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Avila C, Sarter M. Cortico-striatal action control inherent of opponent cognitive-motivational styles. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.12.584623. [PMID: 38559086 PMCID: PMC10979997 DOI: 10.1101/2024.03.12.584623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Turning on cue or stopping at a red light requires the detection of such cues to select action sequences, or suppress action, in accordance with cue-associated action rules. Cortico-striatal projections are an essential part of the brain's attention-motor interface. Glutamate-sensing microelectrode arrays were used to measure glutamate transients in the dorsomedial striatum (DMS) of male and female rats walking a treadmill and executing cued turns and stops. Prelimbic-DMS projections were chemogenetically inhibited to determine their behavioral necessity and the cortico-striatal origin of cue-evoked glutamate transients. Furthermore, we investigated rats exhibiting preferably goal-directed (goal trackers, GTs) versus cue-driven attention (sign trackers, STs), to determine the impact of such cognitive-motivational biases on cortico-striatal control. GTs executed more cued turns and initiated such turns more slowly than STs. During turns, but not missed turns or cued stops, cue-evoked glutamate concentrations were higher in GTs than in STs. In conjunction with turn cue-evoked glutamate spike levels, the presence of a single spike rendered GTs to be almost twice as likely to turn than STs. In contrast, multiple glutamate spikes predicted GTs to be less likely to turn than STs. In GTs, but not STs, inhibition of prelimbic-DMS projections attenuated turn rates, turn cue-evoked glutamate peaks, and increased the number of spikes. These findings suggest that turn cue-evoked glutamate release in GTs is tightly controlled by cortico-striatal neuronal activity. In contrast, in STs, glutamate release from DMS glutamatergic terminals may be regulated by other striatal circuitry, preferably mediating cued suppression of action and reward tracking.
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Affiliation(s)
- Cassandra Avila
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Martin Sarter
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, MI, USA
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Coray RC, Berberat J, Zimmermann J, Seifritz E, Stock AK, Beste C, Cole DM, Unschuld PG, Quednow BB. Striatal Iron Deposition in Recreational MDMA (Ecstasy) Users. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:956-966. [PMID: 36848948 DOI: 10.1016/j.bpsc.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/30/2022] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND The common club drug MDMA (also known as ecstasy) enhances mood, sensory perception, energy, sociability, and euphoria. While MDMA has been shown to produce neurotoxicity in animal models, research on its potential neurotoxic effects in humans is inconclusive and has focused primarily on the serotonin system. METHODS We investigated 34 regular, largely pure MDMA users for signs of premature neurodegenerative processes in the form of increased iron load in comparison to a group of 36 age-, sex-, and education-matched MDMA-naïve control subjects. We used quantitative susceptibility mapping, a novel tool able to detect even small tissue (nonheme) iron accumulations. Cortical and relevant subcortical gray matter structures were grouped into 8 regions of interest and analyzed. RESULTS Significantly increased iron deposition in the striatum was evident in the MDMA user group. The effect survived correction for multiple comparisons and remained after controlling for relevant confounding factors, including age, smoking, and stimulant co-use. Although no significant linear relationship between measurements of the amounts of MDMA intake (hair analysis and self-reports) and quantitative susceptibility mapping values was observed, increased striatal iron deposition might nevertheless point to MDMA-induced neurotoxic processes. Additional factors (hyperthermia and simultaneous co-use of other substances) that possibly amplify neurotoxic effects of MDMA during the state of acute intoxication are discussed. CONCLUSIONS The demonstrated increased striatal iron accumulation may indicate that regular MDMA users have an increased risk potential for neurodegenerative diseases with progressing age.
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Affiliation(s)
- Rebecca C Coray
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Eidgenössische Technische Hochschule Zurich and University of Zurich, Zurich, Switzerland.
| | - Jatta Berberat
- Geriatric Psychiatry, Department of Psychiatry, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland; Institute of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Eidgenössische Technische Hochschule Zurich and University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - David M Cole
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Eidgenössische Technische Hochschule Zurich and University of Zurich, Zurich, Switzerland; Translational Psychiatry Lab, University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Paul G Unschuld
- Geriatric Psychiatry, Department of Psychiatry, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Eidgenössische Technische Hochschule Zurich and University of Zurich, Zurich, Switzerland
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Rissardo JP, Vora N, Mathew B, Kashyap V, Muhammad S, Fornari Caprara AL. Overview of Movement Disorders Secondary to Drugs. Clin Pract 2023; 13:959-976. [PMID: 37623268 PMCID: PMC10453030 DOI: 10.3390/clinpract13040087] [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: 07/16/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
Drug-induced movement disorders affect a significant percentage of individuals, and they are commonly overlooked and underdiagnosed in clinical practice. Many comorbidities can affect these individuals, making the diagnosis even more challenging. Several variables, including genetics, environmental factors, and aging, can play a role in the pathophysiology of these conditions. The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and Related Health Problems (ICD) are the most commonly used classification systems in categorizing drug-induced movement disorders. This literature review aims to describe the abnormal movements associated with some medications and illicit drugs. Myoclonus is probably the most poorly described movement disorder, in which most of the reports do not describe electrodiagnostic studies. Therefore, the information available is insufficient for the diagnosis of the neuroanatomical source of myoclonus. Drug-induced parkinsonism is rarely adequately evaluated but should be assessed with radiotracers when these techniques are available. Tardive dyskinesias and dyskinesias encompass various abnormal movements, including chorea, athetosis, and ballism. Some authors include a temporal relationship to define tardive syndromes for other movement disorders, such as dystonia, tremor, and ataxia. Antiseizure medications and antipsychotics are among the most thoroughly described drug classes associated with movement disorders.
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Affiliation(s)
| | - Nilofar Vora
- Medicine Department, Terna Speciality Hospital and Research Centre, Navi Mumbai 400706, India;
| | - Bejoi Mathew
- Medicine Department, Sri Devaraj Urs Medical College, Kolar Karnataka 563101, India;
| | - Vikas Kashyap
- Medicine Department, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India;
| | - Sara Muhammad
- Neurology Department, Mayo Clinic, Rochester, MN 55906, USA;
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Kim DD, Procyshyn RM, Jones AA, Lee LHN, Panenka WJ, Stubbs JL, Cho LL, Leonova O, Gicas K, Thornton AE, Lang DJ, MacEwan GW, Honer WG, Barr AM. Movement disorders associated with substance use in adults living in precarious housing or homelessness. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110795. [PMID: 37196752 DOI: 10.1016/j.pnpbp.2023.110795] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Many individuals living in precarious housing or homelessness have multimorbid illnesses, including substance use, psychiatric, and neurological disorders. Movement disorders (MDs) associated substance use are amongst the poorly studied subtopics of drug-induced MDs. The aim of the present study was, therefore, to determine the proportion affected and severity of different signs of MDs, as well as their associations with substance use in a community-based sample of precariously housed and homeless individuals. METHODS Participants were recruited from an impoverished urban neighborhood and were assessed for substance dependence and self-reported substance use (alcohol, cannabis, cocaine, methamphetamine, nicotine, and opioids), as well as for the severity of signs of MDs (akathisia, dyskinesia, dystonia, and parkinsonism). Adjusted regression models were used to estimate the associations of the severity of signs with the frequency of substance use over the past 4 weeks and with the baseline diagnosis of substance dependence. RESULTS The proportion of the sample with clinically relevant signs of MDs in any of the four categories was 18.6% (n = 401), and these participants demonstrated lower levels of functioning than those without signs. Of the different types of substance use, only methamphetamine (its frequency of use and dependence) was significantly associated with greater severity of overall signs of MDs. Frequency of methamphetamine use significantly interacted with age and sex, whereby older female participants exhibited the greatest overall severity with increased methamphetamine use. Of the different signs of MDs, methamphetamine use frequency was positively associated with the severity of trunk/limb dyskinesia and hypokinetic parkinsonism. Relative to no use, concurrent use of antipsychotics demonstrated lower severity of trunk/limb dyskinesia and greater severity of hypokinetic parkinsonism with methamphetamine use, and greater severity of dystonia with cocaine use. CONCLUSIONS Our study found a high proportion of MDs in a relatively young sample, and their severity was consistently associated with methamphetamine use, moderated by participant demographics and antipsychotic use. These disabling sequelae represent an important and understudied neurological condition that may affect quality of life and will require further study.
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Affiliation(s)
- David D Kim
- Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Ric M Procyshyn
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Andrea A Jones
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Lik Hang N Lee
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - William J Panenka
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jacob L Stubbs
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Lianne L Cho
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Olga Leonova
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Kristina Gicas
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Donna J Lang
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - G William MacEwan
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - William G Honer
- BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada.
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Audi A, Cunningham B, Newey C. Postanoxia-Induced Chorea Treated with Intravenous Fentanyl. Case Rep Neurol Med 2023; 2023:7652013. [PMID: 37082036 PMCID: PMC10113044 DOI: 10.1155/2023/7652013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/22/2023] Open
Abstract
The case presented is that of a young male with postanoxic brain injury secondary to cocaine overdose who began to exhibit choreiform movements of the left upper extremity. Traditional treatment options for chorea were unsuccessful, leading to the administration of fentanyl, which rapidly resolved the patient's choreiform movements. There is a limited research involving the treatment of chorea in anoxic brain injury as well as fentanyl's role in the movement pathway. We hypothesize that chorea can be caused or exacerbated by opioid withdrawal in a patient with chronic opioid use through modulation of dopamine transmission.
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Affiliation(s)
- Ashley Audi
- Section of Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA
| | - Brittany Cunningham
- Section of Pharmacy, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA
| | - Christopher Newey
- Department Chair of Neurocritical Care and ICU-EEG, Sanford USD Medical Center, Sioux Falls, South Dakota, USA
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Lambert TP, Gazi AH, Harrison AB, Gharehbaghi S, Chan M, Obideen M, Alavi P, Murrah N, Shallenberger L, Driggers EG, Alvarado Ortega R, Washington B, Walton KM, Tang YL, Gupta R, Nye JA, Welsh JW, Vaccarino V, Shah AJ, Bremner JD, Inan OT. Leveraging Accelerometry as a Prognostic Indicator for Increase in Opioid Withdrawal Symptoms. BIOSENSORS 2022; 12:924. [PMID: 36354433 PMCID: PMC9688173 DOI: 10.3390/bios12110924] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Treating opioid use disorder (OUD) is a significant healthcare challenge in the United States. Remaining abstinent from opioids is challenging for individuals with OUD due to withdrawal symptoms that include restlessness. However, to our knowledge, studies of acute withdrawal have not quantified restlessness using involuntary movements. We hypothesized that wearable accelerometry placed mid-sternum could be used to detect withdrawal-related restlessness in patients with OUD. To study this, 23 patients with OUD undergoing active withdrawal participated in a protocol involving wearable accelerometry, opioid cues to elicit craving, and non-invasive Vagal Nerve Stimulation (nVNS) to dampen withdrawal symptoms. Using accelerometry signals, we analyzed how movements correlated with changes in acute withdrawal severity, measured by the Clinical Opioid Withdrawal Scale (COWS). Our results revealed that patients demonstrating sinusoidal-i.e., predominantly single-frequency oscillation patterns in their motion almost exclusively demonstrated an increase in the COWS, and a strong relationship between the maximum power spectral density and increased withdrawal over time, measured by the COWS (R = 0.92, p = 0.029). Accelerometry may be used in an ambulatory setting to indicate the increased intensity of a patient's withdrawal symptoms, providing an objective, readily-measurable marker that may be captured ubiquitously.
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Affiliation(s)
- Tamara P. Lambert
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Asim H. Gazi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Anna B. Harrison
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Sevda Gharehbaghi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Michael Chan
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Malik Obideen
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Parvaneh Alavi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nancy Murrah
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Emily G. Driggers
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Rebeca Alvarado Ortega
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Brianna Washington
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Kevin M. Walton
- Clinical Research Grants Branch, Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, Bethesda, MD 20877, USA
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
- Atlanta VA Medical Center, Decatur, GA 30033, USA
| | - Rahul Gupta
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
- Atlanta VA Medical Center, Decatur, GA 30033, USA
| | - Jonathon A. Nye
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Justine W. Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA
- Division of Cardiology, Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Division of Cardiology, Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - J. Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
- Atlanta VA Medical Center, Decatur, GA 30033, USA
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Omer T. Inan
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Imbriani P, Sciamanna G, El Atiallah I, Cerri S, Hess EJ, Pisani A. Synaptic effects of ethanol on striatal circuitry: therapeutic implications for dystonia. FEBS J 2022; 289:5834-5849. [PMID: 34217152 PMCID: PMC9786552 DOI: 10.1111/febs.16106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/21/2021] [Accepted: 07/02/2021] [Indexed: 12/30/2022]
Abstract
Alcohol consumption affects motor behavior and motor control. Both acute and chronic alcohol abuse have been extensively investigated; however, the therapeutic efficacy of alcohol on some movement disorders, such as myoclonus-dystonia or essential tremor, still does not have a plausible mechanistic explanation. Yet, there are surprisingly few systematic trials with known GABAergic drugs mimicking the effect of alcohol on neurotransmission. In this brief survey, we aim to summarize the effects of EtOH on striatal function, providing an overview of its cellular and synaptic actions in a 'circuit-centered' view. In addition, we will review both experimental and clinical evidence, in the attempt to provide a plausible mechanistic explanation for alcohol-responsive movement disorders, with particular emphasis on dystonia. Different hypotheses emerge, which may provide a rationale for the utilization of drugs that mimic alcohol effects, predicting potential drug repositioning.
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Affiliation(s)
- Paola Imbriani
- Department of Systems MedicineUniversity of Rome ‘Tor Vergata’Italy,IRCCS Fondazione Santa LuciaRomeItaly
| | - Giuseppe Sciamanna
- Department of Systems MedicineUniversity of Rome ‘Tor Vergata’Italy,IRCCS Fondazione Santa LuciaRomeItaly
| | - Ilham El Atiallah
- Department of Systems MedicineUniversity of Rome ‘Tor Vergata’Italy,IRCCS Fondazione Santa LuciaRomeItaly
| | | | - Ellen J. Hess
- Departments of Pharmacology and Chemical Biology and NeurologyEmory UniversityAtlantaGAUSA
| | - Antonio Pisani
- IRCCS Mondino FoundationPaviaItaly,Department of Brain and Behavioral SciencesUniversity of PaviaItaly
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Increased Inflammatory Markers at AMPH-Addicts Are Related to Neurodegenerative Conditions: Alzheimer’s Disease. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Amphetamine addiction is widespread worldwide despite causing severe physical and mental problems, including neurodegeneration. One of the most common neurodegenerative disorders is Alzheimer’s disease (AD). Several inflammatory markers have been linked to AD. Previous studies have also found these biomarkers in amphetamine-addicts (AMPH-add). This study thus seeks to understand how AD and AMPH-addiction are related. A case–control observational study was conducted. Seventeen AMPH-adds ranging in age from 23 to 40 were recruited from Al Amal Psychiatric Hospital. In addition, 19 healthy subjects matching their age and gender were also recruited. The Luminex technique was used to measure serum alpha 1 antichymotrypsin (ACT), pigment epithelium-derived factor (PEDF), and macrophage inflammatory protein-4 (MIP-4), after complying with ethical guidelines and obtaining informed consent. In addition, liver function enzymes were correlated to AD’s predictive biomarkers in AMPH-adds. AMPH-adds had significantly higher serum levels of ACT, PEDF, and MIP-4 when compared to healthy controls (p = 0.03, p = 0.001, and p = 0.012, respectively). Furthermore, there is a significant correlation between lower ALT levels and elevated AST to ALT ratios in AMPH-adds (r = 0.618, 0.651, and p = 0.0001). These changes in inflammatory biomarkers may be linked to the onset of AD at a young age in amphetamine-drug addicts.
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Willems AE, Mentzel CL, Bakker PR, Van Os J, Tenback DE, Gelan P, Daantjes E, Matroos GE, Hoek HW, Van Harten PN. Movement Disorders and Mortality in Severely Mentally Ill Patients: The Curacao Extrapyramidal Syndromes Study XIV. Schizophr Bull 2022; 48:766-773. [PMID: 35486807 PMCID: PMC9212096 DOI: 10.1093/schbul/sbac037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND HYPOTHESIS There is a substantial gap in life expectancy between patients with severe mental illness (SMI) and the general population and it is important to understand which factors contribute to this difference. Research suggests an association between tardive dyskinesia (TD) and mortality; however, results are inconclusive. In addition, studies investigating associations between parkinsonism or akathisia and mortality are rare. We hypothesized that TD would be a risk factor for mortality in patients with SMI. STUDY DESIGN We studied a cohort of 157 patients diagnosed predominantly with schizophrenia on the former Netherlands Antilles. TD, parkinsonism, and akathisia were assessed with rating scales on eight occasions over a period of 18 years. Twenty-four years after baseline, survival status and if applicable date of death were determined. Associations between movement disorders and survival were analyzed using Cox regression. Sex, age, antipsychotics, antidepressants and benzodiazepines at each measurement occasion were tested as covariates. STUDY RESULTS Parkinsonism was a significant risk factor with an HR of 1.02 per point on the motor subscale of the Unified Parkinson's Disease Rating Scale (range 0-56). TD and akathisia were not significantly associated with mortality. CONCLUSIONS Parkinsonism may be an important risk factor for mortality in SMI patients. This finding calls for more follow-up and intervention studies to confirm this finding and to explore whether treatment or prevention of parkinsonism can reduce excess mortality.
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Affiliation(s)
- Anne E Willems
- To whom correspondence should be addressed; GGz Centraal, Zon & Schild, Utrechtseweg 266, 3818 EW Amersfoort, The Netherlands; tel: 31-6-22332116, e-mail:
| | - Charlotte L Mentzel
- Research Department, Psychiatric Centre GGz Centraal, Amersfoort, The Netherlands,School for Mental Health and NeuroScience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | | | - Jim Van Os
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands,King’s College London, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
| | - Diederik E Tenback
- Veldzicht Centre for Transcultural Psychiatry, Custodial Institutions Agency (DJI), Ministry of Justice and Security, Balkbrug, The Netherlands,FPC de Oostvaarderskliniek, Custodial Institutions Agency (DJI), Ministry of Justice and Security, Almere, The Netherlands
| | - Petra Gelan
- Capriles Psychiatric Clinic, GGz Curaçao, Groot Kwartier, Curaçao
| | - Erna Daantjes
- Capriles Psychiatric Clinic, GGz Curaçao, Groot Kwartier, Curaçao
| | - Glenn E Matroos
- Capriles Psychiatric Clinic, GGz Curaçao, Groot Kwartier, Curaçao
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands,Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands,Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Peter N Van Harten
- Research Department, Psychiatric Centre GGz Centraal, Amersfoort, The Netherlands,School for Mental Health and NeuroScience (MHeNS), Maastricht University, Maastricht, The Netherlands
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Nikunj A, Khan N, Rajkhokar D, Mishra B, Rajurkar S. Drug-Induced Oromandibular Dystonia Presenting as Chronic Temporomandibular Joint Dislocation: A Rare Case Report. Cureus 2022; 14:e23478. [PMID: 35494907 PMCID: PMC9045546 DOI: 10.7759/cureus.23478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/22/2022] Open
Abstract
Approximately 15%-30% of patients receiving neuroleptic medication for a longer duration develop drug-induced dystonia. There are many variations of oromandibular dystonia (OMD), but the most common one is involuntary jaw-opening dystonia. A rare case of chronic mandibular dislocation under long-term neuroleptic therapy is reported with clinical features, diagnosis, and various treatment modalities. Chronic dislocation leads to changes in associated soft tissue and muscles. Therefore, besides alteration of bony articular surfaces (eminectomy), soft tissue remodeling is required to achieve the perfect balance for temporomandibular joint (TMJ) working and occlusion. Drug-induced orofacial dystonia presenting as chronic TMJ dislocation is rare. Therefore, in long-standing chronic dislocation cases during treatment, biomechanics of TMJ, its complex neurological system, and the physiology of the masticatory system should be considered to customize the treatment plan.
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11
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Frei K, Truong DD. Medications used to treat tremors. J Neurol Sci 2022; 435:120194. [DOI: 10.1016/j.jns.2022.120194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/06/2022] [Accepted: 02/17/2022] [Indexed: 10/19/2022]
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Herlinger K, Lingford-Hughes A. Opioid use disorder and the brain: a clinical perspective. Addiction 2022; 117:495-505. [PMID: 34228373 DOI: 10.1111/add.15636] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/16/2021] [Accepted: 06/18/2021] [Indexed: 02/06/2023]
Abstract
Opioid use disorder (OUD) has gained increasing publicity and interest during recent years, with many countries describing problems of epidemic proportions with regard to opioid use and deaths related to opioids. While opioids are not themselves acutely neurotoxic, the chronic relapsing and remitting nature of this disorder means that individuals are often exposed to exogenous opioids for lengthy periods of time (either illicit or prescribed as treatment). We are increasingly characterizing the effect of such long-term opioid exposure on the brain. This narrative review aims to summarize the literature regarding OUD and the brain from a clinical perspective. Alterations of brain structure and function are discussed, as well as neurological and psychiatric disorders in OUD. Finally, we review current and new directions for assessment and treatment.
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Affiliation(s)
- Katherine Herlinger
- MRC Addiction Research Clinical Training Programme, Imperial College London, London, UK
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13
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Albert N, Catthoor K, Morrens M. Akathisia after chronic usage of synthetic cathinones: A case study. Front Psychiatry 2022; 13:1046486. [PMID: 36620653 PMCID: PMC9816890 DOI: 10.3389/fpsyt.2022.1046486] [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: 09/16/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Synthetic cathinones are a heterogenous group of new psychoactive substances (NPS) with a surging prevalence of use. They are sold under the name of "Bath Salts," "Legal Highs" or "Research Chemical." It is a heterogeneous group of substances that have a varying binding selectivity and affinity. Due to limited availability of NPS screening tests, inadequate legislation, the exponential increases in availability of new NPS and the comorbid use of other illicit substances, scientific research remains scarce. As a result, insight in their mental and psychomotor effects is limited. CASE DESCRIPTION We present a case of a 21-year-old woman with daily usage of synthetic cathinones, more specifically α-Pyrrolidinopentiophenone (α-PVP-better known as "Flakka"), α-Pyrrolidinohexiophenone (α-PHP) and alpha-Pyrrolidinoisohexaphenone (α-PHiP). Besides a severe paranoid psychotic state of mind, characterized by persecutory and somatic delusions, there was also a very pronounced psychomotor restlessness during the whole period of hospitalization which was diagnosed as akathisia. She reported that she was unable to sit during meals, had difficulty standing still and felt a constant urge to pay attention to the restlessness. The patient did not take any antipsychotic medication at admission. RESULTS The patient was treated in accordance with the current guidelines concerning akathisia with a combination of Quetiapine 200 mg, Propranolol 80 mg, Diazepam 10 mg, Biperiden 4 mg, and Mirtazapine 15 mg without any sufficient alleviation of complaints. Before the start of the treatment, Barnes Akathisia Rating Scale (BARS) score was 11 out of 14 which evolved toward a score of 7 over the course of the 40 day hospitalization, implying persisting severe akathisia which only improved modestly. CONCLUSION The current case suggests that besides cocaine, amphetamines and methamphetamines, synthetic cathinones can also increase the risk for development of extrapyramidal symptoms such as akathisia. Especially a-PVP-analogs as used by the current patient and Pyrovalerone-analogs such as Methylenedioxypyrovalerone (MDPV) are very powerful dopamine reuptake-inhibitors which might lead to strong locomotor activation. Up to this day it remains very difficult to establish a guideline concerning the treatment of intoxication with synthetic cathinones or dependence thereof.
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Affiliation(s)
- Niels Albert
- Hospital Network Antwerp (ZNA), Antwerp, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Kirsten Catthoor
- Hospital Network Antwerp (ZNA), Antwerp, Belgium.,Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Manuel Morrens
- Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.,Scientific Initiative Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre (UPC) Duffel, Duffel, Belgium
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14
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Blandino A, Cotroneo R, Tambuzzi S, Di Candia D, Genovese U, Zoja R. Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues. Forensic Sci Int Synerg 2022; 4:100224. [PMID: 35330981 PMCID: PMC8938866 DOI: 10.1016/j.fsisyn.2022.100224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 12/05/2022]
Abstract
Driving under the influence of alcohol has been shown to increase the risk of involvement in road traffic collisions (RTCs) however, less is known about the effects of illicit drugs, and a clear correlation between drug concentrations and RTC risk is still debated. The goal of this narrative review is to assess the current literature regarding the most detected psychoactive drugs in RTC (ethanol, amphetamines, cannabis, opioids and cocaine), in relation to driving performance. Evidence on impaired driving due to psychoactive substances, forensic issues relating to the assessment of the impact of drugs, blood cut-off values proposed to date as well as scientific basis for proposed legislative limits are discussed. At present there is no unequivocal evidence demonstrating a clear dose/concentration dependent impairment in many substances. Per se and zero tolerance approaches seem to have negative effect on drugged driving fatalities. However, the weight of these approaches needs further investigation. Driving under the influence of psychotropic substances has become a widespread phenomenon. Only a few substances have been reported to have a clear dose/concentration dependent impairment. Statistically significant differences should not be considered as clinically significant per se There is wide variability in legislative cut-offs. Detection limits seems to be the most public safety-oriented legislative approach.
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15
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Costa G, Gołembiowska K. Neurotoxicity of MDMA: Main effects and mechanisms. Exp Neurol 2021; 347:113894. [PMID: 34655576 DOI: 10.1016/j.expneurol.2021.113894] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/01/2021] [Accepted: 10/08/2021] [Indexed: 01/19/2023]
Abstract
Preclinical and clinical studies indicate that 3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy'), in addition to having abuse potential, may elicit acute and persistent abnormalities of varying severity at the central level. Importantly, neurotoxic effects of MDMA have been demonstrated in experimental animals. Accordingly, central toxicity induced by MDMA may pose a serious harm for health, since MDMA is among the substances that are used for recreational purposes by young and adult people. This review provides a concise overview of recent findings from preclinical and clinical studies that evaluated the central effects of MDMA, and the mechanisms involved in the neurotoxicity induced by this amphetamine-related drug.
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Affiliation(s)
- Giulia Costa
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy.
| | - Krystyna Gołembiowska
- Maj Institute of Pharmacology, Polish Academy of Sciences, Department of Pharmacology, 12 Smętna, 31-343 Kraków, Poland
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16
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Mulroy E, Baschieri F, Magrinelli F, Latorre A, Cortelli P, Bhatia KP. Movement Disorders and Liver Disease. Mov Disord Clin Pract 2021; 8:828-842. [PMID: 34401403 PMCID: PMC8354085 DOI: 10.1002/mdc3.13238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
The association of movement disorders with structural or functional hepatic disease occurs in three principal scenarios: (1) combined involvement of both organ systems from a single disease entity, (2) nervous system dysfunction resulting from exposure to toxic compounds in the setting of defective hepatic clearance, or (3) hepatic and/or neurological injury secondary to exposure to exogenous drugs or toxins. An important early step in the workup of any patient with combined movement disorders and liver disease is the exclusion of Wilson's disease. Diagnostic delay remains common for this treatable disorder, and this has major implications for patient outcomes. Thereafter, a structured approach integrating variables such as age of onset, tempo of progression, nature and severity of liver involvement, movement disorder phenomenology, exposure to drugs/toxins and laboratory/neuroimaging findings is key to ensuring timely diagnosis and disease‐specific therapy. Herein, we provide an overview of disorders which may manifest with a combination of movement disorders and liver disease, structured under the three headings as detailed above. In each section, the most common disorders are discussed, along with important clinical pearls, suggested diagnostic workup, differential diagnoses and where appropriate, treatment considerations.
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Affiliation(s)
- Eoin Mulroy
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Francesca Baschieri
- IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy.,Dipartimento di Scienze Biomediche e Neuromotorie Università di Bologna Bologna Italy
| | - Francesca Magrinelli
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Neurosciences Biomedicine and Movement Sciences, University of Verona Verona Italy
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Pietro Cortelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy.,Dipartimento di Scienze Biomediche e Neuromotorie Università di Bologna Bologna Italy
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
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17
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18
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Attention bias modification in drug addiction: Enhancing control of subsequent habits. Proc Natl Acad Sci U S A 2021; 118:2012941118. [PMID: 34074751 DOI: 10.1073/pnas.2012941118] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A relapse in addiction is often precipitated by heightened attention bias to drug-related cues, underpinned by a subcortically mediated transition to habitual/automatized responding and reduced prefrontal control. Modification of such automatized attention bias is a fundamental, albeit elusive, target for relapse reduction. Here, on a trial-by-trial basis, we used electroencephalography and eye tracking with a task that assessed, in this order, drug cue reactivity, its instructed self-regulation via reappraisal, and the immediate aftereffects on spontaneous (i.e., not instructed and automatized) attention bias. The results show that cognitive reappraisal, a facet of prefrontal control, decreased spontaneous attention bias to drug-related cues in cocaine-addicted individuals, more so in those with less frequent recent use. The results point to the mechanisms underlying the disruption of automatized maladaptive drug-related attention bias in cocaine addiction. These results pave the way for future studies to examine the role of such habit disruption in reducing compulsive drug seeking outside the controlled laboratory environment, with the ultimate goal of developing a readily deployable cognitive-behavioral and personalized intervention for drug addiction.
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19
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Begum G, Nkemjika S, Olayinka O, Olupona T, Jolayemi A. Clozapine Response for Vocal Tics in Schizophrenic Patients: A Case Report With Literature Review. Cureus 2021; 13:e14111. [PMID: 33907647 PMCID: PMC8068408 DOI: 10.7759/cureus.14111] [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] [Indexed: 11/23/2022] Open
Abstract
Antipsychotics have been documented in the literature as the most effective pharmacological treatment for tics thus far. Additionally, evidence in the literature has shown that typical and atypical antipsychotics are effective for the treatment of tic disorders in patients who are diagnosed with schizophrenia and other psychiatric illnesses. This evidence is typified as atypical antipsychotic medications, such as risperidone, aripiprazole, and olanzapine, have been documented as being effective for motor tics, particularly in Tourette’s syndrome. Despite the level of evidence with regard to antipsychotics, there is no published literature on the role of clozapine-based treatment for persistent vocal tics in schizophrenia. We present a case of severe adult-onset persistent vocal tics in a schizophrenic patient who was admitted for acute psychotic exacerbation. The patient's vocal tics as well as his comorbid psychotic symptoms were not responsive to risperidone and paliperidone. The combination of risperidone with clozapine for psychosis showed improvements in his symptoms. In addition, the patient’s tics showed excellent response to risperidone and clozapine combination therapy. He was subsequently discharged to the community with clozapine 125 mg twice daily and paliperidone palmitate 156 mg every 28 days. The patient was psychiatrically stable without vocalization at the time of discharge. We suggest that clozapine augmentation therapy could be an approach in treatment-resistant vocal tics among schizophrenic patients who are refractory to atypical antipsychotics.
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Affiliation(s)
- Gulshan Begum
- Psychiatry, Interfaith Medical Center, Brooklyn, USA
| | - Stanley Nkemjika
- Public Health/Epidemiology, Georgia State University, Atlanta, USA.,Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, USA
| | | | - Tolu Olupona
- Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, USA
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20
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Ouellet-Plamondon C, Abdel-Baki A, Jutras-Aswad D. Premier épisode psychotique et trouble de l’usage de substance concomitants : revue narrative des meilleures pratiques et pistes d’approches adaptées pour l’évaluation et le suivi. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1088186ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Does a hypoxic injury from a non-fatal overdose lead to an Alzheimer Disease? Neurochem Int 2020; 143:104936. [PMID: 33309980 DOI: 10.1016/j.neuint.2020.104936] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/21/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022]
Abstract
Long term consequence of non-fatal overdose in people who use opioids are not well understood. The intermittent exposure to non-fatal overdose leads to a tauopathy that is often accompanied by abrogated neuroprotective response, abnormal amyloid processing and other pathologies. The scope and limitations of available literature are discussed including neuropathologies associated with opioid and overdose exposures, contributing comorbidities and proteinopathies. Contrasting postmortem data of overdose victims with animal models of opioid neuropathologies and hypoxic injury paints a picture distinct from other proteinopathies as well as effects of moderate opioid exposure. Furthermore the reported biochemical changes and potential targets for therapeutic intervention were mapped pointing to underlying imbalance between tau kinases and phosphatases that is characteristic of Alzheimer Disease.
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22
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Wu J, Tang H, Chen S, Cao L. Mechanisms and Pharmacotherapy for Ethanol-Responsive Movement Disorders. Front Neurol 2020; 11:892. [PMID: 32982923 PMCID: PMC7477383 DOI: 10.3389/fneur.2020.00892] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 07/13/2020] [Indexed: 12/12/2022] Open
Abstract
Ethanol-responsive movement disorders are a group of movement disorders of which clinical manifestation could receive significant improvement after ethanol intake, including essential tremor, myoclonus-dystonia, and some other hyperkinesia. Emerging evidence supports that the sensitivity of these conditions to ethanol might be attributed to similar anatomical targets and pathophysiologic mechanisms. Cerebellum and cerebellum-related networks play a critical role in these diseases. Suppression of inhibitory neurotransmission and hyper-excitability of these regions are the key points for pathogenesis. GABA pathways, the main inhibitory system involved in these regions, were firstly linked to the pathogenesis of these diseases, and GABAA receptors and GABAB receptors play critical roles in ethanol responsiveness. Moreover, impairment of low-voltage-activated calcium channels, which were considered as a contributor to oscillation activity of the nervous system, also participates in the sensitivity of ethanol in relevant disease. Glutamate transporters and receptors that are closely associated with GABA pathways are the action sites for ethanol as well. Accordingly, alternative medicines aiming at these shared mechanisms appeared subsequently to mimic ethanol-like effects with less liability, and some of them have achieved positive effects on different diseases with well-tolerance. However, more clinical trials with a large sample and long-term follow-ups are needed for pragmatic use of these medicines, and further investigations on mechanisms will continue to deepen the understanding of these diseases and also accelerate the discovery of ideal treatment.
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Affiliation(s)
| | | | | | - Li Cao
- Department of Neurology and Institute of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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23
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Mead J, Parrott A. Mephedrone and MDMA: A comparative review. Brain Res 2020; 1735:146740. [PMID: 32087112 DOI: 10.1016/j.brainres.2020.146740] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 01/10/2023]
Abstract
Mephedrone and MDMA are both constituents of party drugs, with mephedrone being relatively new compared to MDMA. This review compares current knowledge regarding the patterns of usage and neuropsychobiological effects of both mephedrone and MDMA. Both drugs share common psychoactive effects, the duration of which is significantly shorter with mephedrone use, attributing towards a pattern of binge use among users. Both drugs have also been associated with adverse health, psychiatric, and neurocognitive problems. Whilst there is extensive research into the psychobiological problems induced by MDMA, the evidence for mephedrone is comparatively limited. The adverse effect profile of mephedrone appears to be less severe than that of MDMA. Users often believe it to be safer, although both drugs have been associated with overdoses. The neurotoxic potential of mephedrone appears to be low, whereas MDMA can cause long-term damage to the serotonergic system, although this needs further investigation. The abuse liability of mephedrone is significantly greater than that of MDMA, raising concerns regarding the impact of lifetime usage on users. Given that mephedrone is relatively new, the effects of long-term exposure are yet to be documented. Future research focused on lifetime users may highlight more severe neuropsychobiological effects from the drug.
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Affiliation(s)
- Jessica Mead
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.
| | - Andrew Parrott
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
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24
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Ghosh A, Shah R, Naskar C, Prasad S, Sharma N. Dystonia after Shooting Street Heroin: An Underreported Matter of Concern. Indian J Psychol Med 2019; 41:588-591. [PMID: 31772449 PMCID: PMC6875830 DOI: 10.4103/ijpsym.ijpsym_193_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Abhishek Ghosh
- Department of Psychiatry, Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Raghav Shah
- Department of Psychiatry, Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Chandrima Naskar
- Department of Psychiatry, Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sambhu Prasad
- Department of Psychiatry, Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nidhi Sharma
- Department of Psychiatry, Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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25
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Illés A, Balicza P, Molnár V, Bencsik R, Szilvási I, Molnar MJ. Dynamic interaction of genetic risk factors and cocaine abuse in the background of Parkinsonism - a case report. BMC Neurol 2019; 19:260. [PMID: 31660902 PMCID: PMC6816197 DOI: 10.1186/s12883-019-1496-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/13/2019] [Indexed: 11/16/2022] Open
Abstract
Background Parkinsonism is a complex multifactorial neurodegenerative disorder, in which genetic and environmental risk factors may both play a role. Among environmental risk factors cocaine was earlier ambiguously linked to Parkinsonism. Former single case reports described Parkinsonism in chronic cocaine users, but an epidemiological study did not confirm an increased risk of Parkinson’s disease. Here we report a patient, who developed Parkinsonism in young age after chronic cocaine use, in whom a homozygous LRRK2 risk variant was also detected. Case presentation The patient was investigated because of hand tremor, which started after a 1.5-year period of cocaine abuse. Neurological examination suggested Parkinsonism, and asymmetrical pathology was confirmed by the dopamine transporter imaging study. The genetic investigations revealed a homozygous risk allele in the LRRK2 gene. After a period of cocaine abstinence, the patient’s symptoms spontaneously regressed, and the dopamine transporter imaging also returned to near-normal. Conclusions This case report suggests that cocaine abuse indeed might be linked to secondary Parkinsonism and serves as an example of a potential gene-environmental interaction between the detected LRRK2 risk variant and cocaine abuse. The reversible nature of the DaTscan pathology is a unique feature of this case, and needs further evaluation, whether this is incidental or can be a feature of cocaine related Parkinsonism.
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Affiliation(s)
- Anett Illés
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Péter Balicza
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Viktor Molnár
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Renáta Bencsik
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - István Szilvási
- Department of Nuclear Medicine, Hungarian Defence Force Medical Center, Budapest, Hungary
| | - Maria Judit Molnar
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary.
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Kinshella MLW, Gauthier T, Lysyshyn M. Rigidity, dyskinesia and other atypical overdose presentations observed at a supervised injection site, Vancouver, Canada. Harm Reduct J 2018; 15:64. [PMID: 30577844 PMCID: PMC6303894 DOI: 10.1186/s12954-018-0271-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 12/05/2018] [Indexed: 11/22/2022] Open
Abstract
Objective In midst of the overdose crisis, the clinical features of opioid overdoses seem to be changing. Understanding of the adverse effects of synthetic opioids such as fentanyl is currently limited to clinical settings. Insite, a supervised injection site in Vancouver, Canada, provides an opportunity to better understand illicit drug overdose presentations. Methods A review of clinical records at Insite for October 2016 to April 2017 was undertaken to quantify atypical overdose presentations. Overdose reports were reviewed for the number of atypical opioid overdose presentations, temporal trends over the study period, concurrent symptoms, and interventions employed by staff. Results Insite staff responded to 1581 overdoses during the study period, including 497 (31.4%) that did not fit a typical presentation for opioid overdoses. Of these, 485 fit into five categories of atypical features: muscle rigidity, dyskinesia, slow or irregular heart rate, confusion, and anisocoria. Muscle rigidity was the most common atypical presentation, observed in 240 (15.2%) of the overdose cases, followed by dyskinesia, observed in 150 (9.2%). Slow or irregular heart rate was observed in 69 (4.4%) cases, confusion in 24 (1.5%), and anisocoria in 2 (0.1%) of overall overdose cases. Discussion The similarity of atypical overdose cases at Insite with anesthesiology case reports supports the understanding that the illicit drug supply is contaminated by fentanyl and other synthetic opioids. Atypical overdose presentations can affect clinical overdose response. The experience at Insite highlights the potential for supervised consumption sites to be innovative spaces for community learning and knowledge translation.
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Affiliation(s)
| | | | - Mark Lysyshyn
- Vancouver Coastal Health, Vancouver, Canada. .,School of Population and Public Health, University of British Columbia, Vancouver, Canada. .,Office of the Medical Health Officer, 5th Floor, 132 West Esplanade, North Vancouver, Canada.
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Kucinski A, Lustig C, Sarter M. Addiction vulnerability trait impacts complex movement control: Evidence from sign-trackers. Behav Brain Res 2018; 350:139-148. [PMID: 29705686 PMCID: PMC6506847 DOI: 10.1016/j.bbr.2018.04.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/15/2022]
Abstract
Cognitive-motivational vulnerability traits are associated with increased risk for substance addiction and relapse. Sign-tracking (ST) behavior in rats is associated with poor attentional control, mediated by an unresponsive basal forebrain cholinergic system, and an increased risk for substance addiction/relapse. A separate literature links poor attentional control and cholinergic losses to increased fall risk in Parkinson's disease. Here we tested the hypothesis that the relatively inferior attentional control of STs extends to complex movement control and a propensity for falls. STs were found to fall more often than goal-trackers (GTs) while traversing a straight rotating rod and, similar to human fallers, when taxed by a secondary task. Furthermore, STs fell more often while traversing a rotating zig-zag rod. GTs exhibited fewer falls from this rod by avoiding entry to the rotating zig-zag sections when in, or rotating toward, a difficult traversal state. Goal-tracking rats approached risky movement situations using strategies indicative of superior top-down control. These results suggest that the impact of opponent cognitive-cholinergic traits extends to complex movement control, and that impairments in the cognitive-motor interface are likely to be comorbid with addiction vulnerability. Sign-tracking indexes an endophenotype that may increase the risk for a wide range of neurobehavioral disorders.
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Affiliation(s)
- Aaron Kucinski
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Cindy Lustig
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Martin Sarter
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA.
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28
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Priyanka SH, Syam Das S, Thushara AJ, Rauf AA, Indira M. All Trans Retinoic Acid Attenuates Markers of Neuroinflammation in Rat Brain by Modulation of SIRT1 and NFκB. Neurochem Res 2018; 43:1791-1801. [DOI: 10.1007/s11064-018-2595-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/27/2018] [Accepted: 07/10/2018] [Indexed: 12/11/2022]
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Das A, Price D, Clothier J. Choreoathetoid movements associated with methamphetamine: A case report and review of literature. Am J Addict 2018; 27:364-367. [PMID: 29968954 DOI: 10.1111/ajad.12759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/11/2018] [Accepted: 05/20/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Physicians and psychiatrists often encounter patients in the emergency department presenting after methamphetamine use. While physical and psychiatric manifestations associated with methamphetamine use are well known, movement disorders are relatively less common. The aim of this case report is to add to existing literature awareness about the possibility of movement disorders occurring after methamphetamine use, discuss the possible mechanism by which such use leads to dyskinesia, and describe possible management strategies. METHODS AND RESULTS In this case report, we describe choreoathetoid movements occurring in a young female after relatively short-term methamphetamine use. DISCUSSION AND CONCLUSIONS Evidence for treatment of methamphetamine induced choreoathetosis is limited. Expectant management of such symptoms is a viable option if there are no additional comorbidities that require therapy. SCIENTIFIC SIGNIFICANCE Clinicians should be alert to the possibility of movement disorders in methamphetamine users and familiar with treatment options. (Am J Addict 2018;XX:1-4).
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Affiliation(s)
- Aparna Das
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Daniel Price
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Jeffrey Clothier
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Ferrari D, Manca M, Premaschi S, Banfi G, Locatelli M. Toxicological investigation in blood samples from suspected impaired driving cases in the Milan area: Possible loss of evidence due to late blood sampling. Forensic Sci Int 2018; 288:211-217. [DOI: 10.1016/j.forsciint.2018.04.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/24/2018] [Accepted: 04/19/2018] [Indexed: 12/15/2022]
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da Silva FBR, Cunha PA, Ribera PC, Barros MA, Cartágenes SC, Fernandes LMP, Teixeira FB, Fontes-Júnior EA, Prediger RD, Lima RR, Maia CSF. Heavy Chronic Ethanol Exposure From Adolescence to Adulthood Induces Cerebellar Neuronal Loss and Motor Function Damage in Female Rats. Front Behav Neurosci 2018; 12:88. [PMID: 29867389 PMCID: PMC5968384 DOI: 10.3389/fnbeh.2018.00088] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 04/20/2018] [Indexed: 01/23/2023] Open
Abstract
Over the last years, heavy ethanol consumption by teenagers/younger adults has increased considerably among females. However, few studies have addressed the long-term impact on brain structures’ morphology and function of chronic exposure to high ethanol doses from adolescence to adulthood in females. In line with this idea, in the current study we investigated whether heavy chronic ethanol exposure during adolescence to adulthood may induce motor impairments and morphological and cellular alterations in the cerebellum of female rats. Adolescent female Wistar rats (35 days old) were treated with distilled water or ethanol (6.5 g/kg/day, 22.5% w/v) during 55 days by gavage. At 90 days of age, motor function of animals was assessed using open field (OF), pole, beam walking and rotarod tests. Following completion of behavioral tests, morphological and immunohistochemical analyses of the cerebellum were performed. Chronic ethanol exposure impaired significantly motor performance of female rats, inducing spontaneous locomotor activity deficits, bradykinesia, incoordination and motor learning disruption. Moreover, histological analysis revealed that ethanol exposure induced atrophy and neuronal loss in the cerebellum. These findings indicate that heavy ethanol exposure during adolescence is associated with long-lasting cerebellar degeneration and motor impairments in female rats.
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Affiliation(s)
- Fernando B R da Silva
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Polyane A Cunha
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Paula C Ribera
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Mayara A Barros
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Sabrina C Cartágenes
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Luanna M P Fernandes
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Francisco B Teixeira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Enéas A Fontes-Júnior
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Rui D Prediger
- Laboratório Experimental de Doenças Neurodegenerativas (LEXDON), Department of Pharmacology, Center of Biological Sciences, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Rafael R Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Cristiane S F Maia
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
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Rodin I, Braithwaite R. Festival psychiatry. BJPSYCH ADVANCES 2018. [DOI: 10.1192/bja.2017.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYThis article is based on our experience of volunteering for the charity Festival Medical Services, to provide mental healthcare at the Glastonbury Festival of Contemporary Performing Arts and the Reading Festival. It describes the history of these annual events and the development of medical and psychiatric services offered. Principles of assessment and management of mental disorder in festival settings are outlined and common psychiatric presentations are described. Legal aspects of care are discussed. The article is intended primarily to inform others of this interesting and unusual form of mental healthcare and we hope that aspects of our experience will prompt reflection on psychiatric practice in other settings.LEARNING OBJECTIVES•Understand how psychiatric care is provided at the Glastonbury and Reading Festivals•Recognise the symptoms and signs of organic and functional conditions likely to present to psychiatrists at festivals•Identify the principles of psychiatric management in festival settingsDECLARATION OF INTERESTI.R. and R.B. gain free entry to the Glastonbury and Reading Festivals through their voluntary work with Festival Medical Services.
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The Cerebellar GABA AR System as a Potential Target for Treating Alcohol Use Disorder. Handb Exp Pharmacol 2018; 248:113-156. [PMID: 29736774 DOI: 10.1007/164_2018_109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In the brain, fast inhibitory neurotransmission is mediated primarily by the ionotropic subtype of the gamma-aminobutyric acid (GABA) receptor subtype A (GABAAR). It is well established that the brain's GABAAR system mediates many aspects of neurobehavioral responses to alcohol (ethanol; EtOH). Accordingly, in both preclinical studies and some clinical scenarios, pharmacologically targeting the GABAAR system can alter neurobehavioral responses to acute and chronic EtOH consumption. However, many of the well-established interactions of EtOH and the GABAAR system have been identified at concentrations of EtOH ([EtOH]) that would only occur during abusive consumption of EtOH (≥40 mM), and there are still inadequate treatment options for prevention of or recovery from alcohol use disorder (AUD, including abuse and dependence). Accordingly, there is a general acknowledgement that more research is needed to identify and characterize: (1) neurobehavioral targets of lower [EtOH] and (2) associated brain structures that would involve such targets in a manner that may influence the development and maintenance of AUDs.Nearly 15 years ago it was discovered that the GABAAR system of the cerebellum is highly sensitive to EtOH, responding to concentrations as low as 10 mM (as would occur in the blood of a typical adult human after consuming 1-2 standard units of EtOH). This high sensitivity to EtOH, which likely mediates the well-known motor impairing effects of EtOH, combined with recent advances in our understanding of the role of the cerebellum in non-motor, cognitive/emotive/reward processes has renewed interest in this system in the specific context of AUD. In this chapter we will describe recent advances in our understanding of cerebellar processing, actions of EtOH on the cerebellar GABAAR system, and the potential relationship of such actions to the development of AUD. We will finish with speculation about how cerebellar specific GABAAR ligands might be effective pharmacological agents for treating aspects of AUD.
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Josiassen RC, Filmyer DM, Gillean J, Shah SS, Dietterich TE, Shaughnessy RA. Successful Treatment of Severe Tardive Dyskinesia with Valbenazine, Including a Patient's Perspective. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1185-1189. [PMID: 29114100 PMCID: PMC5687123 DOI: 10.12659/ajcr.906454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient: Female, 49 Final Diagnosis: Tardive dyskinesia Symptoms: Dyskinesia • dystonia Medication: — Clinical Procedure: Oral valbenazine Specialty: Psychiatry
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Affiliation(s)
| | | | - Jack Gillean
- TMS Health Solutions, Oakland, CA, USA.,Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Syed Sikandar Shah
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA, USA.,Bayhealth Psychiatry, Dover, DE, USA
| | | | - Rita A Shaughnessy
- Translational Neuroscience LLC, Conshohocken, PA, USA.,Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA, USA
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Puthiyathu M, Sibtain S, Rahmani R, Thomas M. A 31-Year-Old Man with Resting Tremors and a History of Chronic Toluene Use. Psychiatr Ann 2017. [DOI: 10.3928/00485713-20171011-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Few studies have described movement disorders as withdrawal symptoms during psychostimulant detoxification. Although dystonia has been reported as an uncommon adverse effect of methylphenidate treatment, it has not been described in the context of methylphenidate withdrawal. We report a case of dystonia as the main withdrawal symptom in a methylphenidate-dependent adult participating in an inpatient methylphenidate detoxification program. Although movement disorders such as dystonia are very rare adverse effects of methylphenidate withdrawal, practitioners need to be alert to this risk in order to initiate appropriate treatment.
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Downey LA, Tysse B, Ford TC, Samuels AC, Wilson RP, Parrott AC. Psychomotor Tremor and Proprioceptive Control Problems in Current and Former Stimulant Drug Users: An Accelerometer Study of Heavy Users of Amphetamine, MDMA, and Other Recreational Stimulants. J Clin Pharmacol 2017; 57:1330-1337. [PMID: 28425095 DOI: 10.1002/jcph.925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 03/20/2017] [Indexed: 11/08/2022]
Abstract
The recreational use of various stimulant drugs has been implicated in the development of movement disorders through dysregulation of the dopaminergic and serotoninergic neurotransmitter systems. The present study investigated psychomotor differences in current and former recreational stimulant drug users compared with nonusing controls. Sixty participants comprised 3 groups: 20 current stimulant drug users (CSUs; 11 men, aged 31.4 ± 9.1 years), 20 former stimulant drug users (FSUs; 5 men, aged 39.1 ± 8.5 years), and 20 nonuser controls (NUCs; 5 men, aged 35.7 ± 6.4 years). Psychomotor arm steadiness for each participant was assessed with a wrist-attached accelerometer during 5 arm positions with eyes open and then eyes closed. Arm-drop of arm position was indicated by the arm longitudinal rotation axis (ALoRA), and tremor was indicated by the overall vector of dynamic body acceleration (VeDBA). Overall, CSUs performed the most poorly on ALoRA (P < .05) and VeDBA indices (P < .05), and FSUs perform almost as poorly on VeDBA indices (P < .05) compared with NUCs. It was concluded that stimulant drug use, primarily MDMA and amphetamines, may result in acute stimulant-induced tremor as well as long-term proprioceptive deficits in terms of arm-droop.
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Affiliation(s)
- Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University, Hawthorn, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Brenda Tysse
- Department of Biosciences, College of Science, Swansea University, Singleton Park, Swansea, Wales, UK
| | - Talitha C Ford
- Centre for Human Psychopharmacology, Swinburne University, Hawthorn, Melbourne, Australia
| | - Angela C Samuels
- Department of Psychology, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales, UK
| | - Rory P Wilson
- Department of Biosciences, College of Science, Swansea University, Singleton Park, Swansea, Wales, UK
| | - Andrew C Parrott
- Centre for Human Psychopharmacology, Swinburne University, Hawthorn, Melbourne, Australia.,Department of Psychology, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales, UK
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Sutter M, Walter M, Dürsteler KM, Strasser J, Vogel M. Psychosis After Switch in Opioid Maintenance Agonist and Risperidone-Induced Pisa Syndrome: Two Critical Incidents in Dual Diagnosis Treatment. J Dual Diagn 2017; 13:157-165. [PMID: 27935442 DOI: 10.1080/15504263.2016.1269224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case that illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature. CASE DESCRIPTION We report on a 56-year-old patient with schizophrenia and opioid dependence who experienced both risperidone-induced Pisa syndrome and, 3 years later, acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT prolongation. CONCLUSIONS With the current availability of a diversity of substitution opioids in Switzerland (methadone, buprenorphine, diacetylmorphine, sustained-release oral morphine), studies on differential effectiveness of these agents in opioid-dependent subpopulations with selective comorbidity profiles are desirable. The same is true for further investigation of the involvement of the opioid receptor system in schizophrenia. In clinical practice, any alteration of opioid medication in patients with dual diagnosis and a history of schizophrenia should be accompanied by close observation for psychotic symptoms.
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Affiliation(s)
- Manuel Sutter
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Marc Walter
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Kenneth M Dürsteler
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Johannes Strasser
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
| | - Marc Vogel
- a Division of Substance Use Disorders , Psychiatric Hospital of the University of Basel , Basel , Switzerland
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Bortell N, Basova L, Semenova S, Fox HS, Ravasi T, Marcondes MCG. Astrocyte-specific overexpressed gene signatures in response to methamphetamine exposure in vitro. J Neuroinflammation 2017; 14:49. [PMID: 28279172 PMCID: PMC5345234 DOI: 10.1186/s12974-017-0825-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/27/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Astrocyte activation is one of the earliest findings in the brain of methamphetamine (Meth) abusers. Our goal in this study was to identify the characteristics of the astrocytic acute response to the drug, which may be critical in pathogenic outcomes secondary to the use. METHODS We developed an integrated analysis of gene expression data to study the acute gene changes caused by the direct exposure to Meth treatment of astrocytes in vitro, and to better understand how astrocytes respond, what are the early molecular markers associated with this response. We examined the literature in search of similar changes in gene signatures that are found in central nervous system disorders. RESULTS We identified overexpressed gene networks represented by genes of an inflammatory and immune nature and that are implicated in neuroactive ligand-receptor interactions. The overexpressed networks are linked to molecules that were highly upregulated in astrocytes by all doses of methamphetamine tested and that could play a role in the central nervous system. The strongest overexpressed signatures were the upregulation of MAP2K5, GPR65, and CXCL5, and the gene networks individually associated with these molecules. Pathway analysis revealed that these networks are involved both in neuroprotection and in neuropathology. We have validated several targets associated to these genes. CONCLUSIONS Gene signatures for the astrocytic response to Meth were identified among the upregulated gene pool, using an in vitro system. The identified markers may participate in dysfunctions of the central nervous system but could also provide acute protection to the drug exposure. Further in vivo studies are necessary to establish the role of these gene networks in drug abuse pathogenesis.
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Affiliation(s)
- Nikki Bortell
- Cellular and Molecular Neurosciences Department, The Scripps Research Institute, La Jolla, CA, 92037, USA.,Anschutz Medical Campus, University of Colorado, Denver, CO, USA
| | - Liana Basova
- Cellular and Molecular Neurosciences Department, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Svetlana Semenova
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92093, USA
| | - Howard S Fox
- Department of Experimental Pharmacology, University of Nebraska Medical School, Omaha, NE, 68198, USA
| | - Timothy Ravasi
- KAUST Environmental Epigenetic Program (KEEP), Division of Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, Thuwal, 23955, Kingdom of Saudi Arabia.,Department of Medicine, Division of Genetic, University of California San Diego, 9500 Gilman Drive, La Jolla, California, 92093, USA
| | - Maria Cecilia G Marcondes
- Cellular and Molecular Neurosciences Department, The Scripps Research Institute, La Jolla, CA, 92037, USA. .,Present address: San Diego Biomedical Research Institute, 10865 Road to the Cure, Suite 100 - San Diego, San Diego, CA, 92121, USA.
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Silva D, Matias C, Bourne S, Nagel S, Machado A, Lobel D. Effects of chronic alcohol consumption on long-term outcomes of thalamic deep brain stimulation for essential tremor. J Clin Neurosci 2016; 31:142-6. [PMID: 27401226 DOI: 10.1016/j.jocn.2016.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 03/08/2016] [Indexed: 11/28/2022]
Abstract
The prevalence of essential tremor (ET) is about 4% above 40years of age. Chronic alcohol consumption is present in around 20% of patients with ET. Our objective was to identify whether chronic alcohol consumption was associated with a negative effect on tremor outcome after thalamic deep brain stimulation (DBS) in ET patients. We conducted a retrospective chart review, from January 2005 to December 2012, from which 23 patients who had ventral intermediate nucleus (Vim)-DBS surgery for ET were identified. Seven patients had a positive history of chronic alcohol consumption. We defined as chronic alcohol users those patients with a habit of drinking alcohol every day in order to suppress tremor. In the overall group of 23 patients, there was a reduction in the median tremor score from 8 pre-operatively, to 1 post-operatively (p<0.0001). The alcohol consumers group experienced a reduction in the median tremor score from 6 pre-operatively to 0 post-operatively (p=0.03). The non-alcohol consumers group had a reduction in the median tremor score from 8 pre-operatively to 1.7 post-operatively (p<0.0001). Both groups of patients experienced significant benefit from thalamic DBS. A larger study may reveal statistically significant differences between subgroups.
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Affiliation(s)
- Danilo Silva
- Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, OH 44124, USA.
| | - Caio Matias
- Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, OH 44124, USA
| | - Sarah Bourne
- Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, OH 44124, USA
| | - Sean Nagel
- Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, OH 44124, USA
| | - Andre Machado
- Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, OH 44124, USA
| | - Darlene Lobel
- Center for Neurological Restoration, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, OH 44124, USA
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Ayers-Ringler JR, Oliveros A, Qiu Y, Lindberg DM, Hinton DJ, Moore RM, Dasari S, Choi DS. Label-Free Proteomic Analysis of Protein Changes in the Striatum during Chronic Ethanol Use and Early Withdrawal. Front Behav Neurosci 2016; 10:46. [PMID: 27014007 PMCID: PMC4786553 DOI: 10.3389/fnbeh.2016.00046] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/26/2016] [Indexed: 01/03/2023] Open
Abstract
The molecular mechanisms underlying the neuronal signaling changes in alcohol addiction and withdrawal are complex and multifaceted. The cortico-striatal circuit is highly implicated in these processes, and the striatum plays a significant role not only in the early stages of addiction, but in the developed-addictive state as well, including withdrawal symptoms. Transcriptional analysis is a useful method for determining changes in gene expression, however, the results do not always accurately correlate with protein levels. In this study, we employ label-free proteomic analysis to determine changes in protein expression within the striatum during chronic ethanol use and early withdrawal. The striatum, composed primarily of medium spiny GABAergic neurons, glutamatergic and dopaminergic nerve terminals and astrocytes, is relatively homogeneous for proteomic analysis. We were able to analyze more than 5000 proteins from both the dorsal (caudate and putamen) and ventral (nucleus accumbens) striatum and identified significant changes following chronic intermittent ethanol exposure and acute (8 h) withdrawal compared to ethanol naïve and ethanol exposure groups respectively. Our results showed significant changes in proteins involved in glutamate and opioid peptide signaling, and also uncovered novel pathways including mitochondrial function and lipid/cholesterol metabolism, as revealed by changes in electron transport chain proteins and RXR activation pathways. These results will be useful in the development of novel treatments for alcohol withdrawal and thereby aid in recovery from alcohol use disorder.
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Affiliation(s)
| | - Alfredo Oliveros
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Graduate School, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Yanyan Qiu
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Graduate School, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Daniel M Lindberg
- Neurobiology of Disease PhD Program, Mayo Graduate School, Mayo Clinic Rochester, MN, USA
| | - David J Hinton
- Neurobiology of Disease PhD Program, Mayo Graduate School, Mayo Clinic Rochester, MN, USA
| | - Raymond M Moore
- Department of Biochemistry and Molecular Biology, Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA
| | - Surendra Dasari
- Department of Health Sciences Research, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Doo-Sup Choi
- Neurobiology of Disease PhD Program, Mayo Graduate School, Mayo ClinicRochester, MN, USA; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Graduate School, Mayo Clinic College of MedicineRochester, MN, USA; Department of Psychiatry and Psychology, Mayo Clinic College of MedicineRochester, MN, USA
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42
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Alkoholentzugsdelir und akute Komplikationen. Notf Rett Med 2016. [DOI: 10.1007/s10049-015-0108-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Meireles M, Moura E, Vieira-Coelho MA, Santos-Buelga C, Gonzalez-Manzano S, Dueñas M, Mateus N, Faria A, Calhau C. Flavonoids as dopaminergic neuromodulators. Mol Nutr Food Res 2016; 60:495-501. [PMID: 26582321 DOI: 10.1002/mnfr.201500557] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 10/28/2015] [Accepted: 10/31/2015] [Indexed: 12/25/2022]
Abstract
SCOPE The present study aimed to characterize and evaluate flavonoids effects on organic cation uptake in neuronal cells. METHODS AND RESULTS Uptake experiments were conducted using radiolabeled methyl-4-phenylpyridinuim ([(3) H]-MPP(+) ), in human neuronal dopaminergic cells, SH-SY5Y. Catechin did not alter [(3) H]-MPP(+) uptake, however its metabolite 4'-methyl-catechin decreased it by almost 50%. Epicatechin and its methylated metabolites also decreased [(3) H]-MPP(+) uptake. Interestingly, the quercetin flavonol and its metabolite conjugated with glucuronic acid, as well as the flavanones naringenin and hesperitin, increased [(3) H]-MPP(+) uptake. CONCLUSION These results showed that different classes of flavonoids, as well as its metabolites, differently influence neuronal organic cation uptake. Several xeno- and endobiotics, including neurotransmitters, are organic cations. Specific food recommendations may be beneficial in pathological conditions where levels of neurotransmitters, as dopamine, are either increased or decreased.
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Affiliation(s)
- Manuela Meireles
- Department of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Eduardo Moura
- Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Celestino Santos-Buelga
- Unidad de Nutrición y Bromatología, Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno s/n, Salamanca, Espanha
| | - Susana Gonzalez-Manzano
- Unidad de Nutrición y Bromatología, Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno s/n, Salamanca, Espanha
| | - Montserrat Dueñas
- Unidad de Nutrición y Bromatología, Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno s/n, Salamanca, Espanha
| | - Nuno Mateus
- REQUIMTE/LAQV, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Ana Faria
- Department of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal.,REQUIMTE/LAQV, Faculty of Sciences, University of Porto, Porto, Portugal.,Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Conceição Calhau
- Department of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Research in Health Technologies and Information Systems, Faculty of Medicine, University of Porto, Porto, Portugal
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Kovacs GG, Horvath MC, Majtenyi K, Lutz MI, Hurd YL, Keller E. Heroin abuse exaggerates age-related deposition of hyperphosphorylated tau and p62-positive inclusions. Neurobiol Aging 2015; 36:3100-3107. [PMID: 26254956 PMCID: PMC4609594 DOI: 10.1016/j.neurobiolaging.2015.07.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/06/2015] [Accepted: 07/11/2015] [Indexed: 11/26/2022]
Abstract
The observation of increased hyperphosphorylated tau levels correlating with microglial activation in opiate abusers has been interpreted as predisposition to accelerated Alzheimer disease-related changes. The present study focused on evaluating additional neurodegeneration-related proteins, including α-synuclein and TDP-43, and p62-positive deposits. We performed a systematic mapping of protein deposits in the brains of 27 individuals with documented heroin addiction (age: 19-40 years) and compared with 11 controls (age: 15-40 years). We confirm previous findings that heroin addiction associates with tau hyperphosphorylation in predilection brain areas for aging and Alzheimer disease. Furthermore, we show that this occurs also in areas implicated in the molecular disturbances and in vivo neuronal networks related to heroin abuse. There was, however, no presence of amyloid-beta deposits. We extend previous findings by showing the lack of TDP-43 or α-synuclein pathology and emphasize the independent effect of the duration of drug use on the appearance of age-related p62-positive neuritic profiles. These observations provide unique insights about neuropathological alterations in the brains of young heroin addicts and have implications about brain aging and the influences of environmental and toxic factors.
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Affiliation(s)
- Gabor G Kovacs
- Institute of Neurology, Medical University of Vienna, Vienna, Austria; Neuropathology and Prion Disease Reference Center, Semmelweis University, Budapest, Hungary.
| | - Monika Cs Horvath
- Department of Forensic Medicine, National Board of Forensic Medicine, Uppsala University, Uppsala, Sweden
| | - Katalin Majtenyi
- Neuropathology and Prion Disease Reference Center, Semmelweis University, Budapest, Hungary
| | - Mirjam I Lutz
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Yasmin L Hurd
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eva Keller
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary.
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Shu SL, Thompson PD, Kimber TE. Dystonia-Parkinsonism Due to Pallidal and Nigral Necrosis Following Heroin Overdose: Long-Term Evolution. Mov Disord Clin Pract 2015; 3:188-190. [PMID: 30713912 DOI: 10.1002/mdc3.12244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Siew Lee Shu
- Department of Neurology Royal Adelaide Hospital Adelaide Australia
| | - Philip D Thompson
- Department of Neurology Royal Adelaide Hospital Adelaide Australia.,University Department of Medicine University of Adelaide Adelaide Australia
| | - Thomas E Kimber
- Department of Neurology Royal Adelaide Hospital Adelaide Australia.,University Department of Medicine University of Adelaide Adelaide Australia
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Abstract
Psychostimulants are a diverse group of substances with their main psychomotor effects resembling those of amphetamine, methamphetamine, cocaine, or cathinone. Due to their potential as drugs of abuse, recreational use of most of these substances is illegal since 1971 Convention on Psychotropic Substances. In recent years, new psychoactive substances have emerged mainly as synthetic cathinones with new molecules frequently complementing the list. Psychostimulant related movement disorders are a known entity often seen in emergency rooms around the world. These admissions are becoming more frequent as are fatalities associated with drug abuse. Still the legal constraints of the novel synthetic molecules are bypassed. At the same time, chronic and permanent movement disorders are much less frequently encountered. These disorders frequently manifest as a combination of movement disorders. The more common symptoms include agitation, tremor, hyperkinetic and stereotypical movements, cognitive impairment, and also hyperthermia and cardiovascular dysfunction. The pathophysiological mechanisms behind the clinical manifestations have been researched for decades. The common denominator is the monoaminergic signaling. Dopamine has received the most attention but further research has demonstrated involvement of other pathways. Common mechanisms linking psychostimulant use and several movement disorders exist.
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Affiliation(s)
- Andres Asser
- Department of Neurology and Neurosurgery, University of Tartu , Tartu , Estonia
| | - Pille Taba
- Department of Neurology and Neurosurgery, University of Tartu , Tartu , Estonia
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Cui SQ, Wang Q, Zheng Y, Xiao B, Sun HW, Gu XL, Zhang YC, Fu CH, Dong PX, Wang XM. Puerarin protects against damage to spatial learning and memory ability in mice with chronic alcohol poisoning. ACTA ACUST UNITED AC 2015; 48:515-22. [PMID: 25831201 PMCID: PMC4470310 DOI: 10.1590/1414-431x20144250] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/06/2014] [Indexed: 01/08/2023]
Abstract
We evaluated the effect of puerarin on spatial learning and memory ability of mice with chronic alcohol poisoning. A total of 30 male C57BL/6 mice were randomly divided into model, puerarin, and control groups (n=10 each). The model group received 60% (v/v) ethanol by intragastric administration followed by intraperitoneal injection of normal saline 30 min later. The puerarin group received intragastric 60% ethanol followed by intraperitoneal puerarin 30 min later, and the control group received intragastric saline followed by intraperitoneal saline. Six weeks after treatment, the Morris water maze and Tru Scan behavioral tests and immunofluorescence staining of cerebral cortex and hippocampal neurons (by Neu-N) and microglia (by Ib1) were conducted. Glutamic acid (Glu) and gamma amino butyric acid (GABA) in the cortex and hippocampus were assayed by high-performance liquid chromatography (HPLC), and tumor necrosis factor (TNF)-α and interleukin (IL)-1β were determined by ELISA. Compared with mice in the control group, escape latency and distance were prolonged, and spontaneous movement distance was shortened (P<0.05) by puerarin. The number of microglia was increased in both the cortex and hippocampal dentate gyrus (P<0.01), and neurons were reduced only in the hippocampal dentate gyrus (P<0.01) in puerarin-treated mice. In the model group, Glu and GABA levels decreased (P<0.05), and Glu/GABA, TNF-α, and IL-1β increased (P<0.01) with puerarin treatment, returning to near normal levels. In conclusion, puerarin protected against the effects of chronic alcohol poisoning on spatial learning and memory ability primarily because of anti-inflammatory activity and regulation of the balance of Glu and GABA.
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Affiliation(s)
- S Q Cui
- China Shandong Provincial Engineering Laboratory of New Pharmaceutical Excipients, Sustained and Controlled Release Technology, College of Medicine and Nursing, Dezhou University, Dezhou, China
| | - Q Wang
- Department of Physiology, Capital Medical University, Beijing, China
| | - Y Zheng
- Department of Physiology, Capital Medical University, Beijing, China
| | - B Xiao
- Department of Physiology, Capital Medical University, Beijing, China
| | - H W Sun
- China Shandong Provincial Engineering Laboratory of New Pharmaceutical Excipients, Sustained and Controlled Release Technology, College of Medicine and Nursing, Dezhou University, Dezhou, China
| | - X L Gu
- China Shandong Provincial Engineering Laboratory of New Pharmaceutical Excipients, Sustained and Controlled Release Technology, College of Medicine and Nursing, Dezhou University, Dezhou, China
| | - Y C Zhang
- China Shandong Provincial Engineering Laboratory of New Pharmaceutical Excipients, Sustained and Controlled Release Technology, College of Medicine and Nursing, Dezhou University, Dezhou, China
| | - C H Fu
- China Shandong Provincial Engineering Laboratory of New Pharmaceutical Excipients, Sustained and Controlled Release Technology, College of Medicine and Nursing, Dezhou University, Dezhou, China
| | - P X Dong
- China Shandong Provincial Engineering Laboratory of New Pharmaceutical Excipients, Sustained and Controlled Release Technology, College of Medicine and Nursing, Dezhou University, Dezhou, China
| | - X M Wang
- Department of Physiology, Capital Medical University, Beijing, China
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Alkohol induzierte kognitive Dysfunktion. Wien Med Wochenschr 2013; 164:9-14. [DOI: 10.1007/s10354-013-0226-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 06/25/2013] [Indexed: 01/30/2023]
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