Arousal state is regulated by subcortical neuromodulatory nuclei, such as locus coeruleus, which send wide-reaching projections to cortex. Whether higher-order cortical regions have the capacity to recruit neuromodulatory systems to aid cognition is unclear. Here, we hypothesized that select cortical regions activate the arousal system, which, in turn, modulates large-scale brain activity, creating a functional circuit predicting cognitive ability. We utilized the Human Connectome Project 7T functional magnetic resonance imaging dataset (n = 149), acquired at rest with simultaneous eye tracking, along with extensive cognitive assessment for each subject. First, we discovered select frontoparietal cortical regions that drive large-scale spontaneous brain activity specifically via engaging the arousal system. Second, we show that the functionality of the arousal circuit driven by bilateral posterior cingulate cortex (associated with the default mode network) predicts subjects' cognitive abilities. This suggests that a cortical region that is typically associated with self-referential processing supports cognition by regulating the arousal system.
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Affiliation(s)
- Ella Podvalny
- Center for Molecular and Behavioral Neuroscience, Rutgers University, 197 University Ave, Newark, NJ 07102, United States
| | - Ruben Sanchez-Romero
- Center for Molecular and Behavioral Neuroscience, Rutgers University, 197 University Ave, Newark, NJ 07102, United States
| | - Michael W Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, 197 University Ave, Newark, NJ 07102, United States
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3
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Podvalny E, Sanchez-Romero R, Cole MW. Functionality of arousal-regulating brain circuitry at rest predicts human cognitive abilities. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.09.574917. [PMID: 38617344 PMCID: PMC11014470 DOI: 10.1101/2024.01.09.574917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Arousal state is regulated by subcortical neuromodulatory nuclei, such as locus coeruleus, which send wide-reaching projections to cortex. Whether higher-order cortical regions have the capacity to recruit neuromodulatory systems to aid cognition is unclear. Here, we hypothesized that select cortical regions activate the arousal system, which in turn modulates large-scale brain activity, creating a functional circuit predicting cognitive ability. We utilized the Human Connectome Project 7T functional magnetic resonance imaging dataset (N=149), acquired at rest with simultaneous eye tracking, along with extensive cognitive assessment for each subject. First, we discovered select frontoparietal cortical regions that drive large-scale spontaneous brain activity specifically via engaging the arousal system. Second, we show that the functionality of the arousal circuit driven by bilateral posterior cingulate cortex (associated with the default mode network) predicts subjects' cognitive abilities. This suggests that a cortical region that is typically associated with self-referential processing supports cognition by regulating the arousal system.
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Affiliation(s)
- Ella Podvalny
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
| | - Ruben Sanchez-Romero
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
| | - Michael W. Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
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Turan S, Ermiş Ç, Eray Ş, Ağaç N, Aksoy S, Yüksel AS, Bezir Karaca A, Güler D, Tunçtürk M, Çıray RO, Mutlu C, Karaçetin G, Youngstrom EA, İnal N. Psychomotor agitation and irritability in adolescents with manic episode: Clinical data from three inpatient units. Clin Child Psychol Psychiatry 2023; 28:1266-1278. [PMID: 36052859 DOI: 10.1177/13591045221125331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We aimed to investigate the characteristics of adolescents with Bipolar disorder-I with irritability and agitation (Mania+IA) compared to those without irritability and agitation (Mania-IA) in a multi-center representative sample. METHODS Data of 145 patients from three tertiary-care inpatient units between 2016 and 2021 were obtained. Psychomotor agitation was defined as a score of ≥3 on the YMRS "Increased Motor Activity--Energy" item, irritability as a score of ≥4 on the YMRS 'irritability' item, and severity anchors of speech and thought disturbance on the YMRS '6 and 7' items. RESULTS Previous manic episodes (p = 0.013), involuntary hospitalization (p = 0.006), psychotic features (p = 0.001), formal thought disorder (p = 0.010) and aggressive/disruptive behavior (p = 0.021) were more frequent in the Mania+IA group. Conversely, depressive episodes (p = 0.006) and family history of depression (p = 0.024) were more frequent in the Mania-IA group. The Mania+IA had poorer functioning at the time of discharge. CONCLUSIONS Irritability and agitation were closely related to complications, psychotic symptoms and thought disorder. Assessment and monitoring of psychomotor agitation and irritability may help child and adolescent psychiatrists to predict clinical difficulties and appropriate interventions.
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Affiliation(s)
- Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | | | - Şafak Eray
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | - Nilay Ağaç
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Sena Aksoy
- Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | - Ayşe Sena Yüksel
- Department of Child and Adolescent Psychiatry, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Istanbul, Turkey
| | - Ayça Bezir Karaca
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | - Duru Güler
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Mustafa Tunçtürk
- Department of Child and Adolescent Psychiatry, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Istanbul, Turkey
| | | | - Caner Mutlu
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | - Gül Karaçetin
- Department of Child and Adolescent Psychiatry, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Istanbul, Turkey
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, USA & Helping Give Away Psychological Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Neslihan İnal
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, İzmir, Turkey
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Cui L, Zhang Q, Zhang Y, Li T, Li M, Yuan J, Wu Z, Zhang Y, Kong H, Qu H, Zhao Y. Anxiolytic effects of Chrysanthemum morifolium Ramat Carbonisata-based carbon dots in mCPP-induced anxiety-like behavior in mice: a nature-inspired approach. Front Mol Biosci 2023; 10:1222415. [PMID: 37520324 PMCID: PMC10373738 DOI: 10.3389/fmolb.2023.1222415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction: Anxiety disorders have emerged as a predominant health concern, yet existing pharmacological treatments for anxiety still present various challenges. Chrysanthemum morifolium Ramat Carbonisata (CMRC) has been utilized in China for approximately 400 years as a therapeutic intervention for anxiety disorders. In this study, a novel type of carbon dots derived from the decoction of Chrysanthemum morifolium Ramat Carbonisata (CMRC-CDs) was identified and isolated, and their morphological structure and functional groups were characterized. Furthermore, the effects of CMRC-CDs on m-chlorophenylpiperazine (mCPP)-induced anxiety-like behaviour in mice were examined and quantified. In order to investigate the potential mechanisms of their anxiolytic effects, concentrations of hypothalamic-pituitary-adrenal (HPA) axis hormones, amino acid neurotransmitters, and monoamine neurotransmitters were measured. Methods: In this study, we synthesized CMRC-CDs and evaluated their potential anti-anxiety effects in a controlled experiment involving 48 male ICR mice. The mice were randomly divided into six groups, treated with CMRC-CDs at different doses for 14 days, and subjected to Open-Field (OF) and Elevated Plus Maze (EPM) tests. Post-behavioral evaluations, blood samples and brain tissues were collected for neurotransmitter and Hypothalamic-Pituitary-Adrenal (HPA) axis hormone quantification via ELISA. Additionally, cytotoxicity of CMRC-CDs was assessed using a Cell Counting Kit-8 (CCK-8) assay on RAW 264.7 cells. Results and Discussion: CMRC-CDs were spherical and homogeneously dispersed, with diameters ranging from 1.4 to 4.0 nm and an abundance of chemical groups on their surface. In the open-field (OF) test, mice pre-treated with CMRC-CDs demonstrated an increased proportion of time spent in the central area and a higher frequency of entries into the central area. In the elevated plus maze (EPM) test, mice pre-treated with CMRC-CDs exhibited a greater number of entries into the open arm and an extended duration spent in the open arm. CMRC-CDs were observed to decrease serum concentrations of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosterone (CORT). Furthermore, CMRC-CDs were found to increase γ-aminobutyric acid (GABA) and 5-hydroxytryptamine (5-HT) levels, while concurrently reducing glutamic acid (Glu) concentrations in brain tissue. CMRC-CDs demonstrated anxiolytic effects, which may be attributed to their modulation of hormones and neurotransmitters. This finding suggests the potential therapeutic value of CMRC-CDs in the clinical treatment of anxiety disorders.
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Affiliation(s)
- Luming Cui
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Qian Zhang
- Qingdao Zhonghengneng Environmental Science Engineering Research Institute Co., Ltd, Qingdao, China
| | - Yifan Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tingjie Li
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Menghan Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jinye Yuan
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiyi Wu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Zhang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Hui Kong
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Huihua Qu
- Center of Scientific Experiment, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Zhao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Berger A, Koshmanova E, Beckers E, Sharifpour R, Paparella I, Campbell I, Mortazavi N, Balda F, Yi YJ, Lamalle L, Dricot L, Phillips C, Jacobs HIL, Talwar P, El Tahry R, Sherif S, Vandewalle G. Structural and functional characterization of the locus coeruleus in young and late middle-aged individuals. FRONTIERS IN NEUROIMAGING 2023; 2:1207844. [PMID: 37554637 PMCID: PMC10406214 DOI: 10.3389/fnimg.2023.1207844] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/05/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION The brainstem locus coeruleus (LC) influences a broad range of brain processes, including cognition. The so-called LC contrast is an accepted marker of the integrity of the LC that consists of a local hyperintensity on specific Magnetic Resonance Imaging (MRI) structural images. The small size of the LC has, however, rendered its functional characterization difficult in humans, including in aging. A full characterization of the structural and functional characteristics of the LC in healthy young and late middle-aged individuals is needed to determine the potential roles of the LC in different medical conditions. Here, we wanted to determine whether the activation of the LC in a mismatch negativity task changes in aging and whether the LC functional response was associated to the LC contrast. METHODS We used Ultra-High Field (UHF) 7-Tesla functional MRI (fMRI) to record brain response during an auditory oddball task in 53 healthy volunteers, including 34 younger (age: 22.15y ± 3.27; 29 women) and 19 late middle-aged (age: 61.05y ± 5.3; 14 women) individuals. RESULTS Whole-brain analyses confirmed brain responses in the typical cortical and subcortical regions previously associated with mismatch negativity. When focusing on the brainstem, we found a significant response in the rostral part of the LC probability mask generated based on individual LC images. Although bilateral, the activation was more extensive in the left LC. Individual LC activity was not significantly different between young and late middle-aged individuals. Importantly, while the LC contrast was higher in older individuals, the functional response of the LC was not significantly associated with its contrast. DISCUSSION These findings may suggest that the age-related alterations of the LC structural integrity may not be related to changes in its functional response. The results further suggest that LC responses may remain stable in healthy individuals aged 20 to 70.
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Affiliation(s)
- Alexandre Berger
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, Brussels, Belgium
- Synergia Medical SA, Mont-Saint-Guibert, Belgium
| | - Ekaterina Koshmanova
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Elise Beckers
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Alzheimer Centre Limburg, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Roya Sharifpour
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Ilenia Paparella
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Islay Campbell
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Nasrin Mortazavi
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Fermin Balda
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Yeo-Jin Yi
- Institute of Cognitive Neurology and Dementia Research, Department of Natural Sciences, Faculty of Medicine, Otto-von-Guericke-University, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Laurent Lamalle
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Laurence Dricot
- Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, Brussels, Belgium
| | - Christophe Phillips
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Heidi I. L. Jacobs
- Alzheimer Centre Limburg, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Radiology, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Puneet Talwar
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Riëm El Tahry
- Institute of Neuroscience (IoNS), Department of Clinical Neuroscience, Catholic University of Louvain, Brussels, Belgium
- Center for Refractory Epilepsy, Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Walloon Excellence in Life Sciences and Biotechnology (WELBIO) Department, WEL Research Institute, Wavre, Belgium
| | - Siya Sherif
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Gilles Vandewalle
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
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7
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Goodyear BG, Heidari F, Ingram RJM, Cortese F, Sharifi N, Kaplan GG, Ma C, Panaccione R, Sharkey KA, Swain MG. Multimodal Brain MRI of Deep Gray Matter Changes Associated With Inflammatory Bowel Disease. Inflamm Bowel Dis 2023; 29:405-416. [PMID: 35590449 PMCID: PMC9977255 DOI: 10.1093/ibd/izac089] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Behavioral symptoms, including mood disorders, substantially impact the quality of life of patients with inflammatory bowel disease (IBD), even when clinical remission is achieved. Here, we used multimodal magnetic resonance imaging (MRI) to determine if IBD is associated with changes in the structure and function of deep gray matter brain regions that regulate and integrate emotional, cognitive, and stress responses. METHODS Thirty-five patients with ulcerative colitis (UC) or Crohn's disease (CD) and 32 healthy controls underwent 3 Tesla MRIs to assess volume, neural activity, functional connection strength (connectivity), inflammation, and neurodegeneration of key deep gray matter brain regions (thalamus, caudate, pallidum, putamen, amygdala, hippocampus, and hypothalamus) involved in emotional, cognitive and stress processing. Associations with sex, presence of pain, disease activity, and C-reactive protein (CRP) concentration were examined. RESULTS Significantly increased activity and functional connectivity were observed in cognitive and emotional processing brain regions, including parts of the limbic system, basal ganglia, and hypothalamus of IBD patients compared with healthy controls. Inflammatory bowel disease patients exhibited significantly increased volumes of the amygdala and hypothalamus, as well as evidence of neurodegeneration in the putamen and pallidum. Hippocampal neural activity was increased in IBD patients with active disease. The volume of the thalamus was positively correlated with CRP concentration and was increased in females experiencing pain. CONCLUSIONS Patients with IBD exhibit functional and structural changes in the limbic and striatal systems. These changes may be targets for assessing or predicting the response to therapeutic interventions aimed at improving comorbid emotional and cognitive symptoms.
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Affiliation(s)
- Bradley G Goodyear
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.,The Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada.,The Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Faranak Heidari
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,The Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Richard J M Ingram
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Filomeno Cortese
- The Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Nastaran Sharifi
- The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Gilaad G Kaplan
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Christopher Ma
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Remo Panaccione
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Keith A Sharkey
- Department of Physiology & Pharmacology, University of Calgary, Calgary, Alberta, Canada.,The Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,The Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Mark G Swain
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
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8
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Sars D. PE augmented mindfulness: A neurocognitive framework for research and future healthcare. Front Hum Neurosci 2022; 16:899988. [PMID: 36082227 PMCID: PMC9446465 DOI: 10.3389/fnhum.2022.899988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
Various well-controlled studies have suggested that practitioners in mindfulness can be prone to patient drop-out (e.g., due to chronic stress, pathology, cognitive reactivity), despite researchers having identified the underlying mechanisms that link mindfulness to mental health. In this article, a framework for physical exercise (PE) augmented mindfulness is proposed, which posits that consistently practiced PE before meditation can support (early-stage) mindfulness. Neurocognitive research shows PE (aerobic exercises or yoga) and mindfulness to impact similar pathways of stress regulation that involve cognitive control and stress regulation, thereby supporting the proposed synergistic potential of PE augmented mindfulness. Research focused on the psychophysiological impact of PE, showed its practice to promote short-term neurocognitive changes that can promote both cognitive control and the attainment of mindful awareness (MA). In order to chart dose responses required for protocol development, further research will be presented. Together these findings are discussed in light of future research on this multidisciplinary topic, protocol development, mindful walking, and further application in healthcare and beyond.
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Affiliation(s)
- David Sars
- Mettaminds.org, Mindfulness Based Projects, Amsterdam, Netherlands
- Centre for Integral Rehabilitation (CIR), Amsterdam, Netherlands
- *Correspondence: David Sars,
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Quintero J, Gutiérrez-Casares JR, Álamo C. Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review. Neurol Ther 2022; 11:1489-1517. [PMID: 35951288 DOI: 10.1007/s40120-022-00392-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/28/2022] [Indexed: 10/15/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common childhood-onset neurodevelopmental disorder characterised by persistent inattention, hyperactivity and impulsivity. Moreover, ADHD is commonly associated with other comorbid diseases (depression, anxiety, bipolar disorder, etc.). The ADHD symptomatology interferes with subject function and development. The treatment of ADHD requires a multidisciplinary approach based on a combination of non-pharmacological and pharmacological treatments with the aim of ameliorating the symptomatology; among first-line pharmacological treatments are stimulants [such as methylphenidate (MPH) and lisdexamfetamine dimesylate (LDX)]. In this review we explored recent ADHD- and stimulants-related literature, with the aim of compiling available descriptions of molecular pathways altered in ADHD, and molecular mechanisms of current first-line stimulants MPH and LDX. While conducting the narrative review, we applied structured search strategies covering PubMed/MEDLINE database and performed handsearching of reference lists on the results of those searches. The aetiology and pathophysiology of ADHD are incompletely understood; both genetic and environmental factors have been associated with the disorder and its grade of burden, and also the relationship between the molecular mechanisms of pharmacological treatments and their clinical implications. The lack of comprehensive understanding of the underlying molecular pathology makes both the diagnosis and treatment difficult. Few published studies evaluating molecular data on the mechanism of action (MoA) of MPH and LDX on ADHD are available and most of them are based on animal models. Further studies are necessary to improve the knowledge of ADHD pathophysiology and how the MoAs of MPH and LDX differentially modulate ADHD pathophysiology and control ADHD symptomatology.
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Affiliation(s)
- Javier Quintero
- Servicio de Psiquiatría y Salud Mental, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid, Spain
| | - José R Gutiérrez-Casares
- Unidad Ambulatoria de Psiquiatría y Salud Mental de la Infancia, Niñez y Adolescencia, Hospital Perpetuo Socorro, Badajoz, Spain.
| | - Cecilio Álamo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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10
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Baytas O, Kauer JA, Morrow EM. Loss of mitochondrial enzyme GPT2 causes early neurodegeneration in locus coeruleus. Neurobiol Dis 2022; 173:105831. [PMID: 35908744 PMCID: PMC9669404 DOI: 10.1016/j.nbd.2022.105831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 12/02/2022] Open
Abstract
Locus coeruleus (LC) is among the first brain areas to degenerate in Alzheimer’s disease and Parkinson’s disease; however, the underlying causes for the vulnerability of LC neurons are not well defined. Here we report a novel mechanism of degeneration of LC neurons caused by loss of the mitochondrial enzyme glutamate pyruvate transaminase 2 (GPT2). GPT2 Deficiency is a newly-recognized childhood neurometabolic disorder. The GPT2 enzyme regulates cell growth through replenishment of tricarboxylic acid (TCA) cycle intermediates and modulation of amino acid metabolism. In Gpt2-null mice, we observe an early loss of tyrosine hydroxylase (TH)-positive neurons in LC and reduced soma size at postnatal day 18. Gpt2-null LC shows selective positive Fluoro-Jade C staining. Neuron loss is accompanied by selective, prominent microgliosis and astrogliosis in LC. We observe reduced noradrenergic projections to and norepinephrine levels in hippocampus and spinal cord. Whole cell recordings in Gpt2-null LC slices show reduced soma size and abnormal action potentials with altered firing kinetics. Strikingly, we observe early decreases in phosphorylated S6 in Gpt2-null LC, preceding prominent p62 aggregation, increased LC3B-II to LC3B-I ratio, and neuronal loss. These data are consistent with a possible mechanism involving deficiency in protein synthesis and cell growth, associated subsequently with abnormal autophagy and neurodegeneration. As compared to the few genetic animal models with LC degeneration, loss of LC neurons in Gpt2-null mice is developmentally the earliest. Early neuron loss in LC in a model of human neurometabolic disease provides important clues regarding the metabolic vulnerability of LC and may lead to new therapeutic targets.
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Affiliation(s)
- Ozan Baytas
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, USA; Center for Translational Neuroscience, Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, RI 02912, USA; Neuroscience Graduate Program, Brown University, Providence, RI 02912, USA
| | - Julie A Kauer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94035, USA
| | - Eric M Morrow
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, USA; Center for Translational Neuroscience, Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, RI 02912, USA.
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11
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Slater C, Liu Y, Weiss E, Yu K, Wang Q. The Neuromodulatory Role of the Noradrenergic and Cholinergic Systems and Their Interplay in Cognitive Functions: A Focused Review. Brain Sci 2022; 12:890. [PMID: 35884697 PMCID: PMC9320657 DOI: 10.3390/brainsci12070890] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Abstract
The noradrenergic and cholinergic modulation of functionally distinct regions of the brain has become one of the primary organizational principles behind understanding the contribution of each system to the diversity of neural computation in the central nervous system. Decades of work has shown that a diverse family of receptors, stratified across different brain regions, and circuit-specific afferent and efferent projections play a critical role in helping such widespread neuromodulatory systems obtain substantial heterogeneity in neural information processing. This review briefly discusses the anatomical layout of both the noradrenergic and cholinergic systems, as well as the types and distributions of relevant receptors for each system. Previous work characterizing the direct and indirect interaction between these two systems is discussed, especially in the context of higher order cognitive functions such as attention, learning, and the decision-making process. Though a substantial amount of work has been done to characterize the role of each neuromodulator, a cohesive understanding of the region-specific cooperation of these two systems is not yet fully realized. For the field to progress, new experiments will need to be conducted that capitalize on the modular subdivisions of the brain and systematically explore the role of norepinephrine and acetylcholine in each of these subunits and across the full range of receptors expressed in different cell types in these regions.
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Affiliation(s)
- Cody Slater
- Department of Biomedical Engineering, Columbia University, ET 351, 500 W. 120th Street, New York, NY 10027, USA; (C.S.); (Y.L.); (E.W.); (K.Y.)
- Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA
| | - Yuxiang Liu
- Department of Biomedical Engineering, Columbia University, ET 351, 500 W. 120th Street, New York, NY 10027, USA; (C.S.); (Y.L.); (E.W.); (K.Y.)
| | - Evan Weiss
- Department of Biomedical Engineering, Columbia University, ET 351, 500 W. 120th Street, New York, NY 10027, USA; (C.S.); (Y.L.); (E.W.); (K.Y.)
| | - Kunpeng Yu
- Department of Biomedical Engineering, Columbia University, ET 351, 500 W. 120th Street, New York, NY 10027, USA; (C.S.); (Y.L.); (E.W.); (K.Y.)
| | - Qi Wang
- Department of Biomedical Engineering, Columbia University, ET 351, 500 W. 120th Street, New York, NY 10027, USA; (C.S.); (Y.L.); (E.W.); (K.Y.)
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12
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Opioid and Sucrose Craving Are Accompanied by Unique Behavioral and Affective Profiles after Extended Abstinence in Male and Female Rats. eNeuro 2022; 9:ENEURO.0515-21.2022. [PMID: 35241453 PMCID: PMC9007407 DOI: 10.1523/eneuro.0515-21.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 11/21/2022] Open
Abstract
Incubation of craving refers to the intensification of drug-seeking behavior in response to reward-paired cues over the course of abstinence. In rodents, craving and drug-seeking behaviors have been measured by an increase in lever pressing in the absence of reinforcer availability in response to cue presentations. However, craving in rodents is difficult to define and little is known about the behavioral signatures that accompany increased drug-seeking behavior measured by lever pressing. The affective components of relapse are also important, but understudied in rodents. Hormonal fluctuations influence craving for psychostimulants, but little is known about the impact of the estrous cycle on opioid-seeking behavior. This study sought to delineate the behavioral and affective signatures associated with craving, and to examine the influence of the female estrous cycle on craving. Male and female rats underwent 10 d of intravenous opioid self-administration. Separate cohorts of control rats self-administered oral sucrose, a natural nondrug reward. Cue-induced seeking tests were conducted after 1 or 30d of forced abstinence. These sessions were recorded and scored for overall locomotion, instances of sniffing, grooming, or hyperactivity. Ultrasonic vocalizations (USVs) were also recorded to determine affective profiles that accompany opioid seeking. Although active lever presses and overall locomotion increased unanimously over extended abstinence from heroin and sucrose, a sex- and reinforcer-specific behavioral and affective signature of craving emerged. Furthermore, although the female estrous cycle did not affect taking or seeking, it appears to influence more granular behaviors.
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13
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Um YH, Wang SM, Kang DW, Kim NY, Lim HK. Alterations of Resting-State Locus Coeruleus Functional Connectivity After Transdermal Trigeminal Electrical Neuromodulation in Insomnia. Front Psychiatry 2022; 13:875227. [PMID: 35619611 PMCID: PMC9127056 DOI: 10.3389/fpsyt.2022.875227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Transdermal trigeminal electrical neuromodulation (TTEN) is a novel treatment modality that is known for noradrenergic modulation through the trigeminal nerve and locus coeruleus (LC). This study aimed to demonstrate the alterations of LC functional connectivity (FC) in patients with insomnia after a 4-week TTEN. METHODS The Cefaly device targeting the ophthalmic division of the trigeminal nerve was applied to a total of 12 patients with insomnia to monitor for the effects of TTEN. All the patients went through a 4-week daily 20 min TTEN sessions before bedtime. Baseline and post-TTEN demographic data, polysomnography (PSG) parameters, and insomnia severity index (ISI) were attained. Data from pre- and post-intervention resting-state functional magnetic resonance imaging (MRI) were collected. LC FC differences were measured between the pre-and post-TTEN groups through seed-to-voxel analysis. Correlation analyses were conducted between LC FC changes after TTEN, ISI score changes, and PSG parameter changes. RESULTS There was a significantly decreased LC FC with occipital and temporal cortices after a 4-week TTEN. However, there was no significant correlation between LC FC, ISI score changes, and PSG parameter changes. CONCLUSION By targeting hyperarousal symptoms of insomnia, TTEN can be a promising intervention that can modulate LC FC in patients with insomnia patients. The data presented in the study are from a study exploring the effect of TTEN on insomnia (www.clinicaltrials.gov, NCT04838067).
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Li C, Liu Y, Yang N, Lan Z, Huang S, Wu Y, Ma X, Jiang G. Functional Connectivity Disturbances of the Locus Coeruleus in Chronic Insomnia Disorder. Nat Sci Sleep 2022; 14:1341-1350. [PMID: 35942365 PMCID: PMC9356738 DOI: 10.2147/nss.s366234] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In recent years, people have gained a profound understanding of chronic insomnia disorder (CID), but the pathophysiological mechanism of CID is still unclear. There is some evidence that the locus coeruleus (LC) is involved in the regulation of wakefulness in CID, but there have been few studies using brain functional imaging. The purpose of this study was to evaluate the resting-state functional connectivity (FC) between the LC and other brain voxels in CID and whether these abnormal FC are involved in the regulation of wakefulness. METHODS A total of 49 patients with chronic insomnia disorder and 47 healthy controls (HC) matched for gender, age, and education were examined with rs-fMRI in this study. The LC was selected as the region of interest, and then seed-based analysis was conducted on the LC and other voxels to obtain the brain regions with abnormal FC. The correlation between the FC value of the abnormal connection area and the clinical scale score was analyzed. RESULTS Compared with the HC, the FC between the LC and right precuneus, right posterior cingulate cortex, left middle temporal gyrus, left calcarine, and right superior orbitofrontal cortex was significantly enhanced (p < 0.05, FDR correction), and the functional connectivity signal value between the locus coeruleus and left middle temporal gyrus was positively correlated with the Self-Rating Depression Scale (p = 0.021). CONCLUSION The abnormal FC between the LC and multiple brain regions may contribute to a better understanding of the neurobiological mechanism of CID.
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Affiliation(s)
- Chunlong Li
- Department of Medical Imaging, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People' s Republic of China
| | - Yuexia Liu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People' s Republic of China
| | - Ning Yang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Zhihong Lan
- Department of Medical Imaging, Zhuhai City People's Hospital, Zhuhai, People's Republic of China
| | - Shumei Huang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yunfan Wu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Xiaofen Ma
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
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15
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Ueno F, Iwata Y, Nakajima S, Caravaggio F, Rubio JM, Horga G, Cassidy CM, Torres-Carmona E, de Luca V, Tsugawa S, Honda S, Moriguchi S, Noda Y, Gerretsen P, Graff-Guerrero A. Neuromelanin accumulation in patients with schizophrenia: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 132:1205-1213. [PMID: 34718049 PMCID: PMC9059704 DOI: 10.1016/j.neubiorev.2021.10.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022]
Abstract
Although schizophrenia is associated with increased presynaptic dopamine function in the striatum, it remains unclear if neuromelanin levels, which are thought to serve as a biomarker for midbrain dopamine neuron function, are increased in patients with schizophrenia. We conducted a systematic review and meta-analysis of magnetic resonance imaging (MRI) and postmortem studies comparing neuromelanin (NM) levels between patients with schizophrenia and healthy controls (HCs). Standard mean differences were calculated to assess group differences in NM accumulation levels between patients with schizophrenia and HCs. This study included 7 articles in total. Five studies employed NM-sensitive MRI (NM-MRI) and two were postmortem brain studies. The patient group (n = 163) showed higher NM levels in the substantia nigra (SN) than HCs (n = 228) in both the analysis of the seven studies and the subgroup analysis of the 5 NM-MRI studies. This analysis suggest increased NM levels in the SN may be a potential biomarker for stratifying schizophrenia, warranting further research that accounts for the heterogeneity of this disorder.
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Affiliation(s)
- Fumihiko Ueno
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Iwata
- Department of Neuropsychiatry, University of Yamanashi, Faculty of Medicine, Yamanashi, Japan
| | - Shinichiro Nakajima
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
| | - Fernando Caravaggio
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jose M Rubio
- Barbara and Donald Zucker School of Medicine at Hofstra University - Northwell Health, Hempstead, NY, USA; Institute of Behavioral Science, Feinstein Institutes of Medical Research, Manhasset, NY, USA; Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Guillermo Horga
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Translational Imaging, New York State Psychiatric Institute, New York, NY, USA
| | - Clifford M Cassidy
- The Royal's Institute of Mental Health Research Affiliated with the University of Ottawa, Ottawa, Ontario, Canada
| | - Edgardo Torres-Carmona
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Vincenzo de Luca
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada
| | - Sakiko Tsugawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shiori Honda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sho Moriguchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Philip Gerretsen
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada
| | - Ariel Graff-Guerrero
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.
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16
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Büki A, Kekesi G, Horvath G, Vécsei L. A Potential Interface between the Kynurenine Pathway and Autonomic Imbalance in Schizophrenia. Int J Mol Sci 2021; 22:10016. [PMID: 34576179 PMCID: PMC8467675 DOI: 10.3390/ijms221810016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia is a neuropsychiatric disorder characterized by various symptoms including autonomic imbalance. These disturbances involve almost all autonomic functions and might contribute to poor medication compliance, worsened quality of life and increased mortality. Therefore, it has a great importance to find a potential therapeutic solution to improve the autonomic disturbances. The altered level of kynurenines (e.g., kynurenic acid), as tryptophan metabolites, is almost the most consistently found biochemical abnormality in schizophrenia. Kynurenic acid influences different types of receptors, most of them involved in the pathophysiology of schizophrenia. Only few data suggest that kynurenines might have effects on multiple autonomic functions. Publications so far have discussed the implication of kynurenines and the alteration of the autonomic nervous system in schizophrenia independently from each other. Thus, the coupling between them has not yet been addressed in schizophrenia, although their direct common points, potential interfaces indicate the consideration of their interaction. The present review gathers autonomic disturbances, the impaired kynurenine pathway in schizophrenia, and the effects of kynurenine pathway on autonomic functions. In the last part of the review, the potential interaction between the two systems in schizophrenia, and the possible therapeutic options are discussed.
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Affiliation(s)
- Alexandra Büki
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., H-6720 Szeged, Hungary; (A.B.); (G.K.); (G.H.)
| | - Gabriella Kekesi
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., H-6720 Szeged, Hungary; (A.B.); (G.K.); (G.H.)
| | - Gyongyi Horvath
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., H-6720 Szeged, Hungary; (A.B.); (G.K.); (G.H.)
| | - László Vécsei
- Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6., H-6725 Szeged, Hungary
- MTA-SZTE Neuroscience Research Group, H-6725 Szeged, Hungary
- Interdisciplinary Excellence Center, Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6., H-6725 Szeged, Hungary
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Abstract
BACKGROUND Prazosin has been an accepted treatment for patients with post-traumatic stress disorder (PTSD) who experience sleep disturbances, including nightmares. Results of a recent large randomized control trial did not find benefit of prazosin vs placebo in improving such outcomes. A meta-analysis that includes this most recent trial was conducted to examine the pooled effect of prazosin vs placebo on sleep disturbances and overall PTSD symptoms in patients with PTSD. METHODS A systematic review of the published literature on trials comparing prazosin vs placebo for improvement of overall PTSD scores, nightmares, and sleep quality was conducted. Hedges' g standardized mean differences (SMD) between prazosin and placebo were calculated for each outcome across studies. RESULTS Six randomized placebo-controlled studies representing 429 patients were included in the analysis, including two studies with a crossover design. Results showed prazosin significantly improved overall PTSD scores (SMD = -0.31; 95% confidence intervals [CI]: -0.62, -0.01), nightmares (SMD = -0.75; 95% CI: -1.24, -0.27), and sleep quality (SMD = -0.57; 95% CI: -1.02, -0.13). In the largest trial, prazosin showed a reduction in clinical outcome measures similar to past studies, but a relatively large placebo effect size, particularly for nightmares, contributed to no treatment differences. CONCLUSIONS Despite the results of a recent, large randomized study, pooled effect estimates show that prazosin has a statistically significant benefit on PTSD symptoms and sleep disturbances. Limitations that should be considered include heterogeneity of study design and study populations as well as the small number of studies conducted and included in this meta-analysis.
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18
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Hasebe H, Shinba T. Decreased anxiety after catheter ablation for paroxysmal atrial fibrillation is associated with augmented parasympathetic reactivity to stress. Heart Rhythm O2 2021; 1:189-199. [PMID: 34113873 PMCID: PMC8183861 DOI: 10.1016/j.hroo.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Psychological improvement after catheter ablation for atrial fibrillation (AF) has been reported, but its mechanism is unclear. Objective This study aimed to clarify the relationship between cardiac autonomic modification and psychological changes after catheter ablation for paroxysmal AF (PAF). Methods Thirty-five consecutive patients (60.5 ± 11.9 years; male, n = 24) with PAF treated by catheter ablation were enrolled. Autonomic activity and reactivity to stress and psychological status were measured before (baseline) and at 1 and 3 months after ablation. We assessed autonomic activity and reactivity to stress by measuring heart rate variability (HRV) at rest (Rest), and during (Task) and after (After) the execution of a task and assessed relationships between HRV parameters and psychological changes using the State-Trait Anxiety Inventory (STAI) and Self-Rating Depression Scale (SDS). Results The STAI state and trait scores significantly decreased at 3 months compared with baseline, whereas SDS scores essentially remained unchanged. The high-frequency (HF) response index (Task/Rest) and HF recovery index (After/Rest) were significantly higher than baseline at 3 months (0.40 [0.29–0.90] vs 1.30 [0.64–2.18], P = .007 for HF response index; 1.13 [0.92–2.19] vs 1.87 [1.19–2.97], P = .049 for HF recovery index). Reductions in STAI scores positively correlated with increments in the HF recovery index in the entire cohort as well as in 5 patients with recurrent AF. Conclusions Some augmentation of parasympathetic reactivity to stress correlated with reduced anxiety, implying that cardiac autonomic modification plays roles in psychological improvement after catheter ablation for AF.
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Affiliation(s)
- Hideyuki Hasebe
- Department of Arrhythmology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
| | - Toshikazu Shinba
- Department of Psychiatry, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
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19
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Bell E, Boyce P, Porter RJ, Bryant RA, Malhi GS. Irritability in Mood Disorders: Neurobiological Underpinnings and Implications for Pharmacological Intervention. CNS Drugs 2021; 35:619-641. [PMID: 34019255 DOI: 10.1007/s40263-021-00823-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 12/28/2022]
Abstract
Feeling irritable is a common experience, both in health and disease. In the context of psychiatric illnesses, it is a transdiagnostic phenomenon that features across all ages, and often causes significant distress and impairment. In mood disorders, irritability is near ubiquitous and plays a central role in diagnosis and yet, despite its prevalence, it remains poorly understood. A neurobiological model of irritability posits that, in children and adolescents, it is consequent upon deficits in reward and threat processing, involving regions such as the amygdala and frontal cortices. In comparison, in adults with mood disorders, the few studies that have been conducted implicate the amygdala, orbitofrontal cortices, and hypothalamus; however, the patterns of activity in these areas are at variance with the findings in youth. These age-related differences seem to extend to the neurochemistry of irritability, with links between increased monoamine transmission and irritability evident in adults, but aberrant levels of, and responses to, dopamine in youth. Presently, there are no specific treatments that have significant efficacy in reducing irritability in mood disorders. However, treatments that hold some potential and warrant further exploration include agents that act on serotonergic and dopaminergic systems, especially as irritability may serve as a prognostic indicator for overall clinical responsiveness to specific medications. Therefore, for understanding and treatment of irritability to advance meaningfully, it is imperative that an accurate definition and means of measuring irritability are developed. To achieve this, it is necessary that the subjective experience of irritability, both in health and illness, is better understood. These insights will inform an accurate, comprehensive, and valid interrogation of the qualities of irritability in health and illness, and allow not only a clinical appreciation of the phenomenon, but also a deeper understanding of its important role within the development and manifestation of mood disorders.
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Affiliation(s)
- Erica Bell
- Department of Psychiatry, Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.
- Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia.
- Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Level 3, Main Hospital Building, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia.
| | - Phil Boyce
- Department of Psychiatry, Westmead Hospital and the Westmead Clinical School, Wentworthville, NSW, 2145, Australia
- Discipline of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Gin S Malhi
- Department of Psychiatry, Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
- Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia
- Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Level 3, Main Hospital Building, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia
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20
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Perez-Tejada J, Labaka A, Vegas O, Larraioz A, Pescador A, Arregi A. Anxiety and depression after breast cancer: The predictive role of monoamine levels. Eur J Oncol Nurs 2021; 52:101953. [PMID: 33813184 DOI: 10.1016/j.ejon.2021.101953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Despite the fact that the prevalence of anxiety and depression in breast cancer survivors is higher than in the general female population, the psychobiological substrate of this phenomenon has yet to be elucidated. We aimed to examine the predictive role of peripheral dopamine (DA), noradrenaline (NA), serotonin (5-HT) and kynurenine (KYN) in anxiety and depression among breast cancer survivors. METHOD We evaluated 107 women using the Hospital Anxiety and Depression Scale, and monoamine levels were analyzed via high-performance liquid chromatography. RESULTS High KYN levels predicted both disorders, while low NA and DA predicted anxiety and depressive symptoms, respectively. A negative conditional effect of 5-HT was found for anxiety and depression among younger women only, while being both middle-aged and younger influenced the negative conditional effect of DA on depression. CONCLUSION Monoamine variations may render breast cancer survivors more vulnerable to anxiety and depression, with young women being especially vulnerable to the detrimental effect of low DA and 5-HT. Assessing subclinical psychobiological markers allows mental health nurses to identify vulnerable survivors prior to the onset of anxiety and depression, and to adjust nursing interventions accordingly.
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Affiliation(s)
- Joana Perez-Tejada
- Oncologic Center (Onkologikoa), 121 Begiristain, 20014, San Sebastian, Spain.
| | - Ainitze Labaka
- Department of Nursing II, University of the Basque Country, 105 Begiristain, 20014, San Sebastian, Spain.
| | - Oscar Vegas
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, 70 Tolosa Av., 20018, San Sebastian, Spain.
| | - Aitziber Larraioz
- Oncologic Center (Onkologikoa), 121 Begiristain, 20014, San Sebastian, Spain.
| | - Ane Pescador
- Oncologic Center (Onkologikoa), 121 Begiristain, 20014, San Sebastian, Spain.
| | - Amaia Arregi
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, 70 Tolosa Av., 20018, San Sebastian, Spain.
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21
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Cao SX, Wen CX, Sun R, Han JX, Sun YH, Xu XX, Li XM, Lian H. ErbB4 regulate extracellular dopamine through the p38 MAPK signaling pathway. Neurosci Lett 2021; 751:135830. [PMID: 33722543 DOI: 10.1016/j.neulet.2021.135830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
ErbB4 loss-of-function in catecholaminergic neurons induces catecholamine dyshomeostasis. Despite ErbB4's significant role in neuropathology, the signaling pathways that regulate these changes are still widely unknown. In this study, we attempt to identify the downstream pathway of ErbB4 that regulates catecholamine homeostasis. The SH-SY5Y human neuroblastoma cell line was used as the in vitro model for catecholaminergic neurons. Western blotting, enzyme-linked immunosorbent assay, and pharmacological and genetic manipulations by agonist/antagonist or small interference RNA were used to investigate the relationship between ErbB4 and extracellular catecholamines. We confirmed that ErbB4 is abundantly expressed in undifferentiated and retinoic acid-differentiated catecholaminergic cells from the SH-SY5Y cell line. ErbB4 inhibition increase the ratio of phosphorylated p38 to total p38 in SH-SY5Y human neuroblastoma cells. Consistent with previous in vivo observations in mice, ErbB4 deficiency led to increases in extracellular dopamine and norepinephrine levels. However, the resulting increase in extracellular dopamine, but not norepinephrine, could be suppressed by p38 inhibitor SB202190. Our results suggest that both extracellular dopamine and norepinephrine homeostasis could be regulated by ErbB4 in human catecholaminergic cells, and ErbB4 may regulate extracellular dopamine, but not norepinephrine, through the p38 MAPK signaling pathway, thus indicating different regulatory pathways of dopamine and norepinephrine by ErbB4 in catecholaminergic neurons.
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Affiliation(s)
- Shu-Xia Cao
- Department of Neurology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China; NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China
| | - Chen-Xi Wen
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China; Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Rui Sun
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China; Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jia-Xuan Han
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China; Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yan-Hui Sun
- Department of Neurology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China; NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xin-Xin Xu
- Department of Neurology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Xiao-Ming Li
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China; Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Hong Lian
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China; Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
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22
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Bell E, Bryant RA, Boyce P, Porter RJ, Malhi GS. Irritability through Research Domain Criteria: an opportunity for transdiagnostic conceptualisation. BJPsych Open 2021; 7:e36. [PMID: 33461648 PMCID: PMC8058909 DOI: 10.1192/bjo.2020.168] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Irritability is a transdiagnostic phenomenon that, despite its ubiquity and significant impact, is poorly conceptualised, defined and measured. As it lacks specificity, efforts to examine irritability in adults by using a diagnostic category perspective have been hamstrung. Therefore, using a Research Domain Criteria (RDoC) approach to examine irritability in adults, which spans many constructs and domains, may have a better chance of yielding underlying mechanisms that can then be mapped onto various diagnostic categories. Recently, a model has been proposed for irritability in children and adolescents that uses the RDoC framework; however, this model, which accounts for chronic, persistent irritability, may not necessarily transpose to adults. Therefore, use of the RDoC framework to examine irritability in adults is urgently needed, as it may shed light on this currently amorphous phenomenon and the many disorders within which it operates.
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Affiliation(s)
- Erica Bell
- Faculty of Medicine and Health, University of Sydney, Australia
| | | | - Philip Boyce
- Discipline of Psychiatry, Sydney Medical School, Westmead Clinical School, University of Sydney, Australia; and Perinatal Psychiatry Clinical Research Unit, Westmead Hospital, Australia
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Gin S Malhi
- Department of Psychiatry, University of Sydney, Australia
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23
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Zwas DR, Keren A, Amir O, Gotsman I. Treatment of Heart Failure Patients with Anxiolytics Is Associated with Adverse Outcomes, with and without Depression. J Clin Med 2020; 9:jcm9123967. [PMID: 33297471 PMCID: PMC7762354 DOI: 10.3390/jcm9123967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/26/2020] [Accepted: 12/03/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Few studies have evaluated the effect of pharmacologic treatment of anxiety on outcomes in heart failure (HF) patients. This study examined the impact of treatment with anxiolytics on clinical outcomes in a real-world sample of HF patients with and without depression. METHODS Patients diagnosed with HF were retrieved from a large HMO database. Patients prescribed anxiolytic medication and patients diagnosed with depression and/or prescribed anti-depressant medication were followed for cardiac-related hospitalizations and death. RESULTS The study cohort included 6293 HF patients. Treatment with anxiolytics was associated with decreased one-year survival compared to untreated individuals, with a greater reduction in survival seen in patients diagnosed with depression and/or treated with anti-depressants. Multi-variable analysis adjusting for age, sex, NYHA class, cardiac risk factors and laboratory parameters found that treatment with anxiolytics remained a predictor of mortality even when adjusting for depression. Depression combined with anxiolytic treatment was predictive of increased mortality, and treatment with anxiolytics alone, depression alone and anxiolytic treatment together with depression were each associated with an increased hazard ratio for a composite outcome of death and hospitalization. CONCLUSIONS In this real-world study of HF patients, both treatment with anxiolytics and depression were associated with increased mortality, and anxiolytic therapy remained a predictor of mortality when adjusting for depression. Treatment of anxiety together with depression was associated with the highest risk of mortality. Safe and effective treatment for anxiety and depression is warranted to alleviate the detrimental impact of these disorders on quality and of life and adverse events.
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Affiliation(s)
- Donna R. Zwas
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
- Correspondence: ; Tel.: +972-2-6776564; Fax: +972-2- 6411028
| | - Andre Keren
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
| | - Offer Amir
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
| | - Israel Gotsman
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
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24
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Mäki-Marttunen V, Andreassen OA, Espeseth T. The role of norepinephrine in the pathophysiology of schizophrenia. Neurosci Biobehav Rev 2020; 118:298-314. [PMID: 32768486 DOI: 10.1016/j.neubiorev.2020.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022]
Abstract
Several lines of evidence have suggested for decades a role for norepinephrine (NE) in the pathophysiology and treatment of schizophrenia. Recent experimental findings reveal anatomical and physiological properties of the locus coeruleus-norepinephrine (LC-NE) system and its involvement in brain function and cognition. Here, we integrate these two lines of evidence. First, we review the functional and structural properties of the LC-NE system and its impact on functional brain networks, cognition, and stress, with special emphasis on recent experimental and theoretical advances. Subsequently, we present an update about the role of LC-associated functions for the pathophysiology of schizophrenia, focusing on the cognitive and motivational deficits. We propose that schizophrenia phenomenology, in particular cognitive symptoms, may be explained by an abnormal interaction between genetic susceptibility and stress-initiated LC-NE dysfunction. This in turn, leads to imbalance between LC activity modes, dysfunctional regulation of brain network integration and neural gain, and deficits in cognitive functions. Finally, we suggest how recent development of experimental approaches can be used to characterize LC function in schizophrenia.
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Affiliation(s)
| | - Ole A Andreassen
- CoE NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Building 49, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway
| | - Thomas Espeseth
- Department of Psychology, University of Oslo, Postboks 1094, Blindern, 0317 Oslo, Norway; Bjørknes College, Lovisenberggata 13, 0456 Oslo, Norway
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25
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D'Alessio L, Korman GP, Sarudiansky M, Guelman LR, Scévola L, Pastore A, Obregón A, Roldán EJA. Reducing Allostatic Load in Depression and Anxiety Disorders: Physical Activity and Yoga Practice as Add-On Therapies. Front Psychiatry 2020; 11:501. [PMID: 32581876 PMCID: PMC7287161 DOI: 10.3389/fpsyt.2020.00501] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/18/2020] [Indexed: 12/23/2022] Open
Abstract
The allostatic load (AL) index constitutes a useful tool to objectively assess the biological aspects of chronic stress in clinical practice. AL index has been positively correlated with cumulative chronic stress (physical and psychosocial stressors) and with a high risk to develop pathological conditions (e.g., metabolic syndrome, cardiovascular pathology, inflammatory disorders) and the so-called stress-related psychiatric disorders, including anxiety and depressive disorders. Chronic stress has negative effects on brain neuroplasticity, especially on hippocampal neurogenesis and these effects may be reversed by antidepressant treatments. Several evidences indicate that non-pharmacological interventions based on physical activity and yoga practice may add synergizing benefits to classical treatments (antidepressant and benzodiazepines) for depression and anxiety, reducing the negative effects of chronic stress. The aim of this review is to provide a general overview of current knowledge on AL and chronic stress in relation to depression and anxiety, physical activity and yoga practice.
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Affiliation(s)
- Luciana D'Alessio
- Universidad de Buenos Aires, Facultad de Medicina, IBCN-CONICET, Buenos Aires, Argentina
- Universidad de Buenos Aires, Hospital Ramos Mejía, Buenos Aires, Argentina
| | - Guido Pablo Korman
- Universidad de Buenos Aires, Facultad de Psicología, CAEA-CONICET, Buenos Aires, Argentina
| | - Mercedes Sarudiansky
- Universidad de Buenos Aires, Facultad de Psicología, CAEA-CONICET, Buenos Aires, Argentina
| | - Laura Ruth Guelman
- Universidad de Buenos Aires, Facultad de Medicina, CEFYBO-CONICET, Buenos Aires, Argentina
| | - Laura Scévola
- Universidad de Buenos Aires, Hospital Ramos Mejía, Buenos Aires, Argentina
| | | | - Amilcar Obregón
- Dirección Médica y Científica, Gador SA, Buenos Aires, Argentina
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26
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Abstract
Research into irritability has focused largely on its developmental and child-adolescent manifestations. Although irritability appears to be as elemental an experience as anxiety or depression, diagnoses highlighting irritability as the focal ingredient have yet to be delineated for adults. Instead, irritability-related diagnoses in adults have largely emphasized externalizing behaviors, depressed mood, and personality. Consequently, patients complaining of irritability are sometimes shoehorned into diagnostic categories that they do not experience as authentic representations of their lived experiences. This article proposes that the symptom of irritability might be productively reenvisioned as a focal point, analogous to anxiety and depression, around which irritability-related syndromes and disorders in adults might coalesce. If anxiety, depressive, insomnia, and pain disorders, why not irritability disorders? Both state and trait characteristics of irritability can lend themselves to DSM diagnostic frames. Based on clinical observations, specific irritability disorders in adults can be envisioned, modeled as Irritability Disorder of Adulthood, Irritability Disorder Secondary to Another Medical Condition, Substance-Induced Irritability Disorder, Adjustment Disorder With Irritable Mood, and the like. Further delineation of irritability phenomena, syndromes, and possible disorders in adults is warranted to advance investigation, guide assessment, and improve treatment.
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Affiliation(s)
- Joel Yager
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
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27
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Jalles C, Chendo I, Levy P, Reimão S. Neuromelanin changes in first episode psychosis with substance abuse. Schizophr Res 2020; 220:283-284. [PMID: 32253077 DOI: 10.1016/j.schres.2020.03.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/14/2020] [Accepted: 03/18/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Constança Jalles
- Faculty of Medicine, University of Lisbon, Portugal; Clinical Pharmachology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
| | - Inês Chendo
- Clinical Pharmachology Unit, Instituto de Medicina Molecular, Lisbon, Portugal; Psychiatry Department, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal; Psychiatry University Clinic, Faculty of Medicine, University of Lisbon, Portugal
| | - Pedro Levy
- Psychiatry Department, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal
| | - Sofia Reimão
- Clinical Pharmachology Unit, Instituto de Medicina Molecular, Lisbon, Portugal; Imaging University Clinic, Faculty of Medicine, University of Lisbon, Portugal; Neurological Imaging Department, Hospital Santa Maria, Lisbon, Portugal
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28
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Brehl AK, Kohn N, Schene AH, Fernández G. A mechanistic model for individualised treatment of anxiety disorders based on predictive neural biomarkers. Psychol Med 2020; 50:727-736. [PMID: 32204741 PMCID: PMC7168651 DOI: 10.1017/s0033291720000410] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/09/2019] [Accepted: 02/09/2020] [Indexed: 12/29/2022]
Abstract
Increased amygdala responsiveness is the hallmark of fear and a characteristic across patients with anxiety disorders. The amygdala is embedded in a complex regulatory circuit. Multiple different mechanisms may elevate amygdala responsiveness and lead to the occurrence of an anxiety disorder. While top-down control by the prefrontal cortex (PFC) downregulates amygdala responses, the locus coeruleus (LC) drives up amygdala activation via noradrenergic projections. This indicates that the same fearful phenotype may result from different neural mechanisms. We propose a mechanistic model that defines three different neural biomarkers causing amygdala hyper-responsiveness in patients with anxiety disorders: (a) inherent amygdala hypersensitivity, (b) low prefrontal control and (c) high LC drive. First-line treatment for anxiety disorders is exposure-based cognitive behavioural therapy, which strengthens PFC recruitment during emotion regulation and thus targets low-prefrontal control. A treatment response rate around 50% (Loerinc et al., 2015, Clinical Psychological Reviews, 42, 72-82) might indicate heterogeneity of underlying neurobiological mechanisms among patients, presumably leading to high variation in treatment benefit. Transforming insights from cognitive neuroscience into applicable clinical heuristics to categorise patients based on their underlying biomarker may support individualised treatment selection in psychiatry. We review literature on the three anxiety-related mechanisms and present a mechanistic model that may serve as a rational for pathology-based diagnostic and biomarker-guided treatment selection in psychiatry.
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Affiliation(s)
- Anne-Kathrin Brehl
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
| | - Nils Kohn
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
| | | | - Guillen Fernández
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
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29
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Abstract
Interest in the coexistence of manic and depressive symptoms fostered hypotheses on neurobiological underpinnings of mixed states. Neurobiological properties of mixed states, however, have not been comprehensively described. The authors searched databases for articles on neurobiological markers related to mixed states. Results showed that mixed states are characterized by elevated central and peripheral monoamine levels, greater alterations in hypothalamic-pituitary-adrenal axis, increased inflammation, and greater circadian rhythms dysfunction than nonmixed forms. Furthermore, the magnitude of pathophysiologic alterations in mixed states exceeds those associated with nonmixed mania or depression and suggest that hyperactivation and hyperarousal are core features of mixed states.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Centro Lucio Bini, Rome, Italy.
| | - Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Alan C Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA
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30
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Kalinichenko LS, Kornhuber J, Müller CP. Individual differences in inflammatory and oxidative mechanisms of stress-related mood disorders. Front Neuroendocrinol 2019; 55:100783. [PMID: 31415777 DOI: 10.1016/j.yfrne.2019.100783] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 12/16/2022]
Abstract
Emotional stress leads to the development of peripheral disorders and is recognized as a modifiable risk factor for psychiatric disorders, particularly depression and anxiety. However, not all individuals develop the negative consequences of emotional stress due to different stress coping strategies and resilience to stressful stimuli. In this review, we discuss individual differences in coping styles and the potential mechanisms that contribute to individual vulnerability to stress, such as parameters of the immune system and oxidative state. Initial differences in inflammatory and oxidative processes determine resistance to stress and stress-related disorders via the alteration of neurotransmitter content in the brain and biological fluids. Differences in coping styles may serve as possible predictors of resistance to stress and stress-related disorders, even before stressful conditions. The investigation of natural variabilities in stress resilience may allow the development of new methods for preventive medicine and the personalized treatment of stress-related conditions.
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Affiliation(s)
- L S Kalinichenko
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany.
| | - J Kornhuber
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany
| | - C P Müller
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany
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31
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Kalinichenko LS, Hammad L, Reichel M, Kohl Z, Gulbins E, Kornhuber J, Müller CP. Acid sphingomyelinase controls dopamine activity and responses to appetitive stimuli in mice. Brain Res Bull 2019; 146:310-319. [DOI: 10.1016/j.brainresbull.2019.01.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/18/2019] [Accepted: 01/29/2019] [Indexed: 12/16/2022]
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32
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Amin MR, Faghih RT. Sparse Deconvolution of Electrodermal Activity via Continuous-Time System Identification. IEEE Trans Biomed Eng 2019; 66:2585-2595. [PMID: 30629490 DOI: 10.1109/tbme.2019.2892352] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Electrodermal activity (EDA) indicates different eccrine sweat gland activity caused by the stimulation of the autonomic nervous system. Recovering the number, timings, and amplitudes of underlying neural stimuli and physiological system parameters from the EDA is a challenging problem. One of the challenges with the existing methods is the non-convexity of the optimization formulations for estimating the parameters given the stimuli. METHODS We solve this parameter estimation problem using the following continuous-time system identification framework: 1) we specifically use the Hartley modulating function (HMF) for parameter estimation so that the optimization formulation for estimating the parameters given the stimuli is convex; and 2) we use Kaiser windows with different shape parameters to put more emphasis on the significant spectral components so that there is a balance between filtering out the noise and capturing the data. We apply this algorithm to skin conductance (SC) data, a measure of EDA, collected during cognitive stress experiments. RESULTS Under a sparsity constraint, in the HMF domain, we successfully deconvolve the SC signal. We obtain number, timings, and amplitudes of the underlying neural stimuli along with the system parameters with R2 above 0.915. Moreover, using simulated data, we illustrate that our approach outperforms the existing EDA data analysis methods, in recovering underlying stimuli. CONCLUSION We develop a novel approach for deconvolution of SC by employing the HMF method and capturing the significant spectral components of SC data. SIGNIFICANCE Recovering the underlying neural stimuli more accurately using this approach will potentially improve tracking emotional states in affective computing.
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33
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Muladore E, Brown JA, Haefner J, Kupferschmid B. Improving patient education about tobacco withdrawal and nicotine gum use by registered nurses in inpatient psychiatry: A feasibility study. J Psychiatr Ment Health Nurs 2018; 25:496-505. [PMID: 30129262 DOI: 10.1111/jpm.12495] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/03/2018] [Accepted: 08/17/2018] [Indexed: 11/26/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Many psychiatric inpatients use tobacco, but most psychiatric hospital units prohibit tobacco use. Psychiatric nurses do not receive adequate education about how to teach patients to best manage tobacco withdrawal symptoms. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Psychiatric nurses who receive a brief educational intervention about tobacco withdrawal symptoms and best practices for using nicotine gum may be more prepared to teach patients about these topics. In turn, patients may use nicotine gum more often during their hospitalization, leading to improved outcomes for them as well as for staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A simple educational intervention aimed at psychiatric nurses can result in positive outcomes for psychiatric inpatients who use tobacco. Patients who have a positive experience with stopping tobacco use while hospitalized may be more likely to commit to lifelong tobacco cessation afterwards. The results of this feasibility study demonstrate that additional research that builds on the work presented here is warranted. ABSTRACT Introduction Tobacco use is prohibited in most psychiatric facilities in the United States, yet many psychiatric inpatients are tobacco users. Psychiatric nurses have reported inadequate education about best practices for managing tobacco dependence. Aim To explore the feasibility of an educational intervention for psychiatric nurses designed to improve their ability to educate patients about best practices for managing tobacco dependence, as well as effective use of nicotine gum. Method Fourteen nurses on a psychiatric inpatient unit at a community hospital were educated about the targeted topics. Chart reviews of nonequivalent pre-intervention and post-intervention patient groups were conducted to explore the outcomes of the intervention. Results Patients received more teaching, and used nicotine gum more often, following the intervention. However, no statistically significant differences between the pre-intervention and post-intervention patient groups were found. Discussion Educating nurses about best practices for managing tobacco withdrawal symptoms may have positive outcomes. Existing research suggests that such interventions may be most effective when support and structure are provided to ensure long-term practice changes. Implications for practice This feasibility study demonstrates that a brief nurse education intervention has the potential to improve the experience of tobacco withdrawal for psychiatric inpatients. Future research that expands upon the current project is warranted.
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34
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Soria CA, Remedi C, D’Alessio L, Roldán EJA. Sex and Age-Related Differences in Neuroticism and Allostatic Load Index in Urban Patients with General Anxiety Disorder Treated with Alprazolam. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojpsych.2018.83019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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35
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Shah S, Kim JP, Park DY, Kim H, Yuen LD, Do D, Dell'Osso B, Hooshmand F, Miller S, Wang PW, Ketter TA. Lifetime anxiety disorder and current anxiety symptoms associated with hastened depressive recurrence in bipolar disorder. J Affect Disord 2017; 219:165-171. [PMID: 28558363 DOI: 10.1016/j.jad.2017.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/28/2017] [Accepted: 05/06/2017] [Indexed: 11/30/2022]
Abstract
AIMS To assess differential relationships between lifetime anxiety disorder/current anxiety symptoms and longitudinal depressive severity in bipolar disorder (BD). METHODS Stanford BD Clinic outpatients enrolled during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation and followed with the STEP-BD Clinical Monitoring Form while receiving naturalistic treatment for up to two years. Baseline unfavorable illness characteristics/current mood symptoms and times to depressive recurrence/recovery were compared in patients with versus without lifetime anxiety disorder/current anxiety symptoms. RESULTS Among 105 currently recovered patients, lifetime anxiety disorder was significantly associated with 10/27 (37.0%) demographic/other unfavorable illness characteristics/current mood symptoms/current psychotropics, hastened depressive recurrence (driven by earlier onset age), and a significantly (> two-fold) higher Kaplan-Meier estimated depressive recurrence rate, whereas current anxiety symptoms were significantly associated with 10/27 (37.0%) demographic/other unfavorable illness characteristics/current mood symptoms/current psychotropics and hastened depressive recurrence (driven by lifetime anxiety disorder), but only a numerically higher Kaplan-Meier estimated depressive recurrence rate. In contrast, among 153 currently depressed patients, lifetime anxiety disorder/current anxiety symptoms were not significantly associated with time to depressive recovery or depressive recovery rate. LIMITATIONS American tertiary BD clinic referral sample, open naturalistic treatment. CONCLUSIONS Research is needed regarding differential relationships between lifetime anxiety disorder and current anxiety symptoms and hastened/delayed depressive recurrence/recovery - specifically whether lifetime anxiety disorder versus current anxiety symptoms has marginally more robust association with hastened depressive recurrence, and whether both have marginally more robust associations with hastened depressive recurrence versus delayed depressive recovery, and related clinical implications.
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Affiliation(s)
- Saloni Shah
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Jane P Kim
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Dong Yeon Park
- Department of Psychiatry, Seoul National Hospital, Seoul, South Korea
| | - Hyun Kim
- Department of Psychiatry, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, South Korea
| | - Laura D Yuen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Dennis Do
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Bernardo Dell'Osso
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Psychiatry, University of Milan; Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Farnaz Hooshmand
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Shefali Miller
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Po W Wang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
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Nikolaus S, Müller HW, Hautzel H. Different patterns of 5-HT receptor and transporter dysfunction in neuropsychiatric disorders--a comparative analysis of in vivo imaging findings. Rev Neurosci 2016; 27:27-59. [PMID: 26376220 DOI: 10.1515/revneuro-2015-0014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 08/05/2015] [Indexed: 11/15/2022]
Abstract
Impairment of serotonin receptor and transporter function is increasingly recognized to play a major role in the pathophysiology of neuropsychiatric diseases including anxiety disorder (AD), major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ). We conducted a PubMed search, which provided a total of 136 in vivo studies with PET and SPECT, in which 5-HT synthesis, 5-HT transporter binding, 5-HT1 receptor binding or 5-HT2 receptor binding in patients with the primary diagnosis of acute AD, MDD, BD or SZ was compared to healthy individuals. A retrospective analysis revealed that AD, MDD, BD and SZ differed as to affected brain region(s), affected synaptic constituent(s) and extent as well as direction of dysfunction in terms of either sensitization or desensitization of transporter and receptor binding sites.
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Martínez L, Prada E, Satler C, Tavares MCH, Tomaz C. Executive Dysfunctions: The Role in Attention Deficit Hyperactivity and Post-traumatic Stress Neuropsychiatric Disorders. Front Psychol 2016; 7:1230. [PMID: 27602003 PMCID: PMC4993788 DOI: 10.3389/fpsyg.2016.01230] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/02/2016] [Indexed: 11/13/2022] Open
Abstract
Executive functions (EFs) is an umbrella term for various cognitive processes controlled by a complex neural activity, which allow the production of different types of behaviors seeking to achieve specific objectives, one of them being inhibitory control. There is a wide consensus that clinical and behavioral alterations associated with EF, such as inhibitory control, are present in various neuropsychiatric disorders. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and the psychopathological processes associated with attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). A revision on the role of frontal-subcortical neural circuits and their presumable abnormal functioning and the high frequency of neuropsychiatric symptoms could explain the difficulties with putting effector mechanisms into action, giving individuals the necessary tools to act efficiently in their environment. Although, neuronal substrate data about ADHD and PTSD has been reported in the literature, it is isolated. Therefore, this review highlights the overlapping of neural substrates in the symptomatology of ADHD and PTSD disorders concerning EFs, especially in the inhibitory component. Thus, the changes related to impaired EF that accompany disorders like ADHD and PTSD could be explained by disturbances that have a direct or indirect impact on the functioning of these loops. Initially, the theoretical model of EF according to current neuropsychology will be presented, focusing on the inhibitory component. In a second stage, this component will be analyzed for each of the disorders of interest, considering the clinical aspects, the etiology and the neurobiological basis. Additionally, commonalities between the two neuropsychiatric conditions will be taken into consideration from the perspectives of cognitive and emotional inhibition. Finally, the implications and future prospects for research and interventions in the area will be outlined, with the intention of contributing scientific reference information that encompasses the knowledge and understanding of executive dysfunction and its relationship with these treated disorders.
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Affiliation(s)
- Lía Martínez
- Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of Brasilia Brasilia, Brazil
| | - Edward Prada
- Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of BrasiliaBrasilia, Brazil; Faculty of Psychology, Social Sciences Department, Universidad Pontificia Bolivariana Seccional BucaramangaBucaramanga, Colombia
| | - Corina Satler
- Faculty of Ceilandia, University of Brasilia Brasilia, Brazil
| | - Maria C H Tavares
- Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of Brasilia Brasilia, Brazil
| | - Carlos Tomaz
- Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of BrasiliaBrasilia, Brazil; Neuroscience Research Program, University CEUMASão Luis, Brazil
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Yuen LD, Miller S, Wang PW, Hooshmand F, Holtzman JN, Goffin KC, Shah S, Ketter TA. Current irritability robustly related to current and prior anxiety in bipolar disorder. J Psychiatr Res 2016; 79:101-107. [PMID: 27218815 DOI: 10.1016/j.jpsychires.2016.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Although current irritability and current/prior anxiety have been associated in unipolar depression, these relationships are less well understood in bipolar disorder (BD). We investigated relationships between current irritability and current/prior anxiety as well as other current emotions and BD illness characteristics. METHODS Outpatients referred to the Stanford Bipolar Disorders Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Prevalence and clinical correlates of current irritability and current/prior anxiety and other illness characteristics were examined. RESULTS Among 497 BD outpatients (239 Type I, 258 Type II; 58.1% female; mean ± SD age 35.6 ± 13.1 years), 301 (60.6%) had baseline current irritability. Patients with versus without current irritability had significantly higher rates of current anxiety (77.1% versus 42.9%, p < 0.0001) and history of anxiety disorder (73.1% versus 52.6%, p < 0.0001). Current irritability was more robustly related to current anxiety than to current anhedonia, sadness, or euphoria (all p < 0.001), and current irritability-current anxiety associations persisted across current predominant mood states. Current irritability was more robustly related to past anxiety than to all other assessed illness characteristics, including 1° family history of mood disorder, history of alcohol/substance use disorder, bipolar subtype, and current syndromal/subsyndromal depression (all p < 0.05). LIMITATIONS Limited generalizability beyond our predominately white, female, educated, insured American BD specialty clinic sample. CONCLUSIONS In BD, current irritability was robustly related to current/prior anxiety. Further studies are warranted to assess longitudinal clinical implications of relationships between irritability and anxiety in BD.
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Affiliation(s)
- Laura D Yuen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Shefali Miller
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Po W Wang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Farnaz Hooshmand
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Jessica N Holtzman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Kathryn C Goffin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Saloni Shah
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
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Abstract
Fear memory is the best-studied form of memory. It was thoroughly investigated in the past 60 years mostly using two classical conditioning procedures (contextual fear conditioning and fear conditioning to a tone) and one instrumental procedure (one-trial inhibitory avoidance). Fear memory is formed in the hippocampus (contextual conditioning and inhibitory avoidance), in the basolateral amygdala (inhibitory avoidance), and in the lateral amygdala (conditioning to a tone). The circuitry involves, in addition, the pre- and infralimbic ventromedial prefrontal cortex, the central amygdala subnuclei, and the dentate gyrus. Fear learning models, notably inhibitory avoidance, have also been very useful for the analysis of the biochemical mechanisms of memory consolidation as a whole. These studies have capitalized on in vitro observations on long-term potentiation and other kinds of plasticity. The effect of a very large number of drugs on fear learning has been intensively studied, often as a prelude to the investigation of effects on anxiety. The extinction of fear learning involves to an extent a reversal of the flow of information in the mentioned structures and is used in the therapy of posttraumatic stress disorder and fear memories in general.
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Affiliation(s)
- Ivan Izquierdo
- National Institute of Translational Neuroscience, National Research Council of Brazil, and Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cristiane R. G. Furini
- National Institute of Translational Neuroscience, National Research Council of Brazil, and Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jociane C. Myskiw
- National Institute of Translational Neuroscience, National Research Council of Brazil, and Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Feinstein DL, Kalinin S, Braun D. Causes, consequences, and cures for neuroinflammation mediated via the locus coeruleus: noradrenergic signaling system. J Neurochem 2016; 139 Suppl 2:154-178. [PMID: 26968403 DOI: 10.1111/jnc.13447] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/23/2015] [Accepted: 11/24/2015] [Indexed: 12/31/2022]
Abstract
Aside from its roles in as a classical neurotransmitter involved in regulation of behavior, noradrenaline (NA) has other functions in the CNS. This includes restricting the development of neuroinflammatory activation, providing neurotrophic support to neurons, and providing neuroprotection against oxidative stress. In recent years, it has become evident that disruption of physiological NA levels or signaling is a contributing factor to a variety of neurological diseases and conditions including Alzheimer's disease (AD) and Multiple Sclerosis. The basis for dysregulation in these diseases is, in many cases, due to damage occurring to noradrenergic neurons present in the locus coeruleus (LC), the major source of NA in the CNS. LC damage is present in AD, multiple sclerosis, and a large number of other diseases and conditions. Studies using animal models have shown that experimentally induced lesion of LC neurons exacerbates neuropathology while treatments to compensate for NA depletion, or to reduce LC neuronal damage, provide benefit. In this review, we will summarize the anti-inflammatory and neuroprotective actions of NA, summarize examples of how LC damage worsens disease, and discuss several approaches taken to treat or prevent reductions in NA levels and LC neuronal damage. Further understanding of these events will be of value for the development of treatments for AD, multiple sclerosis, and other diseases and conditions having a neuroinflammatory component. The classical neurotransmitter noradrenaline (NA) has critical roles in modulating behaviors including those involved in sleep, anxiety, and depression. However, NA can also elicit anti-inflammatory responses in glial cells, can increase neuronal viability by inducing neurotrophic factor expression, and can reduce neuronal damage due to oxidative stress by scavenging free radicals. NA is primarily produced by tyrosine hydroxylase (TH) expressing neurons in the locus coeruleus (LC), a relatively small brainstem nucleus near the IVth ventricle which sends projections throughout the brain and spinal cord. It has been known for close to 50 years that LC neurons are lost during normal aging, and that loss is exacerbated in neurological diseases including Parkinson's disease and Alzheimer's disease. LC neuronal damage and glial activation has now been documented in a variety of other neurological conditions and diseases, however, the causes of LC damage and cell loss remain largely unknown. A number of approaches have been developed to address the loss of NA and increased inflammation associated with LC damage, and several methods are being explored to directly minimize the extent of LC neuronal cell loss or function. In this review, we will summarize some of the consequences of LC loss, consider several factors that likely contribute to that loss, and discuss various ways that have been used to increase NA or to reduce LC damage. This article is part of the 60th Anniversary special issue.
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Affiliation(s)
- Douglas L Feinstein
- Department of Anesthesiology, University of Illinois, Chicago, IL, USA. .,Jesse Brown VA Medical Center, Chicago, IL, USA.
| | - Sergey Kalinin
- Department of Anesthesiology, University of Illinois, Chicago, IL, USA.,Jesse Brown VA Medical Center, Chicago, IL, USA
| | - David Braun
- Department of Anesthesiology, University of Illinois, Chicago, IL, USA.,Jesse Brown VA Medical Center, Chicago, IL, USA
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Kim N, Hughes TL, Park CG, Quinn L, Kong ID. Resting-State Peripheral Catecholamine and Anxiety Levels in Korean Male Adolescents with Internet Game Addiction. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2016; 19:202-8. [PMID: 26849530 PMCID: PMC4799709 DOI: 10.1089/cyber.2015.0411] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to compare the resting-state plasma catecholamine and anxiety levels of Korean male adolescents with Internet game addiction (IGA) and those without IGA. This cross-sectional comparative study was conducted with 230 male high school students in a South Korean city. Convenience and snowball sampling methods were employed, and data were collected using (1) participant blood samples analyzed for dopamine (DA), epinephrine (Epi), and norepinephrine (NE) and (2) two questionnaires to assess IGA and anxiety levels. Using SPSS 15.0, data were analyzed by descriptive analysis, χ2-tests, t-tests, and Pearson's correlation tests. The plasma Epi (t = 1.962, p < 0.050) and NE (t = 2.003, p = 0.046) levels were significantly lower in the IGA group than in the non-IGA group; DA levels did not significantly differ between the groups. The mean anxiety level of the IGA group was significantly higher compared with the non-IGA group (t =−6.193, p < 0.001). No significant correlations were found between catecholamine and anxiety levels. These results showed that excessive Internet gaming over time induced decreased peripheral Epi and NE levels, thus altering autonomic regulation, and increasing anxiety levels in male high school students. Based on these physiological and psychological effects, interventions intended to prevent and treat IGA should include stabilizing Epi, NE, and anxiety levels in adolescents.
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Affiliation(s)
- Nahyun Kim
- Keimyung University College of Nursing, Daegu, Korea
| | - Tonda L. Hughes
- University of Illinois at Chicago, College of Nursing, Chicago, Illinois
| | - Chang G. Park
- University of Illinois at Chicago, College of Nursing, Chicago, Illinois
| | - Laurie Quinn
- University of Illinois at Chicago, College of Nursing, Chicago, Illinois
| | - In Deok Kong
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
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Skelly MJ, Chappell AE, Carter E, Weiner JL. Adolescent social isolation increases anxiety-like behavior and ethanol intake and impairs fear extinction in adulthood: Possible role of disrupted noradrenergic signaling. Neuropharmacology 2015; 97:149-59. [PMID: 26044636 PMCID: PMC4537360 DOI: 10.1016/j.neuropharm.2015.05.025] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/16/2015] [Accepted: 05/14/2015] [Indexed: 11/21/2022]
Abstract
Alcohol use disorder, anxiety disorders, and post-traumatic stress disorder (PTSD) are highly comorbid, and exposure to chronic stress during adolescence may increase the incidence of these conditions in adulthood. Efforts to identify the common stress-related mechanisms driving these disorders have been hampered, in part, by a lack of reliable preclinical models that replicate their comorbid symptomatology. Prior work by us, and others, has shown that adolescent social isolation increases anxiety-like behaviors and voluntary ethanol consumption in adult male Long-Evans rats. Here we examined whether social isolation also produces deficiencies in extinction of conditioned fear, a hallmark symptom of PTSD. Additionally, as disrupted noradrenergic signaling may contribute to alcoholism, we examined the effect of anxiolytic medications that target noradrenergic signaling on ethanol intake following adolescent social isolation. Our results confirm and extend previous findings that adolescent social isolation increases anxiety-like behavior and enhances ethanol intake and preference in adulthood. Additionally, social isolation is associated with a significant deficit in the extinction of conditioned fear and a marked increase in the ability of noradrenergic therapeutics to decrease ethanol intake. These results suggest that adolescent social isolation not only leads to persistent increases in anxiety-like behaviors and ethanol consumption, but also disrupts fear extinction, and as such may be a useful preclinical model of stress-related psychopathology. Our data also suggest that disrupted noradrenergic signaling may contribute to escalated ethanol drinking following social isolation, thus further highlighting the potential utility of noradrenergic therapeutics in treating the deleterious behavioral sequelae associated with early life stress.
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Affiliation(s)
- M J Skelly
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - A E Chappell
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - E Carter
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - J L Weiner
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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Russell TA, Arcuri SM. A Neurophysiological and Neuropsychological Consideration of Mindful Movement: Clinical and Research Implications. Front Hum Neurosci 2015; 9:282. [PMID: 26074800 PMCID: PMC4443777 DOI: 10.3389/fnhum.2015.00282] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 04/29/2015] [Indexed: 01/17/2023] Open
Abstract
In this article, we present ideas related to three key aspects of mindfulness training: the regulation of attention via noradrenaline, the importance of working memory and its various components (particularly the central executive and episodic buffer), and the relationship of both of these to mind-wandering. These same aspects of mindfulness training are also involved in the preparation and execution of movement and implicated in the pathophysiology of psychosis. We argue that by moving in a mindful way, there may be an additive effect of training as the two elements of the practice (mindfulness and movement) independently, and perhaps synergistically, engage common underlying systems (the default mode network). We discuss how working with mindful movement may be one route to mindfulness training for individuals who would struggle to sit still to complete the more commonly taught mindfulness practices. Drawing on our clinical experience working with individuals with severe and enduring mental health conditions, we show the real world application of these ideas and how they can be used to help those who are suffering and for whom current treatments are still far from adequate.
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Affiliation(s)
- Tamara Anne Russell
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurology, King's College London , London , UK
| | - Silvia Maria Arcuri
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurology, King's College London , London , UK
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Higuera-Matas A, Ucha M, Ambrosio E. Long-term consequences of perinatal and adolescent cannabinoid exposure on neural and psychological processes. Neurosci Biobehav Rev 2015; 55:119-46. [PMID: 25960036 DOI: 10.1016/j.neubiorev.2015.04.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/30/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
Marihuana is the most widely consumed illicit drug, even among adolescents and pregnant women. Given the critical developmental processes that occur in the adolescent and fetal nervous system, marihuana consumption during these stages may have permanent consequences on several brain functions in later adult life. Here, we review what is currently known about the long-term consequences of perinatal and adolescent cannabinoid exposure. The most consistent findings point to long-term impairments in cognitive function that are associated with structural alterations and disturbed synaptic plasticity. In addition, several neurochemical modifications are also evident after prenatal or adolescent cannabinoid exposure, especially in the endocannabinoid, glutamatergic, dopaminergic and opioidergic systems. Important sexual dimorphisms are also evident in terms of the long-lasting effects of cannabinoid consumption during pregnancy and adolescence, and cannabinoids possibly have a protective effect in adolescents who have suffered traumatic life challenges, such as maternal separation or intense stress. Finally, we suggest some future research directions that may encourage further advances in this exciting field.
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Affiliation(s)
- Alejandro Higuera-Matas
- Department of Psychobiology, School of Psychology, National University of Distance Learning (UNED), C/ Juan del Rosal 10, 28040 Madrid, Spain.
| | - Marcos Ucha
- Department of Psychobiology, School of Psychology, National University of Distance Learning (UNED), C/ Juan del Rosal 10, 28040 Madrid, Spain
| | - Emilio Ambrosio
- Department of Psychobiology, School of Psychology, National University of Distance Learning (UNED), C/ Juan del Rosal 10, 28040 Madrid, Spain
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Self-reported aggressiveness during treatment with levetiracetam correlates with depression. Epilepsy Behav 2015; 45:64-7. [PMID: 25845494 DOI: 10.1016/j.yebeh.2015.03.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 03/09/2015] [Accepted: 03/10/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this study was to identify clinical correlates of self-reported aggressiveness (SRA) in patients with epilepsy treated with levetiracetam (LEV) with special reference to the role of depression. METHODS A consecutive sample of adult outpatients with epilepsy was assessed with the Neurological Disorder Depression Inventory for Epilepsy, the Adverse Event Profile (AEP), and the Emotional Thermometer. RESULTS From a total sample of 163 consecutive patients treated with LEV, SRA at any level (from rarely a problem to always) was associated with a 7-fold increased risk of being depressed (95% CI: 3.0-17.5; p<0.001). Self-reported aggressiveness was reported as "always" a problem by 9.8% of the patients. In these patients, apart from depression, SRA was associated with high AEP total scores (55.1 vs. 39.3; p<0.001) and polytherapy (43.8% vs. 19.8%; p=0.034). Anxiety scores were not elevated (4.9 vs. 3.6; p=0.183). CONCLUSIONS Self-reported aggressiveness during treatment with LEV is not an isolated symptom but is associated with depressed mood. Anxiety-mediated mechanisms do not seem to be involved.
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Skelly MJ, Weiner JL. Chronic treatment with prazosin or duloxetine lessens concurrent anxiety-like behavior and alcohol intake: evidence of disrupted noradrenergic signaling in anxiety-related alcohol use. Brain Behav 2014; 4:468-83. [PMID: 25161814 PMCID: PMC4128029 DOI: 10.1002/brb3.230] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 03/18/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Alcohol use disorders have been linked to increased anxiety, and enhanced central noradrenergic signaling may partly explain this relationship. Pharmacological interventions believed to reduce the excitatory effects of norepinephrine have proven effective in attenuating ethanol intake in alcoholics as well as in rodent models of ethanol dependence. However, most preclinical investigations into the effectiveness of these drugs in decreasing ethanol intake have been limited to acute observations, and none have concurrently assessed their anxiolytic effects. The purpose of these studies was to examine the long-term effectiveness of pharmacological interventions presumed to decrease norepinephrine signaling on concomitant ethanol self-administration and anxiety-like behavior in adult rats with relatively high levels of antecedent anxiety-like behavior. METHODS Adult male Long-Evans rats self-administered ethanol on an intermittent access schedule for eight to ten weeks prior to being implanted with osmotic minipumps containing either an a1-adrenoreceptor antagonist (prazosin, 1.5 mg/kg/day), a β1/2-adrenoreceptor antagonist (propranolol, 2.5 mg/kg/day), a serotonin/norepinephrine reuptake inhibitor (duloxetine, 1.5 mg/kg/day) or vehicle (10% dimethyl sulfoxide). These drugs were continuously delivered across four weeks, during which animals continued to have intermittent access to ethanol. Anxiety-like behavior was assessed on the elevated plus maze before treatment and again near the end of the drug delivery period. RESULTS Our results indicate that chronic treatment with a low dose of prazosin or duloxetine significantly decreases ethanol self-administration (P < 0.05). Furthermore, this decrease in drinking is accompanied by significant reductions in the expression of anxiety-like behavior (P < 0.05). CONCLUSIONS These findings suggest that chronic treatment with putative inhibitors of central noradrenergic signaling may attenuate ethanol intake via a reduction in anxiety-like behavior.
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Affiliation(s)
- Mary J Skelly
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Medical Center Boulevard Winston-Salem, North Carolina, 27157
| | - Jeff L Weiner
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Medical Center Boulevard Winston-Salem, North Carolina, 27157
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