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Abstract
The prevalence of chronic pain has reached epidemic levels. In addition to personal suffering chronic pain is associated with psychiatric and medical co-morbidities, notably substance misuse, and a huge a societal cost amounting to hundreds of billions of dollars annually in medical cost, lost wages, and productivity. Chronic pain does not have a cure or quantitative diagnostic or prognostic tools. In this manuscript we provide evidence that this situation is about to change. We first start by summarizing our current understanding of the role of the brain in the pathogenesis of chronic pain. We particularly focus on the concept of learning in the emergence of chronic pain, and the implication of the limbic brain circuitry and dopaminergic signaling, which underly emotional learning and decision making, in this process. Next, we summarize data from our labs and from other groups on the latest brain imaging findings in different chronic pain conditions focusing on results with significant potential for translation into clinical applications. The gaps in the study of chronic pain and brain imaging are highlighted in throughout the overview. Finally, we conclude by discussing the costs and benefits of using brain biomarkers of chronic pain and compare to other potential markers.
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Affiliation(s)
- Zhengwu Zhang
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jennifer S Gewandter
- Anesthesiology and Perioperative Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States
| | - Paul Geha
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States.,Department of Neurology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States.,Del Monte Neuroscience Institute, University of Rochester, Rochester, NY, United States
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Acosta H, Kantojärvi K, Hashempour N, Pelto J, Scheinin NM, Lehtola SJ, Lewis JD, Fonov VS, Collins DL, Evans A, Parkkola R, Lähdesmäki T, Saunavaara J, Karlsson L, Merisaari H, Paunio T, Karlsson H, Tuulari JJ. Partial Support for an Interaction Between a Polygenic Risk Score for Major Depressive Disorder and Prenatal Maternal Depressive Symptoms on Infant Right Amygdalar Volumes. Cereb Cortex 2020; 30:6121-6134. [PMID: 32676648 DOI: 10.1093/cercor/bhaa158] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 12/11/2019] [Revised: 04/02/2020] [Accepted: 05/09/2020] [Indexed: 12/22/2022] Open
Abstract
Psychiatric disease susceptibility partly originates prenatally and is shaped by an interplay of genetic and environmental risk factors. A recent study has provided preliminary evidence that an offspring polygenic risk score for major depressive disorder (PRS-MDD), based on European ancestry, interacts with prenatal maternal depressive symptoms (GxE) on neonatal right amygdalar (US and Asian cohort) and hippocampal volumes (Asian cohort). However, to date, this GxE interplay has only been addressed by one study and is yet unknown for a European ancestry sample. We investigated in 105 Finnish mother-infant dyads (44 female, 11-54 days old) how offspring PRS-MDD interacts with prenatal maternal depressive symptoms (Edinburgh Postnatal Depression Scale, gestational weeks 14, 24, 34) on infant amygdalar and hippocampal volumes. We found a GxE effect on right amygdalar volumes, significant in the main analysis, but nonsignificant after multiple comparison correction and some of the control analyses, whose direction paralleled the US cohort findings. Additional exploratory analyses suggested a sex-specific GxE effect on right hippocampal volumes. Our study is the first to provide support, though statistically weak, for an interplay of offspring PRS-MDD and prenatal maternal depressive symptoms on infant limbic brain volumes in a cohort matched to the PRS-MDD discovery sample.
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Affiliation(s)
- H Acosta
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland.,Department of Psychiatry and Psychotherapy, Philipps University of Marburg, 35037 Marburg, Germany
| | - K Kantojärvi
- Finnish Institute for Health and Welfare, Genomics and Biobank Unit, FI-00271 Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, Helsinki University Central Hospital, University of Helsinki, 00100 Helsinki, Finland
| | - N Hashempour
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland
| | - J Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland
| | - N M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland.,Department of Psychiatry, Turku University Hospital, University of Turku, 20500 Turku, Finland
| | - S J Lehtola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland
| | - J D Lewis
- Montreal Neurological Institute, McGill University, Montreal H3A 0G4, Canada
| | - V S Fonov
- Montreal Neurological Institute, McGill University, Montreal H3A 0G4, Canada
| | - D L Collins
- Montreal Neurological Institute, McGill University, Montreal H3A 0G4, Canada
| | - A Evans
- Montreal Neurological Institute, McGill University, Montreal H3A 0G4, Canada
| | - R Parkkola
- Department of Radiology, Turku University Hospital, University of Turku, 20500 Turku, Finland
| | - T Lähdesmäki
- Department of Pediatric Neurology, Turku University Hospital, University of Turku, 20500 Turku, Finland
| | - J Saunavaara
- Department of Medical Physics, Turku University Hospital, 20521 Turku, Finland
| | - L Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland.,Department of Child Psychiatry, Turku University Hospital, University of Turku, 20500 Turku, Finland
| | - H Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland.,Department of Future Technologies, University of Turku, 20500 Turku, Finland.,Center of Computational Imaging and Personalized Diagnostics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - T Paunio
- Finnish Institute for Health and Welfare, Genomics and Biobank Unit, FI-00271 Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, Helsinki University Central Hospital, University of Helsinki, 00100 Helsinki, Finland
| | - H Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland.,Department of Psychiatry, Turku University Hospital, University of Turku, 20500 Turku, Finland
| | - J J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, 20500 Turku, Finland.,Department of Psychiatry, Turku University Hospital, University of Turku, 20500 Turku, Finland.,Turku Collegium for Science and Medicine, University of Turku, 20500 Turku, Finland.,Department of Psychiatry, University of Oxford, Oxford, OX1 2JD, UK
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Nogovitsyn N, Souza R, Muller M, Srajer A, Metzak PD, Hassel S, Ismail Z, Protzner A, Bray SL, Lebel C, MacIntosh BJ, Goldstein BI, Wang J, Kennedy SH, Addington J, MacQueen GM. Aberrant limbic brain structures in young individuals at risk for mental illness. Psychiatry Clin Neurosci 2020; 74:294-302. [PMID: 32003517 DOI: 10.1111/pcn.12985] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 09/11/2019] [Revised: 01/06/2020] [Accepted: 01/20/2020] [Indexed: 12/13/2022]
Abstract
AIM Alterations in limbic structures may be present before the onset of serious mental illness, but whether subfield-specific limbic brain changes parallel stages in clinical risk is unknown. To address this gap, we compared the hippocampus, amygdala, and thalamus subfield-specific volumes in adolescents at various stages of risk for mental illness. METHODS MRI scans were obtained from 182 participants (aged 12-25 years) from the Canadian Psychiatric Risk and Outcome study. The sample comprised of four groups: asymptomatic youth at risk due to family history of mental illness (Stage 0, n = 32); youth with early symptoms of distress (Stage 1a, n = 41); youth with subthreshold psychotic symptoms (Stage 1b, n = 72); and healthy comparison participants with no family history of serious mental illness (n = 37). Analyses included between-group comparisons of brain measurements and correlational analyses that aimed to identify significant associations between neuroimaging and clinical measurements. A machine-learning technique examined the discriminative properties of the clinical staging model. RESULTS Subfield-specific limbic volume deficits were detected at every stage of risk for mental illness. A machine-learning classifier identified volume deficits within the body of the hippocampus, left amygdala nuclei, and medial-lateral nuclei of the thalamus that were most informative in differentiating between risk stages. CONCLUSION Aberrant subfield-specific changes within the limbic system may serve as biological evidence to support transdiagnostic clinical staging in mental illness. Differential patterns of volume deficits characterize those at risk for mental illness and may be indicative of a risk-stage progression.
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Affiliation(s)
- Nikita Nogovitsyn
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Roberto Souza
- Department of Radiology and Clinical Neuroscience, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Meghan Muller
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amelia Srajer
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Paul D Metzak
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Stefanie Hassel
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Andrea Protzner
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Psychology, University of Calgary, Calgary, Canada
| | - Signe L Bray
- Department of Radiology, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, Calgary, Canada.,Child & Adolescent Imaging Research (CAIR) Program, Calgary, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, Calgary, Canada.,Child & Adolescent Imaging Research (CAIR) Program, Calgary, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - JianLi Wang
- Work & Mental Health Research Unit, University of Ottawa Institute of Mental Health Research, Ottawa, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Psychiatry, Krembil Research Centre, University Health Network, University of Toronto, Toronto, Canada.,Department of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, Canada.,Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Jean Addington
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Nowacka-Chmielewska MM, Kasprowska-Liśkiewicz D, Barski JJ, Obuchowicz E, Małecki A. The behavioral and molecular evaluation of effects of social instability stress as a model of stress-related disorders in adult female rats. Stress 2017; 20:549-561. [PMID: 28911267 DOI: 10.1080/10253890.2017.1376185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The study aimed to test the hypotheses that chronic social instability stress (CSIS) alters behavioral and physiological parameters and expression of selected genes important for stress response and social behaviors. Adult female Sprague-Dawley rats were subjected to the 4-week CSIS procedure, which involves unpredictable rotation between phases of isolation and overcrowding. Behavioral analyses (Experiment 1) were performed on the same rats before and after CSIS (n = 16) and physiological and biochemical measurements (Experiment 2) were made on further control (CON; n = 7) and stressed groups (CSIS; n = 8). Behaviors in the open field test (locomotor and exploratory activities) and elevated-plus maze (anxiety-related behaviors) indicated anxiety after CSIS. CSIS did not alter the physiological parameters measured, i.e. body weight gain, regularity of estrous cycles, and circulating concentrations of stress hormones and sex steroids. QRT-PCR analysis of mRNA expression levels was performed on amygdala, hippocampus, prefrontal cortex (PFC), and hypothalamus. The main finding is that CSIS alters the mRNA levels for the studied genes in a region-specific manner. Hence, expression of POMC (pro-opiomelanocortin), AVPR1a (arginine vasopressin receptor), and OXTR (oxytocin receptor) significantly increased in the amygdala following CSIS, while in PFC and/or hypothalamus, POMC, AVPR1a, AVPR1b, OXTR, and ERβ (estrogen receptor beta) expression decreased. CSIS significantly reduced expression of CRH-R1 (corticotropin-releasing hormone receptor type 1) in the hippocampus. The directions of change in gene expression and the genes and regions affected indicate a molecular basis for the behavior changes. In conclusion, CSIS may be valuable for further analyzing the neurobiology of stress-related disorders in females.
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MESH Headings
- Amygdala/metabolism
- Animals
- Anxiety/genetics
- Anxiety/metabolism
- Behavior, Animal
- Brain/metabolism
- Chronic Disease
- Estrogen Receptor beta/genetics
- Estrogen Receptor beta/metabolism
- Female
- Gene Expression
- Hippocampus/metabolism
- Hypothalamo-Hypophyseal System/metabolism
- Hypothalamus/metabolism
- Pituitary-Adrenal System/metabolism
- Prefrontal Cortex/metabolism
- Pro-Opiomelanocortin/genetics
- Pro-Opiomelanocortin/metabolism
- RNA, Messenger/metabolism
- Rats
- Rats, Sprague-Dawley
- Receptors, Corticotropin-Releasing Hormone/genetics
- Receptors, Corticotropin-Releasing Hormone/metabolism
- Receptors, Oxytocin/genetics
- Receptors, Oxytocin/metabolism
- Receptors, Vasopressin/genetics
- Receptors, Vasopressin/metabolism
- Stress, Psychological/genetics
- Stress, Psychological/metabolism
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Affiliation(s)
- Marta Maria Nowacka-Chmielewska
- a Laboratory of Molecular Biology, Faculty of Physiotherapy , The Jerzy Kukuczka Academy of Physical Education , Katowice , Poland
- b Department of Experimental Medicine, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland
| | - Daniela Kasprowska-Liśkiewicz
- a Laboratory of Molecular Biology, Faculty of Physiotherapy , The Jerzy Kukuczka Academy of Physical Education , Katowice , Poland
- b Department of Experimental Medicine, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland
| | - Jarosław Jerzy Barski
- b Department of Experimental Medicine, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland
- c Department of Physiology, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland
| | - Ewa Obuchowicz
- d Department of Pharmacology, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland
| | - Andrzej Małecki
- a Laboratory of Molecular Biology, Faculty of Physiotherapy , The Jerzy Kukuczka Academy of Physical Education , Katowice , Poland
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