RESUMEN
BACKGROUND: Some glutamatergic modulators have demonstrated rapid and relatively sustained antidepressant properties in patients with major depressive disorder. Because the potassium channel activator diazoxide increases glutamate uptake via potassium channel activation, we hypothesized that it might exert antidepressant effects by increasing the removal of glutamate from the synaptic cleft, thereby reducing excessive glutamate transmission. METHODS: This randomized, double-blind, placebo-controlled, crossover, single-site inpatient clinical study was conducted at the National Institute of Mental Health to assess the efficacy and safety of a 3-week course of diazoxide (200-400 mg daily, twice a day) versus a 3-week course of placebo in 6 participants with treatment-refractory major depressive disorder. The primary clinical outcome measure was change in Montgomery-Asberg Depression Rating Scale score from baseline to posttreatment. Quantitative insulin sensitivity check index, as well as concomitant imaging measures (electroencephalography, proton magnetic resonance spectroscopy, magnetoencephalography), were used as potential surrogate markers of target (KATP channel) engagement. RESULTS: The study was halted due to severe adverse effects. Given the small sample size, statistical evaluation of the effect of diazoxide on Montgomery-Asberg Depression Rating Scale scores or the imaging measures was not pursued. Visual inspection of the quantitative insulin sensitivity check index test revealed no evidence of target engagement. CONCLUSIONS: Although the results are negative, they are an important addition to the literature in this rapidly changing field.
Asunto(s)
Trastorno Depresivo Mayor/tratamiento farmacológico , Trastorno Depresivo Resistente al Tratamiento/tratamiento farmacológico , Diazóxido/administración & dosificación , Canales de Potasio/efectos de los fármacos , Adulto , Anciano , Estudios Cruzados , Trastorno Depresivo Mayor/fisiopatología , Trastorno Depresivo Resistente al Tratamiento/fisiopatología , Diazóxido/efectos adversos , Diazóxido/farmacología , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Terminación Anticipada de los Ensayos Clínicos , Femenino , Ácido Glutámico/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Canales de Potasio/metabolismo , Escalas de Valoración Psiquiátrica , Resultado del TratamientoRESUMEN
Multiple lines of evidence suggest that disturbances in excitatory transmission contribute to depression. Whether these defects involve the number, size, or composition of glutamatergic contacts is unclear. This study used recently introduced procedures for fluorescence deconvolution tomography in a well-studied rat model of congenital depression to characterize excitatory synapses in layer I of infralimbic cortex, a region involved in mood disorders, and of primary somatosensory cortex. Three groups were studied: (1) rats bred for learned helplessness (cLH); (2) rats resistant to learned helplessness (cNLH); and (3) control Sprague Dawley rats. In fields within infralimbic cortex, cLH rats had the same numerical density of synapses, immunolabeled for either the postsynaptic density (PSD) marker PSD95 or the presynaptic protein synaptophysin, as controls. However, PSD95 immunolabeling intensities were substantially lower in cLH rats, as were numerical densities of synapse-sized clusters of the AMPA receptor subunit GluA1. Similar but less pronounced differences (comparable numerical densities but reduced immunolabeling intensity for PSD95) were found in the somatosensory cortex. In contrast, non-helpless rats had 25% more PSDs than either cLH or control rats without any increase in synaptophysin-labeled terminal frequency. Compared with controls, both cLH and cNLH rats had fewer GABAergic contacts. These results indicate that congenital tendencies that increase or decrease depression-like behavior differentially affect excitatory synapses.
Asunto(s)
Corteza Cerebral/patología , Trastorno Depresivo Mayor/patología , Sinapsis/patología , Animales , Modelos Animales de Enfermedad , Desamparo Adquirido , Inmunohistoquímica , Masculino , Ratas , Ratas Sprague-DawleyRESUMEN
Positron emission tomography (PET) neuroimaging and behavioral assays in rodents are widely used in neuroscience. PET gives insights into the molecular processes of neuronal communication, and behavioral methods analyze the actions that are associated with such processes. These methods have not been directly integrated, because PET studies in animals have until now required general anesthesia to immobilize the subject, which precludes behavioral studies. We present a method for imaging awake, behaving rats with PET that allows the simultaneous study of behavior. Key components include the 'rat conscious animal PET' or RatCAP, a miniature portable PET scanner that is mounted on the rat's head, a mobility system that allows considerable freedom of movement, radiotracer administration techniques and methods for quantifying behavior and correlating the two data sets. The simultaneity of the PET and behavioral data provides a multidimensional tool for studying the functions of different brain regions and their molecular constituents.
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Conducta Animal/fisiología , Mapeo Encefálico/instrumentación , Encéfalo/fisiología , Tomografía de Emisión de Positrones/instrumentación , Ratas/fisiología , Animales , Mapeo Encefálico/métodosRESUMEN
In humans metabolic changes, particularly in frontal areas of the brain, accompany depressive disorders, but few studies were conducted in animal models of depression. We used hydrogen-1 magnetic resonance spectroscopy at 9.4 T to measure the metabolic profiles of the hippocampus and frontal cortex in congenital learned helpless (cLH) and wild-type (WT) rats. The learned helplessness model of depression exposes animals to uncontrollable stress to induce changes in emotion, cognition and behaviour, but cLH rats were selectively bred to show changes in behaviour even without exposure to uncontrollable stress. Experimentally naive male 8- to 10-wk-old cLH (n = 10) and WT rats (n = 22) underwent spectroscopy and were exposed to uncontrollable stress 1 wk after the scan. We found that cLH compared to WT rats had lower levels of glutamate in the hippocampus and lower levels of choline-containing compounds in the hippocampus and frontal cortex, but higher levels of taurine and phosphocreatine in these regions, pointing to compensatory efforts of the brain to reduce excitotoxic potential and to increase neuroprotection and energy, possibly as a result of cellular stress and damage. The reduction in choline-containing phospholipids might represent a source or correlate of such stress. Overall, the results indicate that metabolic abnormalities are present in animals with a predisposition to helplessness even without exposure to explicit stress and may help identify non-invasive biomarkers in individuals who are prone to depression.
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Cruzamiento/métodos , Lóbulo Frontal/metabolismo , Desamparo Adquirido , Hipocampo/metabolismo , Espectroscopía de Resonancia Magnética , Animales , Lóbulo Frontal/fisiopatología , Hipocampo/fisiopatología , Espectroscopía de Resonancia Magnética/métodos , Masculino , Protones , Ratas , Ratas Sprague-DawleyRESUMEN
Major depressive disorder involves changes in synaptic structure and function, but the molecular underpinnings of these changes are still not established. In an initial pilot experiment, whole-brain synaptosome screening with quantitative western blotting was performed to identify synaptic proteins that may show concentration changes in a congenital rat learned helplessness model of depression. We found that the N-methyl-d-aspartate receptor (NMDAR) subunits GluN2A/GluN2B, activity-regulated cytoskeleton-associated protein (Arc) and syntaxin-1 showed significant concentration differences between congenitally learned helpless (LH) and nonlearned helpless (NLH) rats. Having identified these three proteins, we then performed more elaborate quantitative immunogold electron microscopic analyses of the proteins in a specific synapse type in the dorsal hippocampus: the Schaffer collateral synapse in the CA1 region. We expanded the setup to include also unstressed wild-type (WT) rats. The concentrations of the proteins in the LH and NLH groups were compared to WT animals. In this specific synapse, we found that the concentration of NMDARs was increased in postsynaptic spines in both LH and NLH rats. The concentration of Arc was significantly increased in postsynaptic densities in LH animals as well as in presynaptic cytoplasm of NLH rats. The concentration of syntaxin-1 was significantly increased in both presynaptic terminals and postsynaptic spines in LH animals, while pre- and postsynaptic syntaxin-1 concentrations were significantly decreased in NLH animals. These protein changes suggest pathways by which synaptic plasticity may be increased in dorsal hippocampal Schaffer collateral synapses during depression, corresponding to decreased synaptic stability.
Asunto(s)
Proteínas del Citoesqueleto/biosíntesis , Depresión/metabolismo , Hipocampo/metabolismo , Proteínas del Tejido Nervioso/biosíntesis , Receptores de N-Metil-D-Aspartato/biosíntesis , Sinapsis/metabolismo , Sintaxina 1/biosíntesis , Animales , Proteínas del Citoesqueleto/análisis , Modelos Animales de Enfermedad , Desamparo Adquirido , Hipocampo/química , Proteínas del Tejido Nervioso/análisis , Ratas , Receptores de N-Metil-D-Aspartato/análisis , Sinapsis/química , Sintaxina 1/análisisRESUMEN
Cognitive processes are assumed to change with learned helplessness, an animal model of depression, but little is known about such deficits. Here we investigated the role of cognitive and related functions in selectively bred helpless (cLH, n=10), non-helpless (cNLH, n=12) and wild type (WT, n=8) Sprague Dawley rats. The animals were exposed to an open field for 10min on each of two test days. On the third day, an object exploration paradigm was carried out. The animals were later tested for helplessness. Both cLH and cNLH rats were more active than WTs on the first day in the open field. Over trials, cNLH and WT rats lowered their activity less than cLH rats. This resistance-to-habituation co-varied with a resistance to develop helplessness. In cLH rats, higher 'anxiety' or less time spent in the center of the open field co-varied with severe helplessness. In WTs, a greater reactivity to novel objects and to a spatially relocated object predicted lower levels of helplessness. In cLH rats (n=4-5 per group), chronic treatment with a high dose of the monoamine oxidase (MAO)-B inhibitor deprenyl (10mg/kg; i.p.), an anti-Parkinson, nootropic and antidepressant drug, attenuated helplessness. Remarkably, helplessness reversal required the experience of repeated test trials, reminiscent of a learning process. Chronic deprenyl (10mg/kg; i.p.) did not alter locomotion/exploration or 'anxiety' in the open field. In conclusion, helplessness may be related to altered mechanisms of reinforcement learning and working memory, and to abnormalities in MAO-A and/or MAO-B functioning.
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Cognición/efectos de los fármacos , Cognición/fisiología , Desamparo Adquirido , Inhibidores de la Monoaminooxidasa/farmacología , Selegilina/farmacología , Envejecimiento , Animales , Ansiedad/dietoterapia , Ansiedad/fisiopatología , Electrochoque , Conducta Exploratoria/efectos de los fármacos , Conducta Exploratoria/fisiología , Habituación Psicofisiológica/efectos de los fármacos , Habituación Psicofisiológica/fisiología , Masculino , Inhibidores de la Monoaminooxidasa/administración & dosificación , Actividad Motora/efectos de los fármacos , Actividad Motora/fisiología , Pruebas Neuropsicológicas , Ratas , Ratas Endogámicas , Selegilina/administración & dosificación , Especificidad de la Especie , Factores de TiempoRESUMEN
To determine if NMDA receptor alterations are present in the cerebellum in schizophrenia, we measured NMDA receptor binding and gene expression of the NMDA receptor subunits in a post-mortem study of elderly patients with schizophrenia and non-affected subjects. Furthermore, we assessed influence of genetic variation in the candidate gene neuregulin-1 (NRG1) on the expression of the NMDA receptor in an exploratory study. Post-mortem samples from the cerebellar cortex of ten schizophrenic patients were compared with nine normal subjects. We investigated NMDA receptor binding by receptor autoradiography and gene expression of the NMDA receptor subunits NR1, NR2A, NR2B, NR2C and NR2D by in situ hybridization. For the genetic study, we genotyped the NRG1 polymorphism rs35753505 (SNP8NRG221533). Additionally, we treated rats with the antipsychotics haloperidol or clozapine and assessed cerebellar NMDA receptor binding and gene expression of subunits to examine the effects of antipsychotic treatment. Gene expression of the NR2D subunit was increased in the right cerebellum of schizophrenic patients compared to controls. Individuals carrying at least one C allele of rs35753505 (SNP8NRG221533) showed decreased expression of the NR2C subunit in the right cerebellum, compared to individuals homozygous for the T allele. Correlation with medication parameters and the animal model revealed no treatment effects. In conclusion, increased NR2D expression results in a hyperexcitable NMDA receptor suggesting an adaptive effect due to receptor hypofunction. The decreased NR2C expression in NRG1 risk variant may cause a deficit in NMDA receptor function. This supports the hypothesis of an abnormal glutamatergic neurotransmission in the right cerebellum in the pathophysiology of schizophrenia.
Asunto(s)
Cerebelo/metabolismo , Expresión Génica/fisiología , Subunidades de Proteína/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Esquizofrenia/patología , Anciano , Animales , Antipsicóticos/uso terapéutico , Autorradiografía/métodos , Biología Computacional/métodos , Modelos Animales de Enfermedad , Maleato de Dizocilpina/farmacocinética , Antagonistas de Aminoácidos Excitadores/farmacocinética , Femenino , Genotipo , Evaluación Geriátrica , Humanos , Masculino , Ratones , Persona de Mediana Edad , Sistemas en Línea , Cambios Post Mortem , Unión Proteica/efectos de los fármacos , Unión Proteica/fisiología , Subunidades de Proteína/genética , Ratas , Ratas Sprague-Dawley , Receptores de N-Metil-D-Aspartato/genética , Esquizofrenia/tratamiento farmacológico , Esquizofrenia/fisiopatologíaRESUMEN
An important risk gene in schizophrenia is D-: amino acid oxidase (DAAO). To establish if expression of DAAO is altered in cortical, hippocampal or thalamic regions of schizophrenia patients, we measured gene expression of DAAO in a post-mortem study of elderly patients with schizophrenia and non-affected controls in both hemispheres differentiating between gray and white matter. We compared cerebral post-mortem samples (granular frontal cortex BA9, middle frontal cortex BA46, superior temporal cortex BA22, entorhinal cortex BA28, sensoric cortex BA1-3, hippocampus (CA4), mediodorsal nucleus of the thalamus) from 10 schizophrenia patients to 13 normal subjects investigating gene expression of DAAO in the gray and white matter of both hemispheres of the above-mentioned brain regions by in situ-hybridization. We found increased expression of DAAO-mRNA in the hippocampal CA4 of schizophrenic patients. Compared to the control group, both hemispheres of the hippocampus of schizophrenic patients showed an increased expression of 46% (right, P = 0.013) and 54% (left, P = 0.019), respectively. None of the other regions examined showed statistically significant differences in DAAO expression. This post-mortem study demonstrated increased gene expression of DAAO in the left and right hippocampus of schizophrenia patients. This increased expression could be responsible for a decrease in local D-: serine levels leading to a NMDA-receptor hypofunction that is hypothesized to play a major role in the pathophysiology of schizophrenia. However, our study group was small and results should be verified using larger samples.
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D-Aminoácido Oxidasa/metabolismo , Giro Dentado/enzimología , Esquizofrenia/enzimología , Anciano , Corteza Cerebral/enzimología , Corteza Cerebral/metabolismo , D-Aminoácido Oxidasa/genética , Giro Dentado/metabolismo , Femenino , Lateralidad Funcional , Expresión Génica , Humanos , Hibridación in Situ , Masculino , Fibras Nerviosas Mielínicas/enzimología , Fibras Nerviosas Mielínicas/metabolismo , Fibras Nerviosas Amielínicas/enzimología , Fibras Nerviosas Amielínicas/metabolismo , ARN Mensajero/metabolismo , Esquizofrenia/genética , Esquizofrenia/metabolismo , Tálamo/enzimología , Tálamo/metabolismoRESUMEN
The Neuregulin (NRG1) gene has been associated with schizophrenia, but its functional implications are largely unknown. Our aim was to assess differential brain activation between patients carrying an at-risk allele on the Neuregulin 1 gene and patients without this genetic risk. Neural signal changes between 14 first episode schizophrenia patients with the at risk allele (SNP8NRG221533) from the Icelandic core haplotype and 14 without were measured with fMRI during a working memory task. Patients without the at risk allele showed greater activations (P < 0.05; corrected) in the left hippocampus, precuneus and cerebellum, as well as the right anterior cingulate. Brain regions previously associated with the pathology of Schizophrenia are differentially affected in those with a genetic at risk status in the NRG1 gene. Heterogeneity of structural and functional measures within patients characterized by clinical phenotypes may be in part due to this genetic variation.
Asunto(s)
Corteza Cerebral/fisiopatología , Haplotipos/genética , Neurregulina-1/genética , Polimorfismo de Nucleótido Simple/genética , Esquizofrenia/genética , Esquizofrenia/fisiopatología , Adulto , Cerebelo/fisiopatología , Corteza Cerebral/patología , Femenino , Lóbulo Frontal/fisiopatología , Lateralidad Funcional/genética , Predisposición Genética a la Enfermedad/genética , Giro del Cíngulo/fisiopatología , Hipocampo/fisiopatología , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Esquizofrenia/diagnóstico , Lóbulo Temporal/fisiopatología , Adulto JovenRESUMEN
OBJECTIVE: Normal tissues, including the central nervous system, tolerate single exposures to narrow planes of synchrotron-generated x-rays (microplanar beams; microbeams) up to several hundred Gy. The repairs apparently involve the microvasculature and the glial system. We evaluate a hypothesis on the involvement of bystander effects in these repairs. METHODS: Confluent cultures of bovine aortic endothelial cells were irradiated with three parallel 27-microm microbeams at 24 Gy. Rats' spinal cords were transaxially irradiated with a single microplanar beam, 270 microm thick, at 750 Gy; the dose distribution in tissue was calculated. RESULTS: Within 6 hours following irradiation of the cell culture the hit cells died, apparently by apoptosis, were lost, and the confluency was maintained. The spinal cord study revealed a loss of oligodendrocytes, astrocytes, and myelin in 2 weeks, but by 3 months repopulation and remyelination was nearly complete. Monte Carlo simulations showed that the microbeam dose fell from the peak's 80% to 20% in 9 microm. CONCLUSIONS: In both studies the repair processes could have involved "beneficial" bystander effects leading to tissue restoration, most likely through the release of growth factors, such as cytokines, and the initiation of cell-signaling cascades. In cell culture these events could have promoted fast disappearance of the hit cells and fast structural response of the surviving neighboring cells, while in the spinal cord study similar events could have been promoting angiogenesis to replace damaged capillary blood vessels, and proliferation, migration, and differentiation of the progenitor glial cells to produce new, mature, and functional glial cells.
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Efecto Espectador/efectos de la radiación , Sistema Nervioso Central/efectos de la radiación , Neovascularización Fisiológica/efectos de la radiación , Regeneración/efectos de la radiación , Traumatismos de la Médula Espinal/metabolismo , Animales , Astrocitos/metabolismo , Astrocitos/patología , Células Cultivadas , Sistema Nervioso Central/irrigación sanguínea , Sistema Nervioso Central/patología , Relación Dosis-Respuesta en la Radiación , Método de Montecarlo , Vaina de Mielina/metabolismo , Oligodendroglía/metabolismo , Oligodendroglía/patología , Dosis de Radiación , Ratas , Ratas Endogámicas F344 , Traumatismos de la Médula Espinal/patología , Rayos XRESUMEN
Working memory dysfunction is a prominent impairment in patients with schizophrenia. Our aim was to determine cerebral dysfunctions by means of functional magnetic resonance imaging (fMRI) in a large sample of first-episode schizophrenia patients during a working memory task. 75 first-episode schizophrenia patients and 81 control subjects, recruited within a multi-center study, performed 2- and 0-back tasks while brain activation was measured with fMRI. In order to guarantee comparability between data quality from different scanners, we developed and adopted a standardized, fully automated quality assurance of scanner hard- and software as well as a measure for in vivo data quality. After these quality-control measures had been implemented, 48 patients and 57 controls were included in the final analysis. During attention-related processes, even when the performance between patients and controls was comparable, there was a recognizable emergence of cerebral dysfunctions with hypoactivations in the ventrolateral prefrontal cortex (VLPFC), in the superior temporal cortex and in the thalamus. During working memory performance, parietal hypoactivations, especially in the precuneus, were prominent and were accompanied by poorer performance in patients. A hyperfrontality emerged in the ventrolateral prefrontal cortex. Hence, results point to a dysfunctional ventrolateral prefrontal-parietal network during working memory in patients, suggesting impairments in basic functions such as retrieval, storage and maintenance. The brain activation pattern of this large and significant sample of first-episode schizophrenia patients indicates an imbalanced system failing to adjust the amount of brain activity required in the cerebral network involved in attention and working memory.
Asunto(s)
Atención/fisiología , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Memoria a Corto Plazo/fisiología , Reconocimiento Visual de Modelos/fisiología , Corteza Prefrontal/fisiopatología , Esquizofrenia/fisiopatología , Aprendizaje Seriado/fisiología , Lóbulo Temporal/fisiopatología , Tálamo/fisiopatología , Adolescente , Adulto , Mapeo Encefálico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Red Nerviosa/fisiopatología , Tiempo de Reacción/fisiología , Valores de Referencia , Esquizofrenia/diagnósticoRESUMEN
The theory of depression is dominated by the monoamine hypothesis but there is increasing evidence that beyond monoamines, glutamate (Glu) and gamma-aminobutyric acid (GABA) play an essential role in the pathogenesis of depression. In this study, the effect of alterations of GABA and Glu were investigated in the congenital learned helplessness paradigm. Proton magnetic resonance spectroscopy is an important monitoring tool to bridge the findings in clinical and preclinical studies. We found increased Glu/GABA ratios in the hippocampus and prefrontal cortex of placebo-treated (saline intraperitoneally) congenital learned helplessness rats versus wild-type rats, and a treatment-induced (desipramine 10 mg/kg intraperitoneally or electroconvulsive shock) decrease of this monoamine ratio in both brain regions. Our results corroborate previous findings of an amino-acid influence on the pathomechanisms of mood disorders.
Asunto(s)
Depresión/metabolismo , Ácido Glutámico/metabolismo , Desamparo Adquirido , Espectroscopía de Resonancia Magnética , Ácido gamma-Aminobutírico/metabolismo , Animales , Conducta Animal , Encéfalo/metabolismo , Encéfalo/patología , Depresión/patología , Modelos Animales de Enfermedad , Ratas , Ratas EndogámicasRESUMEN
Disturbed synaptic transmission contributes to the pathophysiology of mood disorders. Post mortem studies reported reduced expression of the synaptic vesicle protein (SVP) complexins I and II in depression. Antidepressants were found to induce the expression of these genes. Since animals with congenital susceptibility to learned helplessness provide a valid animal model of depression, we investigated the expression of different SVPs in this system by semiquantitative in situ hybridization. Rats bred for congenital learned helpless behavior (cLH, N=6) failed to interrupt foot shock currents by lever pressing (mean 12.3 failures out of 15 trials). These animals showed significantly lower expression of complexins I and II mRNA in hippocampal, limbic and cortical brain areas compared to not helpless animals (cNLH, N=6) with a mean failure rate of 0.83 out of 15 trials. Expression levels of complexins I and II significantly correlated with the failure rate in the test paradigm. In contrast, the expressions of synaptotagmin I and synaptophysin were found unchanged. This investigation provides a further validation of the LH model of depression. The experimental data fit well into current pathogenetic concepts of mood disorders and support the hypothesis, that complexins are pivotal players in the pathophysiology of depression and tentative targets of antidepressants.
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Encéfalo/metabolismo , Regulación de la Expresión Génica/fisiología , Desamparo Adquirido , Proteínas del Tejido Nervioso/metabolismo , Proteínas Adaptadoras del Transporte Vesicular , Animales , Autorradiografía , Encéfalo/anatomía & histología , Reacción de Fuga/fisiología , Hibridación in Situ/métodos , Masculino , Ratas , Ratas Sprague-Dawley , Ratas Wistar , Estadísticas no Paramétricas , Sinaptofisina/metabolismo , Sinaptotagmina I/metabolismoRESUMEN
Although cognitive side effects may occur after electroconvulsive therapy (ECT), no structural brain abnormalities have been detected after ECT with conventional magnetic resonance imaging (MRI). Transient disturbances of memory function are common findings after ECT indicating functional compromise. Diffusion weighted imaging (DWI) has been shown to be sensitive to focal tissue changes associated with compromise of energy metabolism in cerebral ischemia and after prolonged ictal activity. We used conventional MRI and DWI in an exploratory study examining ten patients after treatment with ECT, eight of whom experienced short-lasting memory disturbances. MRI and DWI showed no definite signal abnormalities on qualitative and quantitative analysis. In three patients, equivocal marginal DWI hyperintensity was noted in the hippocampal formation. These findings are in line with previous negative studies using conventional MRI. Higher resolution DWI and serial imaging may be necessary to visualize possible minimal signal changes after ECT.
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Trastorno Depresivo/patología , Trastorno Depresivo/cirugía , Imagen de Difusión por Resonancia Magnética/métodos , Terapia Electroconvulsiva/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The burden of depression as a severe illness with high suicidality and prevalence is immense. Despite substantial advancement in psychopharmacology and psychotherapy over the last decades a residual group of very ill patients with a chronic disease and high suicidal risk remains. Modern theories about the pathophysiology of depression are derived from studies examining the mechanism of antidepressants influencing the serotonergic (5-HT) and noradrenergic (NE) systems. Serotonergic fibers originate from the dorsal raphe nuclei (DRN), noradrenergic fibers from the locus coeruleus (LC). Both nuclei represent relatively small brain regions and both are controlled to some extent by the habenular complex. We propose the hypothesis of an overactivation of the habenula in human major depressive episodes (MDE's). Increased activation of the lateral habenular nucleus leads to the down regulation of the serotonergic, noradrenergic, dopaminergic systems and stimulation of the hypothalamic-pituitary-adrenal (HPA) axis. Functional inhibition of the lateral habenula via deep brain stimulation (DBS) has antidepressive properties. The hypothesis is based on the findings of a clinical imaging study examining the habenular after tryptophan depletion and on several animal studies which are discussed. Providing that our hypothesis will be validated by an analogous tyrosine depletion study and additional preclinical studies, the next logical step would be to directly test our hypothesis in patients. Possible criteria for patient selection, ethical issues and locus of DBS are carefully discussed.
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Estimulación Encefálica Profunda , Trastorno Depresivo Mayor/terapia , Habénula/metabolismo , Animales , Antidepresivos/uso terapéutico , Depresión , Estimulación Eléctrica , Electrofisiología , Humanos , Modelos Teóricos , Tomografía de Emisión de Positrones , Serotonina/metabolismo , Transmisión Sináptica , Triptófano/metabolismo , Tirosina/metabolismoRESUMEN
Altered glucocorticoid receptor (GR) signaling is a postulated mechanism for the pathogenesis of major depression. To mimic the human situation of altered GR function claimed for depression, we generated mouse strains that underexpress or overexpress GR, but maintain the regulatory genetic context controlling the GR gene. To achieve this goal, we used the following: (1) GR-heterozygous mutant mice (GR+/-) with a 50% GR gene dose reduction, and (2) mice overexpressing GR by a yeast artificial chromosome resulting in a twofold gene dose elevation. GR+/- mice exhibit normal baseline behaviors but demonstrate increased helplessness after stress exposure, a behavioral correlate of depression in mice. Similar to depressed patients, GR+/- mice have a disinhibited hypothalamic-pituitary-adrenal (HPA) system and a pathological dexamethasone/corticotropin-releasing hormone test. Thus, they represent a murine depression model with good face and construct validity. Overexpression of GR in mice evokes reduced helplessness after stress exposure, and an enhanced HPA system feedback regulation. Therefore, they may represent a model for a stress-resistant strain. These mouse models can now be used to study biological changes underlying the pathogenesis of depressive disorders. As a first potential molecular correlate for such changes, we identified a downregulation of BDNF protein content in the hippocampus of GR+/- mice, which is in agreement with the so-called neurotrophin hypothesis of depression.
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Trastorno Depresivo/genética , Hipocampo/fisiología , Receptores de Glucocorticoides/genética , Estrés Psicológico/genética , Animales , Factor Neurotrófico Derivado del Encéfalo/metabolismo , Condicionamiento Clásico , Corticosterona/sangre , Dexametasona , Electrochoque , Miedo , Desamparo Adquirido , Hipocampo/fisiopatología , Vivienda para Animales , Ratones , Ratones Mutantes , Modelos Neurológicos , Factores de Crecimiento Nervioso/metabolismo , Receptores de Glucocorticoides/fisiologíaRESUMEN
BACKGROUND: Although the major principles of dopamine (DA) signaling have been well described previously, its precise modulatory impact on the prefrontal cortex (PFC) in humans is poorly understood. Two major neurophysiological models propose segregated functional circuits on the systems level as well as D(1) and D(2) receptor-dependent processing states on the cellular level (two-state model). METHODS: We examined the predictive validity of these models in 10 healthy male volunteers with a haloperidol challenge (HLP). Cortico-striatal-thalamo-cortical (CSTC) motor loop functions were examined during functional magnetic resonance imaging (fMRI) with a sequential finger opposition task. Neuropsychological implications of the two-state model were evaluated with a test battery of D(1)- or D(2)-sensitive prefrontal measures. RESULTS: Analysis of fMRI data revealed a significant HLP-induced blood oxygen level dependent-signal decrease in the sensorimotor striatum and a lateralized activation loss of ipsilateral higher order motor cortices and contralateral cerebellum. Neuropsychological evaluation demonstrated a preferential impairment of D(2)-sensitive functions, whereas D(1) or non-dopaminergic domains were unaffected. CONCLUSIONS: Our data support the hypothesis that mesocortical D(1) and D(2) receptors exert differential influences in the PFC for cognitive function, but the nigrostriatal CSTC network model for the motor domain could not be confirmed.
Asunto(s)
Antagonistas de los Receptores de Dopamina D2 , Lóbulo Frontal/fisiología , Receptores de Dopamina D2/fisiología , Adulto , Mapeo Encefálico , Antagonistas de Dopamina/farmacología , Lóbulo Frontal/irrigación sanguínea , Lóbulo Frontal/efectos de los fármacos , Haloperidol/farmacología , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Vías Nerviosas/irrigación sanguínea , Vías Nerviosas/efectos de los fármacos , Vías Nerviosas/fisiología , Pruebas Neuropsicológicas/estadística & datos numéricos , Oxígeno/sangreRESUMEN
Hippocampal choline-containing compounds (Cho) determined with 1H MR spectroscopy (MRS) are decreased in major depression episodes and return to baseline levels after antidepressive electroconvulsive therapy (ECT). A rise in hippocampal Cho has been observed in rats upon electroconvulsive shocks (ECS), an analogue of human ECT. Choline production involves the activity of various phospholipases. In order to investigate whether the increase of Cho correlates with an enhanced expression of phosphoslipase A2 (PLA2) we took rectangular tissue samples from the region of the MRS voxel for immunoblotting. Our data show a significant inverse correlation (p = 0.018) between PLA2 protein levels and MRS Cho/NAA levels suggesting a possible downregulation of PLA2 in compensation for an upregulation of other phospholipases.
Asunto(s)
Colina/metabolismo , Terapia Electroconvulsiva/métodos , Hipocampo/metabolismo , Espectroscopía de Resonancia Magnética/métodos , Fosfolipasas A/metabolismo , Animales , Western Blotting/métodos , Masculino , Fosfolipasas A2 , Ratas , Ratas Sprague-DawleyRESUMEN
Principles of negative reinforcement learning may play a critical role in the etiology and treatment of depression. We examined the integrity of positive reinforcement learning in congenitally helpless (cH) rats, an animal model of depression, using a random ratio schedule and a devaluation-extinction procedure. Furthermore, we tested whether an antidepressant dose of the monoamine oxidase (MAO)-B inhibitor deprenyl would reverse any deficits in positive reinforcement learning. We found that cH rats (n=9) were impaired in the acquisition of even simple operant contingencies, such as a fixed interval (FI) 20 schedule. cH rats exhibited no apparent deficits in appetite or reward sensitivity. They reacted to the devaluation of food in a manner consistent with a dose-response relationship. Reinforcer motivation as assessed by lever pressing across sessions with progressively decreasing reward probabilities was highest in congenitally non-helpless (cNH, n=10) rats as long as the reward probabilities remained relatively high. cNH compared to wild-type (n=10) rats were also more resistant to extinction across sessions. Compared to saline (n=5), deprenyl (n=5) reduced the duration of immobility of cH rats in the forced swimming test, indicative of antidepressant effects, but did not restore any deficits in the acquisition of a FI 20 schedule. We conclude that positive reinforcement learning was impaired in rats bred for helplessness, possibly due to motivational impairments but not deficits in reward sensitivity, and that deprenyl exerted antidepressant effects but did not reverse the deficits in positive reinforcement learning.
Asunto(s)
Antidepresivos/farmacología , Trastorno Depresivo/tratamiento farmacológico , Desamparo Adquirido , Discapacidades para el Aprendizaje/tratamiento farmacológico , Nootrópicos/farmacología , Selegilina/farmacología , Animales , Apetito , Condicionamiento Operante/efectos de los fármacos , Modelos Animales de Enfermedad , Extinción Psicológica , Masculino , Inhibidores de la Monoaminooxidasa/farmacología , Motivación/efectos de los fármacos , Motivación/fisiología , Actividad Motora/efectos de los fármacos , Ratas Sprague-Dawley , Refuerzo en Psicología , Resiliencia Psicológica/efectos de los fármacos , Especificidad de la EspecieRESUMEN
Some individuals are resilient, whereas others succumb to despair in repeated stressful situations. The neurobiological mechanisms underlying such divergent behavioral responses remain unclear. Here, we employed an automated method for mapping neuronal activity in search of signatures of stress responses in the entire mouse brain. We used serial two-photon tomography to detect expression of c-FosGFP - a marker of neuronal activation - in c-fosGFP transgenic mice subjected to the learned helplessness (LH) procedure, a widely used model of stress-induced depression-like phenotype in laboratory animals. We found that mice showing "helpless" behavior had an overall brain-wide reduction in the level of neuronal activation compared with mice showing "resilient" behavior, with the exception of a few brain areas, including the locus coeruleus, that were more activated in the helpless mice. In addition, the helpless mice showed a strong trend of having higher similarity in whole-brain activity profile among individuals, suggesting that helplessness is represented by a more stereotypic brain-wide activation pattern. This latter effect was confirmed in rats subjected to the LH procedure, using 2-deoxy-2[18F]fluoro-D-glucose positron emission tomography to assess neural activity. Our findings reveal distinct brain activity markings that correlate with adaptive and maladaptive behavioral responses to stress, and provide a framework for further studies investigating the contribution of specific brain regions to maladaptive stress responses.