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Yan H, Han Y, Shan X, Li H, Liu F, Li P, Zhao J, Guo W. Breaking the Fear Barrier: Aberrant Activity of Fear Networks as a Prognostic Biomarker in Patients with Panic Disorder Normalized by Pharmacotherapy. Biomedicines 2023; 11:2420. [PMID: 37760861 PMCID: PMC10525800 DOI: 10.3390/biomedicines11092420] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Panic disorder (PD) is a prevalent type of anxiety disorder. Previous studies have reported abnormal brain activity in the fear network of patients with PD. Nonetheless, it remains uncertain whether pharmacotherapy can effectively normalize these abnormalities. This longitudinal resting-state functional magnetic resonance imaging study aimed to investigate the spontaneous neural activity in patients with PD and its changes after pharmacotherapy, with a focus on determining whether it could predict treatment response. The study included 54 drug-naive patients with PD and 54 healthy controls (HCs). Spontaneous neural activity was measured using regional homogeneity (ReHo). Additionally, support vector regression (SVR) was employed to predict treatment response from ReHo. At baseline, PD patients had aberrant ReHo in the fear network compared to HCs. After 4 weeks of paroxetine treatment (20 mg/day), a significant increase in ReHo was observed in the left fusiform gyrus, which had shown reduced ReHo before treatment. The SVR analysis showed significantly positive correlations (p < 0.0001) between the predicted and actual reduction rates of the severity of anxiety and depressive symptoms. Here, we show patients with PD had abnormal spontaneous neural activities in the fear networks. Furthermore, these abnormal spontaneous neural activities can be partially normalized by pharmacotherapy and serve as candidate predictors of treatment response. Gaining insight into the trajectories of brain activity normalization following treatment holds the potential to provide vital insights for managing PD.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Yiding Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China;
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China;
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar 161006, China;
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
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Battaglia S, Di Fazio C, Vicario CM, Avenanti A. Neuropharmacological Modulation of N-methyl-D-aspartate, Noradrenaline and Endocannabinoid Receptors in Fear Extinction Learning: Synaptic Transmission and Plasticity. Int J Mol Sci 2023; 24:ijms24065926. [PMID: 36983000 PMCID: PMC10053024 DOI: 10.3390/ijms24065926] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
Learning to recognize and respond to potential threats is crucial for survival. Pavlovian threat conditioning represents a key paradigm for investigating the neurobiological mechanisms of fear learning. In this review, we address the role of specific neuropharmacological adjuvants that act on neurochemical synaptic transmission, as well as on brain plasticity processes implicated in fear memory. We focus on novel neuropharmacological manipulations targeting glutamatergic, noradrenergic, and endocannabinoid systems, and address how the modulation of these neurobiological systems affects fear extinction learning in humans. We show that the administration of N-methyl-D-aspartate (NMDA) agonists and modulation of the endocannabinoid system by fatty acid amide hydrolase (FAAH) inhibition can boost extinction learning through the stabilization and regulation of the receptor concentration. On the other hand, elevated noradrenaline levels dynamically modulate fear learning, hindering long-term extinction processes. These pharmacological interventions could provide novel targeted treatments and prevention strategies for fear-based and anxiety-related disorders.
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Affiliation(s)
- Simone Battaglia
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari", Cesena Campus, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Chiara Di Fazio
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari", Cesena Campus, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
| | - Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98122 Messina, Italy
| | - Alessio Avenanti
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari", Cesena Campus, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
- Neuropsicology and Cognitive Neuroscience Research Center (CINPSI Neurocog), Universidad Católica del Maule, Talca 3460000, Chile
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Bui UTD, Milton AL. Making Leaps and Hitting Boundaries in Reconsolidation: Overcoming Boundary Conditions to Increase Clinical Translatability of Reconsolidation-based Therapies. Neuroscience 2023; 519:198-206. [PMID: 36933761 DOI: 10.1016/j.neuroscience.2023.03.013] [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: 11/30/2022] [Revised: 03/03/2023] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Abstract
Reconsolidation results in the restabilisation, and thus persistence, of a memory made labile by retrieval, and interfering with this process is thought to enable modification or weakening of the original trace. As such, reconsolidation-blockade has been a focus of research aiming to target the maladaptive memories underlying mental health disorders, including post-traumatic stress disorder and drug addiction. Current first-line therapies are not effective for all patients, and a substantial proportion of those for whom therapies are effective later relapse. A reconsolidation-based intervention would be invaluable as an alternative treatment for these conditions. However, the translation of reconsolidation-based therapies to the clinic presents a number of challenges, with arguably the greatest being the overcoming of the boundary conditions governing the opening of the reconsolidation window. These include factors such as the age and strength of memory, and can broadly be divided into two categories: intrinsic features of the targeted memory itself, and parameters of the reactivation procedure used. With maladaptive memory characteristics inevitably varying amongst individuals, manipulation of the other limitations imposed by procedural variables have been explored to circumvent the boundary conditions on reconsolidation. Although several apparently discrepant results remain to be reconciled and these limitations yet to be truly defined, many studies have produced successful results which encouragingly demonstrate that boundary conditions may be overcome using various proposed strategies to enable translation of a reconsolidation-based intervention to clinical use.
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Affiliation(s)
- Uyen T D Bui
- Department of Psychology, University of Cambridge, UK
| | - Amy L Milton
- Department of Psychology, University of Cambridge, UK.
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Tseilikman V, Lapshin M, Klebanov I, Chrousos G, Vasilieva M, Pashkov A, Fedotova J, Tseilikman D, Shatilov V, Manukhina E, Tseilikman O, Sarapultsev A, Downey HF. The Link between Activities of Hepatic 11beta-Hydroxysteroid Dehydrogenase-1 and Monoamine Oxidase-A in the Brain Following Repeated Predator Stress: Focus on Heightened Anxiety. Int J Mol Sci 2022; 23:ijms23094881. [PMID: 35563271 PMCID: PMC9102549 DOI: 10.3390/ijms23094881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
We investigated the presence of a molecular pathway from hepatic 11-βHSD-1 to brain MAO-A in the dynamics of plasma corticosterone involvement in anxiety development. During 14 days following repeated exposure of rats to predator scent stress for 10 days, the following variables were measured: hepatic 11-βHSD-1 and brain MAO-A activities, brain norepinephrine, plasma corticosterone concentrations, and anxiety, as reflected by performance on an elevated plus maze. Anxiety briefly decreased and then increased after stress exposure. This behavioral response correlated inversely with plasma corticosterone and with brain MAO-A activity. A mathematical model described the dynamics of the biochemical variables and predicted the factor(s) responsible for the development and dynamics of anxiety. In the model, hepatic 11-βHSD-1 was considered a key factor in defining the dynamics of plasma corticosterone. In turn, plasma corticosterone and oxidation of brain ketodienes and conjugated trienes determined the dynamics of brain MAO-A activity, and MAO-A activity determined the dynamics of brain norepinephrine. Finally, plasma corticosterone was modeled as the determinant of anxiety. Solution of the model equations demonstrated that plasma corticosterone is mainly determined by the activity of hepatic 11-βHSD-1 and, most importantly, that corticosterone plays a critical role in the dynamics of anxiety following repeated stress.
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Affiliation(s)
- Vadim Tseilikman
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- Correspondence: ; Tel.: +7-919311-85-99
| | - Maxim Lapshin
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
| | - Igor Klebanov
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- School of Electronic Engineering and Computer Science, South Ural State University, 454080 Chelyabinsk, Russia
| | - George Chrousos
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Vasilieva
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
| | - Anton Pashkov
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
| | - Julia Fedotova
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- Laboratory of Neuroendocrinology, Pavlov Institute of Physiology, RAS, 199034 St. Petersburg, Russia
- International Research Centre “Biotechnologies of the Third Millennium”, ITMO University, 191002 St. Petersburg, Russia
| | - David Tseilikman
- Zelman Institute of Medicine and Psychology, Novosibirsk State University, 630090 Novosibirsk, Russia;
| | - Vladislav Shatilov
- Basic Medicine Department, Chelyabinsk State University, 454001 Chelyabinsk, Russia;
| | - Eugenia Manukhina
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- Laboratory for Regulatory Mechanisms of Stress and Adaptation, Institute of General Pathology and Pathophysiology, 125315 Moscow, Russia
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Olga Tseilikman
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- Basic Medicine Department, Chelyabinsk State University, 454001 Chelyabinsk, Russia;
| | - Alexey Sarapultsev
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
| | - H. Fred Downey
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (M.L.); (I.K.); (G.C.); (M.V.); (A.P.); (J.F.); (E.M.); (O.T.); (A.S.); (H.F.D.)
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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