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Sakayori T, Ikeda Y, Arakawa R, Nogami T, Tateno A. A randomized placebo controlled trial demonstrates the effect of dl-methylephedrine on brain functions is weaker than that of pseudoephedrine. Sci Rep 2024; 14:20793. [PMID: 39242643 PMCID: PMC11379680 DOI: 10.1038/s41598-024-71851-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 08/31/2024] [Indexed: 09/09/2024] Open
Abstract
Intellectual drug doping in athletics by using stimulants that affect central nervous system functions has been diversified. Stimulants are regulated by the World Anti-Doping Agency according to their levels of urinary concentration. Positron emission tomography could evaluate how stimulants affect central nervous system functions. We aimed to evaluate the effect of stimulants on brain function by examining the difference in brain dopamine transporter occupancy by PET after administration of dl-methylephedrine or pseudoephedrine at the clinical maximum daily dose. Four PET scans without and with drug administration (placebo, dl-methylephedrine 150 mg and pseudoephedrine 240 mg) were performed. The concentrations of dl-methylephedrine and pseudoephedrine in plasma and urine were measured. DAT occupancies in the striatum with placebo, dl-methylephedrine and pseudoephedrine were calculated by PET images. The urinary concentration of dl-methylephedrine (12.7 µg/mL) exceeded the prohibited concentration (10 µg/mL), but the DAT occupancy with dl-methylephedrine (6.1%) did not differ (p = 0.92) from that with placebo (6.2%). By contrast, although the urinary concentration of pseudoephedrine (144.8 µg/mL) was below the prohibited concentration (150 μg/mL), DAT occupancy with pseudoephedrine was 18.4%, which was higher than that with placebo (p = 0.009). At the maximum clinical dose, dl-methylephedrine was shown to have weaker effects on brain function than pseudoephedrine.
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Affiliation(s)
- Takeshi Sakayori
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Yumiko Ikeda
- Department of Pharmacology, Nippon Medical School, Tokyo, Japan
| | - Ryosuke Arakawa
- Department of Pharmacology, Nippon Medical School, Tokyo, Japan
| | - Tsuyoshi Nogami
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Amane Tateno
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
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2
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Sidhu GK, Fontanilla TM, Becker TS. Midlife and Older Age Methamphetamine Poisoning Deaths in Hawai'i. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2024; 83:225-229. [PMID: 39131833 PMCID: PMC11307318 DOI: 10.62547/wwzl3153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Unintentional and undetermined intent drug overdose fatality records from the State Unintentional Drug Overdose Reporting System (SUDORS) for Hawai'i from July 1, 2020, to December 31, 2021 revealed that 58.2% of decedents were aged 50-75. The main substance associated with cause of death for those aged 50-75 years was methamphetamine, followed by a combination of mixed drugs. Of those aged 50 and older, 25.5% died from cardiovascular or neurological complications which were likely to be associated with chronic, long-term methamphetamine use. Based on death investigator narrative reports, 76.5% of the older decedents had a history of substance abuse, suggesting possible long-term substance use starting at a young age. The trajectory of substance use over the life course is often influenced by life events and transitions, which can be stressors. Hawai'i kūpuna (older adults) should be screened for substance use and dependence to ensure that there is treatment if needed, for the entirety of this use trajectory.Also, barriers to kūpuna seeking treatment, such as stigma towards drug use should be addressed.
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Affiliation(s)
| | - Tiana M. Fontanilla
- Adult Mental Health Division, Hawai‘i Department of Health, Honolulu, HI (TMF)
| | - Treena S. Becker
- Center on Aging, University of Hawai‘i at Mānoa, Honolulu, HI (TSB)
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3
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Rogers EJ, Trotter MG, Johnson D, Desbrow B, King N. Caffeine improves the shooting performance and reaction time of first-person shooter esports players: a dose-response study. Front Sports Act Living 2024; 6:1437700. [PMID: 39055173 PMCID: PMC11270538 DOI: 10.3389/fspor.2024.1437700] [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: 05/24/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024] Open
Abstract
Caffeine is recognized as one of the most effective dietary ergogenic aids in sports, yet its evidence-based effectiveness in esports is unclear. This study investigated the effects of two different doses of caffeine on the shooting performance and reaction time of 24 first-person shooter (FPS) esports players (22 men, 2 women; age = 22.29 ± 2.91 years). Participants completed three experimental trials in which they consumed either a water control (CON), a 1 mg·kg-1 BM (CAF1) or a 3 mg·kg-1 BM (CAF3) dose of caffeine. Performance measures (e.g., score, accuracy (%), hit rate (hits/sec), and shots fired) were assessed in a static clicking and reactive tracking style task on the KovaaK's FPS aim trainer. Reaction time was used to assess vigilance on the psychomotor vigilance test (PVT). Performance was measured at four time points in each trial: pre-treatment (PRE), 60 min (POST1), 80 min (POST2), and 100 min (POST3) post-treatment. Significant differences were identified using repeated-measures analysis of variances. Caffeine, irrespective of dose, significantly improved performance compared to CON for static clicking score and hit rate, reactive tracking accuracy, and reaction time on the PVT. Significant interactions between treatment and time were identified and post hoc analyses showed that compared to CON, CAF1 significantly improved static clicking score at POST1 and POST3, static clicking hit rate at POST1, reactive tracking accuracy at POST1, POST2, and POST3, and reaction time on the PVT at POST1 and POST2. Post hoc analysis also showed that compared to CON, CAF3 significantly improved static clicking score, reactive tracking accuracy, and reaction time on the PVT at all time points, in addition to static clicking hit rate at POST1 and POST3. In summary, caffeine supplementation enhances the shooting performance and reaction time of FPS esports players.
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Affiliation(s)
- Ethan J. Rogers
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Daniel Johnson
- School of Computer Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ben Desbrow
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Neil King
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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4
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Thibeault KC, Leonard MZ, Kondev V, Emerson SD, Bethi R, Lopez AJ, Sens JP, Nabit BP, Elam HB, Winder DG, Patel S, Kiraly DD, Grueter BA, Calipari ES. A Cocaine-Activated Ensemble Exerts Increased Control Over Behavior While Decreasing in Size. Biol Psychiatry 2024:S0006-3223(24)01388-X. [PMID: 38901723 DOI: 10.1016/j.biopsych.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Substance use disorder is characterized by long-lasting changes in reward-related brain regions, such as the nucleus accumbens. Previous work has shown that cocaine exposure induces plasticity in broad, genetically defined cell types in the nucleus accumbens; however, in response to a stimulus, only a small percentage of neurons are transcriptionally active-termed an ensemble. Here, we identify an Arc-expressing neuronal ensemble that has a unique trajectory of recruitment and causally controls drug self-administration after repeated, but not acute, cocaine exposure. METHODS Using Arc-CreERT2 transgenic mice, we expressed transgenes in Arc+ ensembles activated by cocaine exposure (either acute [1 × 10 mg/kg intraperitoneally] or repeated [10 × 10 mg/kg intraperitoneally]). Using genetic, optical, and physiological recording and manipulation strategies, we assessed the contribution of these ensembles to behaviors associated with substance use disorder. RESULTS Repeated cocaine exposure reduced the size of the ensemble while simultaneously increasing its control over behavior. Neurons within the repeated cocaine ensemble were hyperexcitable, and their optogenetic excitation was sufficient for reinforcement. Finally, lesioning the repeated cocaine, but not the acute cocaine, ensemble blunted cocaine self-administration. Thus, repeated cocaine exposure reduced the size of the ensemble while simultaneously increasing its contributions to drug reinforcement. CONCLUSIONS We showed that repeated, but not acute, cocaine exposure induced a physiologically distinct ensemble characterized by the expression of the immediate early gene Arc, which was uniquely capable of modulating reinforcement behavior.
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Affiliation(s)
- Kimberly C Thibeault
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee
| | - Michael Z Leonard
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee
| | - Veronika Kondev
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee
| | - Soren D Emerson
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee
| | - Rishik Bethi
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee
| | - Alberto J Lopez
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee
| | - Jonathon P Sens
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Brett P Nabit
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee
| | - Hannah B Elam
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee
| | - Danny G Winder
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt JF Kennedy Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Sachin Patel
- Department of Psychiatry, Northwestern University, Chicago, Illinois
| | - Drew D Kiraly
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Brad A Grueter
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Erin S Calipari
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt JF Kennedy Center, Vanderbilt University School of Medicine, Nashville, Tennessee.
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5
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Geng P, Fan N, Ling R, Guo H, Lu Q, Chen X. The perception of Mandarin speech conveying communicative functions in Chinese heroin addicts. PLoS One 2024; 19:e0299331. [PMID: 38394164 PMCID: PMC10889662 DOI: 10.1371/journal.pone.0299331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Drug addiction can cause severe damage to the human brain, leading to significant problems in cognitive processing, such as irritability, speech distortions, and exaggeration of negative stimuli. Speech plays a fundamental role in social interaction, including both the production and perception. The ability to perceive communicative functions conveyed through speech is crucial for successful interpersonal communication and the maintaining good social relationships. However, due to the limited number of previous studies, it remains unclear whether the cognitive disorder caused by drug addiction affects the perception of communicative function conveyed in Mandarin speech. To address this question, we conducted a perception experiment involving sixty male participants, including 25 heroin addicts and 35 healthy controls. The experiment aimed to examine the perception of three communicative functions (i.e., statement, interrogative, and imperative) under three background noise conditions (i.e., no noise, SNR [Signal to Noise Ratio] = 10, and SNR = 0). Eight target sentences were first recorded by two native Mandarin speakers for each of the three communicative functions. Each half was then combined with Gaussian White Noise under two background noise conditions (i.e., SNR = 10 and SNR = 0). Finally, 48 speech stimuli were included in the experiment with four options provided for perceptual judgment. The results showed that, under the three noise conditions, the average perceptual accuracies of the three communicative functions were 80.66% and 38% for the control group and the heroin addicts, respectively. Significant differences were found in the perception of the three communicative functions between the control group and the heroin addicts under the three noise conditions, except for the recognition of imperative under strong noise condition (i.e., SNR = 0). Moreover, heroin addicts showed good accuracy (around 50%) in recognizing imperative and poor accuracy (i.e., lower than the chance level) in recognizing interrogative. This paper not only fills the research gap in the perception of communicative functions in Mandarin speech among drug addicts but also enhances the understanding of the effects of drugs on speech perception and provides a foundation for the speech rehabilitation of drug addicts.
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Affiliation(s)
- Puyang Geng
- Academy of Forensic Science, Shanghai, China
- Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai, China
| | - Ningxue Fan
- Information Security and Social Management Innovation Lab, Shanghai Open University, Shanghai, China
| | - Rong Ling
- Academy of Forensic Science, Shanghai, China
- Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai, China
| | - Hong Guo
- Academy of Forensic Science, Shanghai, China
- Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai, China
| | - Qimeng Lu
- Academy of Forensic Science, Shanghai, China
- Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai, China
| | - Xingwen Chen
- Network Security Team, Public Security Department of Guangxi Province, Nanning, Guangxi, China
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6
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Ku T, Cao J, Won SJ, Guo J, Camacho-Hernandez GA, Okorom AV, Salomon KW, Lee KH, Loland CJ, Duff HJ, Shi L, Newman AH. Series of (([1,1'-Biphenyl]-2-yl)methyl)sulfinylalkyl Alicyclic Amines as Novel and High Affinity Atypical Dopamine Transporter Inhibitors with Reduced hERG Activity. ACS Pharmacol Transl Sci 2024; 7:515-532. [PMID: 38357284 PMCID: PMC10863442 DOI: 10.1021/acsptsci.3c00322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 02/16/2024]
Abstract
Currently, there are no FDA-approved medications for the treatment of psychostimulant use disorders (PSUD). We have previously discovered "atypical" dopamine transporter (DAT) inhibitors that do not display psychostimulant-like behaviors and may be useful as medications to treat PSUD. Lead candidates (e.g., JJC8-091, 1) have shown promising in vivo profiles in rodents; however, reducing hERG (human ether-à-go-go-related gene) activity, a predictor of cardiotoxicity, has remained a challenge. Herein, a series of 30 (([1,1'-biphenyl]-2-yl)methyl)sulfinylalkyl alicyclic amines was synthesized and evaluated for DAT and serotonin transporter (SERT) binding affinities. A subset of analogues was tested for hERG activity, and the IC50 values were compared to those predicted by our hERG QSAR models, which showed robust predictive power. Multiparameter optimization scores (MPO > 3) indicated central nervous system (CNS) penetrability. Finally, comparison of affinities in human DAT and its Y156F and Y335A mutants suggested that several compounds prefer an inward facing conformation indicating an atypical DAT inhibitor profile.
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Affiliation(s)
- Therese
C. Ku
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Jianjing Cao
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Sung Joon Won
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Jiqing Guo
- Faculty
of Medicine, Libin Institute, Calgary T2N 4N1, Canada
| | - Gisela A. Camacho-Hernandez
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Amarachi V. Okorom
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Kristine Walloe Salomon
- Laboratory
for Membrane Protein Dynamics, Department of Neuroscience, Faculty
of Health and Medical Sciences, University
of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Kuo Hao Lee
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Claus J. Loland
- Laboratory
for Membrane Protein Dynamics, Department of Neuroscience, Faculty
of Health and Medical Sciences, University
of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Henry J. Duff
- Laboratory
for Membrane Protein Dynamics, Department of Neuroscience, Faculty
of Health and Medical Sciences, University
of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Lei Shi
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
| | - Amy Hauck Newman
- Molecular
Targets and Medications Discovery Branch, National Institute on Drug
Abuse–Intramural Research Program, National Institutes of Health, 333 Cassell Drive, Baltimore, Maryland 21224, United States
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7
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Sagheddu C, Cancedda E, Bagheri F, Kalaba P, Muntoni AL, Lubec J, Lubec G, Sanna F, Pistis M. The Atypical Dopamine Transporter Inhibitor CE-158 Enhances Dopamine Neurotransmission in the Prefrontal Cortex of Male Rats: A Behavioral, Electrophysiological, and Microdialysis Study. Int J Neuropsychopharmacol 2023; 26:784-795. [PMID: 37725477 PMCID: PMC10674083 DOI: 10.1093/ijnp/pyad056] [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] [Received: 06/24/2023] [Accepted: 09/17/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Dopamine plays a key role in several physiological functions such as motor control, learning and memory, and motivation and reward. The atypical dopamine transporter inhibitor S,S stereoisomer of 5-(((S)-((S)-(3-bromophenyl)(phenyl)methyl)sulfinyl)methyl)thiazole (CE-158) has been recently reported to promote behavioral flexibility and restore learning and memory in aged rats. METHODS Adult male rats were i.p. administered for 1 or 10 days with CE-158 at the dose of 1 or 10 mg/kg and tested for extracellular dopamine in the medial prefrontal cortex by means of intracerebral microdialysis and single unit cell recording in the same brain area. Moreover, the effects of acute and chronic CE-158 on exploratory behavior, locomotor activity, prepulse inhibition, working memory, and behavioral flexibility were also investigated. RESULTS CE-158 dose-dependently potentiated dopamine neurotransmission in the medial prefrontal cortex as assessed by intracerebral microdialysis. Moreover, repeated exposure to CE-158 at 1 mg/kg was sufficient to increase the number of active pyramidal neurons and their firing frequency in the same brain area. In addition, CE-158 at the dose of 10 mg/kg stimulates exploratory behavior to the same extent after acute or chronic treatment. Noteworthy, the chronic treatment at both doses did not induce any behavioral alterations suggestive of abuse potential (e.g., motor behavioral sensitization) or pro-psychotic-like effects such as disruption of sensorimotor gating or impairments in working memory and behavioral flexibility as measured by prepulse inhibition and Y maze. CONCLUSIONS Altogether, these findings confirm CE-158 as a promising pro-cognitive agent and contribute to assessing its preclinical safety profile in a chronic administration regimen for further translational testing.
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Affiliation(s)
- Claudia Sagheddu
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Enzo Cancedda
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Farshid Bagheri
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Predrag Kalaba
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Chemistry, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Anna Lisa Muntoni
- Neuroscience Institute, Section of Cagliari, National Research Council of Italy, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Jana Lubec
- Programme for Proteomics, Paracelsus Medical University, Salzburg, Austria
| | - Gert Lubec
- Programme for Proteomics, Paracelsus Medical University, Salzburg, Austria
| | - Fabrizio Sanna
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Marco Pistis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
- Neuroscience Institute, Section of Cagliari, National Research Council of Italy, Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
- Unit of Clinical Pharmacology, University Hospital, Cagliari, Italy
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8
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Mariani Y, Covelo A, Rodrigues RS, Julio-Kalajzić F, Pagano Zottola AC, Lavanco G, Fabrizio M, Gisquet D, Drago F, Cannich A, Baufreton J, Marsicano G, Bellocchio L. Striatopallidal cannabinoid type-1 receptors mediate amphetamine-induced sensitization. Curr Biol 2023; 33:5011-5022.e6. [PMID: 37879332 DOI: 10.1016/j.cub.2023.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/24/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
Repeated exposure to psychostimulants, such as amphetamine, causes a long-lasting enhancement in the behavioral responses to the drug, called behavioral sensitization.1 This phenomenon involves several neuronal systems and brain areas, among which the dorsal striatum plays a key role.2 The endocannabinoid system (ECS) has been proposed to participate in this effect, but the neuronal basis of this interaction has not been investigated.3 In the CNS, the ECS exerts its functions mainly acting through the cannabinoid type-1 (CB1) receptor, which is highly expressed at terminals of striatal medium spiny neurons (MSNs) belonging to both the direct and indirect pathways.4 In this study, we show that, although striatal CB1 receptors are not involved in the acute response to amphetamine, the behavioral sensitization and related synaptic changes require the activation of CB1 receptors specifically located at striatopallidal MSNs (indirect pathway). These results highlight a new mechanism of psychostimulant sensitization, a phenomenon that plays a key role in the health-threatening effects of these drugs.
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Affiliation(s)
- Yamuna Mariani
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France
| | - Ana Covelo
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France
| | - Rui S Rodrigues
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France
| | | | - Antonio C Pagano Zottola
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France; Institut de Biochimie et Génétique Cellulaires, UMR 5095, 33077 Bordeaux, France
| | - Gianluca Lavanco
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France; University of Palermo, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties of Excellence "G. D'Alessandro," 90127 Palermo, Italy
| | - Michela Fabrizio
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France; Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS, INSERM, 5 Université PSL, 75231 Paris, France
| | - Doriane Gisquet
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania 95124, Italy
| | - Astrid Cannich
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France
| | | | - Giovanni Marsicano
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France.
| | - Luigi Bellocchio
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France.
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9
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Rich MT, Swinford-Jackson SE, Pierce RC. Epigenetic inheritance of phenotypes associated with parental exposure to cocaine. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2023; 99:169-216. [PMID: 38467481 DOI: 10.1016/bs.apha.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Parental exposure to drugs of abuse induces changes in the germline that can be transmitted across subsequent generations, resulting in enduring effects on gene expression and behavior. This transgenerational inheritance involves a dynamic interplay of environmental, genetic, and epigenetic factors that impact an individual's vulnerability to neuropsychiatric disorders. This chapter aims to summarize recent research into the mechanisms underlying the inheritance of gene expression and phenotypic patterns associated with exposure to drugs of abuse, with an emphasis on cocaine. We will first define the epigenetic modifications such as DNA methylation, histone post-translational modifications, and expression of non-coding RNAs that are impacted by parental cocaine use. We will then explore how parental cocaine use induces heritable epigenetic changes that are linked to alterations in neural circuitry and synaptic plasticity within reward-related circuits, ultimately giving rise to potential behavioral vulnerabilities. This discussion will consider phenotypic differences associated with gestational as well as both maternal and paternal preconception drug exposure and will emphasize differences based on offspring sex. In this context, we explore the complex interactions between genetics, epigenetics, environment, and biological sex. Overall, this chapter consolidates the latest developments in the multigenerational effects and long-term consequences of parental substance abuse.
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Affiliation(s)
- Matthew T Rich
- Brain Health Institute and Department of Psychiatry, Rutgers University, Piscataway, NJ, United States.
| | - Sarah E Swinford-Jackson
- Brain Health Institute and Department of Psychiatry, Rutgers University, Piscataway, NJ, United States
| | - R Christopher Pierce
- Brain Health Institute and Department of Psychiatry, Rutgers University, Piscataway, NJ, United States
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10
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Black JC, Burkett HL, Rockhill KM, Olson R, Dart RC, Iwanicki J. Initiation Patterns and Transitions Among Adults Using Stimulant Drugs: Latent Transition Analysis. J Med Internet Res 2023; 25:e46747. [PMID: 37796607 PMCID: PMC10587808 DOI: 10.2196/46747] [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: 02/24/2023] [Revised: 08/10/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The fourth wave of the drug overdose epidemic in the United States includes increasing rates of stimulant-involved overdose. Recent studies of transitions leading to stimulant misuse have shown complex patterns that are not universally applicable because they have isolated individual populations or individual behaviors. A comprehensive analysis of transitions between behaviors and the associations with present-day problematic drug use has not been conducted. OBJECTIVE This study aims to determine whether adults from the general population who use stimulants initiate use through a heterogeneous combination of behaviors and quantify the association between these typologies with present-day problematic drug use. METHODS Individuals who have reported use of any stimulant in their lifetime were recruited from the 2021 Survey of Nonmedical Use of Prescription Drugs Program, a nationally representative web-based survey on drug use, to participate in a rapid follow-up survey about their past stimulant use. Individuals were asked which stimulants they used, the reasons for use, the routes of administration, and the sources of the stimulant. For each stimulant-related behavior, they were asked at what age, between 6 and 30 years, they initiated each behavior in a 6-year time window. A latent transition analysis was used to characterize heterogeneity in initiation typologies. Mutually exclusive pathways of initiation were identified manually by the researchers. The association of these pathways with present-day problematic drug use was calculated using logistic regression adjusted by the current age of the respondent. RESULTS From a total of 1329 participants, 740 (55.7%) reported lifetime prescription stimulant use and 1077 (81%) reported lifetime illicit stimulant use. Three typologies were identified. The first typology was characterized by illicit stimulant initiation to get high, usually via oral or snorting routes and acquisition from friends or family or a dealer (illicit experimentation). The second typology was characterized by low, but approximately equal probabilities of initiating 1-2 new behaviors in a time window, but no singular set of behaviors characterized the typology (conservative initiation). The third was characterized by a high probability of initiating many diverse combinations of behaviors (nondiscriminatory experimentation). The choice of drug initiated was not a strong differentiator. Categorization of pathways showed those who were only in an illicit experimentation status (reference) had the lowest odds of having severe present-day problematic drug use. Odds were higher for a conservative initiation-only status (odds ratio [OR] 1.84, 95% CI 1.14-2.94), which is higher still for those moving from illicit experimentation to conservative initiation (OR 3.50, 95% CI 2.13-5.74), and highest for a nondiscriminatory experimentation status (OR 5.45, 95% CI 3.39-8.77). CONCLUSIONS Initiation of stimulant-related use behaviors occurred across many time windows, indicating that multiple intervention opportunities are presented. Screening should be continued throughout adulthood to address unhealthy drug use before developing into full substance use disorders.
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Affiliation(s)
- Joshua C Black
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Hannah L Burkett
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Karilynn M Rockhill
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Richard Olson
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Richard C Dart
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Janetta Iwanicki
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
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11
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de Almeida RF, de Oliveira M, Furigo IC, Aquino R, Clarke ND, Tallis J, Guimaraes-Ferreira L. Effects of Acute Caffeine Ingestion on Cognitive Performance before and after Repeated Small-Sided Games in Professional Soccer Players: A Placebo-Controlled, Randomized Crossover Trial. Nutrients 2023; 15:3094. [PMID: 37513512 PMCID: PMC10385153 DOI: 10.3390/nu15143094] [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: 05/26/2023] [Revised: 06/16/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Soccer is a team sport that requires players to process a significant amount of information quickly and respond with both speed and accuracy to the ever-changing demands of the game. As such, success in soccer depends not only on physical attributes but also on cognitive abilities such as perception and decision-making. The aim of the current study was to investigate the acute effects of caffeine ingestion on Stroop test performance before and after repeated small-sided games (SSG) in professional soccer players. Twelve professional male soccer players (29 ± 4.1 years; 78.1 ± 7.7 kg body mass) participated in this study. A randomized crossover double-blind placebo-controlled trial was used. Caffeine (5 mg.kg-1) or a placebo was ingested 45 min before a protocol consisting of five 5 min SSG with 1 min rest intervals. A computerized version of the colour Stroop test was completed immediately before and after the exercise protocol. During the Stroop test, words appeared on the computer screen in three different ways: (i) neutral words (neutral condition); (ii) correspondent colour (i.e., "red" painted in red; congruent condition), or; (iii) different colour (i.e., "red" painted in green; incongruent condition). The incongruent condition aimed to cause the interference effect, as the colour and the word did not match. Ratings of perceived exertion (RPE) were assessed after each SSG. RPE increased during the five sets of the SSG protocol (p < 0.001), without differences between the caffeine and placebo trials. The soccer-specific exercise protocol promoted a faster response during the Stroop test (two-way ANOVA main effect for SSG protocol: p < 0.05), with no differences in accuracy (p > 0.05). Caffeine ingestion resulted in slower reaction time during the Stroop test during the congruent and neutral trials but not during the incongruent trial (two-way ANOVA main effect for supplementation: p = 0.009, p = 0.045, and p = 0.071, respectively). Accuracy was lower in the caffeine trial in congruent and incongruent trials (p < 0.05 caffeine vs. placebo both on the pre- and post-SSG protocol). In conclusion, a soccer-specific exercise protocol improved the Stroop test performance in professional soccer players, but acute caffeine ingestion (5 mg.kg-1) was detrimental.
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Affiliation(s)
- Rodrigo Freire de Almeida
- Centre of Physical Education and Sports, Federal University of Espirito Santo, Vitória 29075-910, ES, Brazil
| | - Mateus de Oliveira
- Centre of Physical Education and Sports, Federal University of Espirito Santo, Vitória 29075-910, ES, Brazil
| | | | - Rodrigo Aquino
- Centre of Physical Education and Sports, Federal University of Espirito Santo, Vitória 29075-910, ES, Brazil
| | - Neil David Clarke
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Jason Tallis
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Lucas Guimaraes-Ferreira
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry CV1 5FB, UK
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12
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Johnson DE, McIntyre RS, Mansur RB, Rosenblat JD. An update on potential pharmacotherapies for cognitive impairment in bipolar disorder. Expert Opin Pharmacother 2023; 24:641-654. [PMID: 36946229 DOI: 10.1080/14656566.2023.2194488] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Cognitive impairment is a core feature of bipolar disorder (BD) that impedes recovery by preventing the return to optimal socio-occupational functioning and reducing quality of life. Presently, there are no efficacious treatments for cognitive impairment in BD, but many pharmacological interventions are being considered as they have the potential to target the underlying pathophysiology of the disorder. AREAS COVERED This review summarizes the available evidence for pharmacological interventions for cognitive impairment in bipolar disorder. We searched PubMed, MedLine, and PsycInfo from inception to December 1st, 2022. Traditional treatments, such as lithium, anticonvulsants (lamotrigine), antipsychotics (aripiprazole, asenapine, cariprazine, lurasidone, and olanzapine), antidepressants (vortioxetine, fluoxetine, and tianeptine) and psychostimulants (modafinil), and emerging interventions, such as acetylcholinesterase inhibitors (galantamine and donepezil), dopamine agonists (pramipexole), erythropoietin, glucocorticoid receptor antagonists (mifepristone), immune modulators (infliximab, minocycline and doxycycline), ketamine, metabolic agents (insulin, metformin, and liraglutide), probiotic supplements, and Withania somnifera are discussed. EXPERT OPINION The investigation of interventions for cognitive impairment in BD is a relatively under-researched area. In the past, methodological pitfalls in BD cognition trials have also been a critical limiting factor. Expanding on the existing literature and identifying novel pharmacological and non-pharmacological treatments for cognitive impairment in BD should be a priority.
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Affiliation(s)
- Danica E Johnson
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Institute of Medical Science, University of Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Department of Psychiatry and Pharmacology, University of Toronto, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Department of Psychiatry, University of Toronto, Canada
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13
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Kosheleff AR, Mason O, Jain R, Koch J, Rubin J. Functional Impairments Associated With ADHD in Adulthood and the Impact of Pharmacological Treatment. J Atten Disord 2023; 27:669-697. [PMID: 36876491 PMCID: PMC10173356 DOI: 10.1177/10870547231158572] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE Among untreated adults, functional impairments associated with ADHD are widespread and cumulative, and can include social, educational, and professional impairments, increased risk of accidents and mortality, and reduced quality of life. Here, we review the most prominent functional impairments in adults with ADHD and summarize evidence describing the potential role of medication in improving outcomes. METHOD Articles related to the search terms "ADHD," "adult," and functional impairments were identified through Google Scholar and PubMed and selected for inclusion based on four criteria: strength of evidence, relevance to current challenges in adult ADHD, impact on the field, and recency of the results. RESULTS We identified 179 papers to support the conclusions on the relationship between ADHD and functional impairments, and the impact of pharmacological therapy on functional impairments. CONCLUSION This narrative review provides evidence that pharmacological treatment can be effective in minimizing not only the symptoms of ADHD, but its functional consequences as well.
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Affiliation(s)
| | - Oren Mason
- Attention MD, Grand Rapids, MI, USA and Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Rakesh Jain
- Texas Tech University School of Medicine, Midland, TX, USA
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14
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The Structure and Individual Patterns of Trait Impulsivity Across Addiction Disorders: a Network Analysis. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01022-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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15
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Bijoch Ł, Klos J, Pawłowska M, Wiśniewska J, Legutko D, Szachowicz U, Kaczmarek L, Beroun A. Whole-brain tracking of cocaine and sugar rewards processing. Transl Psychiatry 2023; 13:20. [PMID: 36683039 PMCID: PMC9868126 DOI: 10.1038/s41398-023-02318-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
Natural rewards, such as food, and sex are appetitive stimuli available for animals in their natural environment. Similarly, addictive rewards such as drugs of abuse possess strong, positive valence, but their action relies on their pharmacological properties. Nevertheless, it is believed that both of these kinds of rewards activate similar brain circuitry. The present study aimed to discover which parts of the brain process the experience of natural and addictive rewards. To holistically address this question, we used a single-cell whole-brain imaging approach to find patterns of activation for acute and prolonged sucrose and cocaine exposure. We analyzed almost 400 brain structures and created a brain-wide map of specific, c-Fos-positive neurons engaged by these rewards. Acute but not prolonged sucrose exposure triggered a massive c-Fos expression throughout the brain. Cocaine exposure on the other hand potentiated c-Fos expression with prolonged use, engaging more structures than sucrose treatment. The functional connectivity analysis unraveled an increase in brain modularity after the initial exposure to both types of rewards. This modularity was increased after repeated cocaine, but not sucrose, intake. To check whether discrepancies between the processing of both types of rewards can be found on a cellular level, we further studied the nucleus accumbens, one of the most strongly activated brain structures by both sucrose and cocaine experience. We found a high overlap between natural and addictive rewards on the level of c-Fos expression. Electrophysiological measurements of cellular correlates of synaptic plasticity revealed that natural and addictive rewards alike induce the accumulation of silent synapses. These results strengthen the hypothesis that in the nucleus accumbens drugs of abuse cause maladaptive neuronal plasticity in the circuitry that typically processes natural rewards.
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Affiliation(s)
- Łukasz Bijoch
- grid.419305.a0000 0001 1943 2944Laboratory of Neuronal Plasticity, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Joanna Klos
- grid.419305.a0000 0001 1943 2944Laboratory of Neuronal Plasticity, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Monika Pawłowska
- grid.419305.a0000 0001 1943 2944Laboratory of Neurobiology, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland ,grid.12847.380000 0004 1937 1290Institute of Experimental Physics, Faculty of Physics, University of Warsaw, Warsaw, Poland
| | - Justyna Wiśniewska
- grid.419305.a0000 0001 1943 2944Laboratory of Neuronal Plasticity, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Diana Legutko
- grid.419305.a0000 0001 1943 2944Laboratory of Neurobiology, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Urszula Szachowicz
- grid.419305.a0000 0001 1943 2944Laboratory of Neuronal Plasticity, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Leszek Kaczmarek
- grid.419305.a0000 0001 1943 2944Laboratory of Neurobiology, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Anna Beroun
- Laboratory of Neuronal Plasticity, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland.
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16
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Coliță D, Coliță CI, Hermann DM, Coliță E, Doeppner TR, Udristoiu I, Popa-Wagner A. Therapeutic Use and Chronic Abuse of CNS Stimulants and Anabolic Drugs. Curr Issues Mol Biol 2022; 44:4902-4920. [PMID: 36286048 PMCID: PMC9600088 DOI: 10.3390/cimb44100333] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
The available evidence suggests that affective disorders, such as depression and anxiety, increase risk for accelerated cognitive decline and late-life dementia in aging individuals. Behavioral neuropsychology studies also showed that cognitive decline is a central feature of aging impacting the quality of life. Motor deficits are common after traumatic brain injuries and stroke, affect subjective well-being, and are linked with reduced quality of life. Currently, restorative therapies that target the brain directly to restore cognitive and motor tasks in aging and disease are available. However, the very same drugs used for therapeutic purposes are employed by athletes as stimulants either to increase performance for fame and financial rewards or as recreational drugs. Unfortunately, most of these drugs have severe side effects and pose a serious threat to the health of athletes. The use of performance-enhancing drugs by children and teenagers has increased tremendously due to the decrease in the age of players in competitive sports and the availability of various stimulants in many forms and shapes. Thus, doping may cause serious health-threatening conditions including, infertility, subdural hematomas, liver and kidney dysfunction, peripheral edema, cardiac hypertrophy, myocardial ischemia, thrombosis, and cardiovascular disease. In this review, we focus on the impact of doping on psychopathological disorders, cognition, and depression. Occasionally, we also refer to chronic use of therapeutic drugs to increase physical performance and highlight the underlying mechanisms. We conclude that raising awareness on the health risks of doping in sport for all shall promote an increased awareness for healthy lifestyles across all generations.
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Affiliation(s)
- Daniela Coliță
- Doctoral School, University of Medicine and Pharmacy “Carol Davila”, 020276 Bucharest, Romania
| | - Cezar-Ivan Coliță
- Doctoral School, University of Medicine and Pharmacy “Carol Davila”, 020276 Bucharest, Romania
- Correspondence: (C.-I.C.); (I.U.); (A.P.-W.)
| | - Dirk M. Hermann
- Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Eugen Coliță
- Doctoral School, University of Medicine and Pharmacy “Carol Davila”, 020276 Bucharest, Romania
| | - Thorsten R. Doeppner
- Department of Neurology, University Medical Center Göttingen, 37075 Gottingen, Germany
- Department of Neurology, University Hospital Giessen, 35394 Giessen, Germany
| | - Ion Udristoiu
- Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (C.-I.C.); (I.U.); (A.P.-W.)
| | - Aurel Popa-Wagner
- Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
- Department of Psychiatry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (C.-I.C.); (I.U.); (A.P.-W.)
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17
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Zada W, VanRyzin JW, Perez-Pouchoulen M, Baglot SL, Hill MN, Abbas G, Clark SM, Rashid U, McCarthy MM, Mannan A. Fatty acid amide hydrolase inhibition and N-arachidonoylethanolamine modulation by isoflavonoids: A novel target for upcoming antidepressants. Pharmacol Res Perspect 2022; 10:e00999. [PMID: 36029006 PMCID: PMC9418665 DOI: 10.1002/prp2.999] [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: 06/29/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 12/01/2022] Open
Abstract
Modulation of the endocannabinoid system (ECS) is a novel putative target for therapeutic intervention in depressive disorders. Altering concentrations of one of the principal endocannabinoids, N‐arachidonoylethanolamine, also known as anandamide (AEA) can affect depressive‐like behaviors through several mechanisms including anti‐inflammatory, hormonal, and neural circuit alterations. Recently, isoflavonoids, a class of plant‐derived compounds, have been of therapeutic interest given their ability to modulate the metabolism of the endogenous ligands of the ECS. To determine the therapeutic potential of isoflavonoids, we screened several candidate compounds (Genistein, Biochanin‐A, and 7‐hydroxyflavone) in silico to determine their binding properties with fatty acid amide hydrolase (FAAH), the primary degrative enzyme for AEA. We further validated the ability of these compounds to inhibit FAAH and determined their effects on depressive‐like and locomotor behaviors in the forced swim test (FST) and open field test in male and female mice. We found that while genistein was the most potent FAAH inhibitor, 7‐hydroxyflavone was most effective at reducing immobility time in the forced swim test. Finally, we measured blood corticosterone and prefrontal cortex AEA concentrations following the forced swim test and found that all tested compounds decreased corticosterone and increased AEA, demonstrating that isoflavonoids are promising therapeutic targets as FAAH inhibitors.
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Affiliation(s)
- Wahid Zada
- Department of Pharmacy, COMSATS University Islamabad, Khyber Pakhtunkhwa, Pakistan.,Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jonathan W VanRyzin
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Miguel Perez-Pouchoulen
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Samantha L Baglot
- Hotchkiss Brain Institute and Mathison Center for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Matthew N Hill
- Hotchkiss Brain Institute and Mathison Center for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Cell Biology and Anatomy & Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Ghulam Abbas
- Department of Pharmacology, Faculty of Pharmacy, Ziauddin University, Karachi, Pakistan
| | - Sarah M Clark
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Umer Rashid
- Department of Chemistry, COMSATS University Islamabad, Khyber Pakhtunkhwa, Pakistan
| | - Margaret M McCarthy
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Abdul Mannan
- Department of Pharmacy, COMSATS University Islamabad, Khyber Pakhtunkhwa, Pakistan
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18
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Romdhani M, Souissi N, Dergaa I, Moussa-Chamari I, Chaabouni Y, Mahdouani K, Abene O, Driss T, Chamari K, Hammouda O. The effect of caffeine, nap opportunity and their combination on biomarkers of muscle damage and antioxidant defence during repeated sprint exercise. Biol Sport 2022; 39:1033-1042. [PMID: 36247953 PMCID: PMC9536395 DOI: 10.5114/biolsport.2023.112088] [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: 10/09/2021] [Revised: 11/21/2021] [Accepted: 12/01/2021] [Indexed: 11/17/2022] Open
Abstract
To investigate the effect of 20 min nap opportunity (N20), 5 mg · kg-1 of caffeine (CAF) and their combination (CAF+N20) on the biochemical response (energetic biomarkers, biomarkers of muscle damage and enzymatic antioxidants) to the running-based anaerobic sprint test. Fourteen highly trained male athletes completed in a double-blind, counterbalanced and randomized order four test sessions: no nap with placebo (PLA), N20, CAF and CAF+N20. Compared to PLA, all treatments enhanced maximum and mean powers. Minimum power was higher [(mean difference) 58.6 (95% confidence interval = 1.31-116) Watts] after CAF and [102 (29.9-175) Watts] after CAF+N20 compared to N20. Also, plasma glucose was higher after CAF [0.81 (0.18-1.45) mmol · l-1] and CAF+N20 [1.03 (0.39-1.64) mmol · l-1] compared to N20. However, plasma lactate was higher [1.64 (0.23-3.03) mmol · l-1] only after N20 compared to pre-exercise, suggesting a higher anaerobic glycolysis during N20 compared to PLA, CAF and CAF+N20. Caffeine ingestion increased post-exercise creatine kinase with [54.3 (16.7-91.1) IU · l-1] or without napping [58.9 (21.3-96.5) IU · l-1] compared to PLA. However, superoxide dismutase was higher after napping with [339 (123-554) U · gHB-1] or without caffeine [410 (195-625) U · gHB-1] compared to PLA. Probably because of the higher aerobic glycolysis contribution in energy synthesis, caffeine ingestion resulted in better repeated sprint performance during CAF and CAF+N20 sessions compared to N20 and PLA. Caffeine ingestion resulted in higher muscle damage, and the short nap enhanced antioxidant defence with or without caffeine ingestion.
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Affiliation(s)
- Mohamed Romdhani
- High Institute of Sport and Physical Education of Sfax, Sfax University, Sfax, Tunisia
- Physical activity, Sport and health, UR18JS01, National Observatory of Sports, Tunis, Tunisia
| | - Nizar Souissi
- Physical activity, Sport and health, UR18JS01, National Observatory of Sports, Tunis, Tunisia
| | | | | | - Yassine Chaabouni
- Department of biochemistry, CHU Ibn Jazzar, Kairouan, Tunisia
- Laboratory of Analysis, Treatment and Valorization of Pollutants of the Environment and Products (LATVEP) Faculty of pharmacy, University of Monastir, Monastir, Tunisia
| | - Kacem Mahdouani
- Department of biochemistry, CHU Ibn Jazzar, Kairouan, Tunisia
- Laboratory of Analysis, Treatment and Valorization of Pollutants of the Environment and Products (LATVEP) Faculty of pharmacy, University of Monastir, Monastir, Tunisia
| | - Olfa Abene
- Regional center of sport medicine, Kairouan, Tunisia
| | - Tarak Driss
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
| | - Karim Chamari
- ASPETAR, Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Omar Hammouda
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
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Becker M, Repantis D, Dresler M, Kühn S. Cognitive enhancement: Effects of methylphenidate, modafinil, and caffeine on latent memory and resting state functional connectivity in healthy adults. Hum Brain Mapp 2022; 43:4225-4238. [PMID: 35670369 PMCID: PMC9435011 DOI: 10.1002/hbm.25949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 12/02/2022] Open
Abstract
Stimulants like methylphenidate, modafinil, and caffeine have repeatedly shown to enhance cognitive processes such as attention and memory. However, brain-functional mechanisms underlying such cognitive enhancing effects of stimulants are still poorly characterized. Here, we utilized behavioral and resting-state fMRI data from a double-blind randomized placebocontrolled study of methylphenidate, modafinil, and caffeine in 48 healthy male adults. The results show that performance in different memory tasks is enhanced, and functional connectivity (FC) specifically between the frontoparietal network (FPN) and default mode network (DMN) is modulated by the stimulants in comparison to placebo. Decreased negative connectivity between right prefrontal and medial parietal but also between medial temporal lobe and visual brain regions predicted stimulant-induced latent memory enhancement. We discuss dopamine's role in attention and memory as well as its ability to modulate FC between large-scale neural networks (e.g., FPN and DMN) as a potential cognitive enhancement mechanism.
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Affiliation(s)
- Maxi Becker
- Department of PsychologyHumboldt‐University BerlinBerlinGermany
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Dimitris Repantis
- Department of Psychiatry and PsychotherapyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu BerlinBerlinGermany
| | - Martin Dresler
- Donders Institute for Brain, Cognition and BehaviourRadboud University Medical Center NijmegenNijmegenThe Netherlands
| | - Simone Kühn
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- Lise Meitner Group for Environmental NeuroscienceMax Planck Institute for Human DevelopmentBerlinGermany
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Moustafa Y, Chauhan M, Rummans TA. Attention-Deficit/Hyperactivity Disorder Overdiagnosis and Overprescriptions: Medicalization of Distractions. Mayo Clin Proc 2022; 97:1339-1344. [PMID: 35787861 DOI: 10.1016/j.mayocp.2022.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 12/01/2022]
Abstract
The use and misuse of prescription stimulants has escalated during the past decade, with concerns of being "the next epidemic." The diagnosis of attention-deficit/hyperactivity disorder and the use of prescription stimulants have rapidly increased in children and adults in the past decade. Amphetamine use more than doubled from 2006 to 2016. In 2018, among illicit substance users in the past year (53.2 million), more than 5 million 12 years or older had misused prescription stimulants. The most commonly reported motivations for misuse were to help with alertness and concentration, in approximately 60% of respondents. Most persons who misused prescription stimulants received the medication from a friend or relative, who got it through a health care provider. It is important to reexamine the pattern of prescription stimulant use after the loosening of Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for attention-deficit/hyperactivity disorder diagnosis. Caveats to the this report could be the understudied specific populations (such as medical students), the exclusion of the military and institutionalized populations from the study, and the variations among individual states in stimulant prescribing patterns.
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Affiliation(s)
- Yara Moustafa
- Department of Behavioral Health, St Elizabeth's Hospital, Washington, DC.
| | - Mohit Chauhan
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
| | - Teresa A Rummans
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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21
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Markowitz JS, Melchert PW. The Pharmacokinetics and Pharmacogenomics of Psychostimulants. Child Adolesc Psychiatr Clin N Am 2022; 31:393-416. [PMID: 35697392 DOI: 10.1016/j.chc.2022.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The psychostimulants-amphetamine and methylphenidate-have been in clinical use for well more than 60 years. In general, both stimulants are rapidly absorbed with relatively poor bioavailability and short half-lives. The pharmacokinetics of both stimulants are generally linear and dose proportional although substantial interindividual variability in pharmacokinetics is in evidence. Amphetamine (AMP) is highly metabolized by several oxidative enzymes forming multiple metabolites while methylphenidate (MPH) is primarily metabolized by hydrolysis to the inactive metabolite ritalinic acid. At present, pharmacogenomic testing as an aid to guide dosing and personalized treatment cannot be recommended for either agent. Few pharmacokinetically based drug-drug interactions (DDIs) have been documented for either stimulant.
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Affiliation(s)
- John S Markowitz
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL 32610-0486, USA; Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610-0486, USA.
| | - Philip W Melchert
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL 32610-0486, USA
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22
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Mckenzie A, Meshkat S, Lui LMW, Ho R, Di Vincenzo JD, Ceban F, Cao B, McIntyre RS. The effects of psychostimulants on cognitive functions in individuals with attention-deficit hyperactivity disorder: A systematic review. J Psychiatr Res 2022; 149:252-259. [PMID: 35303614 DOI: 10.1016/j.jpsychires.2022.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/09/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is associated with a broad range of deficits in cognitive functions which has significant implications for quality of life. Psychostimulants are demonstrated to improve symptoms of inattention and hyperactivity/impulsivity, however, their impact on cognition remains incompletely characterized. Herein, the aim of this systematic review is to synthesize the extant literature reporting on the effects of psychostimulants on cognitive function in individuals with ADHD. METHOD A systematic search of PubMed, Scopus, and Web of Science from inception to July 2021 was conducted. Additional studies were identified through Google Scholar and a manual search of the reference lists of relevant articles. Inclusion criteria were original studies that evaluated the cognitive function of individuals with ADHD taking psychostimulants drugs. We assessed the quality of the included papers using the Newcastle-Ottawa scale (NOS). RESULTS A total of 10 studies involving 753 subjects with ADHD and 194 healthy controls were identified and eligible for inclusion. Nine studies evaluated the impact of methylphenidate on cognitive function and one study investigated the use of lisdexamfetamine. Results indicated that attentional deficits such as memory, vigilance, divided attention, phasic and tonic alertness, and focused attention were improved in ADHD patients treated with psychostimulants. The efficacy of psychostimulants in improving other domains of cognition remains inconclusive due to conflicting evidence or insignificant findings (ie. academic performance and executive function). Overall, results indicate that psychostimulants may improve only select domains of cognition (ie. memory and attention). CONCLUSION Psychostimulants are reported to improve several disparate aspects of cognition among individuals with ADHD. Further research is needed to better understand the complex relationships between cognition and behavior in ADHD, as well as the impact of medication on these distinct aspects of functioning. Further research is also needed to determine whether the pro-cognitive effect of stimulants would be transferable to other mental disorders.
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Affiliation(s)
- Andrea Mckenzie
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
| | - Shakila Meshkat
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Leanna M W Lui
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger Ho
- Department of Psychological Medicine, National University Health System, Singapore; Institute for Health Innovation and Technology (iHealthtech, National University of Singapore, Singapore
| | - Joshua D Di Vincenzo
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Felicia Ceban
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, PR China
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
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23
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Xu L, Yang X, Peng Z, Song T, Wang L, Dai C, Xu M, Shao Y, Lv J. Modafinil ameliorates the decline in pronunciation-related working memory caused by 36-h acute total sleep deprivation: an ERP study. Neurobiol Learn Mem 2022; 192:107625. [DOI: 10.1016/j.nlm.2022.107625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 01/08/2023]
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24
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Blandino A, Cotroneo R, Tambuzzi S, Di Candia D, Genovese U, Zoja R. Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues. Forensic Sci Int Synerg 2022; 4:100224. [PMID: 35330981 PMCID: PMC8938866 DOI: 10.1016/j.fsisyn.2022.100224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 12/05/2022]
Abstract
Driving under the influence of alcohol has been shown to increase the risk of involvement in road traffic collisions (RTCs) however, less is known about the effects of illicit drugs, and a clear correlation between drug concentrations and RTC risk is still debated. The goal of this narrative review is to assess the current literature regarding the most detected psychoactive drugs in RTC (ethanol, amphetamines, cannabis, opioids and cocaine), in relation to driving performance. Evidence on impaired driving due to psychoactive substances, forensic issues relating to the assessment of the impact of drugs, blood cut-off values proposed to date as well as scientific basis for proposed legislative limits are discussed. At present there is no unequivocal evidence demonstrating a clear dose/concentration dependent impairment in many substances. Per se and zero tolerance approaches seem to have negative effect on drugged driving fatalities. However, the weight of these approaches needs further investigation.
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Affiliation(s)
- Alberto Blandino
- Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli 31, Milan, Italy
| | - Rosy Cotroneo
- Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli 31, Milan, Italy
| | - Stefano Tambuzzi
- Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli 31, Milan, Italy
| | - Domenico Di Candia
- Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli 31, Milan, Italy
| | - Umberto Genovese
- Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli 31, Milan, Italy
| | - Riccardo Zoja
- Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli 31, Milan, Italy
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25
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El-Solh AA, Rudraraju A, Pasrija D, Bui H. Pharmacotherapy of residual excessive sleepiness among continuous positive airway pressure (CPAP) treated patients with sleep apnea. Expert Opin Pharmacother 2022; 23:507-516. [PMID: 35045769 DOI: 10.1080/14656566.2022.2029408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Patients with persistent sleepiness after adequate treatment of obstructive sleep apnea (OSA) with nasal continuous positive airway pressure (nCPAP) experience impaired cognition, reduced productivity, and worse quality of life. Although the mechanisms responsible for this phenomenon are not completely understood, neuroimaging studies have identified reduced gray matter in the frontal cortex and alterations in white matter integrity suggestive of axonal and myelin damage. The intermittent hypoxia with resulting oxidative injury is considered a prime culprit behind the loss of wake-promoting catecholaminergic neurons. AREAS COVERED This narrative review gives an overview of the pathophysiology and approaches to managing patients with residual sleepiness. The authors explore different targeted strategies aimed at improving selection of appropriate pharmacotherapy. EXPERT OPINION Wake-stimulant medications (modafinil and armodafinil) have demonstrated efficacy in reducing sleepiness in adequately treated OSA. The recent FDA approval of pitolisant and solriamfetol complements the use of modafinil by substituting for direct sympathomimetic agents. The distinctive pharmacologic profile and mode of action of each of these agents offer the opportunity of a personalized approach to the management of this disorder. Further studies should be conducted on the long-term effect of these agents alone or in combination on brain structural and functional changes.
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Affiliation(s)
- Ali A El-Solh
- Research and Development, The Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA.,Department of Epidemiology and Environmental Health; School of Public Health and Health Professions, University at Buffalo, USA
| | - Avantika Rudraraju
- Research and Development, The Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, USA
| | - Divij Pasrija
- Research and Development, The Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, USA
| | - Hoang Bui
- Research and Development, The Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA
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26
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Pantoni MM, Kim JL, Van Alstyne KR, Anagnostaras SG. MDMA and memory, addiction, and depression: dose-effect analysis. Psychopharmacology (Berl) 2022; 239:935-949. [PMID: 35179622 PMCID: PMC8891111 DOI: 10.1007/s00213-022-06086-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/07/2022] [Indexed: 12/17/2022]
Abstract
RATIONALE ±3,4-Methylenedioxymethamphetamine (MDMA) is a recreational drug that shows substantial promise as a psychotherapeutic agent. Still, there is some concern regarding its behavioral toxicity, and its dose-effect relationship is poorly understood. We previously explored the role of dose in the cognitive effects of MDMA in a systematic review of existing literature and found no evidence in animals that MDMA impairs memory at low doses (< 3 mg/kg) but mixed results at high doses (≥ 3 mg/kg). Since this review comprised mostly of single-dose studies and an assortment of methodologies, an empirical dose-ranging study on this topic is warranted. OBJECTIVES The current study aims to evaluate the conclusion from our systematic review that 3 mg/kg may be the threshold for MDMA-induced amnesia, and to further understand the dose-effect relationship of MDMA on behavioral assays of memory, addiction, and depression. METHODS We systematically examined the effects of 0.01 to 10 mg/kg MDMA on Pavlovian fear conditioning; behavioral sensitization, conditioned place preference, and conditioned responding; and the Porsolt forced swim test in mice. RESULTS High doses of MDMA (≥ 3 mg/kg) produced amnesia of fear conditioning memory, some evidence of an addictive potential, and antidepressant effects, while low doses of MDMA (≤ 1 mg/kg) had no effect on these behaviors. CONCLUSIONS The present dose-ranging study provides further evidence that 3 mg/kg is the threshold for MDMA-induced amnesia. These findings, in addition to our systematic review, demonstrate that careful selection of MDMA dose is critical. High doses (≥ 3 mg/kg) should likely be avoided due to evidence that they can produce amnesia and addiction. Conversely, there is little evidence to suggest that low doses, which are usually administered in clinical studies (approximately 1-2 mg/kg), will lead to these same adverse effects. Ultra-low doses (< 1 mg/kg) are likely even safer and should be investigated for therapeutic effects in future studies.
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Affiliation(s)
- Madeline M. Pantoni
- grid.266100.30000 0001 2107 4242Molecular Cognition Laboratory, Department of Psychology, University of California San Diego, La Jolla, CA USA ,grid.266102.10000 0001 2297 6811Translational Psychedelic Research Program, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, CA San Francisco, USA
| | - Jinah L. Kim
- grid.266100.30000 0001 2107 4242Molecular Cognition Laboratory, Department of Psychology, University of California San Diego, La Jolla, CA USA
| | - Kaitlin R. Van Alstyne
- grid.266100.30000 0001 2107 4242Molecular Cognition Laboratory, Department of Psychology, University of California San Diego, La Jolla, CA USA
| | - Stephan G. Anagnostaras
- grid.266100.30000 0001 2107 4242Molecular Cognition Laboratory, Department of Psychology, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Molecular Cognition Laboratory, Program in Neurosciences, University of California San Diego, La Jolla, CA USA
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27
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Jian-Min C, Zhi-Yuan W, Shi-Xuan W, Rui S, Ning W, Jin L. Effects of Lisdexamfetamine, a Prodrug of D-Amphetamine, on Locomotion, Spatial Cognitive Processing and Neurochemical Profiles in Rats: A Comparison With Immediate-Release Amphetamine. Front Psychiatry 2022; 13:885574. [PMID: 35558431 PMCID: PMC9086831 DOI: 10.3389/fpsyt.2022.885574] [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: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 12/03/2022] Open
Abstract
D-amphetamine has been used to enhance cognitive performance over the last few decades. Due to the rapid absorption after administration, d-amphetamine shows narrow effective window and severe abuse potential. Lisdexamfetamine, a prodrug of d-amphetamine, reduces the magnitude of plasma d-amphetamine concentration and prolongs the action duration when compared with immediate-release d-amphetamine at equimolar doses. However, the differences of these two drugs, which produce distinct pharmacokinetic characteristics, in cognition improvement still unclear. In present study, we compared the effects of d-amphetamine (i.p) and lisdexamfetamine (p.o) at equimolar doses (0.2, 0.5, 1.5, 4.5, and 13.5 mg/kg of d-amphetamine base) on locomotion, spatial working memory and recognition memory in rats. Given the crucial involvement of dopamine neurotransmitter system within the medial prefrontal cortex (mPFC) in cognitive processing, microdialysis was conducted to profile the difference in neurochemical characteristics between the two drugs. In our results, d-amphetamine ranges from 0.5 to 1.5 mg/kg significantly increased locomotor activity. However, d-amphetamine ranges from 0.2 to 13.5 mg/kg failed to improve spatial working memory and recognition memory in Y-maze-based spontaneous alternation and two-trial delayed alternation tasks of rats, respectively. In contrast, lisdexamfetamine with 4.5 mg/kg significantly increased the locomotion and improved both spatial working and recognition memory. Further, microdialysis showed that lisdexamfetamine induced lower magnitude and longer duration of extracellular dopamine increase than that of d-amphetamine. These results suggest that lisdexamfetamine was more effective than d-amphetamine in improving spatial cognitive performance, which was attributed to the steady and lasting dopamine release pattern within the mPFC.
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Affiliation(s)
- Chen Jian-Min
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Wang Zhi-Yuan
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Wu Shi-Xuan
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Song Rui
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Wu Ning
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Li Jin
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
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28
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Higgins GA, Silenieks LB. The Effects of Drug Treatments for ADHD in Measures of Cognitive Performance. Curr Top Behav Neurosci 2022; 57:321-362. [PMID: 35606638 DOI: 10.1007/7854_2022_341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Based on core symptoms of inattention and deficient impulse control, and the identification of effective pharmacotherapies such as amphetamine (AMP; Adderall®), methylphenidate (MPH; Ritalin®), and atomoxetine (ATX; Strattera®), ADHD is a clinical condition which provides opportunity for translational research. Neuropsychological tests such as the 5-Choice and Continuous Performance Tasks, which measure aspects of attention and impulse control in animals and humans, provide scope for both forward (animal to human) and reverse (human to animal) translation. Rodent studies support pro-attentive effects of AMP and MPH and effectiveness in controlling some forms of impulsive behavior. In contrast, any pro-attentive effects of ATX appear to be less consistent, the most reliable effects of ATX are recorded in tests of impulsivity. These differences may account for AMP and MPH being recognized as first-line treatments for ADHD with a higher efficacy relative to ATX. DSM-5 classifies three "presentations" of ADHD: predominantly inattentive type (ADHD-I), predominantly hyperactive/impulsive type (ADHD-HI), or combined (ADHD-C). Presently, it is unclear whether AMP, MPH, or ATX has differential levels of efficacy across these presentation types. Nonetheless, these studies encourage confidence for the forward translation of NCEs in efforts to identify newer pharmacotherapies for ADHD.
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Affiliation(s)
- Guy A Higgins
- Intervivo Solutions, Toronto, ON, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
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29
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Riccardi E, Blasi E, Zwergel C, Mai A, Morena M, Campolongo P. Sex-dependent Effects of the Drugs of Abuse Amphetamine and the Smart Drug 3,4-Methylenedioxypyrovalerone on Fear Memory Generalization in Rats. Neuroscience 2021; 497:107-117. [PMID: 34968670 DOI: 10.1016/j.neuroscience.2021.12.027] [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: 09/16/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022]
Abstract
In recent years there has been an increase in the development of new synthetic drugs, among which the "bath salt" 3,4-methylenedioxypyrovalerone (MDPV), a psychostimulant with a mechanism of action similar to those of cocaine and amphetamine, stands out. Drugs of abuse have been consistently shown to affect memory function in male rodents. We have recently shown that amphetamine and MDPV induce generalization of fear memory in an inhibitory avoidance discrimination task in male rats. Although abuse of illicit drugs is more prevalent in men than in women, several studies have demonstrated that females are more vulnerable to the effects of drugs of abuse than males and the effects caused by substance dependence on memory in females are still under-investigated. Thus, we examined the effects of subchronic amphetamine or MDPV administrations on memory in a contextual fear conditioning/generalization paradigm in adult male and female rats. Animals were given daily subchronic injections of the drugs, starting 6 days prior the beginning of the behavioral procedures until the end of the paradigm. On day 1 of the experimental protocol, all rats were exposed to a safe context and, the day after, to a slightly different chamber where they received an unsignaled footshock. Twenty-four and forty-eight hours later, freezing behavior and emission of 22 kHz-ultrasonic vocalizations (USVs) were measured in the two different contexts to assess fear memory retention and generalization. Our results indicate that MDPV treatment altered freezing in both sexes, USVs were affected by amphetamine in males while by MDPV in females.
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Affiliation(s)
- Eleonora Riccardi
- Dept. of Physiology and Pharmacology, Sapienza University of Rome, 00185 Rome, Italy; European Center for Brain Research (CERC), Santa Lucia Foundation, 00143 Rome, Italy
| | - Eleonora Blasi
- Dept. of Physiology and Pharmacology, Sapienza University of Rome, 00185 Rome, Italy; European Center for Brain Research (CERC), Santa Lucia Foundation, 00143 Rome, Italy
| | - Clemens Zwergel
- Dept. of Drug Chemistry & Technologies, Sapienza University of Rome, 00185 Rome, Italy; Dept. of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Antonello Mai
- Dept. of Drug Chemistry & Technologies, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Morena
- Dept. of Physiology and Pharmacology, Sapienza University of Rome, 00185 Rome, Italy; European Center for Brain Research (CERC), Santa Lucia Foundation, 00143 Rome, Italy
| | - Patrizia Campolongo
- Dept. of Physiology and Pharmacology, Sapienza University of Rome, 00185 Rome, Italy; European Center for Brain Research (CERC), Santa Lucia Foundation, 00143 Rome, Italy.
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30
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Shyu BC, Gao ZY, Wu JJS, He ABH, Cheng CN, Huang ACW. Methamphetamine and Modulation Functionality of the Prelimbic Cortex for Developing a Possible Treatment of Alzheimer's Disease in an Animal Model. Front Aging Neurosci 2021; 13:751913. [PMID: 34744692 PMCID: PMC8564002 DOI: 10.3389/fnagi.2021.751913] [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: 08/02/2021] [Accepted: 09/27/2021] [Indexed: 11/24/2022] Open
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative condition that causes cognitive impairment and other neuropsychiatric symptoms. Previously, little research has thus far investigated whether methamphetamine (MAMPH) can enhance cognitive function or ameliorate AD symptoms. This study examined whether a low dose of MAMPH can induce conditioned taste aversion (CTA) learning, or can increase plasma corticosterone levels, neural activity, and neural plasticity in the medial prefrontal cortex (mPFC) (responsible for cognitive function), the nucleus accumbens (NAc) and the amygdala (related to rewarding and aversive emotion), and the hippocampus (responsible for spatial learning). Furthermore, the excitations or lesions of the prelimbic cortex (PrL) can affect MAMPH-induced CTA learning, plasma corticosterone levels, and neural activity or plasticity in the mPFC [i.e., PrL, infralimbic cortex (IL), cingulate cortex 1 (Cg1)], the NAc, the amygdala [i.e., basolateral amygdala (BLA) and central amygdala (CeA)], and the hippocampus [i.e., CA1, CA2, CA3, and dentate gyrus (DG)]. In the experimental procedure, the rats were administered either saline or NMDA solutions, which were injected into the PrL to excite or destroy PrL neurons. Additionally, rats received 0.1% saccharin solution for 15 min, followed by intraperitoneal injections of either normal saline or 1 mg/kg MAMPH to induce CTA. A one-way ANOVA was performed to analyze the effects of saccharin intake on CTA, plasma corticosterone levels, and the expression of c-Fos and p-ERK. The results showed that the MAMPH induced CTA learning and increased plasma corticosterone levels. The mPFC, and particularly the PrL and IL and the DG of the hippocampus, appeared to show increased neural activity in c-Fos expression or neural plasticity in p-ERK expression. The excitation of the PrL neurons upregulated neural activity in c-Fos expression and neural plasticity in p-ERK expression in the PrL and IL. In summary, MAMPH may be able to improve cognitive and executive function in the brain and reduce AD symptoms. Moreover, the excitatory modulation of the PrL with MAMPH administration can facilitate MAMPH-induced neural activity and plasticity in the PrL and IL of the mPFC. The present data provide clinical implications for developing a possible treatment for AD in an animal model.
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Affiliation(s)
- Bai-Chuang Shyu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Zhi-Yue Gao
- Yuanshan Branch, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Alan Bo Han He
- Department of Psychology, Fo Guang University, Yilan, Taiwan
| | - Cai-N Cheng
- Department of Psychology, Fo Guang University, Yilan, Taiwan.,Department of Life Sciences, National Central University, Taoyuan City, Taiwan
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31
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Gagnon LR, Sadasivan C, Perera K, Oudit GY. Cardiac Complications of Common Drugs of Abuse: Pharmacology, Toxicology and Management. Can J Cardiol 2021; 38:1331-1341. [PMID: 34737034 DOI: 10.1016/j.cjca.2021.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022] Open
Abstract
Cardiovascular complications from drugs of abuse are becoming more apparent due to increased usage worldwide. Substance abuse can cause both acute and chronic cardiovascular complications and is increasing in prevalence especially in young adults. These substances contribute to the development of acute coronary syndrome, type II myocardial injury, arrhythmias, cardiomyopathies and have numerous other cardiovascular complications. Although no screening guidelines exist, clinical awareness of these potential complications and their prevention, clinical presentation, diagnosis, and treatment are critically important. Management of cardiovascular disease should be coupled with appropriate social and mental health interventions to provide sustained clinical benefit. The higher the number of substances used recreationally, the greater the risk of premature heart disease. Epidemiological studies showed that 1 in 5 young adults misuse several substances and often start using at younger ages with a greater risk for adverse health outcomes over the long-term. The aim of this review is to highlight the basic epidemiology, cardiac complications, and disease-specific treatment options of commonly abused substances including methamphetamine, cocaine, alcohol, anabolic-androgenic steroids, cannabis, and tobacco.
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Affiliation(s)
- Luke R Gagnon
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Chandu Sadasivan
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin Perera
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Gavin Y Oudit
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
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Adam LC, Repantis D, Konrad BN, Dresler M, Kühn S. Memory enhancement with stimulants: Differential neural effects of methylphenidate, modafinil, and caffeine. A pilot study. Brain Cogn 2021; 154:105802. [PMID: 34592684 DOI: 10.1016/j.bandc.2021.105802] [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: 05/27/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 11/18/2022]
Abstract
Human memory is susceptible to manipulation in many respects. While consolidation is well known to be prone to disruption, there is also growing evidence for the enhancement of memory function. Beside cognitive strategies and mnemonic training, the use of stimulants may improve memory processing in healthy adults. In this single-dose, double-blind, within-subject, randomized, placebo-controlled pilot study, 20 mg methylphenidate (N = 13) or 200 mg modafinil (N = 12) or 200 mg caffeine (N = 14) were administrated to in total 39 healthy participants while performing a declarative memory task. Each participant received only one substance and functional magnetic resonance imaging (fMRI) was used to assess drug-dependent memory effects of the substance for encoding and recognition compared to task-related activation under placebo. While methylphenidate showed some behavioral effect regarding memory recall performance, on the neural level, methylphenidate-dependent deactivations were found in fronto-parietal and temporal regions during recognition of previously learned words. No BOLD alterations were seen during encoding. Caffeine led to deactivations in the precentral gyrus during encoding whereas modafinil did not show any BOLD signal alterations at all. These results should be interpreted with caution since this a pilot study with several limitations, most importantly the small number of participants per group. However, our main finding of task-related deactivations may point to a drug-dependent increase of efficiency in physiological response to memory processing.
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Affiliation(s)
- Lucas C Adam
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Dimitris Repantis
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany.
| | - Boris N Konrad
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Simone Kühn
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany; University Medical Center Hamburg-Eppendorf (UKE), Department of Psychiatry and Psychotherapy, Hamburg, Germany
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Krief S, Berrebi‐Bertrand I, Nagmar I, Giret M, Belliard S, Perrin D, Uguen M, Robert P, Lecomte J, Schwartz J, Finance O, Ligneau X. Pitolisant, a wake-promoting agent devoid of psychostimulant properties: Preclinical comparison with amphetamine, modafinil, and solriamfetol. Pharmacol Res Perspect 2021; 9:e00855. [PMID: 34423920 PMCID: PMC8381683 DOI: 10.1002/prp2.855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 01/04/2023] Open
Abstract
Several therapeutic options are currently available to treat excessive daytime sleepiness (EDS) in patients suffering from narcolepsy or obstructive sleep apnea. However, there are no comparisons between the various wake-promoting agents in terms of mechanism of action, efficacy, or safety. The goal of this study was to compare amphetamine, modafinil, solriamfetol, and pitolisant at their known primary pharmacological targets, histamine H3 receptors (H3R), dopamine, norepinephrine, and serotonin transporters, and in various in vivo preclinical models in relation to neurochemistry, locomotion, behavioral sensitization, and food intake. Results confirmed that the primary pharmacological effect of amphetamine, modafinil, and solriamfetol was to increase central dopamine neurotransmission, in part by inhibiting its transporter. Furthermore, solriamfetol increased levels of extracellular dopamine in the nucleus accumbens, and decreased the 3,4-dihydroxyphenyl acetic acid (DOPAC)/DA ratio in the striatum, as reported for modafinil and amphetamine. All these compounds produced hyperlocomotion, behavioral sensitization, and hypophagia, which are common features of psychostimulants and of compounds with abuse potential. In contrast, pitolisant, a selective and potent H3R antagonist/inverse agonist that promotes wakefulness, had no effect on striatal dopamine, locomotion, or food intake. In addition, pitolisant, devoid of behavioral sensitization by itself, attenuated the hyperlocomotion induced by either modafinil or solriamfetol. Therefore, pitolisant presents biochemical, neurochemical, and behavioral profiles different from those of amphetamine and other psychostimulants such as modafinil or solriamfetol. In conclusion, pitolisant is a differentiated therapeutic option, when compared with psychostimulants, for the treatment of EDS, as this agent does not show any amphetamine-like properties within in vivo preclinical models.
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Ferrucci M, Biagioni F, Busceti CL, Vidoni C, Castino R, Isidoro C, Ryskalin L, Frati A, Puglisi-Allegra S, Fornai F. Inhibition of Autophagy In Vivo Extends Methamphetamine Toxicity to Mesencephalic Cell Bodies. Pharmaceuticals (Basel) 2021; 14:ph14101003. [PMID: 34681227 PMCID: PMC8538796 DOI: 10.3390/ph14101003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 01/21/2023] Open
Abstract
Methamphetamine (METH) is a widely abused psychostimulant and a stress-inducing compound, which leads to neurotoxicity for nigrostriatal dopamine (DA) terminals in rodents and primates including humans. In vitro studies indicate that autophagy is a strong modulator of METH toxicity. In detail, suppressing autophagy increases METH toxicity, while stimulating autophagy prevents METH-induced toxicity in cell cultures. In the present study, the role of autophagy was investigated in vivo. In the whole brain, METH alone destroys meso-striatal DA axon terminals, while fairly sparing DA cell bodies within substantia nigra pars compacta (SNpc). No damage to either cell bodies or axons from ventral tegmental area (VTA) is currently documented. According to the hypothesis that ongoing autophagy prevents METH-induced DA toxicity, we tested whether systemic injection of autophagy inhibitors such as asparagine (ASN, 1000 mg/Kg) or glutamine (GLN, 1000 mg/Kg), may extend METH toxicity to DA cell bodies, both within SNpc and VTA, where autophagy was found to be inhibited. When METH (5 mg/Kg × 4, 2 h apart) was administered to C57Bl/6 mice following ASN or GLN, a frank loss of cell bodies takes place within SNpc and a loss of both axons and cell bodies of VTA neurons is documented. These data indicate that, ongoing autophagy protects DA neurons and determines the refractoriness of cell bodies to METH-induced toxicity.
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Affiliation(s)
- Michela Ferrucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy; (M.F.); (L.R.)
| | - Francesca Biagioni
- I.R.C.C.S. Neuromed, Via Atinense 18, 86077 Isernia, Italy; (F.B.); (C.L.B.); (A.F.); (S.P.-A.)
| | - Carla L. Busceti
- I.R.C.C.S. Neuromed, Via Atinense 18, 86077 Isernia, Italy; (F.B.); (C.L.B.); (A.F.); (S.P.-A.)
| | - Chiara Vidoni
- Department of Health Sciences, Università del Piemonte Orientale, Via P. Solaroli 17, 28100 Novara, Italy; (C.V.); (R.C.); (C.I.)
| | - Roberta Castino
- Department of Health Sciences, Università del Piemonte Orientale, Via P. Solaroli 17, 28100 Novara, Italy; (C.V.); (R.C.); (C.I.)
| | - Ciro Isidoro
- Department of Health Sciences, Università del Piemonte Orientale, Via P. Solaroli 17, 28100 Novara, Italy; (C.V.); (R.C.); (C.I.)
| | - Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy; (M.F.); (L.R.)
| | - Alessandro Frati
- I.R.C.C.S. Neuromed, Via Atinense 18, 86077 Isernia, Italy; (F.B.); (C.L.B.); (A.F.); (S.P.-A.)
- Neurosurgery Division, Human Neurosciences Department, Sapienza University, 00135 Rome, Italy
| | - Stefano Puglisi-Allegra
- I.R.C.C.S. Neuromed, Via Atinense 18, 86077 Isernia, Italy; (F.B.); (C.L.B.); (A.F.); (S.P.-A.)
| | - Francesco Fornai
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy; (M.F.); (L.R.)
- I.R.C.C.S. Neuromed, Via Atinense 18, 86077 Isernia, Italy; (F.B.); (C.L.B.); (A.F.); (S.P.-A.)
- Correspondence: or ; Tel.: +39-050-2218601
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Ryskalin L, Biagioni F, Busceti CL, Polzella M, Lenzi P, Frati A, Ferrucci M, Fornai F. Lactoferrin Protects against Methamphetamine Toxicity by Modulating Autophagy and Mitochondrial Status. Nutrients 2021; 13:nu13103356. [PMID: 34684361 PMCID: PMC8537867 DOI: 10.3390/nu13103356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 01/18/2023] Open
Abstract
Lactoferrin (LF) was used at first as a vehicle to deliver non-soluble active compounds to the body, including the central nervous system (CNS). Nonetheless, it soon became evident that, apart from acting as a vehicle, LF itself owns active effects in the CNS. In the present study, the effects of LF are assessed both in baseline conditions, as well as to counteract methamphetamine (METH)-induced neurodegeneration by assessing cell viability, cell phenotype, mitochondrial status, and specific autophagy steps. In detail, cell integrity in baseline conditions and following METH administration was carried out by using H&E staining, Trypan blue, Fluoro Jade B, and WST-1. Western blot and immuno-fluorescence were used to assess the expression of the neurofilament marker βIII-tubulin. Mitochondria were stained using Mito Tracker Red and Green and were further detailed and quantified by using transmission electron microscopy. Autophagy markers were analyzed through immuno-fluorescence and electron microscopy. LF counteracts METH-induced degeneration. In detail, LF significantly attenuates the amount of cell loss and mitochondrial alterations produced by METH; and mitigates the dissipation of autophagy-related proteins from the autophagy compartment, which is massively induced by METH. These findings indicate a protective role of LF in the molecular mechanisms of neurodegeneration.
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Affiliation(s)
- Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy; (L.R.); (P.L.); (M.F.)
| | - Francesca Biagioni
- Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy; (F.B.); (C.L.B.); (A.F.)
| | - Carla L. Busceti
- Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy; (F.B.); (C.L.B.); (A.F.)
| | - Maico Polzella
- Aliveda Laboratories, Viale Karol Wojtyla, 19, 56042 Crespina Lorenzana, Italy;
| | - Paola Lenzi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy; (L.R.); (P.L.); (M.F.)
| | - Alessandro Frati
- Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy; (F.B.); (C.L.B.); (A.F.)
- Neurosurgery Division, Human Neurosciences Department, Sapienza University, 00135 Rome, Italy
| | - Michela Ferrucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy; (L.R.); (P.L.); (M.F.)
| | - Francesco Fornai
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy; (L.R.); (P.L.); (M.F.)
- Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy; (F.B.); (C.L.B.); (A.F.)
- Correspondence:
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Fedotchev A, Parin S, Polevaya S, Zemlianaia A. EEG-based musical neurointerfaces in the correction of stress-induced states. BRAIN-COMPUTER INTERFACES 2021. [DOI: 10.1080/2326263x.2021.1964874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alexander Fedotchev
- Department of Psychophysiology, Lobachevsky State University of Nizhni Novgorod, Nizhny Novgorod, Russia
- Department of Mechanisms of Reception, Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, Russia
| | - Sergey Parin
- Department of Psychophysiology, Lobachevsky State University of Nizhni Novgorod, Nizhny Novgorod, Russia
| | - Sofia Polevaya
- Department of Psychophysiology, Lobachevsky State University of Nizhni Novgorod, Nizhny Novgorod, Russia
| | - Anna Zemlianaia
- Department of Psychophysiology, Moscow Research Institute of Psychiatry, Branch of the Serbsky‘ National Medical Research Center of Psychiatry and Narcology, Russian Ministry of Health, Moscow, Russia
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Nirogi R, Mohammed AR, Shinde AK, Gagginapally SR, Kancharla DM, Ravella SR, Bogaraju N, Middekadi VR, Subramanian R, Palacharla RC, Benade V, Muddana N, Abraham R, Medapati RB, Thentu JB, Mekala VR, Petlu S, Lingavarapu BB, Yarra S, Kagita N, Goyal VK, Pandey SK, Jasti V. Discovery and Preclinical Characterization of Usmarapride (SUVN-D4010): A Potent, Selective 5-HT 4 Receptor Partial Agonist for the Treatment of Cognitive Deficits Associated with Alzheimer's Disease. J Med Chem 2021; 64:10641-10665. [PMID: 34251799 DOI: 10.1021/acs.jmedchem.1c00703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A series of oxadiazole derivatives were synthesized and evaluated as 5-hydroxytryptamine-4 receptor (5-HT4R) partial agonists for the treatment of cognitive deficits associated with Alzheimer's disease. Starting from a reported 5-HT4R antagonist, a systematic structure-activity relationship was conducted, which led to the discovery of potent and selective 5-HT4R partial agonist 1-isopropyl-3-{5-[1-(3-methoxypropyl) piperidin-4-yl]-[1,3,4]oxadiazol-2-yl}-1H-indazole oxalate (Usmarapride, 12l). It showed balanced physicochemical-pharmacokinetic properties with robust nonclinical efficacy in cognition models. It also showed disease-modifying potential, as it increased neuroprotective soluble amyloid precursor protein alpha levels, and dose-dependent target engagement and correlation of efficacy with oral exposures. Phase 1 clinical studies have been completed and projected efficacious concentration was achieved without any major safety concerns. Phase 2 enabling long-term safety studies have been completed with no concerns for further development.
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Affiliation(s)
- Ramakrishna Nirogi
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Abdul Rasheed Mohammed
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Anil Karbhari Shinde
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | | | | | - Srinivasa Rao Ravella
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Narsimha Bogaraju
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Vanaja Reddy Middekadi
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Ramkumar Subramanian
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | | | - Vijay Benade
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Nageswararao Muddana
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Renny Abraham
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Rajesh Babu Medapati
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Jagadeesh Babu Thentu
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Venkat Reddy Mekala
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Surendra Petlu
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Bujji Babu Lingavarapu
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Sivasekhar Yarra
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Narendra Kagita
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Vinod Kumar Goyal
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Santosh Kumar Pandey
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
| | - Venkat Jasti
- Suven Life Sciences Limited, Serene Chambers, Road-5, Avenue-7, Banjara Hills, Hyderabad 500 034, India
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Valenti O, Zambon A, Boehm S. Orchestration of Dopamine Neuron Population Activity in the Ventral Tegmental Area by Caffeine: Comparison With Amphetamine. Int J Neuropsychopharmacol 2021; 24:832-841. [PMID: 34278424 PMCID: PMC8538898 DOI: 10.1093/ijnp/pyab049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/30/2021] [Accepted: 07/16/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Among psychostimulants, the dopamine transporter ligands amphetamine and cocaine display the highest addictive potential; the adenosine receptor antagonist caffeine is most widely consumed but less addictive. Psychostimulant actions of amphetamine were correlated with its ability to orchestrate ventral tegmental dopamine neuron activity with contrasting shifts in firing after single vs repeated administration. Whether caffeine might impinge on dopamine neuron activity has remained elusive. METHODS Population activity of ventral tegmental area dopamine neurons was determined by single-unit extracellular recordings and set in relation to mouse behavior in locomotion and conditioned place preference experiments, respectively. RESULTS A single dose of caffeine reduced population activity as did amphetamine and the selective adenosine A2A antagonist KW-6002, but not the A1 antagonist DPCPX. Repeated administration of KW-6002 or amphetamine led to drug-conditioned place preference and to unaltered or even enhanced population activity. Recurrent injection of caffeine or DPCPX, in contrast, failed to cause conditioned place preference and persistently reduced population activity. Subsequent to repetitive drug administration, re-exposure to amphetamine or KW-6002, but not to caffeine or DPCPX, was able to reduce population activity. CONCLUSIONS Behavioral sensitization to amphetamine is attributed to persistent activation of ventral tegmental area dopamine neurons via the ventral hippocampus. Accordingly, a switch from acute A2A receptor-mediated reduction of dopamine neuron population activity to enduring A1 receptor-mediated suppression is correlated with tolerance rather than sensitization in response to repeated caffeine intake.
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Affiliation(s)
- Ornella Valenti
- Division of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University Vienna, Vienna, Austria,Correspondence: Assoc. Prof. Ornella Valenti, Schwarzspanierstrasse 17, 1090 Vienna, Austria ()
| | - Alice Zambon
- Division of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University Vienna, Vienna, Austria
| | - Stefan Boehm
- Division of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University Vienna, Vienna, Austria
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Haghighi M, Doostizadeh M, Jahangard L, Soltanian A, Faryadres M, Dürsteler KM, Beatrix Brühl A, Sadeghi-Bahmani D, Brand S. Influence of Lisdexamfetamine Dimesylate on Early Ejaculation-Results from a Double-Blind Randomized Clinical Trial. Healthcare (Basel) 2021; 9:859. [PMID: 34356237 PMCID: PMC8303163 DOI: 10.3390/healthcare9070859] [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: 06/01/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Among male sexual dysfunctions, erectile dysfunction and early ejaculation have the highest prevalence rates. Here, we tested the influence of lisdexamfetamine dimesylate (Vyas®) on early ejaculation. To this end, we performed a double-blind randomized clinical trial among males with early ejaculation. METHODS A total of 46 males with early ejaculation (mean age: 35.23 years) and in stable marital relationships with regular weekly penile-vaginal intercourse were randomly assigned either to the lisdexamfetamine dimesylate condition (30 mg) or to the placebo condition. Compounds were taken about six hours before intended penile-vaginal intercourse. At baseline and four weeks later at the end of the study, participants completed a series of self-rating questionnaires covering early ejaculation. Female partners also rated participants' early ejaculation profile. RESULTS Compared to the placebo condition, dimensions of early ejaculation improved over time in the lisdexamfetamine condition, though improvements were also observed in the placebo condition. CONCLUSIONS Among male adults in stable marital relationships with regular weekly penile-vaginal intercourse, lisdexamfetamine dimesylate improved dimensions of early ejaculation. Given that improvements were also observed in the placebo condition, psychological factors such as increased attention to early ejaculation and favorable expectations of the compound should be considered.
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Affiliation(s)
- Mohammad Haghighi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Mona Doostizadeh
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Leila Jahangard
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Alireza Soltanian
- Modeling of Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
| | - Mohammad Faryadres
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
| | - Kenneth M. Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002 Basel, Switzerland;
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8001 Zurich, Switzerland
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
| | - Dena Sadeghi-Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
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Ahmed A, Ruiz MJ, Cohen Kadosh K, Patton R, Resurrección DM. Khat and neurobehavioral functions: A systematic review. PLoS One 2021; 16:e0252900. [PMID: 34111184 PMCID: PMC8192015 DOI: 10.1371/journal.pone.0252900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/24/2021] [Indexed: 12/09/2022] Open
Abstract
Background Khat is a plant that is used for its amphetamine-like stimulant properties. However, although khat is very popular in Eastern Africa, Arabian Peninsula, and the Middle East, there is still a lack of studies researching the possible neurobehavioral impairment derived from khat use. Methods A systematic review was conducted to identify studies that assessed the effects of khat use on neurobehavioral functions. MedLine, Scopus, Cochrane, Web of Science and Open Grey literature were searched for relevant publications from inception to December 2020. Search terms included (a) khat and (b) several cognitive domains. References from relevant publications and grey literature were also reviewed to identify additional citations for inclusion. Results A total of 142 articles were reviewed, 14 of which met the inclusion criteria (nine human and five rodent studies). Available human studies suggest that long term khat use is associated with significant deficits in several cognitive domains, including learning, motor speed/coordination, set-shifting/response inhibition functions, cognitive flexibility, short term/working memory, and conflict resolution. In addition, rodent studies indicated daily administration of khat extract resulted in dose-related impairments in behavior such as motor hyperactivity and decreased cognition, mainly learning and memory. Conclusions The findings presented in this review indicates that long-term khat use may be contributing to an impairment of neurobehavioral functions. However, gaps in literature were detected that future studies could potentially address to better understand the health consequences of khat use.
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Affiliation(s)
- Ayan Ahmed
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
- * E-mail:
| | - Manuel J. Ruiz
- Department of Psychology, University of Extremadura, Badajoz, Badajoz, Spain
| | - Kathrin Cohen Kadosh
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Robert Patton
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
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Marazziti D, Avella MT, Ivaldi T, Palermo S, Massa L, Vecchia AD, Basile L, Mucci F. Neuroenhancement: State of the Art and Future Perspectives. CLINICAL NEUROPSYCHIATRY 2021; 18:137-169. [PMID: 34909030 PMCID: PMC8629054 DOI: 10.36131/cnfioritieditore20210303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pharmacological neuroenhancement refers to the non-medical use of prescription drugs, alcohol, illegal drugs, or the so-called soft enhancers for the purpose of improving cognition, mood, pro-social behavior, or work and academic performance. This phenomenon is undoubtedly more frequent than previously supposed especially amongst university students. The aim of the present paper was to carefully review and comment on the available literature on neuroenhancement, according to Prisma guidelines. The results showed a great use of all prescribed drugs (benzodiazepines, antidepressants, antipsychotics, nootropic compounds, and especially stimulants) as neuroenhancers amongst healthy subjects, although probably the real prevalence is underestimated. The use of illicit drugs and soft enhancers is similarly quite common. Data on the improvement of cognition by other compounds, such as oxytocin and pheromones, or non-pharmacological techniques, specifically deep brain stimulation and transcranial magnetic stimulation, are still limited. In any case, if it is true that human beings are embedded by the desire to overcome the limits of their intrinsic nature, neuroenhancement practices put into question the concept of authenticity. Therefore, the problem appears quite complex and requires to be deepened and analyzed with no prejudice, although within an ethical conceptual frame.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Maria Teresa Avella
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Tea Ivaldi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Stefania Palermo
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Alessandra Della Vecchia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Basile
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy
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Belloni S, Arrigoni C, de Sanctis R, Arcidiacono MA, Dellafiore F, Caruso R. A systematic review of systematic reviews and pooled meta-analysis on pharmacological interventions to improve cancer-related fatigue. Crit Rev Oncol Hematol 2021; 166:103373. [PMID: 34051301 DOI: 10.1016/j.critrevonc.2021.103373] [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: 02/25/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Evidence regarding the pharmacological interventions to manage cancer-related fatigue (CRF) is currently synthesized in several systematic reviews, portraying a fragmented literature synthesis. Thus, we aimed to critically appraise the available systematic reviews on pharmacological intervention for improving CRF in adult cancer patients. METHODS Three databases were systematically searched from January 2010 to July 2020. The pooled meta-analyses' effect sizes (standardized mean difference, SMD) were quantitatively pooled using a random-effects model. Chi-squared (Q) and I-square statistics (I²) tested the heterogeneity. RESULTS The SMD of the effect of psychostimulants on CRF was -0.20 (95% CI: -0.32, 0.08; p < 0.0001), along with significant higher improvement of fatigue (SMD=-0.69; 95% CI=-1.29, -0,09, p < 0.0001) after methylphenidate administration. No statistical differences were found in the occurrences of adverse events between methylphenidate and placebo. CONCLUSIONS This study corroborated that psychostimulant therapy may be moderately effective in reducing CRF. Scarce evidence on the short- and long-term adverse events. PROSPERO CRD42020181879 (registration date: 26/07/2020).
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Affiliation(s)
- Silvia Belloni
- Educational and research unit, Humanitas Research Hospital - IRCCS, via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Rita de Sanctis
- Medical Oncology and Hematology Unit, Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | | | - Federica Dellafiore
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Lifetime evolution of ADHD treatment. J Neural Transm (Vienna) 2021; 128:1085-1098. [PMID: 33993352 DOI: 10.1007/s00702-021-02336-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD), has been traditionally considered a neurodevelopmental disorder affecting children and adolescents characterized by inattention, hyperactivity, disruptive behavior, and impulsivity. Although still debated, it is evident that ADHD is also present in adulthood, but this diagnosis is rarely carried out, mainly for the frequent comorbidity with other psychiatric and/or substance abuse disorders. Given the need to shed more light on the pharmacological treatment of ADHD, we performed a naturalistic review to review and comment on the available literature of ADHD treatment across the lifespan. Indeed, stimulants are endowed of a prompt efficacy and safety, whilst non-stimulants, although requiring some weeks to be fully effective, are useful when a substance abuse history is detected. In any case, the pharmacological management of ADHD appears to be still largely influenced by the individual experience of the clinicians. Further longitudinal studies with a careful and detailed characterization of participants across different phases of the lifespan are also required to provide relevant confirmations (or denials) regarding pharmacological treatments amongst the different age groups.
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Kuo HI, Qi FX, Paulus W, Kuo MF, Nitsche MA. Noradrenergic Enhancement of Motor Learning, Attention, and Working Memory in Humans. Int J Neuropsychopharmacol 2021; 24:490-498. [PMID: 33617635 PMCID: PMC8278798 DOI: 10.1093/ijnp/pyab006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/15/2020] [Accepted: 02/18/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Noradrenaline has an important role as a neuromodulator of the central nervous system. Noradrenergic enhancement was recently shown to enhance glutamate-dependent cortical facilitation and long term potentiation-like plasticity. As cortical excitability and plasticity are closely linked to various cognitive processes, here we aimed to explore whether these alterations are associated with respective cognitive performance changes. Specifically, we assessed the impact of noradrenergic enhancement on motor learning (serial reaction time task), attentional processes (Stroop interference task), and working memory performance (n-back letter task). METHODS The study was conducted in a cross-over design. Twenty-five healthy humans performed the respective cognitive tasks after a single dose of the noradrenaline reuptake inhibitor reboxetine or placebo administration. RESULTS The results show that motor learning, attentional processes, and working memory performance in healthy participants were improved by reboxetine application compared with placebo. CONCLUSIONS The results of the present study thus suggest that noradrenergic enhancement can improve memory formation and executive functions in healthy humans. The respective changes are in line with related effects of noradrenaline on cortical excitability and plasticity.
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Affiliation(s)
- Hsiao-I Kuo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan,Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Feng-Xue Qi
- Key Laboratory of Sport Training of General Admission of Sport of China, Beijing Sport University, Xinxin Road, Haidian District, Beijing, China,Department of Sport Training, Sport Coaching College, Beijing Sport University, Beijing, China
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Min-Fang Kuo
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Michael A Nitsche
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany,Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany,Correspondence: M. A. Nitsche, MD, Department Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Ardeystrasse 67, 44139 Dortmund, Germany ()
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Karnib N, van Staaden MJ. The Deep Roots of Addiction: A Comparative Perspective. BRAIN, BEHAVIOR AND EVOLUTION 2021; 95:222-229. [PMID: 33567426 DOI: 10.1159/000514180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022]
Abstract
Addiction is a debilitating condition that extracts enormous social and economic tolls. Despite several decades of research, our knowledge of its etiology, preventive measures, and treatments is limited. A relatively recent research field with the potential to provide a more holistic understanding, and subsequently treatments, takes a phylogenetic view of addiction. This perspective is based on deep homologies at the genetic, proteomic, and behavioral levels, which are shared across all metazoan life; particularly those organisms faced with plant secondary metabolites as defensive compounds against insect herbivory. These addictive alkaloids, such as nicotine, cocaine, or cathinone, are commonly referred to as "human drugs of abuse" even though humans had little to no role in the co-evolutionary processes that determined their initial emergence or continued selection. This commentary discusses the overwhelming homologies of addictive alkaloid effects on neural systems across a wide range of taxa, as we aim to develop a broader comparative view of the "addicted brain." Taking nicotine as an example, homologous physiological responses to this compound identify common underlying cellular and molecular mechanisms that advocate for the adoption of a phylogenetic view of addiction.
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Affiliation(s)
- Nabil Karnib
- Department of Biological Sciences, JP Scott Center for Neuroscience, Mind and Behavior, Bowling Green State University, Bowling Green, Ohio, USA
| | - Moira J van Staaden
- Department of Biological Sciences, JP Scott Center for Neuroscience, Mind and Behavior, Bowling Green State University, Bowling Green, Ohio, USA,
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Repantis D, Bovy L, Ohla K, Kühn S, Dresler M. Cognitive enhancement effects of stimulants: a randomized controlled trial testing methylphenidate, modafinil, and caffeine. Psychopharmacology (Berl) 2021; 238:441-451. [PMID: 33201262 PMCID: PMC7826302 DOI: 10.1007/s00213-020-05691-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022]
Abstract
RATIONAL At all times humans have made attempts to improve their cognitive abilities by different means, among others, with the use of stimulants. Widely available stimulants such as caffeine, but also prescription substances such as methylphenidate and modafinil, are being used by healthy individuals to enhance cognitive performance. OBJECTIVES There is a lack of knowledge on the effects of prescription stimulants when taken by healthy individuals (as compared with patients) and especially on the effects of different substances across different cognitive domains. METHODS We conducted a pilot study with three arms in which male participants received placebo and one of three stimulants (caffeine, methylphenidate, modafinil) and assessed cognitive performance with a test battery that captures various cognitive domains. RESULTS Our study showed some moderate effects of the three stimulants tested. Methylphenidate had positive effects on self-reported fatigue as well as on declarative memory 24 hours after learning; caffeine had a positive effect on sustained attention; there was no significant effect of modafinil in any of the instruments of our test battery. All stimulants were well tolerated, and no trade-off negative effects on other cognitive domains were found. CONCLUSIONS The few observed significant positive effects of the tested stimulants were domain-specific and of rather low magnitude. The results can inform the use of stimulants for cognitive enhancement purposes as well as direct further research to investigate the effects of stimulants on specific cognitive domains that seem most promising, possibly by using tasks that are more demanding.
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Affiliation(s)
- Dimitris Repantis
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany.
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany.
| | - Leonore Bovy
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kathrin Ohla
- Institute of Neuroscience and Medicine (INM-3), Jülich Research Centre, Jülich, Germany
| | - Simone Kühn
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Tamura JK, Carvalho IP, Leanna LMW, Feng JN, Rosenblat JD, Mansur R, Lee Y, Cha DS, Teopiz K, Ahmad Z, Nasri F, Kim J, McIntyre RS. Management of cognitive impairment in bipolar disorder: a systematic review of randomized controlled trials. CNS Spectr 2021:1-22. [PMID: 33706820 DOI: 10.1017/s1092852921000092] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Cognitive impairment is common in bipolar disorder and is emerging as a therapeutic target to enhance quality of life and function. A systematic search was conducted on PubMed, PsycInfo, Cochrane, clinicaltrials.gov, and Embase databases for blinded or open-label randomized controlled trials evaluating the pro-cognitive effects of pharmacological, neurostimulation, or psychological interventions for bipolar disorder. Twenty-two trials were identified, evaluating a total of 16 different pro-cognitive interventions. The methodological quality of the identified trials were assessed using the Cochrane Risk of Bias tool. Currently, no intervention (i.e., pharmacologic, neurostimulation, cognitive remediation) has demonstrated robust and independent pro-cognitive effects in adults with bipolar disorder. Findings are preliminary and methodological limitations limit the interpretation of results. Methodological considerations including, but not limited to, the enrichment with populations with pre-treatment cognitive impairment, as well as the inclusion of individuals who are in remission are encouraged. Future trials may also consider targeting interventions to specific cognitive subgroups and the use of biomarkers of cognitive function.
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Affiliation(s)
- Jocelyn K Tamura
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Isabelle P Carvalho
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Lui M W Leanna
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Jia Nuo Feng
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Rodrigo Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Danielle S Cha
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Kayla Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Zara Ahmad
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Flora Nasri
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Jiin Kim
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
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Cândido RCF, Menezes de Padua CA, Golder S, Junqueira DR. Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev 2021; 1:CD013011. [PMID: 33460048 PMCID: PMC8092481 DOI: 10.1002/14651858.cd013011.pub2] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is characterized by symptoms of inattention or impulsivity or both, and hyperactivity, which affect children, adolescents, and adults. In some countries, methylphenidate is the first option to treat adults with moderate or severe ADHD. However, evidence on the efficacy and adverse events of immediate-release (IR) methylphenidate in the treatment of ADHD in adults is limited and controversial. OBJECTIVES To evaluate the efficacy and harms (adverse events) of IR methylphenidate for treating ADHD in adults. SEARCH METHODS In January 2020, we searched CENTRAL, MEDLINE, Embase, eight additional databases and three trial registers. We also searched internal reports on the European Medicines Agency and the US Food and Drug Administration websites. We checked citations of included trials to identify additional trials not captured by the electronic searches. SELECTION CRITERIA Randomized controlled trials (RCTs) comparing IR methylphenidate, at any dose, with placebo or other pharmacological interventions (including extended-release formulations of methylphenidate) for ADHD in adults. Primary outcomes comprised changes in the symptoms of ADHD (efficacy) and harms. Secondary outcomes included changes in the clinical impression of severity and improvement, level of functioning, depression, anxiety and quality of life. Outcomes could have been rated by investigators or participants. DATA COLLECTION AND ANALYSIS Two review authors extracted data independently on the characteristics of the trials, participants, interventions; outcomes and financial conflict of interests. We resolved disagreements by discussion or consulting a third review author. We obtained additional, unpublished information from the authors of one included trial that had reported efficacy data in a graph. We calculated mean differences (MDs) or standardized MDs (SMDs) with 95% confidence intervals (CIs) for continuous data reported on the same or different scales, respectively. We summarized dichotomous variables as risk ratios (RRs) with 95% CI. MAIN RESULTS We included 10 trials published between 2001 and 2016 involving 497 adults with ADHD. Three trials were conducted in Europe and one in Argentina; the remaining trials did not report their location. The RCTs compared IR methylphenidate with placebo, an osmotic-release oral system (OROS) of methylphenidate (an extended-release formulation), an extended-release formulation of bupropion, lithium, and Pycnogenol® (maritime pine bark extract). Participants comprised outpatients, inpatients in addiction treatment, and adults willing to attend an intensive outpatient program for cocaine dependence. The duration of the follow-up ranged from 6 to 18 weeks. IR methylphenidate versus placebo We found very low-certainty evidence that, compared with placebo, IR methylphenidate may reduce symptoms of ADHD when measured with investigator-rated scales (MD -20.70, 95% CI -23.97 to -17.43; 1 trial, 146 participants; end scores; Adult ADHD Investigator Symptom Report Scale (AISRS), scored from 0 to 54), but the evidence is uncertain. The effect of IR methylphenidate on ADHD symptoms when measured with participant-rated scales was moderate, but the certainty of the evidence is very low (SMD -0.59, 95% CI -1.25 to 0.06; I2 = 69%; 2 trials, 138 participants; end scores). There is very low-certainty evidence that, compared with placebo, IR methylphenidate may reduce the clinical impression of the severity of ADHD symptoms (MD -0.57, 95% CI -0.85 to -0.28; 2 trials, 139 participants; I2 = 0%; change and end scores; Clinical Global Impression (CGI)-Severity scale (scored from 1 (very much improved) to 7 (very much worse))). There is low-certainty evidence that, compared with placebo, IR methylphenidate may slightly impact the clinical impression of an improvement in symptoms of ADHD (MD -0.94, 95% CI -1.37 to -0.51; 1 trial, 49 participants; end scores; CGI-Improvement scale (scored from 1 (very much improved) to 7 (very much worse))). There is no clear evidence of an effect on anxiety (MD -0.20, 95% CI -4.84 to 4.44; 1 trial, 19 participants; change scores; Hamilton Anxiety Scale (HAM-A; scored from 0 to 56); very low-certainty evidence) or depression (MD 2.80, 95% CI -0.09 to 5.69; 1 trial, 19 participants; change scores; Hamilton Depression Scale (HAM-D; scored from 0 to 52); very low-certainty evidence) in analyses comparing IR methylphenidate with placebo. IR methylphenidate versus lithium Compared with lithium, it is uncertain whether IR methylphenidate increases or decreases symptoms of ADHD (MD 0.60, 95% CI -3.11 to 4.31; 1 trial, 46 participants; end scores; Conners' Adult ADHD Rating Scale (scored from 0 to 198); very low-certainty evidence); anxiety (MD -0.80, 95% CI -4.49 to 2.89; 1 trial, 46 participants; end scores; HAM-A; very low-certainty evidence); or depression (MD -1.20, 95% CI -3.81 to 1.41, 1 trial, 46 participants; end scores; HAM-D scale; very low-certainty evidence). None of the included trials assessed participant-rated changes in symptoms of ADHD, or clinical impression of severity or improvement in participants treated with IR methylphenidate compared with lithium. Adverse events were poorly assessed and reported. We rated all trials at high risk of bias due to selective outcome reporting of harms and masking of outcome assessors (failure to blind outcome assessor to measure adverse events). Overall, four trials with 203 participants who received IR methylphenidate and 141 participants who received placebo described the occurrence of harms. The use of IR methylphenidate in these trials increased the risk of gastrointestinal complications (RR 1.96, 95% CI 1.13 to 2.95) and loss of appetite (RR 1.77, 95% CI 1.06 to 2.96). Cardiovascular adverse events were reported inconsistently, preventing a comprehensive analysis. One trial comparing IR methylphenidate to lithium reported five and nine adverse events, respectively. We considered four trials to have notable concerns of vested interests influencing the evidence, and authors from two trials omitted information related to the sources of funding and conflicts of interest. AUTHORS' CONCLUSIONS We found no certain evidence that IR methylphenidate compared with placebo or lithium can reduce symptoms of ADHD in adults (low- and very low-certainty evidence). Adults treated with IR methylphenidate are at increased risk of gastrointestinal and metabolic-related harms compared with placebo. Clinicians should consider whether it is appropriate to prescribe IR methylphenidate, given its limited efficacy and increased risk of harms. Future RCTs should explore the long-term efficacy and risks of IR methylphenidate, and the influence of conflicts of interest on reported effects.
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Affiliation(s)
| | | | - Su Golder
- Department of Health Sciences, University of York, York, UK
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Newman AH, Ku T, Jordan CJ, Bonifazi A, Xi ZX. New Drugs, Old Targets: Tweaking the Dopamine System to Treat Psychostimulant Use Disorders. Annu Rev Pharmacol Toxicol 2021; 61:609-628. [PMID: 33411583 PMCID: PMC9341034 DOI: 10.1146/annurev-pharmtox-030220-124205] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The abuse of illicit psychostimulants such as cocaine and methamphetamine continues to pose significant health and societal challenges. Despite considerable efforts to develop medications to treat psychostimulant use disorders, none have proven effective, leaving an underserved patient population and unanswered questions about what mechanism(s) of action should be targeted for developing pharmacotherapies. As both cocaine and methamphetamine rapidly increase dopamine (DA) levels in mesolimbic brain regions, leading to euphoria that in some can lead to addiction, targets in which this increased dopaminergic tone may be mitigated have been explored. Further, understanding and targeting mechanisms underlying relapse are fundamental to the success of discovering medications that reduce the reinforcing effects of the drug of abuse, decrease the negative reinforcement or withdrawal/negative affect that occurs during abstinence, or both. Atypical inhibitors of the DA transporter and partial agonists/antagonists at DA D3 receptors are described as two promising targets for future drug development.
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Affiliation(s)
- Amy Hauck Newman
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA;
| | - Therese Ku
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA;
| | - Chloe J Jordan
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA;
| | - Alessandro Bonifazi
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA;
| | - Zheng-Xiong Xi
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA;
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The cognitive and behavioral effects of D-amphetamine and nicotine sensitization in adult zebrafish. Psychopharmacology (Berl) 2021; 238:2191-2200. [PMID: 33963883 PMCID: PMC8292302 DOI: 10.1007/s00213-021-05844-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Zebrafish are growing in use as a model for understanding drug dependence and addiction. Sensitization paradigms have been a useful tool in identifying mechanisms involved in drug-induced behavioral and neurological changes, but in zebrafish have tended to focus on locomotor, rather than cognitive, endpoints. METHODS Here, we used a novel method, the FMP Y-maze, which measures continuous performance through a series of repeated binary choices (L vs R), to establish a model for assessing parameters associated with psychostimulant-induced behavioral and cognitive sensitization in adult zebrafish. RESULTS Repeat, intermittent exposure to d-amphetamine (AMPH) for 14 days increased alternations (LRLR) in the maze, suggesting improved working memory, which was enhanced further following drug challenge after a short withdrawal period, suggesting behavioral sensitization. However, this cognitive enhancement coincided with a reduction in the use of other exploration strategies, hypolocomotion, and inhibition of cognitive flexibility. Like AMPH, exposure to nicotine (NIC) increased alternations following drug challenge after chronic treatment. Repeat NIC exposure appeared to induce both cognitive and psychomotor sensitization, as evidenced by increased working memory performance (alternations) and locomotor activity, without negatively impacting other search strategies or cognitive flexibility. CONCLUSION Chronic treatment with AMPH or NIC boosts cognitive performance in adult zebrafish. Cognitive sensitization occurred with both drugs, resulting in enhanced working memory; however, repeat AMPH exposure, following a withdrawal period, resulted in inhibited cognitive flexibility, an effect not evident with repeat NIC exposure. Cognitive and behavioral sensitization paradigms in zebrafish could serve as a useful tool for assessing cognitive states which result in cognitive enhancing or impairing effects of drugs.
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