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Azimzadeh M, Noorbakhshnia M. Maternal linalool treatment protects against radiofrequency wave-induced deteriorations in adolescent rats: A behavioral and electrophysiological study. Sci Rep 2024; 14:17257. [PMID: 39060318 PMCID: PMC11282235 DOI: 10.1038/s41598-024-68103-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Recent years, the rapid advancement of technology has raised concerns. We studied the effects of prenatal exposure to 900 MHz radiofrequency (RF) from mobile phones and the protective effects of linalool on learning and memory, and anxiety in adolescent male and female offspring rats. Pregnant rats were divided into four groups: control, wave, wave + linalool, and linalool. Rats received linalool (25mg/kg) by gavage for 21 days. Irradiation was conducted from day 0 to day 21 of pregnancy. Offsprings underwent behavioral and electrophysiological tests on days 50 and 60 after birth. Exposure to RF during pregnancy caused anxiety-like behavior in the EPM test and impairment of learning and memory in the Morris water maze and shuttle box tests. Electrophysiological properties and synaptic plasticity of the dorsal hippocampal CA3-CA1 synapse showed a decrease in fEPSP amplitude and slope. The trace element levels in both male and female offspring were consistent across all groups compared to their respective controls. In the hippocampus tissue, the levels of Fe, Cu, and Mn, as well as the Cu/Zn ratio, were significantly higher in the exposed groups (wave groups) compared to their controls. Moreover, Zn levels were significantly lower in the hippocampus tissue of the exposed groups. Linalool administration mitigated the excessive increase in Fe, Cu, Mn, and Cu/Zn ratio and normalized the disrupted levels of trace elements, except for Zn levels in both male and female offspring. Sex differences were observed in the EPM and shuttle box tests, females were more sensitive than males. In summary, our study demonstrates that prenatal exposure to mobile phone radiation induces stress-like behaviors, disrupts learning and memory, alters hippocampal electrophysiological properties and trace element balance in offspring. Treatment with linalool mitigates these deleterious effects, highlighting its potential as a therapeutic intervention. These findings contribute to our understanding of the impact of prenatal environmental exposures on neurodevelopment and offer insights into potential strategies for neuroprotection.
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Affiliation(s)
- Mansour Azimzadeh
- Department of Plant and Animal Biology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Maryam Noorbakhshnia
- Department of Plant and Animal Biology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
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Shen D, Chang L, Su F, Huang S, Xu H, Si Y, Wang F, Xue Y. The gut microbiome modulates the susceptibility to traumatic stress in a sex-dependent manner. J Neurosci Res 2024; 102:e25315. [PMID: 38439584 DOI: 10.1002/jnr.25315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/30/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
Post-traumatic stress disorder (PTSD), a psychological condition triggered by exposure to extreme or chronic stressful events, exhibits a sex bias in incidence and clinical manifestations. Emerging research implicates the gut microbiome in the pathogenesis of PTSD and its roles in stress susceptibility. However, it is unclear whether differential gut microbiota contribute to PTSD susceptibility in male and female rats. Here, we utilized the single prolonged stress animal model and employed unsupervised machine learning to classify stressed animals into stress-susceptible subgroups and stress-resilient subgroups. Subsequently, using 16S V3-V4 rDNA sequencing, we investigated the differential gut microbiota alterations between susceptible and resilient individuals in male and female rats. Our findings revealed distinct changes in gut microbiota composition between the sexes at different taxonomic levels. Furthermore, the abundance of Parabacteroides was lower in rats that underwent SPS modeling compared to the control group. In addition, the abundance of Tenericutes in the stress-susceptible subgroup was higher than that in the control group and stress-resilient subgroup, suggesting that Tenericutes may be able to characterize stress susceptibility. What is particularly interesting here is that Cyanobacteria may be particularly associated with anti-anxiety effects in male rats. This study underscores sex-specific variations in gut microbiota composition in response to stress and sex differences should be taken into account when using macrobiotics for neuropsychiatric treatment, highlighting potential targets for PTSD therapeutic interventions.
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Affiliation(s)
- Dan Shen
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Liang Chang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Feng Su
- College of Future Technology, Peking University, Beijing, China
| | - Shihao Huang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Hubo Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yue Si
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Feng Wang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Yanxue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
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Gou L, Li Y, Liu S, Sang H, Lan J, Chen J, Wang L, Li C, Lian B, Zhang X, Sun H, Sun L. (2R,6R)-hydroxynorketamine improves PTSD-associated behaviors and structural plasticity via modulating BDNF-mTOR signaling in the nucleus accumbens. J Affect Disord 2023; 335:129-140. [PMID: 37137411 DOI: 10.1016/j.jad.2023.04.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/16/2023] [Accepted: 04/28/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a mental illness caused by either experiencing or observing a traumatic event that is perceived to pose a serious risk to one's life. (2R,6R)-HNK has an alleviating effect on negative emotions, nevertheless, the mechanism of (2R,6R)-HNK action is unclear. METHODS In this study, the single prolonged stress and electric foot shock (SPS&S) method was used to establish a rat model of PTSD. After determining the validity of the model, (2R,6R)-HNK was administered to the NAc by microinjection using a concentration gradient of 10, 50, and 100 μM, and the effects of the drug in the SPS&S rat model were evaluated. Moreover, our study measured changes in related proteins in the NAc (BDNF, p-mTOR/mTOR, and PSD95) and synaptic ultrastructure. RESULTS In the SPS&S group, the protein expression of brain-derived neurotrophic factor (BDNF), mammalian target of rapamycin (mTOR), and PSD95 was reduced and synaptic morphology was damaged in the NAc. In contrast, after the administration of 50 μM (2R,6R)-HNK, SPS&S-treated rats improved their exploration and depression-linked behavior, while protein levels and synaptic ultrastructure were also restored in the NAc. With the administration of 100 μM (2R,6R)-HNK, locomotor behavior, and social interaction improved in the PTSD model. LIMITATIONS The mechanism of BDNF-mTOR signaling after (2R,6R)-HNK administration was not explored. CONCLUSION (2R,6R)-HNK may ameliorate negative mood and social avoidance symptoms in PTSD rats by regulating BDNF/mTOR-mediated synaptic structural plasticity in the NAc, providing new targets for the development of anti-PTSD drugs.
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Affiliation(s)
- Luping Gou
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Yu Li
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Shiqi Liu
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Haohan Sang
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Jiajun Lan
- School of Clinical Medical, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Jinhong Chen
- College of Extended Education, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Ling Wang
- Clinical Competency Training Center, Medical Experiment and Training Center, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong, 261053, China
| | - Changjiang Li
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Bo Lian
- Department of Bioscience and Technology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Xianqiang Zhang
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China; National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital/Institute of Mental Health and the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Hongwei Sun
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China.
| | - Lin Sun
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China.
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Wang X, Wang X, Xie F, Sun Z, Guo B, Li F, Wang S, Wang Y, Tian Y, Zhao Y, Qian L. Leucine mediates cognitive dysfunction in early life stress-induced mental disorders by activating autophagy. Front Cell Neurosci 2023; 16:1060712. [PMID: 36687518 PMCID: PMC9846360 DOI: 10.3389/fncel.2022.1060712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/11/2022] [Indexed: 01/06/2023] Open
Abstract
Objectives To explore the relationship between leucine in cerebrospinal fluid (CSF) and cognitive dysfunction in rats with early life stress (ELS) induced mental illness, and pathophysiological mechanism involved. Methods The maternal separation (MS), an animal paradigm used widely as a preclinical model of ELS which is one of the important risk factors for mental disorders. Behavioral experiments including open-field test, sucrose preference, object recognition and Morris water maze tests, Nissl staining, transmission electron microscopy and WES were employed in the present study. Results The behavioral results showed that MS rats were more prone to cognitive impairment and depression-and-anxiety-like behaviors than controls, including spatial self-exploration ability, memory ability, and spatial learning and memory function. Nissl staining analysis indicated that the number of neurons in the CA1 and CA3 regions of the hippocampus significantly decreased and the arrangement of nerve cells was abnormal. The leucine levels were decreased in the CSF of MS rats and highly correlated with the number of hippocampal neurons, and yet leucine supplementation improved the degree of MS-induced cognitive impairment. Furthermore, there were autophagosomes in the hippocampus of the low-leucine diet rats of the control and MS group but not in the high-leucine diet MS group by transmission electron microscopy. The protein expression of Beclin-1 in the hippocampus was significantly increased in the MS normal diet group and MS low-leucine diet group, yet decreased in the MS high-leucine diet group compared with the MS low-leucine diet group. Meanwhile, the Bcl-2/Bax ratio was significantly decreased in the control low-leucine diet group, MS normal diet group and MS low-leucine diet group. Ultimately, in vitro experiments suggested that leucine deficiency could activate neuronal autophagy including enhanced LC3II/LC3I and mRFP-GFP-LC3, which was consistent with the in vivo results, and the cell apoptosis rate and lactate dehydrogenase (LDH) cytotoxicity were also increased with leucine deficiency, while the above effects could be partly reversed by autophagy inhibitor treatment. Conclusions MS model caused adult male rats to be susceptible to cognitive dysfunction, which may regulate autophagy in hippocampal neurons through leucine metabolism in CSF.
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Zhang YD, Shi DD, Zhang S, Wang Z. Sex-specific transcriptional signatures in the medial prefrontal cortex underlying sexually dimorphic behavioural responses to stress in rats. J Psychiatry Neurosci 2023; 48:E61-E73. [PMID: 36796857 PMCID: PMC9943549 DOI: 10.1503/jpn.220147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/03/2022] [Accepted: 11/18/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Converging evidence suggests that stress alters behavioural responses in a sex-specific manner; however, the underlying molecular mechanisms of stress remain largely unknown. METHODS We adapted unpredictable maternal separation (UMS) and adult restraint stress (RS) paradigms to mimic stress in rats in early life or adulthood, respectively. The sexual dimorphism of the prefrontal cortex was noted, and we performed RNA sequencing (RNA-Seq) to identify specific genes or pathways responsible for sexually dimorphic responses to stress. We then performed quantitative reverse transcription polymerase chain reaction (qRT-PCR) to verify the results of RNA-Seq. RESULTS Female rats exposed to either UMS or RS showed no negative effects on anxiety-like behaviours, whereas the emotional functions of the PFC were impaired markedly in stressed male rats. Leveraging differentially expressed genes (DEG) analyses, we identified sex-specific transcriptional profiles associated with stress. There were many overlapping DEGs between UMS and RS transcriptional data sets, where 1406 DEGs were associated with both biological sex and stress, while only 117 DEGs were related to stress. Notably, Uba52 and Rpl34-ps1 were the first-ranked hub gene in 1406 and 117 DEGs respectively, and Uba52 was higher than Rp134-ps1, suggesting that stress may have led to a more pronounced effect on the set of 1406 DEGs. Pathway analysis revealed that 1406 DEGs were primarily enriched in ribosomal pathway. These results were confirmed by qRT-PCR. LIMITATIONS Sex-specific transcriptional profiles associated with stress were identified in this study, but more in-depth experiments, such as single-cell sequencing and manipulation of male and female gene networks in vivo, are needed to verify our findings. CONCLUSION Our findings show sex-specific behavioural responses to stress and highlight sexual dimorphism at the transcriptional level, shedding light on developing sex-specific therapeutic strategies for stress-related psychiatric disorders.
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Affiliation(s)
- Ying-Dan Zhang
- From the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Y.-D. Zhang, Shi, S. Zhang, Wang); the Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Shi, S. Zhang, Wang); and the Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China (Wang)
| | - Dong-Dong Shi
- From the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Y.-D. Zhang, Shi, S. Zhang, Wang); the Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Shi, S. Zhang, Wang); and the Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China (Wang)
| | - Sen Zhang
- From the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Y.-D. Zhang, Shi, S. Zhang, Wang); the Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Shi, S. Zhang, Wang); and the Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China (Wang)
| | - Zhen Wang
- From the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Y.-D. Zhang, Shi, S. Zhang, Wang); the Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Shi, S. Zhang, Wang); and the Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China (Wang)
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Fabris D, Carvalho MC, Brandão ML, Prado WA, Zuardi AW, Crippa JA, de Oliveira AR, Lovick TA, Genaro K. Sex-dependent differences in the anxiolytic-like effect of cannabidiol in the elevated plus-maze. J Psychopharmacol 2022; 36:1371-1383. [PMID: 36239039 PMCID: PMC9716492 DOI: 10.1177/02698811221125440] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
RATIONALE Cannabidiol (CBD), the major non-psychoactive constituent of cannabis, has therapeutic potential for the treatment of anxiety. Most preclinical studies investigate only acute effects of CBD and only in males, yet the drug is most likely to be used over a sustained period in clinical practice. OBJECTIVES The objectives of this study were to investigate the anxiolytic-like effect of CBD in female rats compared to males and to determine whether the responsiveness of females was influenced by the stage of the estrous cycle. METHODS We carried out experiments to compare the effect of CBD in male and female rats in the elevated plus maze (EPM) in response to acute and short-term (4 days) administration through a complete cycle in females. RESULTS Male and female rats behaved in a similar manner in the EPM, but females in the late diestrus (LD) phase exhibited more anxiety-like behavior than at other stages, the difference reaching statistical significance compared to proestrus stages. CBD produced anxiolytic-like effects in both sexes, but female rats were responsive only in LD and 10-fold lower dose than males. After sub-chronic (4 days) treatment, responsiveness to CBD was maintained in females in LD, but females in proestrus remained unresponsive to CBD treatment. CONCLUSIONS We suggest that there are sex differences in the anxiolytic-like effects of CBD in rats that reflect different underlying mechanisms: based on literature data, gonadal hormone status linked to GABAA receptor expression in females, and 5-HT1A receptor activation in males.
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Affiliation(s)
- Débora Fabris
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil,Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Psychology, Center of Education and Human Sciences, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Milene C Carvalho
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil
| | - Marcus L Brandão
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Wiliam A Prado
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil,National Institute of Science and Technology for Translational Medicine, Conselho Nacional de Desenvolvimento Científico e Tecnológico (INCT-TM, CNPq), Brasília, DF, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil,National Institute of Science and Technology for Translational Medicine, Conselho Nacional de Desenvolvimento Científico e Tecnológico (INCT-TM, CNPq), Brasília, DF, Brazil
| | - Amanda R de Oliveira
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Psychology, Center of Education and Human Sciences, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Thelma A Lovick
- Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Karina Genaro
- Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirao Preto, SP, Brazil,Department of Anesthesiology, School of Medicine, University of California, Irvine, CA, USA,Karina Genaro, Department of Anesthesiology, School of Medicine, University of California, 837 Health Sci. Rd. Gillespie BLDG., Irvine, CA 92617, USA.
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Reemst K, Ruigrok SR, Bleker L, Naninck EFG, Ernst T, Kotah JM, Lucassen PJ, Roseboom TJ, Pollux BJA, de Rooij SR, Korosi A. Sex-dependence and comorbidities of the early-life adversity induced mental and metabolic disease risks: Where are we at? Neurosci Biobehav Rev 2022; 138:104627. [PMID: 35339483 DOI: 10.1016/j.neubiorev.2022.104627] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/15/2022] [Accepted: 03/13/2022] [Indexed: 01/02/2023]
Abstract
Early-life adversity (ELA) is a major risk factor for developing later-life mental and metabolic disorders. However, if and to what extent ELA contributes to the comorbidity and sex-dependent prevalence/presentation of these disorders remains unclear. We here comprehensively review and integrate human and rodent ELA (pre- and postnatal) studies examining mental or metabolic health in both sexes and discuss the role of the placenta and maternal milk, key in transferring maternal effects to the offspring. We conclude that ELA impacts mental and metabolic health with sex-specific presentations that depend on timing of exposure, and that human and rodent studies largely converge in their findings. ELA is more often reported to impact cognitive and externalizing domains in males, internalizing behaviors in both sexes and concerning the metabolic dimension, adiposity in females and insulin sensitivity in males. Thus, ELA seems to be involved in the origin of the comorbidity and sex-specific prevalence/presentation of some of the most common disorders in our society. Therefore, ELA-induced disease states deserve specific preventive and intervention strategies.
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Affiliation(s)
- Kitty Reemst
- University of Amsterdam, Swammerdam Institute of Life Sciences, Center for Neuroscience, Brain Plasticity Group, Amsterdam, The Netherlands
| | - Silvie R Ruigrok
- University of Amsterdam, Swammerdam Institute of Life Sciences, Center for Neuroscience, Brain Plasticity Group, Amsterdam, The Netherlands
| | - Laura Bleker
- Amsterdam University Medical Center, University of Amsterdam, Department of Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Eva F G Naninck
- University of Amsterdam, Swammerdam Institute of Life Sciences, Center for Neuroscience, Brain Plasticity Group, Amsterdam, The Netherlands
| | - Tiffany Ernst
- Wageningen University, Department of Animal Sciences, Experimental Zoology &Evolutionary Biology Group, Wageningen, The Netherlands
| | - Janssen M Kotah
- University of Amsterdam, Swammerdam Institute of Life Sciences, Center for Neuroscience, Brain Plasticity Group, Amsterdam, The Netherlands
| | - Paul J Lucassen
- University of Amsterdam, Swammerdam Institute of Life Sciences, Center for Neuroscience, Brain Plasticity Group, Amsterdam, The Netherlands; Centre for Urban Mental Health, University of Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Amsterdam University Medical Center, University of Amsterdam, Department of Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Bart J A Pollux
- Wageningen University, Department of Animal Sciences, Experimental Zoology &Evolutionary Biology Group, Wageningen, The Netherlands
| | - Susanne R de Rooij
- Amsterdam University Medical Center, University of Amsterdam, Department of Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Aniko Korosi
- University of Amsterdam, Swammerdam Institute of Life Sciences, Center for Neuroscience, Brain Plasticity Group, Amsterdam, The Netherlands.
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Guan L, Shi X, Tang Y, Yan Y, Chen L, Chen Y, Gao G, Lin C, Chen A. Contribution of Amygdala Histone Acetylation in Early Life Stress-Induced Visceral Hypersensitivity and Emotional Comorbidity. Front Neurosci 2022; 16:843396. [PMID: 35600618 PMCID: PMC9120649 DOI: 10.3389/fnins.2022.843396] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 04/19/2022] [Indexed: 01/04/2023] Open
Abstract
Patients with irritable bowel syndrome (IBS) experience not only enhanced visceral pain but also emotional comorbidities, such as anxiety and depression. Early life stress (ELS) is a high-risk for the development of IBS. Literatures have reported an important epigenetic modulation in sustaining extrinsic phenotypes. The amygdala is closely related to the regulation of visceral functions and emotional experiences. In this study, we hypothesized that ELS-induced reprogramming inappropriate adaptation of histone acetylation modification in the amygdala may result in visceral hypersensitivity and anxiety-like behaviors in ELS rats. To test this hypothesis, the model of ELS rats was established by neonatal colorectal dilatation (CRD). Visceral hypersensitivity was assessed based on the electromyography response of the abdominal external oblique muscle to CRD. Emotional comorbidities were examined using the elevated plus maze test, open field test, and sucrose preference test. Trichostatin A (TSA) and C646 were microinjected into the central amygdala (CeA) individually to investigate the effects of different levels of histone acetylation modification on visceral hypersensitivity and emotion. We found neonatal CRD resulted in visceral hypersensitivity and anxiety-like behaviors after adulthood. Inhibiting histone deacetylases (HDACs) in the CeA by TSA enhanced visceral sensitivity but did not affect anxiety-like behaviors, whereas inhibiting HAT by C646 attenuated visceral hypersensitivity in ELS rats. Interestingly, CeA treatment with TSA induced visceral sensitivity and anxiety-like behaviors in the control rats. Western blot showed that the expressions of acetylated 9 residue of Histone 3 (H3K9) and protein kinase C zeta type (PKMζ) were higher in the ELS rats compared to those of the controls. The administration of the PKMζ inhibitor ZIP into the CeA attenuated visceral hypersensitivity of ELS rats. Furthermore, the expression of amygdala PKMζ was enhanced by TSA treatment in control rats. Finally, western blot and immunofluorescence results indicated the decrease of HDAC1 and HDAC2 expressions, but not HDAC3 expression, contributed to the enhancement of histone acetylation in ELS rats. Our results support our hypothesis that amygdala-enhanced histone acetylation induced by stress in early life results in visceral hypersensitivity and anxiety-like behaviors in ELS rats, and reversing the abnormal epigenetic mechanisms may be crucial to relieve chronic symptoms in ELS rats.
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Affiliation(s)
- Le Guan
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
| | - Xi Shi
- Department of Medical Oncology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Ying Tang
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
| | - Yan Yan
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
| | - Liang Chen
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
| | - Yu Chen
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
| | - Guangcheng Gao
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
| | - Chun Lin
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
- Department of Pediatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- *Correspondence: Chun Lin,
| | - Aiqin Chen
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Pain Research Institute, Fujian Medical University, Fuzhou, China
- Department of Medical Oncology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Aiqin Chen,
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9
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Effects of early life adversities upon memory processes and cognition in rodent models. Neuroscience 2022; 497:282-307. [PMID: 35525496 DOI: 10.1016/j.neuroscience.2022.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 01/14/2023]
Abstract
Exposure to stressors in early postnatal life induces long-lasting modifications in brainfunction.Thisplasticity,an essential characteristic of the brain that enables adaptation to the environment, may also induce impairments in some psychophysiological functions, including learning and memory. Early life stress (ELS) has long-term effects on thehypothalamic-pituitary-adrenal axisresponse to stressors, and has been reported to lead toneuroinflammation,altered levelsof neurotrophic factors, modifications inneurogenesis andsynaptic plasticity,with changes in neurotransmitter systems and network functioning. In this review, we focus on early postnatal stress in animal models and their effects on learning and memory.Many studies have reported ELS-induced impairments in different types of memories, including spatial memory, fear memory, recognition (both for objects and social) memory, working memory and reversal learning. Studies are not always in agreement, however, no effects, or sometimes facilitation, being reported, depending on the nature and intensity of the early intervention, as well as the age when the outcome was evaluated and the sex of the animals. When considering processes occurring after consolidation, related with memory maintenance or modification, there are a very reduced number of reports. Future studies addressing the mechanisms underlying memory changes for ELS should shed some light on the understanding of the different effects induced by stressors of different types and intensities on cognitive functions.
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10
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Díaz-Hung ML, Hetz C. Proteostasis and resilience: on the interphase between individual's and intracellular stress. Trends Endocrinol Metab 2022; 33:305-317. [PMID: 35337729 DOI: 10.1016/j.tem.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
A long proportion of the population is resilient to the negative consequences of stress. Glucocorticoids resulting from endocrine responses to stress are essential adaptive mediators, but also drive alterations to brain function, negatively impacting neuronal connectivity, synaptic plasticity, and memory-related processes. Recent evidence has indicated that organelle function and cellular stress responses are relevant determinant of vulnerability and resistance to environmental stress. At the molecular level, a fundamental mechanism of cellular stress adaptation is the maintenance of proteostasis, which also have key roles in sustaining basal neuronal function. Here, we discuss recent evidence suggesting that proteostasis unbalance at the level of the endoplasmic reticulum, the main site for protein folding in the cell, represents a possible mechanistic link between individuals and cellular stress.
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Affiliation(s)
- Mei-Li Díaz-Hung
- Biomedical Neuroscience Institute (BNI), Faculty of Medicine, University of Chile, Santiago, Chile; Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, University of Chile, Santiago, Chile; FONDAP Center for Geroscience, Brain Health and Metabolism, Santiago, Chile
| | - Claudio Hetz
- Biomedical Neuroscience Institute (BNI), Faculty of Medicine, University of Chile, Santiago, Chile; Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, University of Chile, Santiago, Chile; FONDAP Center for Geroscience, Brain Health and Metabolism, Santiago, Chile; Buck Institute for Research on Aging, Novato, CA, USA.
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11
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Fabbri M, Simione L, Martoni M, Mirolli M. The Relationship between Acceptance and Sleep–Wake Quality before, during, and after the First Italian COVID-19 Lockdown. Clocks Sleep 2022; 4:172-184. [PMID: 35323170 PMCID: PMC8947186 DOI: 10.3390/clockssleep4010016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/23/2022] Open
Abstract
Several studies have reported that the COVID-19 pandemic has had deleterious effects on sleep quality and mood, but the mechanisms underlying these effects are not clearly understood. Recently, it has been shown that the acceptance component of mindfulness reduces anxiety, and, in turn, lower anxiety improves sleep quality. The purpose of this cross-sectional study was to assess changes in mindfulness traits, sleep–wake quality, and general distress, before, during, and after the first COVID-19 wave, testing the model in which acceptance influences sleep through anxiety in each period. A total of 250 participants were recruited before (Pre-Lockdown group: 69 participants, 29 females, 33.04 ± 12.94 years), during (Lockdown group: 78 participants, 59 females, 29.174 ± 8.50 years), and after (After-Lockdown group: 103 participants, 86 females, 30.29 ± 9.46 years) the first Italian lockdown. In each group, self-report questionnaires, assessing mindfulness facets, distress, and sleep–wake quality, were administered and assessed. The Lockdown group reported lower acceptance and higher depression, while the After-Lockdown group reported lower sleep–wake quality and higher anxiety. The results of the path analysis confirmed that higher acceptance reduced anxiety and higher anxiety decreased sleep–wake quality in all groups. Our results confirm that acceptance influences sleep through the mediating role of anxiety.
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Affiliation(s)
- Marco Fabbri
- Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy
- Correspondence:
| | - Luca Simione
- Institute of Cognitive Sciences and Technologies, National Research Council (ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy; (L.S.); (M.M.)
| | - Monica Martoni
- Department of Experimental, Diagnostic and Specialized Medicine, St.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy;
| | - Marco Mirolli
- Institute of Cognitive Sciences and Technologies, National Research Council (ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy; (L.S.); (M.M.)
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12
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Mei Z, Wu X, Zhang X, Zheng X, Li W, Fan R, Yu H, Zhang S, Gu Y, Wang X, Xia Y, Meng G, Shen J, Niu K. The occurrence and risk factors associated with post-traumatic stress disorder among discharged COVID-19 patients in Tianjin, China. Brain Behav 2022; 12:e2492. [PMID: 35064764 PMCID: PMC8865157 DOI: 10.1002/brb3.2492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/27/2021] [Accepted: 12/31/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a serious mental health condition that is triggered by a terrifying event. We aimed to investigate the occurrence and risk factors of PTSD among discharged COVID-19 patients. METHODS This study included 144 discharged COVID-19 patients. PTSD was assessed by using validated cut-offs of the impact of event scale-revised (IES-R, score ≥25). All patients completed a detailed questionnaire survey, and clinical parameters were routinely measured in the hospital. Binary logistic regression models were applied to identify factors associated with PTSD. RESULTS Of the 144 participants with laboratory-confirmed COVID-19, the occurrence of PTSD was 16.0%. In multivariable analyses, age above 40 years (adjusted OR [95% CI], 5.19 [2.17-12.32]), female sex (adjusted OR [95% CI], 7.82 [3.18-18.21]), current smoker (adjusted OR [95% CI], 6.72 [3.23-15.26]), and ≥3 involved pulmonary lobes (adjusted OR [95% CI], 5.76 [1.19-15.71]) were significantly associated with a higher risk of PTSD. Conversely, history of hypertension and serum hemoglobin levels were significantly associated with a lower risk of PTSD with adjusted ORs (95% CI) of 0.37 (0.12-0.87) and 0.91 (0.82-0.96), respectively. CONCLUSION Old age, gender (being female), current smoking, bacterial pneumonia, and ≥3 involved pulmonary lobes were associated with an increased occurrence of PTSD among discharged COVID-19 patients.
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Affiliation(s)
- Zaoxian Mei
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, No.890 JinGu Road, Jinnan District, Tianjin, 300350, China
| | - Xiaohui Wu
- Tianjin Key Laboratory on Technologies Enabling Development of Clinical, Therapeutics and Diagnostics, College of Pharmacy, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Xueli Zhang
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, No.890 JinGu Road, Jinnan District, Tianjin, 300350, China
| | - Xingjie Zheng
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, No.890 JinGu Road, Jinnan District, Tianjin, 300350, China
| | - Wenxin Li
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, No.890 JinGu Road, Jinnan District, Tianjin, 300350, China
| | - Rui Fan
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, No.890 JinGu Road, Jinnan District, Tianjin, 300350, China
| | - Hongwei Yu
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, No.890 JinGu Road, Jinnan District, Tianjin, 300350, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yang Xia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Jun Shen
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, No.890 JinGu Road, Jinnan District, Tianjin, 300350, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, China
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13
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de Souza JA, da Silva MC, de Souza Ferraz Junior JC, de Souza FL, de Souza SL. Maternal separation in the light or dark phase of the circadian cycle has different effects on the corticosterone levels and anxiety-like behavior in male adult rats. Physiol Behav 2022; 247:113725. [DOI: 10.1016/j.physbeh.2022.113725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 11/26/2022]
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14
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Knox D, Stout-Oswald SA, Tan M, George SA, Liberzon I. Maternal Separation Induces Sex-Specific Differences in Sensitivity to Traumatic Stress. Front Behav Neurosci 2021; 15:766505. [PMID: 34955778 PMCID: PMC8708561 DOI: 10.3389/fnbeh.2021.766505] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder with a high economic burden. Two risk factors for increasing the chances of developing PTSD are sex (being female) and early life stress. These risk factors suggest that early life stress-induced changes and sex differences in emotional circuits and neuroendocrinological systems lead to susceptibility to traumatic stress. Exploring mechanisms via which stress leads to specific effects can be accomplished in animal models, but reliable animal models that allow for an examination of how early life stress interacts with sex to increase susceptibility to traumatic stress is lacking. To address this, we examined the effects of early life stress [using the maternal separation (MS) model] and late adolescence/early adult traumatic stress [using the single prolonged stress (SPS) model] on startle reactivity, anxiety-like behavior in the open field (OF), and basal corticosterone levels in male and female rats. Female rats exposed to MS and SPS (MS/SPS) showed enhanced startle reactivity relative to MS/control female rats. Enhanced startle reactivity was not observed in MS/SPS male rats. Instead, non-maternally separated male rats that were exposed to SPS showed enhanced startle reactivity relative to controls. Female rats had enhanced locomotor activity in the OF and higher basal corticosterone levels in comparison to males, but measures in the OF and basal corticosterone were not affected by MS or SPS. Overall the results suggest that the combined MS and SPS models can be used to explore how changes in maternal care during infancy lead to sex differences in sensitivity to the effects of traumatic stress as adolescents and adults.
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Affiliation(s)
- Dayan Knox
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Stephanie A Stout-Oswald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Veterans Affairs Hospital, Ann Arbor, MI, United States
| | - Melissa Tan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Veterans Affairs Hospital, Ann Arbor, MI, United States
| | - Sophie A George
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryant, TX, United States
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15
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Holubová-Kroupová A, Šlamberová R. Perinatal Stress and Methamphetamine Exposure Decreases Anxiety-Like Behavior in Adult Male Rats. Front Behav Neurosci 2021; 15:648780. [PMID: 33994969 PMCID: PMC8116599 DOI: 10.3389/fnbeh.2021.648780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
Methamphetamine (MA) is an illicit synthetic psychostimulant drug, and its abuse is growing worldwide. MA has been reported as the primary drug of choice, by drug-abusing women, during pregnancy. Since MA easily crosses the placental barrier, the fetus is exposed to MA in a similar fashion to the mother. This study aimed to evaluate the effect of long-term perinatal stressors and drug exposure on anxiety-like behavior in adult male rats using the open field test (OF) and elevated plus maze (EPM). Dams were divided into three groups according to drug treatment during pregnancy: controls (C), saline-SA [subcutaneous (s.c.), 1 ml/kg], and MA (s.c., 5 mg/kg). Litters were divided into four groups according to postnatal stressors: non-stressed controls (N), maternal separation (S), maternal cold water stress (W), and maternal separation plus maternal cold water stress (SW). Forty-five minutes before testing (in both OF and EPM), one-half of adult male rats received an (s.c.) injection of MA and the other half received an SA injection. Prenatal MA/stress exposure did not affect anxiety-like behavior in adult male rats in both tests. In the OF, an acute MA dose in adulthood increased the time spent in the central disk area, decreased time spent in the corners, and decreased time spent immobile and grooming. Also, postnatal stress increased time spent in the central disk area, decreased time spent in corners, and increased mobility compared to controls. All groups of rats exposed to postnatal stressors spent significantly less time in the closed arms of the EPM compared to controls. Overall, our results indicate that early postnatal stress and a single acute MA administration in adulthood decreases the parameters of anxiety-like behavior in adult male rats regardless of prenatal MA exposure. Moreover, postnatal stress via maternal separation impacts the effect of acute MA administration in adulthood. Long-term postnatal stress may thus result in improved adaptation to subsequent stressful experiences later in life.
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Affiliation(s)
- Anna Holubová-Kroupová
- Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Romana Šlamberová
- Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czechia
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16
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Sun H, Zhang X, Kong Y, Gou L, Lian B, Wang Y, Jiang L, Li Q, Sun H, Sun L. Maternal Separation-Induced Histone Acetylation Correlates with BDNF-Programmed Synaptic Changes in an Animal Model of PTSD with Sex Differences. Mol Neurobiol 2021; 58:1738-1754. [PMID: 33245480 DOI: 10.1007/s12035-020-02224-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022]
Abstract
Maternal separation (MS) causes long-lasting epigenetic changes in the brain and increases vulnerability to traumatic events in adulthood. Of interest, there may be sex-specific differences in these epigenetic changes. In this study, the extent of histone acetylation in the hippocampus (HIP) and the expression of BDNF were measured to determine whether BDNF influences risk of PTSD following MS in early life. Rat offspring were separated from their dams (3 h/day or 6 h/day from PND2~PND14). Then, pups were treated with a single prolonged stress (SPS) procedure when they reached adulthood (PND80). In animals stressed with the SPS procedure in adulthood, those that had increased MS intensity in childhood demonstrated more significant changes in performance on tests of anxiety, depression, and contextual fear memory. Reduced levels of total BDNF mRNA and protein were observed after SPS treatment and further declined in groups with greater MS time in childhood. Interestingly, these changes were correlated with decreased H3K9ac levels and increased HDAC2 levels. Additional MS also led to more severe ultrastructural synaptic damage in rats that experienced the SPS procedure, particularly in the CA1 and CA3 region of the HIP, reflecting impaired synaptic plasticity in these regions. Interestingly, male rats in the MS3h-PTSD group showed decreased anxiety, but no similar changes were found in female rats, suggesting a degree of gender specificity in coping with stress after mild MS. In summary, this study suggests that the epigenetic signatures of the BDNF genes can be linked to HIP responses to stress, providing insights that may be relevant for people at risk of stress-related psychopathologies.
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MESH Headings
- Acetylation
- Animals
- Behavior, Animal
- Brain-Derived Neurotrophic Factor/metabolism
- CA1 Region, Hippocampal/metabolism
- CA1 Region, Hippocampal/ultrastructure
- CA3 Region, Hippocampal/metabolism
- CA3 Region, Hippocampal/ultrastructure
- Corticosterone/blood
- Disease Models, Animal
- Elevated Plus Maze Test
- Fear
- Female
- Gene Expression Regulation
- Histone Deacetylase 2/genetics
- Histone Deacetylase 2/metabolism
- Histones/metabolism
- Immobilization
- Male
- Maternal Deprivation
- Open Field Test
- Rats, Sprague-Dawley
- Regression Analysis
- Sex Characteristics
- Stress Disorders, Post-Traumatic/blood
- Stress Disorders, Post-Traumatic/complications
- Stress Disorders, Post-Traumatic/metabolism
- Stress, Psychological/blood
- Stress, Psychological/complications
- Swimming
- Synapses/metabolism
- Synapses/ultrastructure
- Rats
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Affiliation(s)
- Haoran Sun
- School of Clinical Medicine, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China
| | - Xianqiang Zhang
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital/Institute of Mental Health and the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, 100083, People's Republic of China
| | - Yujia Kong
- School of Public Health, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China
| | - Luping Gou
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China
| | - Bo Lian
- School of Bioscience and Technology, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China
| | - Yanyu Wang
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China
| | - Li Jiang
- Cerebral Center, Sunshine Union Hospital, 9000# Yingqian Street, Weifang, 261205, Shandong, People's Republic of China
| | - Qi Li
- Department of Psychiatry and Centre for Reproduction Growth and Development, University of Hong Kong, Hong Kong, People's Republic of China
| | - Hongwei Sun
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China
| | - Lin Sun
- School of Psychology, Weifang Medical University, 7166# Baotong West Street, Weifang, 261053, Shandong, People's Republic of China.
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17
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Zakeri MA, Hossini Rafsanjanipoor SM, Sedri N, Kahnooji M, Sanji Rafsanjani M, Zakeri M, Zakeri Bazmandeh A, Talebi A, Dehghan M. Psychosocial status during the prevalence of COVID-19 disease: the comparison between healthcare workers and general population. CURRENT PSYCHOLOGY 2021; 40:6324-6332. [PMID: 33746463 PMCID: PMC7963465 DOI: 10.1007/s12144-021-01582-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of COVID-19 disease continues to be a significant psychosocial status among health care workers (HCWs) and the general population worldwide. This cross sectional study aimed to compare the psychosocial status between healthcare workers and general population during the prevalence of COVID-19 disease in southeast Iran. Totally 415 health care workers of a medical service center for COVID-19 patients and 1023 people of general population participated in the study. An online socio-demographic characteristics questionnaire, General Health Questionnaire (GHQ −28), and Generalized Anxiety Disorder 7-item (GAD-7) were utilized to evaluate psychosocial status. According to GHQ, the psychological disorders of the HCWs were significantly higher than that of the general population (P < 0.001). According to GAD-7, no significant difference was found between general population and HCWs. Multivariate logistic analysis showed no difference between general population and HCWs in the psychological disorder. Although HCWs suffered from psychological disorders more than general population, nearly one third to half of the participants in both groups had psychosocial disorders.
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Affiliation(s)
- Mohammad Ali Zakeri
- Determinants of Health Research Centre, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Nadia Sedri
- Student Research Committee, Zarand faculty of Nursing, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Kahnooji
- Department of internal medicine, Faculty of medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mojtaba Sanji Rafsanjani
- Emergency Department, Ali Ebn Abitaleb Hospital, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Maryam Zakeri
- Physiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Abbas Zakeri Bazmandeh
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Talebi
- Student Research Committee, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
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18
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Sex differences in the elevated plus-maze test and large open field test in adult Wistar rats. Pharmacol Biochem Behav 2021; 204:173168. [PMID: 33684454 DOI: 10.1016/j.pbb.2021.173168] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/21/2022]
Abstract
There is a growing need for a better understanding of sex differences in animal models of psychiatric disorders. The elevated plus-maze (EPM) test and large open field (LOF) test are widely used to study anxiety-like behavior in rodents. Our studies explored sex differences in anxiety and activity parameters in the LOF and EPM and determined whether these parameters correlate within and between tests. Drug naïve adult male and female Wistar rats (n = 47/sex) were used for the studies, and the rats were tested for 5 min in the EPM and 10 min in the LOF. The females spent more time on the open arms of the EPM and made more open arms entries than the males. The females also spent more time in the center zone of the LOF and made more center zone entries. The females traveled a greater distance in the LOF and EPM. There was a moderate positive correlation between time on the open arms of the EPM and time in the center zone of the LOF. There was also a moderate positive correlation between open arms entries in the EPM and center zone entries in the LOF. A hierarchical cluster analysis revealed one cluster with LOF parameters, one cluster with EPM parameters, and one cluster with parameters related to the avoidance of open spaces. In conclusion, these findings indicate that female rats display less anxiety-like behavior in the EPM and LOF. Furthermore, there are sex differences for almost all behavioral parameters in these anxiety tests.
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19
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Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, Wu L, Sun Z, Zhou Y, Wang Y, Liu W. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Res 2020; 287:112921. [PMID: 32240896 PMCID: PMC7102622 DOI: 10.1016/j.psychres.2020.112921] [Citation(s) in RCA: 839] [Impact Index Per Article: 209.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 03/15/2020] [Indexed: 12/11/2022]
Abstract
The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.
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Affiliation(s)
- Nianqi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Fan Zhang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Cun Wei
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yanpu Jia
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhilei Shang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Luna Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Lili Wu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhuoer Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yaoguang Zhou
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yan Wang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Weizhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China.
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20
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Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, Wu L, Sun Z, Zhou Y, Wang Y, Liu W. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Res 2020; 287:112921. [PMID: 32240896 DOI: 10.1016/j.psychres] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 03/15/2020] [Indexed: 05/23/2023]
Abstract
The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.
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Affiliation(s)
- Nianqi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Fan Zhang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Cun Wei
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yanpu Jia
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhilei Shang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Luna Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Lili Wu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhuoer Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yaoguang Zhou
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yan Wang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Weizhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China.
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Region-specific effects of maternal separation on oxidative stress accumulation in parvalbumin neurons of male and female rats. Behav Brain Res 2020; 388:112658. [PMID: 32339550 DOI: 10.1016/j.bbr.2020.112658] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022]
Abstract
Early life adversity in humans is linked to cognitive deficits and increased risk of mental illnesses, including depression, bipolar disorder, and schizophrenia, with evidence for different vulnerabilities in men versus women. Modeling early life adversity in rodents shows similar neuropsychological deficits that may partially be driven by sex-dependent dysfunction in parvalbumin (PV) interneurons in the prefrontal cortex (PFC), hippocampus (HPC), and basolateral amygdala (BLA). Research demonstrates that PV interneurons are particularly susceptible to oxidative stress; therefore, accumulation of oxidative damage may drive PV dysfunction following early life adversity. The goal of this study was to quantify oxidative stress accumulation in PV neurons in rats exposed to maternal separation (MS). Pups were separated from their dam and littermates for 4 h per day from postnatal day (P)2 to 20. Serial sections from the PFC, HPC, and BLA of juvenile (P20) rats of both sexes were immunohistochemically stained with antibodies against PV and 8-oxo-dG, a marker for oxidative DNA damage. PV cell counts, colocalization with 8-oxo-dG, and intensity of each signal were measured in each region to determine the effects of MS and establish whether MS-induced oxidative damage varies between sexes. A significant increase in colocalization of PV and 8-oxo-dG was found in the PFC and HPC, indicating increased oxidative stress in that cell population following MS. Region-specific sex differences were also revealed in the PFC, BLA, and HPC. These data identify oxidative stress during juvenility as a potential mechanism mediating PV dysfunction in individuals with a history of early life adversity.
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Herzog JI, Thome J, Demirakca T, Koppe G, Ende G, Lis S, Rausch S, Priebe K, Müller-Engelmann M, Steil R, Bohus M, Schmahl C. Influence of Severity of Type and Timing of Retrospectively Reported Childhood Maltreatment on Female Amygdala and Hippocampal Volume. Sci Rep 2020; 10:1903. [PMID: 32024861 PMCID: PMC7002661 DOI: 10.1038/s41598-020-57490-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 12/23/2019] [Indexed: 12/28/2022] Open
Abstract
Deleterious effects of adverse childhood experiences (ACE) on human brain volume are widely reported. First evidence points to differential effects of ACE on brain volume in terms of timing of ACE. Upcoming studies additionally point towards the impact of different types (i.e., neglect and abuse) of ACE in terms of timing. The current study aimed to investigate the correlation between retrospectively reported severity of type (i.e., the extent to which subjects were exposed to abuse and/or neglect, respectively) and timing of ACE on female brain volume in a sample of prolonged traumatized subjects. A female sample with ACE (N = 68) underwent structural magnetic resonance imaging and a structured interview exploring the severity of ACE from age 3 up to 17 using the “Maltreatment and Abuse Chronology of Exposure” (MACE). Random forest regression with conditional interference trees was applied to assess the impact of ACE severity as well as the severity of ACE type, (i.e. to what extent individuals were exposed to neglect and/or abuse) at certain ages on pre-defined regions of interest such as the amygdala, hippocampus, and anterior cingulate (ACC) volume. Analyses revealed differential type and timing-specific effects of ACE on stress sensitive brain structures: Amygdala and hippocampal volume were affected by ACE severity during a period covering preadolescence and early adolescence. Crucially, this effect was driven by the severity of neglect.
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Affiliation(s)
- Julia I Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany.
| | - Janine Thome
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany.,Department of Theoretical Neuroscience, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany.,Department of Psychiatry, University of Western Ontario, 339 Windermere Rd., London, N6A 5A5, ON, Canada
| | - Traute Demirakca
- Department of Neuroimaging, Central Institute of Mental Health Mannheim, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Georgia Koppe
- Department of Theoretical Neuroscience, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Gabriele Ende
- Department of Neuroimaging, Central Institute of Mental Health Mannheim, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Stefanie Lis
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Sophie Rausch
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Kathlen Priebe
- Department of Psychology, Faculty of Life Sciences, Humboldt-University of Berlin, Unter den Linden 6, 10999, Berlin, Germany
| | - Meike Müller-Engelmann
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe-University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt am Main, Germany
| | - Regina Steil
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe-University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt am Main, Germany
| | - Martin Bohus
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany.,Department of Psychiatry, University of Western Ontario, 339 Windermere Rd., London, N6A 5A5, ON, Canada
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