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Kallupi M, Kononoff J, Melas PA, Qvist JS, de Guglielmo G, Kandel ER, George O. Deep brain stimulation of the nucleus accumbens shell attenuates cocaine withdrawal but increases cocaine self-administration, cocaine-induced locomotor activity, and GluR1/GluA1 in the central nucleus of the amygdala in male cocaine-dependent rats. Brain Stimul 2022; 15:13-22. [PMID: 34742997 PMCID: PMC8816878 DOI: 10.1016/j.brs.2021.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/21/2021] [Accepted: 11/01/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cocaine addiction is a major public health problem. Despite decades of intense research, no effective treatments are available. Both preclinical and clinical studies strongly suggest that deep brain stimulation of the nucleus accumbens (NAcc) is a viable target for the treatment of cocaine use disorder (CUD). OBJECTIVE Although previous studies have shown that DBS of the NAcc decreases cocaine seeking and reinstatement, the effects of DBS on cocaine intake in cocaine-dependent animals have not yet been investigated. METHODS Rats were made cocaine dependent by allowing them to self-administer cocaine in extended access conditions (6 h/day, 0.5 mg/kg/infusion). The effects of monophasic bilateral high-frequency DBS (60 μs pulse width and 130 Hz frequency) stimulation with a constant current of 150 μA of the NAcc shell on cocaine intake was then evaluated. Furthermore, cocaine-induced locomotor activity, irritability-like behavior during cocaine abstinence, and the levels of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor subunits 1 and 2 (GluR1/GluA1 and GluR2/GluA2) after DBS were investigated. RESULTS Contrary to our expectations, DBS of the NAcc shell induced a slight increase in cocaine self-administration, and increased cocaine-induced locomotion after extended access of cocaine self-administration. In addition, DBS decreased irritability-like behavior 18 h into cocaine withdrawal. Finally, DBS increased both cytosolic and synaptosomal levels of GluR1, but not GluR2, in the central nucleus of the amygdala but not in other brain regions. CONCLUSIONS These preclinical results with cocaine-dependent animals support the use of high-frequency DBS of the NAcc shell as a therapeutic approach for the treatment of the negative emotional state that emerges during cocaine abstinence, but also demonstrate that DBS does not decrease cocaine intake in active, long-term cocaine users. These data, together with the existing evidence that DBS of the NAcc shell reduces the reinstatement of cocaine seeking in abstinent animals, suggest that NAcc shell DBS may be beneficial for the treatment of the negative emotional states and craving during abstinence, although it may worsen cocaine use if individuals continue drug use.
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Affiliation(s)
- Marsida Kallupi
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA 92093, USA,Department of Neuroscience, The Scripps Research Institute, 10550 N.Torrey Pines Rd, La Jolla, CA 92037, USA,Correspondence to: and
| | - Jenni Kononoff
- Department of Neuroscience, The Scripps Research Institute, 10550 N.Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Philippe A. Melas
- Department of Neuroscience, Columbia University, New York, NY 10032, USA,Mortimer B. Zuckerman Mind Brain Behavior Institute, Jerome L. Greene Science Center, New York, NY 10027, USA,Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, 17176, Sweden
| | - Johanna S. Qvist
- Department of Neuroscience, Columbia University, New York, NY 10032, USA,Mortimer B. Zuckerman Mind Brain Behavior Institute, Jerome L. Greene Science Center, New York, NY 10027, USA
| | - Giordano de Guglielmo
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA 92093, USA,Department of Neuroscience, The Scripps Research Institute, 10550 N.Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Eric R. Kandel
- Department of Neuroscience, Columbia University, New York, NY 10032, USA,Mortimer B. Zuckerman Mind Brain Behavior Institute, Jerome L. Greene Science Center, New York, NY 10027, USA,Kavli Institute for Brain Science, Columbia University, New York, NY 10032, USA,Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA
| | - Olivier George
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA 92093, USA,Department of Neuroscience, The Scripps Research Institute, 10550 N.Torrey Pines Rd, La Jolla, CA 92037, USA,Correspondence to: and
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Kimbrough A, Kononoff J, Simpson S, Kallupi M, Sedighim S, Palomino K, Conlisk D, Momper JD, de Guglielmo G, George O. Oxycodone self-administration and withdrawal behaviors in male and female Wistar rats. Psychopharmacology (Berl) 2020; 237:1545-1555. [PMID: 32114633 PMCID: PMC7269712 DOI: 10.1007/s00213-020-05479-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 02/06/2020] [Indexed: 12/22/2022]
Abstract
RATIONALE Over the last decade, oxycodone has become one of the most widely abused drugs in the USA. Oxycodone use disorder (OUD) is a serious health problem that has prompted a need to develop animal models of OUD that have both face and predictive validity. Oxycodone use in humans is more prevalent in women and leads to pronounced hyperalgesia and irritability during withdrawal. However, unclear is whether current animal models of oxycodone self-administration recapitulate these characteristics in humans. OBJECTIVES We assessed the face validity of a model of extended-access oxycodone self-administration in rats by examining the escalation of oxycodone intake and behavioral symptoms of withdrawal, including irritability-like behavior and mechanical nociception, in male and female Wistar rats. RESULTS Both male and female rats escalated their oxycodone intake over fourteen 12-h self-administration sessions. After escalation, female rats administered more drug than male rats. No differences in plasma oxycodone levels were identified, but males had a significantly higher level of oxycodone in the brain at 30 min. Extended access to oxycodone significantly decreased aggressive-like behavior and increased defensive-like behaviors when tested immediately after a 12-h self-administration session, followed by a rebound increase in aggressive-like behavior 12 h into withdrawal. Tests of mechanical nociception thresholds during withdrawal indicated pronounced hyperalgesia. No sex differences in irritability-like behavior or pain sensitivity were observed. CONCLUSIONS The present study demonstrated the face validity of the extended access model of oxycodone self-administration by identifying sex differences in the escalation of oxycodone intake and pronounced changes in pain and affective states.
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Affiliation(s)
- Adam Kimbrough
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Jenni Kononoff
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Sierra Simpson
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA,Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Marsida Kallupi
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Sharona Sedighim
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Kenia Palomino
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Dana Conlisk
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Jeremiah D. Momper
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Giordano de Guglielmo
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA 92093-0737, USA
| | - Olivier George
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA, 92093-0737, USA.
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Kallupi M, Carrette LLG, Kononoff J, Solberg Woods LC, Palmer AA, Schweitzer P, George O, de Guglielmo G. Nociceptin attenuates the escalation of oxycodone self-administration by normalizing CeA-GABA transmission in highly addicted rats. Proc Natl Acad Sci U S A 2020; 117:2140-2148. [PMID: 31932450 PMCID: PMC6994987 DOI: 10.1073/pnas.1915143117] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Approximately 25% of patients who are prescribed opioids for chronic pain misuse them, and 5 to 10% develop an opioid use disorder. Although the neurobiological target of opioids is well known, the molecular mechanisms that are responsible for the development of addiction-like behaviors in some but not all individuals are poorly known. To address this issue, we used a unique outbred rat population (heterogeneous stock) that better models the behavioral and genetic diversity that is found in humans. We characterized individual differences in addiction-like behaviors using an addiction index that incorporates the key criteria of opioid use disorder: escalated intake, highly motivated responding, and hyperalgesia. Using in vitro electrophysiological recordings in the central nucleus of the amygdala (CeA), we found that rats with high addiction-like behaviors (HA) exhibited a significant increase in γ-aminobutyric acid (GABA) transmission compared with rats with low addiction-like behaviors (LA) and naive rats. The superfusion of CeA slices with nociceptin/orphanin FQ peptide (N/OFQ; 500 nM), an endogenous opioid-like peptide, normalized GABA transmission in HA rats. Intra-CeA levels of N/OFQ were lower in HA rats than in LA rats. Intra-CeA infusions of N/OFQ (1 μg per site) reversed the escalation of oxycodone self-administration in HA rats but not in LA rats. These results demonstrate that the downregulation of N/OFQ levels in the CeA may be responsible for hyper-GABAergic tone in the CeA that is observed in individuals who develop addiction-like behaviors. Based on these results, we hypothesize that small molecules that target the N/OFQ system might be useful for the treatment of opioid use disorder.
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Affiliation(s)
- Marsida Kallupi
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037
| | - Lieselot L G Carrette
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037
- Center for Medical Genetics, Ghent University, 9000 Ghent, Belgium
| | - Jenni Kononoff
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Leah C Solberg Woods
- Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101
| | - Abraham A Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA 92093
| | - Paul Schweitzer
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037
| | - Olivier George
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093;
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037
| | - Giordano de Guglielmo
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093;
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037
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Ylisaukko-Oja T, Torvinen S, Ventola H, Schmidt S, Herrala S, Kononoff J, Voutilainen M. Healthcare resource utilization and treatment costs of Finnish chronic inflammatory bowel disease patients treated with infliximab . Scand J Gastroenterol 2019; 54:726-732. [PMID: 31203693 DOI: 10.1080/00365521.2019.1627579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives: Inflammatory bowel disease (IBD) is associated with a high economic burden to society due to its early onset and chronic character. Here, we set out to characterize healthcare resource utilization and associated costs in Crohn's disease (CD) and ulcerative colitis (UC) patients with infliximab treatment, the most widely used first-line biologic agent in Finland, in a real-world clinical setting. Methods: This was a retrospective, non-interventional single-center study. Infliximab was administered in routine care, and data were collected retrospectively from electronic health records. All adult anti-TNF naïve CD or UC patients whose infliximab treatment was initiated at the Hospital District of Southwest Finland between the years of 2014 and 2016 were included in the study. Each patient was followed-up for 12 months after the initiation of infliximab treatment. Results: A total of 155 patients were included (45 CD, 110 UC). Altogether, 60.0% (n = 27) of all CD patients and 43.6% (n = 48) of all UC patients persisted on infliximab therapy 12 months after treatment initiation. The total cost was similar for both CD and UC cohorts (CD, €10,243; UC, €10,770), infliximab treatment being the highest individual cost (60.3% of the total cost in CD; 53.4% in UC). The mean number of infliximab infusions during the 12-month follow-up was 7.0 for CD and 6.5 for UC patients. Conclusions: IBD causes a significant burden to the Finnish healthcare system. This study provides a detailed characterization of the cost landscape of IBD and contributes to optimizing treatment strategies and healthcare resource use in the biosimilar era.
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Affiliation(s)
- Tero Ylisaukko-Oja
- MedEngine Oy , Helsinki , Finland.,Center for Life Course Health Research, University of Oulu , Oulu , Finland
| | | | | | | | | | | | - Markku Voutilainen
- Division of Medicine, Turku University Hospital , Turku , Finland.,Department of Medicine, University of Turku , Turku , Finland
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Kimbrough A, de Guglielmo G, Kononoff J, Kallupi M, Zorrilla EP, George O. CRF 1 Receptor-Dependent Increases in Irritability-Like Behavior During Abstinence from Chronic Intermittent Ethanol Vapor Exposure. Alcohol Clin Exp Res 2017; 41:1886-1895. [PMID: 28833238 DOI: 10.1111/acer.13484] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/17/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND In humans, emotional and physical signs of withdrawal from ethanol are commonly seen. Many of these symptoms, including anxiety-like and depression-like behavior, have been characterized in animal models of ethanol dependence. One issue with several current behavioral tests that measure withdrawal in animal models is that they are often not repeatable within subjects over time. Additionally, irritability, one of the most common symptoms of ethanol withdrawal in humans, has not been well characterized in animal models. The corticotropin-releasing factor (CRF)-CRF1 receptor system has been suggested to be critical for the emergence of anxiety-like behavior in ethanol dependence, but the role of this system in irritability-like behavior has not been characterized. METHODS The present study compared the effects of chronic intermittent ethanol (CIE) vapor exposure-induced ethanol dependence on irritability-like behavior in rats using the bottle-brush test during acute withdrawal and protracted abstinence. Rats were trained to self-administer ethanol in operant chambers and then either left in a nondependent state or made dependent via CIE. Naïve, nondependent, and dependent rats were tested for irritability-like behavior in the bottle-brush test 8 hours and 2 weeks into abstinence from ethanol. Separate cohorts of dependent and nondependent rats were used to examine the effect of the specific CRF1 receptor antagonist R121919 on irritability-like behavior. RESULTS Dependent rats exhibited escalated ethanol intake compared with their own pre-CIE baseline and nondependent rats. At both time points of abstinence, ethanol-dependent rats exhibited increased aggressive-like responses compared with naïve and nondependent rats. R121919 reduced irritability-like behavior in both dependent and nondependent rats, but dependent rats were more sensitive to R121919. CONCLUSIONS Irritability-like behavior is a clinically relevant and reliable measure of negative emotional states that is partially mediated by activation of the CRF-CRF1 system and remains elevated during protracted abstinence in ethanol-dependent rats.
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Affiliation(s)
- Adam Kimbrough
- Department of Neuroscience (AK, GdG, JK, MK, EPZ, OG), The Scripps Research Institute, La Jolla, California
| | - Giordano de Guglielmo
- Department of Neuroscience (AK, GdG, JK, MK, EPZ, OG), The Scripps Research Institute, La Jolla, California
| | - Jenni Kononoff
- Department of Neuroscience (AK, GdG, JK, MK, EPZ, OG), The Scripps Research Institute, La Jolla, California
| | - Marsida Kallupi
- Department of Neuroscience (AK, GdG, JK, MK, EPZ, OG), The Scripps Research Institute, La Jolla, California
| | - Eric P Zorrilla
- Department of Neuroscience (AK, GdG, JK, MK, EPZ, OG), The Scripps Research Institute, La Jolla, California
| | - Olivier George
- Department of Neuroscience (AK, GdG, JK, MK, EPZ, OG), The Scripps Research Institute, La Jolla, California
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de Guglielmo G, Matzeu A, Kononoff J, Mattioni J, Martin-Fardon R, George O. Cebranopadol Blocks the Escalation of Cocaine Intake and Conditioned Reinstatement of Cocaine Seeking in Rats. J Pharmacol Exp Ther 2017. [PMID: 28645915 DOI: 10.1124/jpet.117.241042] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cebranopadol is a novel agonist of nociceptin/orphanin FQ peptide (NOP) and opioid receptors with analgesic properties that is being evaluated in clinical Phase 2 and Phase 3 trials for the treatment of chronic and acute pain. Recent evidence indicates that the combination of opioid and NOP receptor agonism may be a new treatment strategy for cocaine addiction. We sought to extend these findings by examining the effects of cebranopadol on cocaine self-administration (0.5 mg/kg/infusion) and cocaine conditioned reinstatement in rats with extended access to cocaine. Oral administration of cebranopadol (0, 25, and 50 μg/kg) reversed the escalation of cocaine self-administration in rats that were given extended (6 hour) access to cocaine, whereas it did not affect the self-administration of sweetened condensed milk (SCM). Cebranopadol induced conditioned place preference but did not affect locomotor activity during the conditioning sessions. Finally, cebranopadol blocked the conditioned reinstatement of cocaine seeking. These results show that oral cebranopadol treatment prevented addiction-like behaviors (i.e., the escalation of intake and reinstatement), suggesting that it may be a novel strategy for the treatment of cocaine use disorder. However, the conditioned place preference that was observed after cebranopadol administration suggests that this compound may have some intrinsic rewarding effects.
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Affiliation(s)
| | - Alessandra Matzeu
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
| | - Jenni Kononoff
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
| | - Julia Mattioni
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
| | - Rémi Martin-Fardon
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
| | - Olivier George
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
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