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Girotti M, Bulin SE, Carreno FR. Effects of chronic stress on cognitive function - From neurobiology to intervention. Neurobiol Stress 2024; 33:100670. [PMID: 39295772 PMCID: PMC11407068 DOI: 10.1016/j.ynstr.2024.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 08/30/2024] [Accepted: 09/01/2024] [Indexed: 09/21/2024] Open
Abstract
Exposure to chronic stress contributes considerably to the development of cognitive impairments in psychiatric disorders such as depression, generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and addictive behavior. Unfortunately, unlike mood-related symptoms, cognitive impairments are not effectively treated by available therapies, a situation in part resulting from a still incomplete knowledge of the neurobiological substrates that underly cognitive domains and the difficulty in generating interventions that are both efficacious and safe. In this review, we will present an overview of the cognitive domains affected by stress with a specific focus on cognitive flexibility, behavioral inhibition, and working memory. We will then consider the effects of stress on neuronal correlates of cognitive function and the factors which may modulate the interaction of stress and cognition. Finally, we will discuss intervention strategies for treatment of stress-related disorders and gaps in knowledge with emerging new treatments under development. Understanding how cognitive impairment occurs during exposure to chronic stress is crucial to make progress towards the development of new and effective therapeutic approaches.
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Affiliation(s)
- Milena Girotti
- Department of Pharmacology and Center for Biomedical Neuroscience, UT Health San Antonio, 7703 Floyd Curl Dr., San Antonio, TX, 78229, USA
| | - Sarah E Bulin
- Department of Pharmacology and Center for Biomedical Neuroscience, UT Health San Antonio, 7703 Floyd Curl Dr., San Antonio, TX, 78229, USA
| | - Flavia R Carreno
- Department of Pharmacology and Center for Biomedical Neuroscience, UT Health San Antonio, 7703 Floyd Curl Dr., San Antonio, TX, 78229, USA
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Levenson JS, Harris DA. The Ripple Effects of Post-Conviction Traumatic Stress in People Required to Register as Sex Offenders and their Families. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2024; 36:572-602. [PMID: 37487051 DOI: 10.1177/10790632231191116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Post-Conviction Traumatic Stress (PCTS) describes the cognitive, psychological, and physiological symptoms of trauma that result from a range of experiences with the criminal justice system. This pilot study aimed to empirically validate the construct of PCTS utilizing the Post-Traumatic Checklist (PCL-5), an existing measure of Post-Traumatic Stress Disorder (PTSD) according to DSM-5 diagnostic criteria. Using mixed methods, the survey asked about the traumagenic impact of arrests, court proceedings, incarceration, probation/parole supervision, and sex offender registration requirements in a sample of people required to register as sexual offenders (RSOs; n = 290) and their family members (n = 126). The PCL-5 was used to estimate the prevalence of PTSD and to explore the unique presentation of symptoms. Findings indicated that 69% of registrants and 62% of family members reported clinically significant indicators of PTSD. Examples of specific symptom presentations are illustrated through qualitative responses. Implications for clinical treatment, policy, and future research related to PCTS are discussed.
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Affiliation(s)
- Jill S Levenson
- School of Social Work, Barry University, Miami Shores, FL, USA
| | - Danielle Arlanda Harris
- Griffith Youth Forensic Service | Griffith Criminology Institute, School of Criminology and Criminal Justice, Griffith University, Mt Gravatt, QLD, Australia
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Kassa MA, Fenta S, Anbesaw T, Tesfa NA, Zemariam AB, Kassaw GM, Abate BB, Semagn EG. Post-traumatic stress disorder and associated factors among high school students who experienced war in Woldia town. Front Psychiatry 2024; 15:1359370. [PMID: 39081535 PMCID: PMC11286586 DOI: 10.3389/fpsyt.2024.1359370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/31/2024] [Indexed: 08/02/2024] Open
Abstract
Background The experience of war in recent time is very common around the world, and the impact is profound on the mental health of the victims, especially among the young population. The most implicated mental health problem is post-traumatic stress disorder, which comes after an exposure to trauma as a severe and long-term result of the traumatic event. Studies in developed countries revealed this finding, but there is insufficient information in developing countries, where much of war and conflict exist and young population live including Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of post-traumatic stress disorder among high school students who experienced war. Objective We assessed the prevalence and factors associated with post-traumatic stress disorder among high school students who experienced war. Methods A multi-centered school base cross-sectional study was conducted from May 23 to June 08, 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression was used to identify the independent factors associated with post-traumatic stress disorder. Results A total of 338 of the 410 students participated in this study (94.5% response rate). The prevalence of post-traumatic stress disorder was 39.2%. In the multivariable analysis, poor social support (AOR = 3.40, 95% CI: 1.45, 7.95), depression (AOR = 3.24, 95% CI: 1.69,6.21), high level of perceived stress (AOR = 2.98, 95% CI: 1.61, 5.50), being in war fighting situation (AOR = 2.85, 95% CI: 1.40, 5.78), and witnessing the murder of family members or friends (AOR = 3.05, 95% CI: 1.47, 6.32) were factors significantly associated with post-traumatic stress disorder at a p-value <0.05. Conclusions and recommendations In this study, around two in five of high school students had post-traumatic stress disorder. Independent factors of PTSD were depression, high stress levels, poor social support, witnessing the murder of family members/friends, and being in war fighting situation. We recommend that the Ministry of Education and the Ministry of Health collaborate to integrate mental health services into schools. This focuses on the early detection of students at risk of PTSD, such as those with depression, high perceived stress levels, and exposure to murder or war, and provides necessary social support to prevent PTSD.
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Affiliation(s)
- Mulat Awoke Kassa
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Sefineh Fenta
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Natnael Amare Tesfa
- School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
| | - Genanew Mulugeta Kassaw
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Elsabet Gezmu Semagn
- Department of Veterinary Parasitology, School of Veterinary Medicine, Wollo University, Dessie, Ethiopia
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Bucaktepe PGE, Akgül F, Çelİk SB. Evaluation of the effects of pandemic-related fears on anxiety and depression: the mediating roles of traumatic stress and loneliness. BMC Psychol 2024; 12:388. [PMID: 38997784 PMCID: PMC11241983 DOI: 10.1186/s40359-024-01880-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The detrimental mental health effects which emerged from COVID-19 have profoundly affected healthcare workers (HCWs) worldwide. The aim of this study was to investigate the mediating effects of traumatic stress and loneliness on the fears of contracting and dying from COVID-19, and anxiety and depression of HCWs during the pandemic. METHODS A cross-sectional online survey was completed by HCWs in a province of Turkey. The Hospital Anxiety Depression Scale, Impact of Events Scale-Revised and numerical rating scales (for fears of COVID-19 and loneliness) were used and a bootstrap approach was used in the analyses with SPSS PROCESS macro software. RESULTS Of the HCWs evaluated, 150 (34.4%) were doctors, with a mean duration of work experience of 10.6 ± 7.5 years. The results indicated that fear of contracting COVID-19 was directly related to anxiety (β = 0.244, p < 0.001) and depression (β = 0.135, p < 0.01) and that traumatic stress and loneliness mediated the relationships between the fear of contracting COVID-19 and anxiety (β = 0.435, p < 0.001; β = 0.235, p < 0.001, respectively) and depression (β = 0.365, p < 0.001; β = 0.294, p < 0.001, respectively). The fear of dying from COVID-19 was determined to be directly associated with anxiety (β = 0.190, p < 0.001) but not with depression (β = 0.066, p = 0.116), and traumatic stress and loneliness mediated the relationships between the fear of dying from COVID-19 and anxiety (β = 0.476, p < 0.001; β = 0.259, p < 0.001, respectively) and depression (β = 0.400, p < 0.001; β = 0.311, p < 0.001, respectively). CONCLUSIONS The study results demonstrated the important roles of traumatic stress and loneliness in exacerbating the negative consequences of fears of COVID-19 on anxiety and depression, and provide insights for identifying HCWs at greater risk.
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Affiliation(s)
| | - Fethiye Akgül
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - Sercan Bulut Çelİk
- Batman GAP Family Health Center, Provincial Health Directorate, Batman, Turkey
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Karpov G, Lin MH, Headley DB, Baker TE. Oscillatory correlates of threat imminence during virtual navigation. Psychophysiology 2024; 61:e14551. [PMID: 38516942 DOI: 10.1111/psyp.14551] [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: 09/21/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 03/23/2024]
Abstract
The Predatory Imminence Continuum Theory proposes that defensive behaviors depend on the proximity of a threat. While the neural mechanisms underlying this proposal are well studied in animal models, it remains poorly understood in humans. To address this issue, we recorded EEG from 24 (15 female) young adults engaged in a first-person virtual reality Risk-Reward interaction task. On each trial, participants were placed in a virtual room and presented with either a threat or reward conditioned stimulus (CS) in the same room location (proximal) or different room location (distal). Behaviorally, all participants learned to avoid the threat-CS, with most using the optimal behavior to actively avoid the proximal threat-CS (88% accuracy) and passively avoid the distal threat-CS (69% accuracy). Similarly, participants learned to actively approach the distal reward-CS (82% accuracy) and to remain passive to the proximal reward-CS (72% accuracy). At an electrophysiological level, we observed a general increase in theta power (4-8 Hz) over the right posterior channel P8 across all conditions, with the proximal threat-CS evoking the largest theta response. By contrast, distal cues induced two bursts of gamma (30-60 Hz) power over midline-parietal channel Pz (200 msec post-cue) and right frontal channel Fp2 (300 msec post-cue). Interestingly, the first burst of gamma power was sensitive to the distal threat-CS and the second burst at channel Fp2 was sensitive to the distal reward-CS. Together, these findings demonstrate that oscillatory processes differentiate between the spatial proximity information during threat and reward encoding, likely optimizing the selection of the appropriate behavioral response.
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Affiliation(s)
- Galit Karpov
- Center for Molecular and Behavioral Neuroscience, Rutgers State University, Newark, New Jersey, USA
| | - Mei-Heng Lin
- Center for Molecular and Behavioral Neuroscience, Rutgers State University, Newark, New Jersey, USA
| | - Drew B Headley
- Center for Molecular and Behavioral Neuroscience, Rutgers State University, Newark, New Jersey, USA
| | - Travis E Baker
- Center for Molecular and Behavioral Neuroscience, Rutgers State University, Newark, New Jersey, USA
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Mazaheri M, Radahmadi M, Sharifi MR. Effects of chronic social equality and inequality conditions on passive avoidance memory and PTSD-like behaviors in rats under chronic empathic stress. Int J Neurosci 2024:1-12. [PMID: 38598305 DOI: 10.1080/00207454.2024.2341913] [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: 02/26/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Social inequality conditions induce aversion and affect brain functions and mood. This study investigated the effects of chronic social equality and inequality (CSE and CSI, respectively) conditions on passive avoidance memory and post-traumatic stress disorder (PTSD)-like behaviors in rats under chronic empathic stress. METHODS Rats were divided into different groups, including control, sham-observer, sham-demonstrator, observer, demonstrator, and co-demonstrator groups. Chronic stress (2 h/day) was administered to all stressed groups for 21 days. Fear learning, fear memory, memory consolidation, locomotor activity, and PTSD-like behaviors were evaluated using the passive avoidance test. Apart from the hippocampal weight, the correlations of memory and right hippocampal weight with serum corticosterone (CORT) levels were separately assessed for all experimental groups. RESULTS Latency was significantly higher in the demonstrator and sham-demonstrator groups compared to the control group. It was decreased significantly in other groups compared to the control group. Latency was also decreased in the observer and co-demonstrator groups compared to the demonstrator group. Moreover, the right hippocampal weight was significantly decreased in the demonstrator and sham-demonstrator groups compared to the control group. Pearson's correlation of memory and hippocampal weight with serum CORT levels supported the present findings. CONCLUSION Maladaptive fear responses occurred in demonstrators and sham-demonstrators. Also, extremely high levels of psychological stress, especially under CSI conditions (causing abnormal fear learning) led to heightened fear memory and PTSD-like behaviors. Right hippocampal atrophy confirmed the potential role of CSI conditions in promoting PTSD-like behaviors. Compared to inequality conditions, the abnormal fear memory was reduced under equality conditions.
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Affiliation(s)
- Mohammad Mazaheri
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Radahmadi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Sharifi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Xiao H, Xi K, Wang K, Zhou Y, Dong B, Xie J, Xie Y, Zhang H, Ma G, Wang W, Feng D, Guo B, Wu S. Restoring the Function of Thalamocortical Circuit Through Correcting Thalamic Kv3.2 Channelopathy Normalizes Fear Extinction Impairments in a PTSD Mouse Model. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2305939. [PMID: 38102998 PMCID: PMC10916658 DOI: 10.1002/advs.202305939] [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] [Received: 08/22/2023] [Revised: 12/04/2023] [Indexed: 12/17/2023]
Abstract
Impaired extinction of fear memory is one of the most common symptoms in post-traumatic stress disorder (PTSD), with limited therapeutic strategies due to the poor understanding of its underlying neural substrates. In this study, functional screening is performed and identified hyperactivity in the mediodorsal thalamic nucleus (MD) during fear extinction. Furthermore, the encoding patterns of the hyperactivated MD is investigated during persistent fear responses using multiple machine learning algorithms. The anterior cingulate cortex (ACC) is also identified as a functional downstream region of the MD that mediates the extinction of fear memory. The thalamocortical circuit is comprehensively analyzed and found that the MD-ACC parvalbumin interneurons circuit is preferentially enhanced in PTSD mice, disrupting the local excitatory and inhibitory balance. It is found that decreased phosphorylation of the Kv3.2 channel contributed to the hyperactivated MD, primarily to the malfunctioning thalamocortical circuit. Using a lipid nanoparticle-based RNA therapy strategy, channelopathy is corrected via a methoxylated siRNA targeting the protein phosphatase 6 catalytic subunit and restored fear memory extinction in PTSD mice. These findings highlight the function of the thalamocortical circuit in PTSD-related impaired extinction of fear memory and provide therapeutic insights into Kv3.2-targeted RNA therapy for PTSD.
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Affiliation(s)
- Haoxiang Xiao
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Kaiwen Xi
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Kaifang Wang
- Department of AnesthesiologyTangdu HospitalFourth Military Medical UniversityXi'an710032China
| | - Yongsheng Zhou
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
- Eastern Theater Air Force Hospital of PLANanjing210000China
| | - Baowen Dong
- Department of NeurosurgeryTangdu HospitalFourth Military Medical UniversityXi'an710032China
| | - Jinyi Xie
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Yuqiao Xie
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Haifeng Zhang
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Guaiguai Ma
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Wenting Wang
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Dayun Feng
- Department of NeurosurgeryTangdu HospitalFourth Military Medical UniversityXi'an710032China
| | - Baolin Guo
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
| | - Shengxi Wu
- Department of NeurobiologySchool of Basic MedicineFourth Military Medical UniversityXi'an710032China
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Norred MA, Zuschlag ZD, Hamner MB. A Neuroanatomic and Pathophysiologic Framework for Novel Pharmacological Approaches to the Treatment of Post-traumatic Stress Disorder. Drugs 2024; 84:149-164. [PMID: 38413493 DOI: 10.1007/s40265-023-01983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 02/29/2024]
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating disorder inflicting high degrees of symptomatic and socioeconomic burdens. The development of PTSD results from a cascade of events with contributions from multiple processes and the underlying pathophysiology is complex, involving neurotransmitters, neurocircuitry, and neuroanatomical pathways. Presently, only two medications are US FDA-approved for the treatment of PTSD, both selective serotonin reuptake inhibitors (SSRIs). However, the complex underlying pathophysiology suggests a number of alternative pathways and mechanisms that may be targets for potential drug development. Indeed, investigations and drug development are proceeding in a number of these alternative, non-serotonergic pathways in an effort to improve the management of PTSD. In this manuscript, the authors introduce novel and emerging treatments for PTSD, including drugs in various stages of development and clinical testing (BI 1358894, BNC-210, PRAX-114, JZP-150, LU AG06466, NYV-783, PH-94B, SRX246, TNX-102), established agents and known compounds being investigated for their utility in PTSD (brexpiprazole, cannabidiol, doxasoin, ganaxolone, intranasal neuropeptide Y, intranasal oxytocin, tianeptine oxalate, verucerfont), and emerging psychedelic interventions (ketamine, MDMA-assisted psychotherapy, psilocybin-assisted psychotherapy), with an aim to examine and integrate these agents into the underlying pathophysiological frameworks of trauma-related disorders.
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Affiliation(s)
- Michael A Norred
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans Hospital, Tampa, FL, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
| | - Zachary D Zuschlag
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans Hospital, Tampa, FL, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
| | - Mark B Hamner
- Behavioral Health Service, Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC, 29401, USA.
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
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Braun J, Patel M, Kameneva T, Keatch C, Lambert G, Lambert E. Central stress pathways in the development of cardiovascular disease. Clin Auton Res 2024; 34:99-116. [PMID: 38104300 DOI: 10.1007/s10286-023-01008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Mental stress is of essential consideration when assessing cardiovascular pathophysiology in all patient populations. Substantial evidence indicates associations among stress, cardiovascular disease and aberrant brain-body communication. However, our understanding of the flow of stress information in humans, is limited, despite the crucial insights this area may offer into future therapeutic targets for clinical intervention. METHODS Key terms including mental stress, cardiovascular disease and central control, were searched in PubMed, ScienceDirect and Scopus databases. Articles indicative of heart rate and blood pressure regulation, or central control of cardiovascular disease through direct neural innervation of the cardiac, splanchnic and vascular regions were included. Focus on human neuroimaging research and the flow of stress information is described, before brain-body connectivity, via pre-motor brainstem intermediates is discussed. Lastly, we review current understandings of pathophysiological stress and cardiovascular disease aetiology. RESULTS Structural and functional changes to corticolimbic circuitry encode stress information, integrated by the hypothalamus and amygdala. Pre-autonomic brain-body relays to brainstem and spinal cord nuclei establish dysautonomia and lead to alterations in baroreflex functioning, firing of the sympathetic fibres, cellular reuptake of norepinephrine and withdrawal of the parasympathetic reflex. The combined result is profoundly adrenergic and increases the likelihood of cardiac myopathy, arrhythmogenesis, coronary ischaemia, hypertension and the overall risk of future sudden stress-induced heart failure. CONCLUSIONS There is undeniable support that mental stress contributes to the development of cardiovascular disease. The emerging accumulation of large-scale multimodal neuroimaging data analytics to assess this relationship promises exciting novel therapeutic targets for future cardiovascular disease detection and prevention.
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Affiliation(s)
- Joe Braun
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia.
| | - Mariya Patel
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Tatiana Kameneva
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Charlotte Keatch
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Gavin Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Elisabeth Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
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Kyriatzis G, Khrestchatisky M, Ferhat L, Chatzaki EA. Neurotensin and Neurotensin Receptors in Stress-related Disorders: Pathophysiology & Novel Drug Targets. Curr Neuropharmacol 2024; 22:916-934. [PMID: 37534788 PMCID: PMC10845085 DOI: 10.2174/1570159x21666230803101629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 08/04/2023] Open
Abstract
Neurotensin (NT) is a 13-amino acid neuropeptide widely distributed in the CNS that has been involved in the pathophysiology of many neural and psychiatric disorders. There are three known neurotensin receptors (NTSRs), which mediate multiple actions, and form the neurotensinergic system in conjunction with NT. NTSR1 is the main mediator of NT, displaying effects in both the CNS and the periphery, while NTSR2 is mainly expressed in the brain and NTSR3 has a broader expression pattern. In this review, we bring together up-to-date studies showing an involvement of the neurotensinergic system in different aspects of the stress response and the main stress-related disorders, such as depression and anxiety, post-traumatic stress disorder (PTSD) and its associated symptoms, such as fear memory and maternal separation, ethanol addiction, and substance abuse. Emphasis is put on gene, mRNA, and protein alterations of NT and NTSRs, as well as behavioral and pharmacological studies, leading to evidence-based suggestions on the implicated regulating mechanisms as well as their therapeutic exploitation. Stress responses and anxiety involve mainly NTSR1, but also NTSR2 and NTSR3. NTSR1 and NTSR3 are primarily implicated in depression, while NTSR2 and secondarily NTSR1 in PTSD. NTSR1 is interrelated with substance and drug abuse and NTSR2 with fear memory, while all NTSRs seem to be implicated in ethanol consumption. Some of the actions of NT and NTSRs in these pathological settings may be driven through interactions between NT and corticotrophin releasing factor (CRF) in their regulatory contribution, as well as by NT's pro-inflammatory mediating actions.
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Affiliation(s)
- Grigorios Kyriatzis
- Laboratory of Pharmacology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Institute of Neurophysiopathology, INP, CNRS, Aix-Marseille University, 13005 Marseille, France
| | - Michel Khrestchatisky
- Institute of Neurophysiopathology, INP, CNRS, Aix-Marseille University, 13005 Marseille, France
| | - Lotfi Ferhat
- Institute of Neurophysiopathology, INP, CNRS, Aix-Marseille University, 13005 Marseille, France
| | - Ekaterini Alexiou Chatzaki
- Laboratory of Pharmacology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Institute of Agri-Food and Life Sciences, University Research Centre, Hellenic Mediterranean University, 71410 Heraklion, Greece
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Arthur Cully S, Björnsdotter M. Lateral prefrontal cortex thickness is associated with stress but not cognitive fatigue in exhaustion disorder. Front Psychiatry 2023; 14:1314667. [PMID: 38193132 PMCID: PMC10772140 DOI: 10.3389/fpsyt.2023.1314667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Impaired executive functioning, including cognitive fatigue, is a core feature of the long-term stress-related condition exhaustion disorder (ED). Recent research suggests that a key area for executive control, the lateral prefrontal cortex (LPFC), may be mechanistically linked to cognitive fatigue due to stress. Here, we therefore asked if and how stress, the LPFC and cognitive fatigue may be related in ED. Methods We used a multimodal cross-sectional study design with high-resolution structural magnetic resonance imaging (MRI), self-reported measures, and path analysis modeling in 300 participants with ED. Results We found positive associations between stress and cognitive fatigue, and stress and LPFC thickness,but no association between LPFC thickness and cognitive fatigue. Furthermore, LPFC thickness did not mediate or moderate the association between stress and cognitive fatigue. Discussion These findings suggest that LPFC brain morphology is related to perceived stress levels but not cognitive fatigue, expanding previous research on the role of the LPFC in executive functioning. Moreover, the results support the notion that the LPFC may be mechanistically involved in stress-related executive function impairment but prompt further research into if and how this may be related to cognitive symptoms in ED.
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Affiliation(s)
- Sean Arthur Cully
- Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Malin Björnsdotter
- Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center for Cognitive and Computational Neuropsychiatry, Karolinska Institutet, Stockholm, Sweden
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Dmytriv TR, Tsiumpala SA, Semchyshyn HM, Storey KB, Lushchak VI. Mitochondrial dysfunction as a possible trigger of neuroinflammation at post-traumatic stress disorder (PTSD). Front Physiol 2023; 14:1222826. [PMID: 37942228 PMCID: PMC10628526 DOI: 10.3389/fphys.2023.1222826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a neuropsychiatric disorder that occurs in approximately 15% of people as a result of some traumatic events. The main symptoms are re-experiencing and avoidance of everything related to this event and hyperarousal. The main component of the pathophysiology of PTSD is an imbalance in the functioning of the hypothalamic-pituitary-adrenal axis (HPA) and development of neuroinflammation. In parallel with this, mitochondrial dysfunction is observed, as in many other diseases. In this review, we focus on the question how mitochondria may be involved in the development of neuroinflammation and its maintaining at PTSD. First, we describe the differences in the operation of the neuro-endocrine system during stress versus PTSD. We then show changes in the activity/expression of mitochondrial proteins in PTSD and how they can affect the levels of hormones involved in PTSD development, as well as how mitochondrial damage/pathogen-associated molecule patterns (DAMPs/PAMPs) trigger development of inflammation. In addition, we examine the possibility of treating PTSD-related inflammation using mitochondria as a target.
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Affiliation(s)
- Tetiana R. Dmytriv
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Sviatoslav A. Tsiumpala
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Halyna M. Semchyshyn
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Kenneth B. Storey
- Department of Biology, Institute of Biochemistry, Carleton University, Ottawa, ON, Canada
| | - Volodymyr I. Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
- Research and Development University, Ivano-Frankivsk, Ukraine
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13
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EKMEKCİ HS, MUFTAREVİÇ S. Epigenetic Effects of Social Stress and Epigenetic Inheritance. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1059315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Social events that cause stress can cause epigenetic changes on living things. The study of the effects of social events experienced by an individual on epigenetic marks on the genome has created the field of social epigenetics. Social epigenetics examines the effects of psychosocial stress factors such as poverty, war trauma and childhood abuse on epigenetic mechanisms. Epigenetic mechanisms alter chemical markers in the genome structure without changing the DNA sequence. Among these mechanisms, DNA methylation in particular may have different phenotypic effects in response to stressors that may occur in the psychosocial environment. Post-traumatic stress disorder is one of the most significant proofs of the effects of epigenetic expressions altered due to traumatic events on the phenotype. The field of epigenetic inheritance has shown that epigenetic changes triggered by environmental influences can, in some cases, be transmitted through generations. This field provides a better understanding of the basis of many psychological disorders. This review provides an overview of social epigenetics, PTSD, and epigenetic inheritance.
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14
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Tanriverdi B, Gregory DF, Olino TM, Ely TD, Harnett NG, van Rooij SJH, Lebois LAM, Seligowski AV, Jovanovic T, Ressler KJ, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Pearson C, Domeier RM, Rathlev NK, O'Neil BJ, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Harte SE, Elliott JM, McLean SA, Kessler RC, Koenen KC, Stevens JS, Murty VP. Hippocampal Threat Reactivity Interacts with Physiological Arousal to Predict PTSD Symptoms. J Neurosci 2022; 42:6593-6604. [PMID: 35879096 PMCID: PMC9410748 DOI: 10.1523/jneurosci.0911-21.2022] [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: 04/26/2021] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022] Open
Abstract
Hippo campal impairments are reliably associated with post-traumatic stress disorder (PTSD); however, little research has characterized how increased threat sensitivity may interact with arousal responses to alter hippocampal reactivity, and further how these interactions relate to the sequelae of trauma-related symptoms. In a sample of individuals recently exposed to trauma (N = 116, 76 female), we found that PTSD symptoms at 2 weeks were associated with decreased hippocampal responses to threat as assessed with fMRI. Further, the relationship between hippocampal threat sensitivity and PTSD symptomology only emerged in individuals who showed transient, high threat-related arousal, as assayed by an independently collected measure of fear potentiated startle. Collectively, our finding suggests that development of PTSD is associated with threat-related decreases in hippocampal function because of increases in fear-potentiated arousal.SIGNIFICANCE STATEMENT Alterations in hippocampal function linked to threat-related arousal are reliably associated with post-traumatic stress disorder (PTSD); however, how these alterations relate to the sequelae of trauma-related symptoms is unknown. Prior models based on nontrauma samples suggest that arousal may impact hippocampal neurophysiology leading to maladaptive behavior. Here we show that decreased hippocampal threat sensitivity interacts with fear-potentiated startle to predict PTSD symptoms. Specifically, individuals with high fear-potentiated startle and low, transient hippocampal threat sensitivity showed the greatest PTSD symptomology. These findings bridge literatures of threat-related arousal and hippocampal function to better understand PTSD risk.
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Affiliation(s)
- Büşra Tanriverdi
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
| | - David F Gregory
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
| | - Thomas M Olino
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Antonia V Seligowski
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan 48202
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Francesca L Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and Miriam Hospital, Providence, Rhode Island 02930
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, California 94143
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia 30332
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts 02478
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
- Institute for Technology in Psychiatry/Department of Psychiatry, McLean Hospital, Belmont, Massachusetts 02478
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida 32209
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida 32209
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey 08103
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267
- College of Nursing, University of Cincinnati, Cincinnati, Ohio 45221
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama 35294
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, Alabama 35294
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts 02118
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, Pennsylvania 19141
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan 48202
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, Michigan 48197
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts 01107
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan 48202
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts 02115
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, Missouri 63121
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts 02130
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, Connecticut 06516
- Department of Psychiatry, Yale School of Medicine, West Haven, Connecticut 06510
| | - Jutta Joormann
- Department of Psychology, Yale University, West Haven, Connecticut 06520
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri 63130
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - John F Sheridan
- Department of Biosciences, Ohio State University Wexner Medical Center, Columbus, Ohio 43210
- Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus, Ohio 43211
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts 02114
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts 02142
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan 48109
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - James M Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales 2006, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60208
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Vishnu P Murty
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
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15
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Fawcett JW, Fyhn M, Jendelova P, Kwok JCF, Ruzicka J, Sorg BA. The extracellular matrix and perineuronal nets in memory. Mol Psychiatry 2022; 27:3192-3203. [PMID: 35760878 PMCID: PMC9708575 DOI: 10.1038/s41380-022-01634-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023]
Abstract
All components of the CNS are surrounded by a diffuse extracellular matrix (ECM) containing chondroitin sulphate proteoglycans (CSPGs), heparan sulphate proteoglycans (HSPGs), hyaluronan, various glycoproteins including tenascins and thrombospondin, and many other molecules that are secreted into the ECM and bind to ECM components. In addition, some neurons, particularly inhibitory GABAergic parvalbumin-positive (PV) interneurons, are surrounded by a more condensed cartilage-like ECM called perineuronal nets (PNNs). PNNs surround the soma and proximal dendrites as net-like structures that surround the synapses. Attention has focused on the role of PNNs in the control of plasticity, but it is now clear that PNNs also play an important part in the modulation of memory. In this review we summarize the role of the ECM, particularly the PNNs, in the control of various types of memory and their participation in memory pathology. PNNs are now being considered as a target for the treatment of impaired memory. There are many potential treatment targets in PNNs, mainly through modulation of the sulphation, binding, and production of the various CSPGs that they contain or through digestion of their sulphated glycosaminoglycans.
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Affiliation(s)
- James W Fawcett
- John van Geest Centre for Brain Repair, Department Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0PY, UK.
- Centre for Reconstructive Neuroscience, Institute for Experimental Medicine CAS, Videnska 1083, Prague 4, Prague, Czech Republic.
| | - Marianne Fyhn
- Department of Biosciences, University of Oslo, Oslo, Norway
| | - Pavla Jendelova
- Centre for Reconstructive Neuroscience, Institute for Experimental Medicine CAS, Videnska 1083, Prague 4, Prague, Czech Republic
| | - Jessica C F Kwok
- Centre for Reconstructive Neuroscience, Institute for Experimental Medicine CAS, Videnska 1083, Prague 4, Prague, Czech Republic
- School of Biomedical Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Jiri Ruzicka
- Centre for Reconstructive Neuroscience, Institute for Experimental Medicine CAS, Videnska 1083, Prague 4, Prague, Czech Republic
| | - Barbara A Sorg
- Robert S. Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, USA
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16
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Desai S, Borg B, Cuttler C, Crombie KM, Rabinak CA, Hill MN, Marusak HA. A Systematic Review and Meta-Analysis on the Effects of Exercise on the Endocannabinoid System. Cannabis Cannabinoid Res 2022; 7:388-408. [PMID: 34870469 PMCID: PMC9418357 DOI: 10.1089/can.2021.0113] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction: The endocannabinoid (eCB) system plays a key role in maintaining homeostasis, including the regulation of metabolism and stress responses. Chronic stress may blunt eCB signaling, and disruptions in eCB signaling have been linked to stress-related psychiatric disorders and physical health conditions, including anxiety, depression, post-traumatic stress disorder (PTSD), diabetes, and obesity. Pharmacological and nonpharmacological behavioral interventions (e.g., exercise) that target the eCB system may be promising therapeutic approaches for the prevention and treatment of stress-related diseases. In this study, we perform a systematic review and the first meta-analysis to examine the impact of exercise on circulating eCB concentrations. Materials and Methods: We performed a review of the MEDLINE (PubMed) database for original articles examining the impact of exercise on eCBs in humans and animal models. A total of 262 articles were screened for initial inclusion. Results: Thirty-three articles (reporting on 57 samples) were included in the systematic review and 10 were included in the meta-analysis. The majority of samples that measured anandamide (AEA) showed a significant increase in AEA concentrations following acute exercise (74.4%), whereas effects on 2-arachidonoylglycerol (2-AG) were inconsistent. The meta-analysis, however, revealed a consistent increase in both AEA and 2-AG following acute exercise across modalities (e.g., running, cycling), species (e.g., humans, mice), and in those with and without pre-existing health conditions (e.g., PTSD, depression). There was substantial heterogeneity in the magnitude of the effect across studies, which may relate to exercise intensity, physical fitness, timing of measurement, and/or fasted state. Effects of chronic exercise were inconsistent. Conclusions: Potential interpretations and implications of exercise-induced mobilization of eCBs are discussed, including refilling of energy stores and mediating analgesic and mood elevating effects of exercise. We also offer recommendations for future work and discuss therapeutic implications for exercise in the prevention and treatment of stress-related psychopathology.
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Affiliation(s)
- Shreya Desai
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Breanna Borg
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Kevin M. Crombie
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Christine A. Rabinak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan, USA
- Department of Pharmacy Practice and Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan, USA
| | - Matthew N. Hill
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Hilary A. Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan, USA
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan, USA
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17
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Wu X, Geng X, Shang Z, Wang Z, Lu H, Ma H, Liu W, Xu H. Post-traumatic stress disorder in patients with rheumatic disease during the COVID-19 outbreak: a cross-sectional case-control study in China. BMJ Open 2022; 12:e049749. [PMID: 35354638 PMCID: PMC8968122 DOI: 10.1136/bmjopen-2021-049749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic is not only a traumatic event, but a collective stressor unfolding over time, causing devastating implications for the mental health. This study aimed to shed light on the mental health status of patients with rheumatic disease (RD) during the massive outbreak of COVID-19 in China, especially the prevalence and severity of post-traumatic stress disorder (PTSD) compared with healthy individuals. METHODS A total of 486 patients with RD and 486 age-matched and sex-matched healthy individuals were recruited into the study. For each participant, we collected demographic and clinical characteristics data. The PTSD Checklist for DSM-5 (PCL-5) and four items from the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the prevalence and severity of PTSD and sleep quality, respectively. RESULTS Compared with healthy control subjects (n=486), patients with RD (n=486) had a higher prevalence of PTSD (12.1% vs 4.1%; p<0.001). Higher total scores on the PCL-5 and on all four items from the PSQI (p≤0.001) were also observed. Female, old age, poor sleep quality, long duration of RD, poor subjective evaluation of the disease and pessimistic subjective perception of the epidemic were identified as risk factors of PTSD in patients with RD during the COVID-19 epidemic. CONCLUSION During the COVID-19 outbreak, patients with RD presented a higher prevalence and severity of PTSD and showed more sleep disturbances. Our findings confirm the importance of psychological assessment and mental healthcare out of regular clinical care for patients with RD during the pandemic.
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Affiliation(s)
- Xin Wu
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xuqiang Geng
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Zhilei Shang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, China
| | - Zhen Wang
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Hongjuan Lu
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Haiying Ma
- Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, China
| | - Weizhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, China
| | - Huji Xu
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
- School of Clinical Medicine, Tsinghua University, Beijing, China
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18
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Acid Sphingomyelinase Is a Modulator of Contextual Fear. Int J Mol Sci 2022; 23:ijms23063398. [PMID: 35328819 PMCID: PMC8954852 DOI: 10.3390/ijms23063398] [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: 02/17/2022] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/23/2022] Open
Abstract
Acid sphingomyelinase (ASM) regulates a variety of physiological processes and plays an important role in emotional behavior. The role of ASM in fear-related behavior has not been investigated so far. Using transgenic mice overexpressing ASM (ASMtg) and ASM deficient mice, we studied whether ASM regulates fear learning and expression of cued and contextual fear in a classical fear conditioning paradigm, a model used to investigate specific attributes of post-traumatic stress disorder (PTSD). We show that ASM does not affect fear learning as both ASMtg and ASM deficient mice display unaltered fear conditioning when compared to wild-type littermates. However, ASM regulates the expression of contextual fear in a sex-specific manner. While ASM overexpression enhances the expression of contextual fear in both male and female mice, ASM deficiency reduces the expression of contextual fear specifically in male mice. The expression of cued fear, however, is not regulated by ASM as ASMtg and ASM deficient mice display similar tone-elicited freezing levels. This study shows that ASM modulates the expression of contextual fear but not of cued fear in a sex-specific manner and adds a novel piece of information regarding the involvement of ASM in hippocampal-dependent aversive memory.
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19
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Giesbrecht G, Rojas L, Patel S, Kuret V, MacKinnon A, Tomfohr-Madsen L, Lebel C. Fear of COVID-19, mental health, and pregnancy outcomes in the pregnancy during the COVID-19 pandemic study: Fear of COVID-19 and pregnancy outcomes. J Affect Disord 2022; 299:483-491. [PMID: 34952107 PMCID: PMC8690287 DOI: 10.1016/j.jad.2021.12.057] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/19/2021] [Accepted: 12/18/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sustained fear during pregnancy has the potential to increase psychological distress and obstetric risk. This study aimed to (1) identify factors and characteristics associated with fear of COVID-19, (2) investigate the relationship between fear of COVID-19 and maternal anxiety and depression, and (3) determine the relationship between fear of COVID-19 and pregnancy outcomes. METHODS 9251 pregnant Canadians were recruited between April - December 2020. Participants self-reported (scale of 0-100) the degree of threat they perceived from the SARS-CoV-2 virus in relation to themselves and their unborn baby. RESULTS Mean fear scores indicated moderate to elevated concern. In multivariable linear regression, fear of COVID-19 was associated with food insecurity, ethnicity, geographic location, history of anxiety prior to pregnancy, having a chronic health condition, pre-pregnancy BMI, parity, and stage of pregnancy at study enrollment. Higher COVID-19 fear was associated with increased odds of depression, adjusted odds ratio (aOR) = 1.75, p < 0.001, 95% CI 1.66-1.85, and anxiety, aOR=2.04, p < 0.001, 95% CI 1.94-2.15). Furthermore, fear of COVID-19 was associated with a 192-gram reduction in infant birthweight, and a 6.1-day reduction in gestational age at birth. LIMITATIONS The sample has higher education compared to the Canadian population and cannot test causal effects. CONCLUSION This study suggests that sociodemographic, health, and obstetric factors may contribute to increased fear of COVID-19 and associated adverse psychological and pregnancy outcomes.
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Affiliation(s)
- G.F. Giesbrecht
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada,Department of Psychology, University of Calgary, Calgary, AB, Canada,Corresponding author at: Department of Paediatrics, University of Calgary, 2500 University Drive, NW, Calgary, AB, T2N 1N4
| | - L. Rojas
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada
| | - S. Patel
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - V. Kuret
- Department of Obstetrics & Gynecology, University of Calgary, AB, Canada
| | - A.L. MacKinnon
- Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada,Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - L. Tomfohr-Madsen
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada,Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - C. Lebel
- Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada,Department of Radiology, University of Calgary, Calgary, AB, Canada
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20
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Positive modulation of N-methyl-D-aspartate receptors in the mPFC reduces the spontaneous recovery of fear. Mol Psychiatry 2022; 27:2580-2589. [PMID: 35418600 PMCID: PMC9135632 DOI: 10.1038/s41380-022-01498-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 02/04/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
N-methyl-D-aspartate receptor (NMDAR) modulators have recently received increased attention as potential therapeutics for posttraumatic stress disorder (PTSD). Here, we tested a novel NMDAR-positive modulator, NYX-783, in the following two rodent models of PTSD: an auditory fear-conditioning model and a single-prolonged stress (SPS) model. We examined the ability of NYX-783 to reduce subsequent fear-based behaviors by measuring enhanced fear extinction and reduced spontaneous recovery (spontaneous return of fear) in male mice. NYX-783 administration significantly reduced spontaneous recovery in both PTSD models and enhanced fear extinction in the SPS model. Furthermore, NYX-783 increased the NMDA-induced inward currents of excitatory and inhibitory neurons in the infralimbic medial prefrontal cortex (IL mPFC) and that the GluN2B subunit of NMDARs on pyramidal neurons in the IL mPFC is required for its effect on spontaneous recovery. The downstream expression of brain-derived neurotrophic factor was required for NYX-783 to achieve its behavioral effect. These results elucidate the cellular targets of NYX-783 and the molecular mechanisms underlying the inhibition of spontaneous recovery. These preclinical findings support the hypothesis that NYX-783 may have therapeutic potential for PTSD treatment and may be particularly useful for inhibiting spontaneous recovery.
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21
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Coloma-Carmona A, Carballo JL. Predicting PTSS in general population during COVID-19 pandemic: The mediating role of health anxiety. J Affect Disord 2021; 294:329-336. [PMID: 34311333 PMCID: PMC8302506 DOI: 10.1016/j.jad.2021.07.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 05/14/2021] [Accepted: 07/10/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite health anxiety (HA) is associated with higher incidence of anxiety disorders, no studies have examined the association between this variable and the increased levels of Post-Traumatic Stress Symptoms (PTSS) reported during COVID pandemic. METHODS This study was conducted online between April and May 2020. Data were collected from 468 men and women from the Spanish general population. Sociodemographic and COVID-19-related data, health anxiety, PTSS, fear of becoming infected, social support, sleep problems and past/current psychological/psychiatric history were assessed. The mediating effect of HA when predicting PTSS was explored with mediational analyses. Moderated mediational analyses were also performed to test if receiving psychological treatment during pandemic changes the mediating effect of HA. RESULTS Prevalence of PTSS was higher in high-scorers in HA (p<.01). High HA was also more likely to be reported by women, individuals with sleep problems, frequently fear of getting infected, and those who have previously received psychological treatment (p<.01). HA mediates the relationship between PTSS and the following predictors of PTSS: sleep problems, psychiatric history and fear of getting infected. Being under psychological treatment did not moderate the mediating effect of health anxiety. LIMITATIONS Further longitudinal studies with bigger sample sizes are needed to examine the causal relationship between HA and PTSS after COVID-19 pandemic. CONCLUSIONS Our findings suggest that HA could influence the psychological consequences of the pandemic. Screening of HA could be useful to identify people with heightened risk of developing PTSS during pandemic.
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Affiliation(s)
- Ainhoa Coloma-Carmona
- Center for Applied Psychology, Department of Health Psychology, Miguel Hernández University, Avenida Universidad s/n, Elche 03202, Spain.
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22
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Lguensat A, Boudjafad Z, Giorla E, Bennis M, Baunez C, Garcia R, Ba-M'hamed S. Repeated ethanol exposure following avoidance conditioning impairs avoidance extinction and modifies conditioning-associated prefrontal dendritic changes in a mouse model of post-traumatic stress disorder. Eur J Neurosci 2021; 54:7710-7732. [PMID: 34670326 DOI: 10.1111/ejn.15499] [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: 04/06/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/28/2022]
Abstract
Treatment of post-traumatic stress disorder is complicated by the presence of alcohol use disorder comorbidity. Little is known about the underlying brain mechanisms. We have recently shown, in mice, that the post-traumatic stress disorder-like phenotype is characterised by the increase and decrease in total dendritic number and length in the prelimbic and infralimbic areas of the medial prefrontal cortex, respectively. Here, we examined whether repeated ethanol exposure would exacerbate these changes and whether this would be associated with difficulty to extinguish passive avoidance behaviour, as an indicator of treatment resistance. We also analysed whether other known trauma-associated changes, like increased or decreased corticosterone and decreased brain-derived neurotrophic factor levels, would also be exacerbated. Male mice underwent trauma exposure (1.5-mA footshock), followed, 8 days later, by a conditioned place preference training with ethanol. Tests for fear sensitization, passive avoidance, anxiety-like behaviour, extinction acquisition and relapse susceptibility were used to assess behaviour changes. Plasma corticosterone and brain-derived neurotrophic factor levels and prefrontal dendritic changes were subsequently measured. Trauma-susceptible mice exposed to ethanol acquired a strong place preference and behaved differently from those not exposed to ethanol, with delayed avoidance extinction and higher avoidance relapse vulnerability. Ethanol potentiated trauma-associated dendritic changes in the prelimbic area and suppressed trauma-associated dendritic changes in the infralimbic area. However, ethanol had no effect on trauma-induced increased corticosterone and decreased brain-derived neurotrophic factor levels. These data suggest that the modification of prefrontal trauma-related changes, due to alcohol use, can characterise, and probably support, treatment-resistant post-traumatic stress disorder.
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Affiliation(s)
- Asmae Lguensat
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie et Environnement, Université Cadi Ayyad, Marrakesh, Morocco.,Centre National de la Recherche Scientifique, Institut de Neurosciences de la Timone, Aix Marseille Université, Marseille, France
| | - Zineb Boudjafad
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie et Environnement, Université Cadi Ayyad, Marrakesh, Morocco
| | - Elodie Giorla
- Centre National de la Recherche Scientifique, Institut de Neurosciences de la Timone, Aix Marseille Université, Marseille, France
| | - Mohamed Bennis
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie et Environnement, Université Cadi Ayyad, Marrakesh, Morocco
| | - Christelle Baunez
- Centre National de la Recherche Scientifique, Institut de Neurosciences de la Timone, Aix Marseille Université, Marseille, France
| | - René Garcia
- Centre National de la Recherche Scientifique, Institut de Neurosciences de la Timone, Aix Marseille Université, Marseille, France.,Graduate School of Life and Health Sciences, Université Côte d'Azur, Nice, France
| | - Saadia Ba-M'hamed
- Laboratoire de Pharmacologie, Neurobiologie, Anthropologie et Environnement, Université Cadi Ayyad, Marrakesh, Morocco
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23
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Bhattacharjee A, Prajapati SK, Krishnamurthy S. Supplementation of taurine improves ionic homeostasis and mitochondrial function in the rats exhibiting post-traumatic stress disorder-like symptoms. Eur J Pharmacol 2021; 908:174361. [PMID: 34297965 DOI: 10.1016/j.ejphar.2021.174361] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/24/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE Current pharmacotherapy for post-traumatic stress disorder (PTSD) is limited to few antidepressants. Mitochondrial dysfunction is observed in PTSD, along with altered potassium homeostasis. Nutritional supplementation of taurine can improve ionic homeostasis and thereby treat PTSD-like symptoms in rats. AIM The purpose is to study the pharmacological effect of taurine in stress re-stress-induced PTSD in rats. METHODS As per protocol, animals were restrained for 2 h then exposed to footshock (FS) (2 mA/10 s) followed by halothane-induced anesthesia. Behavioral assessments such as elevated plus maze (EPM) and Y-maze tests were performed on days 2, 8, and 32 of experimental protocol after re-stress. In addition, daily oral administration of taurine (100, 200, and 300 mg/kg) and paroxetine (PAX) (10 mg/kg) was done from D-8 to D-32 followed by re-stress. The plasma concentration of taurine, corticosterone, and potassium was measured on Day-32 along with mitochondrial function in discrete brain regions. RESULTS Sub-chronic administration of taurine in high and medium doses significantly ameliorated PTSD-like symptoms such as hyperarousal, anxiety, and improved spatial recognition memory. Taurine in all doses restored the plasma concentration of corticosterone and potassium. SRS-induced alterations in mitochondrial bioenergetics, complex enzyme activities, and reduced mitochondrial membrane potential in different brain regions were ameliorated by taurine. CONCLUSION Nutritional supplementation of taurine improves potassium ionic homeostasis, mitochondrial function, and attenuated PTSD-like symptoms in SRS subjected rats.
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Affiliation(s)
- Anindita Bhattacharjee
- Neurotherapeutics Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, 221 005, U.P., India
| | - Santosh Kumar Prajapati
- Neurotherapeutics Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, 221 005, U.P., India
| | - Sairam Krishnamurthy
- Neurotherapeutics Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, 221 005, U.P., India.
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Tanaka M, Tóth F, Polyák H, Szabó Á, Mándi Y, Vécsei L. Immune Influencers in Action: Metabolites and Enzymes of the Tryptophan-Kynurenine Metabolic Pathway. Biomedicines 2021; 9:734. [PMID: 34202246 PMCID: PMC8301407 DOI: 10.3390/biomedicines9070734] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/16/2022] Open
Abstract
The tryptophan (TRP)-kynurenine (KYN) metabolic pathway is a main player of TRP metabolism through which more than 95% of TRP is catabolized. The pathway is activated by acute and chronic immune responses leading to a wide range of illnesses including cancer, immune diseases, neurodegenerative diseases and psychiatric disorders. The presence of positive feedback loops facilitates amplifying the immune responses vice versa. The TRP-KYN pathway synthesizes multifarious metabolites including oxidants, antioxidants, neurotoxins, neuroprotectants and immunomodulators. The immunomodulators are known to facilitate the immune system towards a tolerogenic state, resulting in chronic low-grade inflammation (LGI) that is commonly present in obesity, poor nutrition, exposer to chemicals or allergens, prodromal stage of various illnesses and chronic diseases. KYN, kynurenic acid, xanthurenic acid and cinnabarinic acid are aryl hydrocarbon receptor ligands that serve as immunomodulators. Furthermore, TRP-KYN pathway enzymes are known to be activated by the stress hormone cortisol and inflammatory cytokines, and genotypic variants were observed to contribute to inflammation and thus various diseases. The tryptophan 2,3-dioxygenase, the indoleamine 2,3-dioxygenases and the kynurenine-3-monooxygenase are main enzymes in the pathway. This review article discusses the TRP-KYN pathway with special emphasis on its interaction with the immune system and the tolerogenic shift towards chronic LGI and overviews the major symptoms, pro- and anti-inflammatory cytokines and toxic and protective KYNs to explore the linkage between chronic LGI, KYNs, and major psychiatric disorders, including depressive disorder, bipolar disorder, substance use disorder, post-traumatic stress disorder, schizophrenia and autism spectrum disorder.
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Affiliation(s)
- Masaru Tanaka
- MTA-SZTE—Neuroscience Research Group, H-6725 Szeged, Hungary; (M.T.); (F.T.)
- Interdisciplinary Excellence Centre, Department of Neurology, Faculty of Medicine, University of Szeged, H-6725 Szeged, Hungary; (H.P.); (Á.S.)
| | - Fanni Tóth
- MTA-SZTE—Neuroscience Research Group, H-6725 Szeged, Hungary; (M.T.); (F.T.)
| | - Helga Polyák
- Interdisciplinary Excellence Centre, Department of Neurology, Faculty of Medicine, University of Szeged, H-6725 Szeged, Hungary; (H.P.); (Á.S.)
| | - Ágnes Szabó
- Interdisciplinary Excellence Centre, Department of Neurology, Faculty of Medicine, University of Szeged, H-6725 Szeged, Hungary; (H.P.); (Á.S.)
| | - Yvette Mándi
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Szeged, H-6720 Szeged, Hungary;
| | - László Vécsei
- MTA-SZTE—Neuroscience Research Group, H-6725 Szeged, Hungary; (M.T.); (F.T.)
- Interdisciplinary Excellence Centre, Department of Neurology, Faculty of Medicine, University of Szeged, H-6725 Szeged, Hungary; (H.P.); (Á.S.)
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25
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Carballo JL, Coloma-Carmona A, Arteseros-Bañón S, Pérez-Jover V. The Moderating Role of Caregiving on Fear of COVID-19 and Post-Traumatic Stress Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6125. [PMID: 34204088 PMCID: PMC8201199 DOI: 10.3390/ijerph18116125] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/23/2022]
Abstract
Caregiving has been associated with increased levels of fear and post-traumatic stress symptoms (PTSS) during COVID-19 pandemic. However, there is a lack of studies that analyze when the relationship between fear and PTSS occur, using informal caregiving as a moderator variable. To explore this moderating role, we conducted a cross-sectional online study between November 2020 and January 2021. A total of 503 men and women from the Spanish general population completed the survey. Sociodemographic and Covid-19-related data, fear of COVID-19, PTSS symptoms, and current psychological history were assessed. Prevalence of informal caregiving in the sample was 16.5%. Increased levels of fear and PTSS were found in caregivers compared to non-caregivers. Female gender and high number of COVID-19 related risk factors was also associated with fear and PTSS severity. The moderation analyses showed an interaction effect between caregiving and fear of COVID-19 when predicting PTSS symptoms. Particularly, results showed that informal caregivers reported greater PTSS symptoms, when compared to non-caregivers with same levels of fear of COVID-19. This evidence suggests that being a caregiver could increase the fear's impact on PTSS severity in the context of pandemics. Further studies with larger samples are needed to confirm these findings.
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Affiliation(s)
- José Luis Carballo
- Center for Applied Psychology, Miguel Hernández University, Avenida Universidad s/n, 03202 Elche, Spain; (S.A.-B.); (V.P.-J.)
| | - Ainhoa Coloma-Carmona
- Center for Applied Psychology, Miguel Hernández University, Avenida Universidad s/n, 03202 Elche, Spain; (S.A.-B.); (V.P.-J.)
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26
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Lathabhavan R, Vispute S. Examining the Mediating Effects of Stress on Fear of COVID-19 and Well-being Using Structural Equation Modeling. Int J Ment Health Addict 2021; 20:2681-2689. [PMID: 34025306 PMCID: PMC8130788 DOI: 10.1007/s11469-021-00541-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2021] [Indexed: 12/19/2022] Open
Abstract
This study focuses on the effects of fear factor due to COVID-19 on stress and well-being of college students in India. The authors conducted a cross-sectional survey among 625 Indian students across various Indian universities and structural equation modeling (SEM) has been performed for analyzing the data. The findings of the study show a positive effect of fear of COVID-19 on stress with β = .27, p < 0.05, and a negative effect on well-being (β = -.13, p < 0.05). The results also depicted the mediating role of stress between fear of COVID-19 and well-being. Therefore, it is suggested that measures must be taken by individuals, society, and policy makers to include mental health maintenance in the pandemic response activities. Further longitudinal studies in different geographical regions and demographics can provide a more generalized understanding of the relationship between the pandemic and mental health. The limitations, policy implications, and suggestions are discussed.
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27
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Kostelnik C, Lucki I, Choi KH, Browne CA. Translational relevance of fear conditioning in rodent models of mild traumatic brain injury. Neurosci Biobehav Rev 2021; 127:365-376. [PMID: 33961927 DOI: 10.1016/j.neubiorev.2021.04.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/12/2021] [Accepted: 04/29/2021] [Indexed: 01/19/2023]
Abstract
Mild traumatic brain injury (mTBI) increases the risk of posttraumatic stress disorder (PTSD) in military populations. Utilizing translationally relevant animal models is imperative for establishing a platform to delineate neurobehavioral deficits common to clinical PTSD that emerge in the months to years following mTBI. Such platforms are required to facilitate preclinical development of novel therapeutics. First, this mini review provides an overview of the incidence of PTSD following mTBI in military service members. Secondly, the translational relevance of fear conditioning paradigms used in conjunction with mTBI in preclinical studies is evaluated. Next, this review addresses an important gap in the current preclinical literature; while incubation of fear has been studied in other areas of research, there are relatively few studies pertaining to the enhancement of cued and contextual fear memory over time following mTBI. Incubation of fear paradigms in conjunction with mTBI are proposed as a novel behavioral approach to advance this critical area of research. Lastly, this review discusses potential neurobiological substrates implicated in altered fear memory post mTBI.
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Affiliation(s)
- Claire Kostelnik
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States
| | - Irwin Lucki
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States; Department of Pharmacology & Molecular Therapeutics, Uniformed Services University, Bethesda MD 20814, United States; Department of Psychiatry, Uniformed Services University, Bethesda MD 20814, United States
| | - Kwang H Choi
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States; Department of Psychiatry, Uniformed Services University, Bethesda MD 20814, United States.
| | - Caroline A Browne
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States; Department of Pharmacology & Molecular Therapeutics, Uniformed Services University, Bethesda MD 20814, United States.
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28
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Mount RA, Sridhar S, Hansen KR, Mohammed AI, Abdulkerim M, Kessel R, Nazer B, Gritton HJ, Han X. Distinct neuronal populations contribute to trace conditioning and extinction learning in the hippocampal CA1. eLife 2021; 10:56491. [PMID: 33843589 PMCID: PMC8064758 DOI: 10.7554/elife.56491] [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] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Trace conditioning and extinction learning depend on the hippocampus, but it remains unclear how neural activity in the hippocampus is modulated during these two different behavioral processes. To explore this question, we performed calcium imaging from a large number of individual CA1 neurons during both trace eye-blink conditioning and subsequent extinction learning in mice. Our findings reveal that distinct populations of CA1 cells contribute to trace conditioned learning versus extinction learning, as learning emerges. Furthermore, we examined network connectivity by calculating co-activity between CA1 neuron pairs and found that CA1 network connectivity patterns also differ between conditioning and extinction, even though the overall connectivity density remains constant. Together, our results demonstrate that distinct populations of hippocampal CA1 neurons, forming different sub-networks with unique connectivity patterns, encode different aspects of learning.
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Affiliation(s)
- Rebecca A Mount
- Department of Biomedical Engineering, Boston University, Boston, United States
| | - Sudiksha Sridhar
- Department of Biomedical Engineering, Boston University, Boston, United States
| | - Kyle R Hansen
- Department of Biomedical Engineering, Boston University, Boston, United States
| | - Ali I Mohammed
- Department of Biomedical Engineering, Boston University, Boston, United States
| | - Moona Abdulkerim
- Department of Biomedical Engineering, Boston University, Boston, United States
| | - Robb Kessel
- Department of Biomedical Engineering, Boston University, Boston, United States
| | - Bobak Nazer
- Department of Electrical and Computer Engineering, Boston University, Boston, United States
| | - Howard J Gritton
- Department of Biomedical Engineering, Boston University, Boston, United States
| | - Xue Han
- Department of Biomedical Engineering, Boston University, Boston, United States
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29
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Manthey A, Sierk A, Brakemeier EL, Walter H, Daniels JK. Does trauma-focused psychotherapy change the brain? A systematic review of neural correlates of therapeutic gains in PTSD. Eur J Psychotraumatol 2021; 12:1929025. [PMID: 34394855 PMCID: PMC8354020 DOI: 10.1080/20008198.2021.1929025] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND Meta-analytic results indicate that posttraumatic stress disorder (PTSD) is associated with hypoactivation of the medial prefrontal cortex (mPFC), hyperactivation of the amygdala, and volume reductions of the hippocampus. Effective psychotherapeutic treatments were hypothesized to normalize these neural patterns via upregulation of prefrontal structures, which in turn downregulate limbic regions. OBJECTIVE To gain a sound understanding of the effects of successful psychotherapy on the brain, neural changes from pre- to post-treatment in PTSD patients will be aggregated. METHOD A systematic literature search identified 24 original studies employing structural or functional MRI measurements both before and after treatment of patients diagnosed with PTSD. RESULTS In conjunction, the review returned little evidence of an activation increase in the mPFC/rostral anterior cingulate cortex (rACC) following successful treatment. Five out of 12 studies observed such an increase (especially during emotion processing tasks), albeit in partially non-overlapping brain regions. Conversely, neither the putative related activation decrease in the amygdala nor volumetric changes or altered activation during the resting state could be convincingly established. CONCLUSION Successful psychological treatments might potentially work via upregulation of the mPFC, which thus may be involved in symptom reduction. However, the role of the amygdala in recovery from PTSD remains unclear. There is currently no indication that the various PTSD treatment approaches employed by the reviewed studies differ regarding their action mechanisms, but further research on this topic is needed.
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Affiliation(s)
- Antje Manthey
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Anika Sierk
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Eva-Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy, Universität Greifswald, Greifswald, Germany.,Psychologische Hochschule Berlin, Berlin, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Judith K Daniels
- Psychologische Hochschule Berlin, Berlin, Germany.,Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
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30
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Zhang J, Wong SM, Richardson JD, Jetly R, Dunkley BT. Predicting PTSD severity using longitudinal magnetoencephalography with a multi-step learning framework. J Neural Eng 2020; 17. [PMID: 33166947 DOI: 10.1088/1741-2552/abc8d6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/09/2020] [Indexed: 12/29/2022]
Abstract
Objective The present study explores the effectiveness of incorporating temporal information in predicting Post-Traumatic Stress Disorder (PTSD) severity using magnetoencephalography (MEG) imaging data. The main objective was to assess the relationship between longitudinal MEG functional connectome data, measured across a variety of neural oscillatory frequencies and collected at two-timepoints (Phase I & II), against PTSD severity captured at the later time point. Approach We used an in-house developed informatics solution, featuring a two-step process featuring pre-learn feature selection (CV-SVR-rRF-FS, cross-validation with support vector regression and recursive random forest feature selection) and deep learning (long-short term memory recurrent neural network, LSTM-RNN) techniques. Main results The pre-learn step selected a small number of functional connections (or edges) from Phase I MEG data associated with Phase II PTSD severity, indexed using the PTSD CheckList (PCL) score. This strategy identified the functional edges affected by traumatic exposure and indexed disease severity, either permanently or evolving dynamically over time, for optimal predictive performance. Using the selected functional edges, LSTM modelling was used to incorporate the Phase II MEG data into longitudinal regression models. Single timepoint (Phase I and Phase II MEG data) SVR models were generated for comparison. Assessed with holdout test data, alpha and high gamma bands showed enhanced predictive performance with the longitudinal models comparing to the Phase I single timepoint models. The best predictive performance was observed for lower frequency ranges compared to the higher frequencies (low gamma), for both model types. Significance This study identified the neural oscillatory signatures that benefited from additional temporal information when estimating the outcome of PTSD severity using MEG functional connectome data. Crucially, this approach can similarly be applied to any other mental health challenge, using this effective informatics foundation for longitudinal tracking of pathological brain states and predicting outcome with a MEG-based neurophysiology imaging system.
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Affiliation(s)
- Jing Zhang
- Hospital for Sick Children, Toronto, Ontario, M5G 1X8, CANADA
| | - Simeon M Wong
- Hospital for Sick Children, Toronto, Ontario, CANADA
| | | | - Rakesh Jetly
- Canadian Forces Health Services HQ, Ottawa, Ontario, CANADA
| | - Benjamin T Dunkley
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, CANADA
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31
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Chaby LE, Sadik N, Burson NA, Lloyd S, O'Donnel K, Winters J, Conti AC, Liberzon I, Perrine SA. Repeated stress exposure in mid-adolescence attenuates behavioral, noradrenergic, and epigenetic effects of trauma-like stress in early adult male rats. Sci Rep 2020; 10:17935. [PMID: 33087769 PMCID: PMC7578655 DOI: 10.1038/s41598-020-74481-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/30/2020] [Indexed: 12/11/2022] Open
Abstract
Stress in adolescence can regulate vulnerability to traumatic stress in adulthood through region-specific epigenetic activity and catecholamine levels. We hypothesized that stress in adolescence would increase adult trauma vulnerability by impairing extinction-retention, a deficit in PTSD, by (1) altering class IIa histone deacetylases (HDACs), which integrate effects of stress on gene expression, and (2) enhancing norepinephrine in brain regions regulating cognitive effects of trauma. We investigated the effects of adolescent-stress on adult vulnerability to severe stress using the single-prolonged stress (SPS) model in male rats. Rats were exposed to either (1) adolescent-stress (33-35 postnatal days) then SPS (58-60 postnatal days; n = 14), or (2) no adolescent-stress and SPS (58-60 postnatal days; n = 14), or (3) unstressed conditions (n = 8). We then measured extinction-retention, norepinephrine, HDAC4, and HDAC5. As expected, SPS exposure induced an extinction-retention deficit. Adolescent-stress prior to SPS eliminated this deficit, suggesting adolescent-stress conferred resiliency to adult severe stress. Adolescent-stress also conferred region-specific resilience to norepinephrine changes. HDAC4 and HDAC5 were down-regulated following SPS, and these changes were also modulated by adolescent-stress. Regulation of HDAC levels was consistent with the pattern of cognitive effects of SPS; only animals exposed to SPS without adolescent-stress exhibited reduced HDAC4 and HDAC5 in the prelimbic cortex, hippocampus, and striatum. Thus, HDAC regulation caused by severe stress in adulthood interacts with stress history such that seemingly conflicting reports describing effects of adolescent stress on adult PTSD vulnerability may stem in part from dynamic HDAC changes following trauma that are shaped by adolescent stress history.
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MESH Headings
- Adolescent
- Adolescent Behavior/physiology
- Adolescent Behavior/psychology
- Animals
- Brain/metabolism
- Disease Models, Animal
- Epigenesis, Genetic
- Extinction, Psychological/physiology
- Histone Deacetylases/metabolism
- Humans
- Male
- Norepinephrine/metabolism
- Psychology, Adolescent
- Rats, Sprague-Dawley
- Retention, Psychology/physiology
- Stress Disorders, Post-Traumatic/etiology
- Stress Disorders, Post-Traumatic/genetics
- Stress Disorders, Post-Traumatic/metabolism
- Stress Disorders, Post-Traumatic/psychology
- Stress, Psychological
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Affiliation(s)
- Lauren E Chaby
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Nareen Sadik
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nicole A Burson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Scott Lloyd
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
- Research Service, John D. Dingell VA Medical Center, Detroit, MI, USA
| | - Kelly O'Donnel
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
| | - Jesse Winters
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Alana C Conti
- Research Service, John D. Dingell VA Medical Center, Detroit, MI, USA
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M College of Medicine, Bryan, TX, USA
| | - Shane A Perrine
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
- Research Service, John D. Dingell VA Medical Center, Detroit, MI, USA
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32
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Horovitz O, Ardi Z, Ashkenazi SK, Ritov G, Anunu R, Richter-Levin G. Network Neuromodulation of Opioid and GABAergic Receptors Following a Combination of "Juvenile" and "Adult Stress" in Rats. Int J Mol Sci 2020; 21:ijms21155422. [PMID: 32751453 PMCID: PMC7432657 DOI: 10.3390/ijms21155422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/18/2022] Open
Abstract
Early life stress is suggested to alter behavioral responses during stressful challenges in adulthood and to exacerbate pathological symptoms that reminisce posttraumatic stress disorder (PTSD). These effects are often associated with changes in γ-Aminobutyric acid type A (GABAA) and κ opioid receptor expression and neuromodulation of the limbic system. Anxiety-like and stress coping behaviors were assessed in rats exposed to stress in adulthood on the background of previous exposure to stress in juvenility. Two weeks following behavioral assessment in adulthood, GABAAR α1 and α2 subunits and κ opioid receptor expression levels were measured in the medial prefrontal cortex (mPFC), nucleus accumbens (NAc), amygdala, and periaqueductal gray (PAG). To illustrate changes at the network level, an integrated expression profile was constructed. We found that exposure to juvenile stress affected rats’ behavior during adult stress. The combination of juvenile and adult stress significantly affected rats’ long term anxious-like behavior. Probabilities predicting model integrating the expression of GABAA α1-α2 and κ opioid receptors in different brain regions yielded highly successful classification rates. This study emphasizes the ability of exposure to stress in juvenility to exacerbate the impact of coping with stress in adulthood. Moreover, the use of integrated receptor expression network profiling was found to effectively characterize the discussed affective styles and their behavioral manifestations.
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Affiliation(s)
- Omer Horovitz
- Psychology Department, Tel-Hai Academic College, Haifa 1220800, Israel;
| | - Ziv Ardi
- Department of Behavioral Sciences, Kinneret Academic College on the Sea of Galilee, Sea of Galilee 15132, Israel
- Correspondence: ; Tel.: +972-46653803
| | - Shiri Karni Ashkenazi
- Sagol Department of Neurobiology, University of Haifa, Mount Carmel 31095, Israel; (S.K.A.); (G.R.-L.)
| | - Gilad Ritov
- The Institute for the Study of Affective Neuroscience (ISAN), Mount Carmel 31095, Israel; (G.R.); (R.A.)
| | - Rachel Anunu
- The Institute for the Study of Affective Neuroscience (ISAN), Mount Carmel 31095, Israel; (G.R.); (R.A.)
| | - Gal Richter-Levin
- Sagol Department of Neurobiology, University of Haifa, Mount Carmel 31095, Israel; (S.K.A.); (G.R.-L.)
- The Institute for the Study of Affective Neuroscience (ISAN), Mount Carmel 31095, Israel; (G.R.); (R.A.)
- Psychology Department, University of Haifa, Mount Carmel 31095, Israel
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33
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Proximal threats promote enhanced acquisition and persistence of reactive fear-learning circuits. Proc Natl Acad Sci U S A 2020; 117:16678-16689. [PMID: 32601212 DOI: 10.1073/pnas.2004258117] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Physical proximity to a traumatic event increases the severity of accompanying stress symptoms, an effect that is reminiscent of evolutionarily configured fear responses based on threat imminence. Despite being widely adopted as a model system for stress and anxiety disorders, fear-conditioning research has not yet characterized how threat proximity impacts the mechanisms of fear acquisition and extinction in the human brain. We used three-dimensional (3D) virtual reality technology to manipulate the egocentric distance of conspecific threats while healthy adult participants navigated virtual worlds during functional magnetic resonance imaging (fMRI). Consistent with theoretical predictions, proximal threats enhanced fear acquisition by shifting conditioned learning from cognitive to reactive fear circuits in the brain and reducing amygdala-cortical connectivity during both fear acquisition and extinction. With an analysis of representational pattern similarity between the acquisition and extinction phases, we further demonstrate that proximal threats impaired extinction efficacy via persistent multivariate representations of conditioned learning in the cerebellum, which predicted susceptibility to later fear reinstatement. These results show that conditioned threats encountered in close proximity are more resistant to extinction learning and suggest that the canonical neural circuitry typically associated with fear learning requires additional consideration of a more reactive neural fear system to fully account for this effect.
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34
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Quinones MM, Gallegos AM, Lin FV, Heffner K. Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:455-480. [PMID: 32170605 PMCID: PMC7682894 DOI: 10.3758/s13415-020-00782-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.
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Affiliation(s)
- Maria M Quinones
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Autumn M Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Feng Vankee Lin
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Kathi Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Division of Geriatrics & Aging, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Lee W, Lee YR, Yoon JH, Lee HJ, Kang MY. Occupational post-traumatic stress disorder: an updated systematic review. BMC Public Health 2020; 20:768. [PMID: 32448255 PMCID: PMC7245752 DOI: 10.1186/s12889-020-08903-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/12/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although numerous studies on occupational post-traumatic stress disorder (PTSD) have been conducted prior to the 1950-2010 seminal systematic review by Skogstad et al., the prevalence, risk factors, and impact of this disorder following traumatic events in occupational settings remain unclear. This study aims to address this knowledge gap by reviewing the literature published after 2010. METHODS We reviewed literature from databases such as PubMed and Google Scholar using PRISMA guidelines to identify studies that address occupational PTSD and examined the status (prevalence or incidence), the risk factors, and the health effects of PTSD among workers. RESULTS In total, 123 articles were identified, and finally, 31 (25.2%) articles were selected after excluding duplicates. Various occupational traumatic physical events were reported such as natural or manmade disaster, explosion, accident, handling refugee corpses, or bullying at work. Risk of PTSD was closely associated with working conditions, severity of injury, history of mental disorder, occurrence of psychiatric symptoms at the time of the event, personality, interpersonal relationships, etc. Workers with PTSD were likely to experience a deterioration of physical and psychological health and impairment of social and occupational functioning. CONCLUSIONS Our review suggests that many workers remain highly vulnerable to occupational PTSD and its consequences.
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Affiliation(s)
- Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Yi-Ryoung Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye-Ji Lee
- Occupational Safety and Health Research Institute, Ulsan, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Lijffijt M, Green CE, Balderston N, Iqbal T, Atkinson M, Vo-Le B, Vo-Le B, O’Brien B, Grillon C, Swann AC, Mathew SJ. A Proof-of-Mechanism Study to Test Effects of the NMDA Receptor Antagonist Lanicemine on Behavioral Sensitization in Individuals With Symptoms of PTSD. Front Psychiatry 2019; 10:846. [PMID: 31920733 PMCID: PMC6923195 DOI: 10.3389/fpsyt.2019.00846] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/24/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Individuals with post-traumatic stress disorder (PTSD) have a heightened sensitivity to subsequent stressors, addictive drugs, and symptom recurrence, a form of behavioral sensitization. N-methyl-D-aspartate receptors (NMDARs) are involved in the establishment and activation of sensitized behavior. Objective: We describe a protocol of a randomized placebo-controlled Phase 1b proof-of-mechanism trial to examine target engagement, safety, tolerability, and possible efficacy of the NMDAR antagonist lanicemine in individuals with symptoms of PTSD (Clinician Administered PTSD Scale [CAPS-5] score ≥ 25) and evidence of behavioral sensitization measured as enhanced anxiety-potentiated startle (APS; T-score ≥ 2.8). Methods: Subjects (n = 24; age range 21-65) receive three 60-min intravenous infusions of placebo or 100 mg lanicemine over 5 non-consecutive days. Primary endpoint is change in APS from pre-treatment baseline to after the third infusion. NMDAR engagement is probed with resting state EEG gamma band power, 40 Hz auditory steady state response, the mismatch negativity amplitude, and P50 sensory gating. Change in CAPS-5 scores is an exploratory clinical endpoint. Bayesian statistical methods will evaluate endpoints to determine suitability of this agent for further study. Conclusion: In contrast to traditional early-phase trials that use symptom severity to track treatment efficacy, this study tracks engagement of the study drug on expression of behavioral sensitization, a functional mechanism likely to cut across disorders. This experimental therapeutics design is consistent with recent NIMH-industry collaborative studies, and could serve as a template for testing novel pharmacological agents in psychiatry. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03166501.
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Affiliation(s)
- Marijn Lijffijt
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Charles E. Green
- Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
- Department of Pediatrics - Center for Evidence Based Medicine, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Nicholas Balderston
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Tabish Iqbal
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Megan Atkinson
- Department of Anesthesiology, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Department of Anesthesiology, Baylor College of Medicine, Houston, TX, United States
| | - Brittany Vo-Le
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Bylinda Vo-Le
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Brittany O’Brien
- Research Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Christian Grillon
- Department of Pediatrics - Center for Evidence Based Medicine, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Alan C. Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
| | - Sanjay J. Mathew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
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37
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González JL, Alonso-Fernández M, Matías-Pompa B, Carretero I, Nieto-Bona MP, López-López A. Cardiovascular Responses of Women with Fibromyalgia to a Laboratory Stressor: Does Post-traumatic Stress Disorder Comorbidity Matter? PAIN MEDICINE 2019; 20:988-999. [PMID: 30476240 DOI: 10.1093/pm/pny210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES This study compared cardiovascular responses to a laboratory trauma-unrelated stressor of two groups of women diagnosed with fibromyalgia (FM), one of them with comorbid post-traumatic stress disorder (PTSD), with a group of healthy controls in order to detect the possible existence of differences linked to comorbidity. DESIGN Case-controls. METHODS Eighteen women diagnosed with FM and comorbid PTSD, 18 women diagnosed with FM and no PTSD, and 38 healthy women were exposed to an arithmetic task with harassment while blood pressure and heart rate were measured during task exposure and recovery. RESULTS Although heart rate response evidenced a general blunted reactivity for both groups of FM patients, only those with comorbid PTSD presented lower levels of reactivity in terms of their systolic blood pressure response. In addition, systolic blood pressure response was sensitive to the presence of depression in both groups of FM patients and controls. Finally, although both groups of FM patients showed significantly slower rates of recovery, their final recovery state was not worse after twelve minutes of recording. CONCLUSIONS Results of this study point to comorbid PTSD as a significant contributor to the blunted cardiovascular reactivity observed in FM patients, which may be dependent to a great extent on depressive symptomatology. As some degree of cardiovascular response to stress is functional in that it mobilizes energy and triggers the necessary compensatory mechanisms to manage stressors, this study supports the well-recognized clinical strategies of detection and treatment of PTSD and concomitant depression in the management of FM.
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Affiliation(s)
- José Luis González
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology, King Juan Carlos University, Madrid, Spain
| | - Miriam Alonso-Fernández
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology, King Juan Carlos University, Madrid, Spain
| | - Borja Matías-Pompa
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology, King Juan Carlos University, Madrid, Spain
| | - Isabel Carretero
- Department of Psychology and Pedagogy, San Pablo CEU University, King Juan Carlos University, Madrid, Spain
| | - Ma Paz Nieto-Bona
- Department of Basic Health Sciences, King Juan Carlos University, Madrid, Spain
| | - Almudena López-López
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology, King Juan Carlos University, Madrid, Spain
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38
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Asok A, Hijazi J, Harvey LR, Kosmidis S, Kandel ER, Rayman JB. Sex Differences in Remote Contextual Fear Generalization in Mice. Front Behav Neurosci 2019; 13:56. [PMID: 30967765 PMCID: PMC6439350 DOI: 10.3389/fnbeh.2019.00056] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/06/2019] [Indexed: 12/21/2022] Open
Abstract
The generalization of fear is adaptive in that it allows an animal to respond appropriately to novel threats that are not identical to previous experiences. In contrast, the overgeneralization of fear is maladaptive and is a hallmark of post-traumatic stress disorder (PTSD), a psychiatric illness that is characterized by chronic symptomatology and a higher incidence in women compared to men. Therefore, understanding the neural basis of fear generalization at remote time-points in female animals is of particular translational relevance. However, our understanding of the neurobiology of fear generalization is largely restricted to studies employing male mice and focusing on recent time-points (i.e., within 24-48 h following conditioning). To address these limitations, we examined how male and female mice generalize contextual fear at remote time intervals (i.e., 3 weeks after conditioning). In agreement with earlier studies of fear generalization at proximal time-points, we find that the test order of training and generalization contexts is a critical determinant of generalization and context discrimination, particularly for female mice. However, tactile elements that are present during fear conditioning are more salient for male mice. Our study highlights long-term sex differences in defensive behavior between male and female mice and may provide insight into sex differences in the processing and retrieval of remote fear memory observed in humans.
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Affiliation(s)
- Arun Asok
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Joud Hijazi
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Lucas R. Harvey
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Stylianos Kosmidis
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
| | - Eric R. Kandel
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
- Howard Hughes Medical Institute, Columbia University, New York, NY, United States
- Kavli Institute for Brain Science, Columbia University, New York, NY, United States
| | - Joseph B. Rayman
- Department of Neuroscience, Jerome L. Greene Science Center, Columbia University, New York, NY, United States
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, United States
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39
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Abdallah CG, Averill LA, Akiki TJ, Raza M, Averill CL, Gomaa H, Adikey A, Krystal JH. The Neurobiology and Pharmacotherapy of Posttraumatic Stress Disorder. Annu Rev Pharmacol Toxicol 2019; 59:171-189. [PMID: 30216745 PMCID: PMC6326888 DOI: 10.1146/annurev-pharmtox-010818-021701] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
New approaches to the neurobiology of posttraumatic stress disorder (PTSD) are needed to address the reported crisis in PTSD drug development. These new approaches may require the field to move beyond a narrow fear-based perspective, as fear-based medications have not yet demonstrated compelling efficacy. Antidepressants, particularly recent rapid-acting antidepressants, exert complex effects on brain function and structure that build on novel aspects of the biology of PTSD, including a role for stress-related synaptic dysconnectivity in the neurobiology and treatment of PTSD. Here, we integrate this perspective within a broader framework-in other words, a dual pathology model of ( a) stress-related synaptic loss arising from amino acid-based pathology and ( b) stress-related synaptic gain related to monoamine-based pathology. Then, we summarize the standard and experimental (e.g., ketamine) pharmacotherapeutic options for PTSD and discuss their putative mechanism of action and clinical efficacy.
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Affiliation(s)
- Chadi G Abdallah
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - Lynnette A Averill
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - Teddy J Akiki
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - Mohsin Raza
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - Christopher L Averill
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - Hassaan Gomaa
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - Archana Adikey
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
| | - John H Krystal
- Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA;
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA
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40
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Abdallah CG, Sanacora G, Duman RS, Krystal JH. The neurobiology of depression, ketamine and rapid-acting antidepressants: Is it glutamate inhibition or activation? Pharmacol Ther 2018; 190:148-158. [PMID: 29803629 PMCID: PMC6165688 DOI: 10.1016/j.pharmthera.2018.05.010] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The discovery of the antidepressant effects of ketamine has opened a breakthrough opportunity to develop a truly novel class of safe, effective, and rapid-acting antidepressants (RAADs). In addition, the rapid and robust biological and behavioral effects of ketamine offered a unique opportunity to utilize the drug as a tool to thoroughly investigate the neurobiology of stress and depression in animals, and to develop sensitive and reproducible biomarkers in humans. The ketamine literature over the past two decades has considerably enriched our understanding of the mechanisms underlying chronic stress, depression, and RAADs. However, considering the complexity of the pharmacokinetics and in vivo pharmacodynamics of ketamine, several questions remain unanswered and, at times, even answered questions continue to be considered controversial or at least not fully understood. The current perspective paper summarizes our understanding of the neurobiology of depression, and the mechanisms of action of ketamine and other RAADs. The review focuses on the role of glutamate neurotransmission - reviewing the history of the "glutamate inhibition" and "glutamate activation" hypotheses, proposing a synaptic connectivity model of chronic stress pathology, and describing the mechanism of action of ketamine. It will also summarize the clinical efficacy findings of putative RAADs, present relevant human biomarker findings, and discuss current challenges and future directions.
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Affiliation(s)
- Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA; Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, USA.
| | - Gerard Sanacora
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, USA
| | - Ronald S Duman
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA; Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, USA
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA; Clinical Neuroscience Division, Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, USA
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