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Maddern XJ, Walker LC, Anversa RG, Lawrence AJ, Campbell EJ. Understanding sex differences and the translational value of models of persistent substance use despite negative consequences. Neurobiol Learn Mem 2024:107944. [PMID: 38825163 DOI: 10.1016/j.nlm.2024.107944] [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: 01/28/2024] [Revised: 05/14/2024] [Accepted: 05/27/2024] [Indexed: 06/04/2024]
Abstract
Persistent substance use despite negative consequences is a key facet of substance use disorder. The last decade has seen the preclinical field adopt the use of punishment to model adverse consequences associated with substance use. This has largely involved the pairing of drug use with either electric foot shock or quinine, a bitter tastant. Whilst at face value, these punishers may model aspects of the physical and psychological consequences of substance use, such models are yet to assist the development of approved medications for treatment. This review discusses progress made with animal models of punishment to understand the behavioral consequences of persistent substance use despite negative consequences. We highlight the importance of examining sex differences, especially when the behavioral response to punishment changes following drug exposure. Finally, we critique the translational value these models provide for the substance use disorder field.
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Affiliation(s)
- Xavier J Maddern
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia; Florey Department of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia
| | - Leigh C Walker
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia; Florey Department of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia
| | - Roberta G Anversa
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia; Florey Department of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia; Florey Department of Neuroscience and Mental Health, University of Melbourne, VIC, 3010, Australia
| | - Erin J Campbell
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Brain Neuromodulation Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
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Mulloy SM, Aback EM, Gao R, Engel S, Pawaskar K, Win C, Moua A, Hillukka L, Lee AM. Subregion and sex differences in ethanol activation of cholinergic and glutamatergic cells in the mesopontine tegmentum. Sci Rep 2024; 14:46. [PMID: 38168499 PMCID: PMC10762073 DOI: 10.1038/s41598-023-50526-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Ethanol engages cholinergic signaling and elicits endogenous acetylcholine release. Acetylcholine input to the midbrain originates from the mesopontine tegmentum (MPT), which is composed of the laterodorsal tegmentum (LDT) and the pedunculopontine tegmental nucleus (PPN). We investigated the effect of acute and chronic ethanol administration on cholinergic and glutamatergic neuron activation in the PPN and LDT in male and female mice. We show that ethanol activates neurons of the PPN and not the LDT in male mice. Chronic 15 daily injections of 2 g/kg ethanol induced Fos expression in cholinergic and glutamatergic PPN neurons in male mice, whereas ethanol did not increase cholinergic and glutamatergic neuronal activation in the LDT. A single acute 4 g/kg injection, but not a single 2 g/kg injection, induced cholinergic neuron activation in the male PPN but not the LDT. In contrast, acute or chronic ethanol at either dose or duration had no effect on the activation of cholinergic or glutamatergic neurons in the MPT of female mice. Female mice had higher baseline level of activation in cholinergic neurons compared with males. We also found a population of co-labeled cholinergic and glutamatergic neurons in the PPN and LDT which were highly active in the saline- and ethanol-treated groups in both sexes. These findings illustrate the complex differential effects of ethanol across dose, time point, MPT subregion and sex.
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Affiliation(s)
- S M Mulloy
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - E M Aback
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - R Gao
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - S Engel
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - K Pawaskar
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - C Win
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - A Moua
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - L Hillukka
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - A M Lee
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA.
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3
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Mulloy SM, Aback EM, Gao R, Engel S, Pawaskar K, Win C, Moua A, Hillukka L, Lee AM. Subregion and sex differences in ethanol activation of cholinergic and glutamatergic cells in the mesopontine tegmentum. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.08.566053. [PMID: 38014248 PMCID: PMC10680559 DOI: 10.1101/2023.11.08.566053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Ethanol engages cholinergic signaling and elicits endogenous acetylcholine release. Acetylcholine input to the midbrain originates from the mesopontine tegmentum (MPT), which is composed of the laterodorsal tegmentum (LDT) and the pedunculopontine tegmental nucleus (PPN). We investigated the effect of acute and chronic ethanol administration on cholinergic and glutamatergic neuron activation in the PPN and LDT in male and female mice. We show that ethanol selectively activates neurons of the PPN and not the LDT in male mice. Acute 4.0 g/kg and chronic 15 daily injections of 2.0 g/kg i.p. ethanol induced Fos expression in cholinergic and glutamatergic PPN neurons in male mice, whereas cholinergic and glutamatergic neurons of the LDT were unresponsive. In contrast, acute or chronic ethanol at either dose or duration had no effect on the activation of cholinergic or glutamatergic neurons in the MPT of female mice. Female mice had higher level of baseline activation in cholinergic neurons compared with males. We also found a population of co-labeled cholinergic and glutamatergic neurons in the PPN and LDT which were highly active in the saline- and ethanol-treated groups in both sexes. These findings illustrate the complex differential effects of ethanol across dose, time point, MPT subregion and sex.
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Affiliation(s)
- S M Mulloy
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - E M Aback
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - R Gao
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - S Engel
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - K Pawaskar
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - C Win
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - A Moua
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - L Hillukka
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - A M Lee
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, USA
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
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Arnold ME, Schank JR. Aversion-associated drug and alcohol seeking in females. Front Neuroendocrinol 2023; 71:101095. [PMID: 37558185 DOI: 10.1016/j.yfrne.2023.101095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 08/11/2023]
Abstract
Compulsive drug intake is characterized by the continuation of use regardless of negative consequences. This is modeled preclinically using procedures where a negative stimulus is delivered contingently with consumption of the reinforcer. In humans, women and men exhibit different drug taking behavior as it pertains to overall use, withdrawal symptoms, and rate of dependence. In substance use research, females have often been excluded from many studies due to concerns that circulating sex hormones may affect drug seeking behavior. However, the more recent inclusion of females in preclinical studies has identified interesting sex differences in aversion-resistant intake of drugs and alcohol. This review will serve to summarize key findings in aversion-related intake of alcohol, psychostimulants, and opioids in females by examining studies that have included female subjects. Further discussion will examine the effect of intake model, neuroanatomical pathways, and sex hormones in the expression of aversion-resistant drug and alcohol consumption.
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Affiliation(s)
- Miranda E Arnold
- Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Jesse R Schank
- Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
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Sneddon EA, Fennell KA, Bhati S, Setters JE, Schuh KM, DeMedio JN, Arnold BJ, Monroe SC, Quinn JJ, Radke AK. Greater resistance to footshock punishment in female C57BL/6J mice responding for ethanol. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:678-686. [PMID: 36822578 PMCID: PMC10149597 DOI: 10.1111/acer.15039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/11/2023] [Accepted: 02/09/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND One characteristic of alcohol use disorder is compulsive drinking or drinking despite negative consequences. When quinine is used to model such aversion-resistant drinking, female rodents typically are more resistant to punishment than males. Using an operant response task where C57BL/6J responded for ethanol mixed with quinine, we previously demonstrated that female mice tolerate higher concentrations of quinine in ethanol than males. Here, we aimed to determine whether this female vulnerability to aversion-resistant drinking behavior is similarly observed with footshock punishment. METHODS Male and female C57BL/6J mice were trained to respond for 10% ethanol in an operant task on a fixed-ratio three schedule. After consistent responding, mice were tested in a punishment session using either a 0.25 mA or 0.35 milliamp (mA) footshock. To assess footshock sensitivity, a subset of mice underwent a flinch, jump, and vocalize test in which behavioral responses to increasing amplitudes of footshock (0.05 to 0.95 mA) were assessed. In a separate cohort of mice, males and females were trained to respond for 2.5% sucrose and responses were punished using a 0.25 mA footshock. RESULTS Males and females continued to respond for 10% ethanol when paired with a 0.25 mA footshock. Females alone continued to respond for ethanol when a 0.35 mA footshock was delivered. Both males and females reduced responding for 2.5% sucrose when punished with a 0.25 mA footshock. Footshock sensitivity in the flinch, jump, and vocalize test did not differ by sex. CONCLUSIONS Females continue to respond for 10% ethanol despite a 0.35 mA footshock, and this behavior is not due to differences in footshock sensitivity between males and females. These results show that female C57BL/6J mice are generally more resistant to punishment in an operant self-administration paradigm. The findings add to the literature characterizing aversion-resistant alcohol-drinking behaviors in females.
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Affiliation(s)
- Elizabeth A. Sneddon
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Kaila A. Fennell
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Sachi Bhati
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Joshua E. Setters
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Kristen M. Schuh
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Jenelle N. DeMedio
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Brandon J. Arnold
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Sean C. Monroe
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Jennifer J. Quinn
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Anna K. Radke
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
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Echeveste Sanchez M, Quadir SG, Whindleton CM, Hoffman JL, Faccidomo SP, Guhr Lee TN, Esther CR, Hodge CW, Herman MA. The effects of electronic nicotine vapor on voluntary alcohol consumption in female and male C57BL/6 J mice. Drug Alcohol Depend 2022; 241:109676. [PMID: 36343590 PMCID: PMC9979979 DOI: 10.1016/j.drugalcdep.2022.109676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022]
Abstract
SIGNIFICANCE Alcohol drinking and nicotine vaping often co-occur and dependence on both substances is common. However, the impact of nicotine vaping on alcohol consumption is not fully understood. METHODS We examined the effects of nicotine vaping on ethanol drinking in female and male C57BL/6 J mice using an electronic nicotine delivery system and intermittent access two-bottle choice (IA-2BC) drinking. Mice were exposed to electronic nicotine vapor (3%) or propylene glycol/vegetable glycerol (PG/VG) control for 3 h sessions daily for 4 weeks and voluntary alcohol consumption was monitored. Nicotine vapor exposure was stopped and voluntary alcohol drinking was measured for a 2 week abstinence period. We also examined the effects of alcohol and nicotine on locomotion, temperature, and nicotine metabolism. RESULTS Following acute nicotine vapor exposure, alcohol drinking was increased in males but not in females. Thermoregulation was disrupted following nicotine vapor exposure and voluntary drinking. Male and female mice displayed increased locomotor activity immediately following chronic nicotine vapor exposure, and an anxiolytic effect was seen in males. In nicotine vapor abstinence, female mice displayed increased alcohol consumption. Locomotor activity and anxiolytic effects remained elevated in male but not female mice. Female mice displayed higher levels of serum nicotine and hydroxycotinine, suggesting impaired metabolism following chronic drinking and nicotine vapor exposure. CONCLUSION Collectively, these results suggest that while both male and female ethanol-drinking mice experience the stimulatory effects of nicotine vapor, only in males is there a parallel increase in ethanol drinking and only females display impairments in nicotine metabolism after drinking.
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Affiliation(s)
- M Echeveste Sanchez
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - S G Quadir
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - C M Whindleton
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - J L Hoffman
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - S P Faccidomo
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - T N Guhr Lee
- Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Division of Pediatric Pulmonology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - C R Esther
- Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Division of Pediatric Pulmonology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - C W Hodge
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - M A Herman
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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7
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Carpio MJ, Gao R, Wooner E, Cayton CA, Richard JM. Alcohol availability during withdrawal gates the impact of alcohol vapor exposure on responses to alcohol cues. Psychopharmacology (Berl) 2022; 239:3103-3116. [PMID: 35881146 PMCID: PMC9526241 DOI: 10.1007/s00213-022-06192-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/08/2022] [Indexed: 11/27/2022]
Abstract
RATIONALE Chronic intermittent ethanol (CIE) vapor inhalation is a widely used model of alcohol dependence, but the impact of CIE on cue-elicited alcohol seeking is poorly understood. OBJECTIVE Here, we assessed the effects of CIE on alcohol-seeking elicited by cues paired with alcohol before or after CIE vapor inhalation. METHODS In experiment 1, male and female Long-Evans rats were trained in a discriminative stimulus (DS) task, in which one auditory cue (the DS) predicts the availability of 15% ethanol and a control cue (the NS) predicts no ethanol. Rats then underwent CIE or served as controls. Subsets of each group received access to oral ethanol twice a week during acute withdrawal. After CIE, rats were presented with the DS and NS cues under extinction and retraining conditions to determine whether they would alter their responses to these cues. In experiment 2, rats underwent CIE prior to training in the DS task. RESULTS CIE enhanced behavioral responses to cues previously paired with alcohol, but only in rats that received access to alcohol during acute withdrawal. When CIE occurred before task training, male rats were slower to develop cue responses and less likely to enter the alcohol port, even though they had received alcohol during acute withdrawal. CONCLUSIONS These results suggest that CIE vapor inhalation alone does not potentiate the motivational value of alcohol cues but that an increase in cue responses requires alcohol experience during acute withdrawal. Furthermore, under some conditions, CIE may disrupt responses to alcohol-paired cues.
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Affiliation(s)
- M J Carpio
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, 55415, USA
- Medical Discovery Team On Addiction, University of Minnesota, Minneapolis, MN, 55415, USA
| | - Runbo Gao
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, 55415, USA
- Medical Discovery Team On Addiction, University of Minnesota, Minneapolis, MN, 55415, USA
| | - Erica Wooner
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, 55415, USA
- Medical Discovery Team On Addiction, University of Minnesota, Minneapolis, MN, 55415, USA
| | - Christelle A Cayton
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, 55415, USA
- Medical Discovery Team On Addiction, University of Minnesota, Minneapolis, MN, 55415, USA
| | - Jocelyn M Richard
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, 55415, USA.
- Medical Discovery Team On Addiction, University of Minnesota, Minneapolis, MN, 55415, USA.
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Stinson BT, Galbo LK, Flynn SM, Gouin A, Epperly PM, Davenport AT, Czoty PW. Punishment of ethanol choice in rhesus monkeys. Behav Pharmacol 2022; 33:395-401. [PMID: 35942846 PMCID: PMC9373234 DOI: 10.1097/fbp.0000000000000683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A defining characteristic of individuals diagnosed with alcohol use disorder (AUD) is that negative outcomes related to drinking do not lead them to reduce their alcohol use. In rodent models of AUD, this characteristic has been studied by adding the bitter tastant quinine to an ethanol solution. In this study, we extended this approach to a nonhuman primate model in which the ability of quinine to decrease the choice of a 4% ethanol solution vs. water was measured. Five adult female rhesus monkeys with 7.3 years of experience drinking ethanol were given access to a 4% ethanol solution and water for 3 h per day. When ethanol choice was stable, a single quinine concentration (0.03-5.6 g /L) was added to the ethanol solution for 1 day until a quinine concentration-effect curve was generated. After determining the quinine concentration that reduced ethanol choice by half (the quinine EC 50 ), the relative reinforcing strength of ethanol was manipulated by adding quinine or sucrose to the water alternative depending on the monkey's baseline choice. Adding quinine to ethanol produced a concentration-dependent decrease in ethanol choice and intake. Importantly, water intake increased, indicating an effect on response allocation rather than simply a decrease in fluid consumption. Consistent with this conclusion, the addition of quinine or sucrose to the water alternative resulted in predictable increases and decreases, respectively, in ethanol choice. These studies establish a model of punishment of ethanol choice in nonhuman primates that can be used to understand the contextual, biologic and pharmacologic factors that influence sensitivity to the punishment of alcohol drinking.
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Affiliation(s)
- Benjamin T Stinson
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Katner SN, Sentir AM, Steagall KB, Ding ZM, Wetherill L, Hopf FW, Engleman EA. Modeling Aversion Resistant Alcohol Intake in Indiana Alcohol-Preferring (P) Rats. Brain Sci 2022; 12:brainsci12081042. [PMID: 36009105 PMCID: PMC9406111 DOI: 10.3390/brainsci12081042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 12/26/2022] Open
Abstract
With the substantial social and medical burden of addiction, there is considerable interest in understanding risk factors that increase the development of addiction. A key feature of alcohol use disorder (AUD) is compulsive alcohol (EtOH) drinking, where EtOH drinking becomes “inflexible” after chronic intake, and animals, such as humans with AUD, continue drinking despite aversive consequences. Further, since there is a heritable component to AUD risk, some work has focused on genetically-selected, EtOH-preferring rodents, which could help uncover critical mechanisms driving pathological intake. In this regard, aversion-resistant drinking (ARD) takes >1 month to develop in outbred Wistar rats (and perhaps Sardinian-P EtOH-preferring rats). However, ARD has received limited study in Indiana P-rats, which were selected for high EtOH preference and exhibit factors that could parallel human AUD (including front-loading and impulsivity). Here, we show that P-rats rapidly developed compulsion-like responses for EtOH; 0.4 g/L quinine in EtOH significantly reduced female and male intake on the first day of exposure but had no effect after one week of EtOH drinking (15% EtOH, 24 h free-choice paradigm). Further, after 4−5 weeks of EtOH drinking, males but not females showed resistance to even higher quinine (0.5 g/L). Thus, P-rats rapidly developed ARD for EtOH, but only males developed even stronger ARD with further intake. Finally, rats strongly reduced intake of quinine-adulterated water after 1 or 5 weeks of EtOH drinking, suggesting no changes in basic quinine sensitivity. Thus, modeling ARD in P-rats may provide insight into mechanisms underlying genetic predispositions for compulsive drinking and lead to new treatments for AUDs.
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Affiliation(s)
- Simon N. Katner
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Alena M. Sentir
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Kevin B. Steagall
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Zheng-Ming Ding
- Departments of Anesthesiology and Perioperative Medicine and Pharmacology, Pennsylvania State University College of Medicine, 700 HMC Crescent Road, Hershey, PA 17033, USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Frederic W. Hopf
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Eric A. Engleman
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Correspondence:
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10
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Banna FKE, Otto JM, Mulloy SM, Tsai W, McElroy SM, Wong AL, Cutts G, Vrieze SI, Lee AM. Back-translating GWAS findings to animal models reveals a role for Hgfac and Slc39a8 in alcohol and nicotine consumption. Sci Rep 2022; 12:9336. [PMID: 35661789 PMCID: PMC9167284 DOI: 10.1038/s41598-022-13283-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
Alcohol and tobacco are the most commonly used addictive substances, with high comorbidity rates between alcohol use disorder and tobacco use disorder. Risk for alcohol and nicotine addiction is highly heritable, and they share common genetic factors. A GWAS in over 1 million individuals has revealed 566 genetic variants in 406 loci associated with multiple stages of alcohol and tobacco use. Three novel genes-SLC39A8, GRK4 and HGFAC-within loci associated with altered alcoholic drinks per week (ADW) or cigarettes per day (CPD) were selected to further study their role in alcohol and tobacco use disorder. The role of these genes was assessed using the two-bottle choice addiction paradigm in transgenic mice for each of the genes. We found significant decreases in chronic alcohol consumption and preference in female Hgfac knockout (KO) mice, and decreased nicotine preference in male Hgfac KO compared with wild-type (WT) mice. Additionally, male Slc39a8 hypomorph mice showed greater overall nicotine preference compared with WT mice, while no differences were detected for Grk4 KO mice in alcohol or nicotine consumption and preference in either sex. Thus, this study implicates Hgfac and Slc39a8 in alcohol and tobacco use in a sex-specific manner.
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Affiliation(s)
- F K El Banna
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA.,Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - J M Otto
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - S M Mulloy
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - W Tsai
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - S M McElroy
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - A L Wong
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - G Cutts
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - S I Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - A M Lee
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA.
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Hu X, Zhang T, Ma H, Zhou X, Wang H, Wang X, Cheng C, Li Y, Duan R, Zhang B, Wang H, Lu J, Kang C, Zhao N, Zhang Y, Tian L, Liu J, Shi J, Wang Z, Zhou X, Zhu S, Liu Q, Li X, Wang H, Nie M, Yang M, Yang J, Chi Y, Zhu X, Hu J, Jia Y, Peng Y, Liu L. Repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy treatment in alcohol-dependent patients: A randomized, double-blind sham-controlled multicenter clinical trial. Front Psychiatry 2022; 13:935491. [PMID: 36299538 PMCID: PMC9590282 DOI: 10.3389/fpsyt.2022.935491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol dependence (AD) is a complex addictive disorder with a high relapse rate. Previous studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioral therapy (CBT) may be effective for AD, and we aim to explore more effective treatment options to reduce relapse rates for AD. MATERIALS AND METHODS A total of 263 AD patients were recruited. They were divided into six groups according to the location and the type of rTMS: left dorsolateral prefrontal cortex (DLPFC), right DLPFC, sham stimulation, and whether they received CBT treatment: with a fixed schedule (C1) and without a fixed plan (C0). There were included in sham rTMS + C0 group (n = 50), sham rTMS + C1 group (n = 37), right rTMS + C0 group (n = 45), right rTMS + C1 group (n = 42), left rTMS + C0 group (n = 49), left rTMS + C1 group (n = 40). We used obsessive compulsive drinking scale (OCDS), visual analogue scale (VAS), alcohol dependence scale (ADS), montreal cognitive assessment (MoCA), generalized anxiety disorder-7 (GAD-7), patient health questionnaire-9 items (PHQ-9), and Pittsburgh sleep quality index (PSQI) to assess alcohol cravings, alcohol dependence, cognition, anxiety, depression, and sleep quality. They were followed up and evaluated for relapse. RESULTS The sham rTMS + C0 group relapse rate was significantly higher than the right rTMS + C1 group (P = 0.006), the left rTMS + C0 group (P = 0.031), the left rTMS + C1 group (P = 0.043). The right rTMS + C0 group showed significantly higher relapse rate compared to the right rTMS + C1 group (P = 0.046). There was no significant difference in relapse rates between other groups. The repeated-measures ANOVA showed an interaction effect between group and time was significant in the rate of patient health questionnaire-9 items (PHQ-9) scale reduction (P = 0.020). Logistic analysis indicated that smoking and alcohol consumption were independent determinants of relapse (P < 0.05). At 24 weeks of follow-up, Kaplan-Meier survival analysis reveal that there is statistically significant relapse rate between six groups (P = 0.025), left rTMS + C1 group has the best treatment effect for alcohol dependent patients. Cox regression analysis confirmed that current smoking, total cholesterol, and total bilirubin (TBIL) level were risk factors of relapse (P < 0.05). CONCLUSION This study is the first to suggest that the combination of rTMS and CBT may be a potentially effective treatment for reducing relapse.
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Affiliation(s)
- Xiaorui Hu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Tian Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongkun Ma
- Department of Epidemiology and Health Statistics, Mudanjiang Medical University, Mudanjiang, China
| | - Xuhui Zhou
- Hunan Provincial Brain Hospital, Changsha, China
| | - Hongxuan Wang
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaohong Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chang Cheng
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanfei Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ranran Duan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Zhang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Huaizhi Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jia Lu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chuanyi Kang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Na Zhao
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yingjie Zhang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Lu Tian
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jun Liu
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Jingjing Shi
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhe Wang
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Xinxin Zhou
- The First Psychiatric Hospital of Harbin, Harbin, China
| | - Shuang Zhu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Qingxia Liu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xuemin Li
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Honghui Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Mingxuan Nie
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Mei Yang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Jianzhong Yang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yong Chi
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiaofeng Zhu
- Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, China
| | - Jian Hu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanjie Jia
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Peng
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Liu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Moen JK, Lee AM. Sex Differences in the Nicotinic Acetylcholine Receptor System of Rodents: Impacts on Nicotine and Alcohol Reward Behaviors. Front Neurosci 2021; 15:745783. [PMID: 34621155 PMCID: PMC8490611 DOI: 10.3389/fnins.2021.745783] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/31/2021] [Indexed: 12/20/2022] Open
Abstract
Alcohol and nicotine are the two most widely used and misused drugs around the world, and co-consumption of both substances is highly prevalent. Multiple lines of evidence show a profound effect of sex in many aspects of alcohol and nicotine reward, with women having more difficulty quitting smoking and showing a faster progression toward developing alcohol use disorder compared with men. Both alcohol and nicotine require neuronal nicotinic acetylcholine receptors (nAChRs) to elicit rewarding effects within the mesolimbic system, representing a shared molecular pathway that likely contributes to the frequent comorbidity of alcohol and nicotine dependence. However, the majority of preclinical studies on the mechanisms of alcohol and nicotine reward behaviors utilize only male rodents, and thus our understanding of alcohol and nicotine neuropharmacology relies heavily on male data. As preclinical research informs the development and refinement of therapies to help patients reduce drug consumption, it is critical to understand the way biological sex and sex hormones influence the rewarding properties of alcohol and nicotine. In this review, we summarize what is known about sex differences in rodent models of alcohol and nicotine reward behaviors with a focus on neuronal nAChRs, highlighting exciting areas for future research. Additionally, we discuss the way circulating sex hormones may interact with neuronal nAChRs to influence reward-related behavior.
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Affiliation(s)
- Janna K Moen
- Graduate Program in Neuroscience, University of Minnesota Twin Cities, Minneapolis, MN, United States
| | - Anna M Lee
- Graduate Program in Neuroscience, University of Minnesota Twin Cities, Minneapolis, MN, United States.,Department of Pharmacology, University of Minnesota Twin Cities, Minneapolis, MN, United States
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13
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Electronic Nicotine Vapor Exposure Produces Differential Changes in Central Amygdala Neuronal Activity, Thermoregulation and Locomotor Behavior in Male Mice. eNeuro 2021; 8:ENEURO.0189-21.2021. [PMID: 34321216 PMCID: PMC8362686 DOI: 10.1523/eneuro.0189-21.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/22/2022] Open
Abstract
Nicotine is an addictive substance historically consumed through smoking and more recently through the use of electronic vapor devices. The increasing prevalence and popularity of vaping prompts the need for preclinical rodent models of nicotine vapor exposure and an improved understanding of the impact of vaping on specific brain regions, bodily functions, and behaviors. We used a rodent model of electronic nicotine vapor exposure to examine the cellular and behavioral consequences of acute and repeated vapor exposure. Adult male C57BL/6J mice were exposed to a single 3-h session (acute exposure) or five daily sessions (repeated exposure) of intermittent vapes of 120 mg/ml nicotine in propylene glycol:vegetable glycerol (PG/VG) or PG/VG control. Acute and repeated nicotine vapor exposure did not alter body weight, and both exposure paradigms produced pharmacologically significant serum nicotine and cotinine levels in the 120 mg/ml nicotine group compared with PG/VG controls. Acute exposure to electronic nicotine vapor increased central amygdala (CeA) activity in individual neuronal firing and in expression of the molecular activity marker, cFos. The changes in neuronal activity following acute exposure were not observed following repeated exposure. Acute and repeated nicotine vapor exposure decreased core body temperature, however acute exposure decreased locomotion while repeated exposure increased locomotion. Collectively, these studies provide validation of a mouse model of nicotine vapor exposure and important evidence for how exposure to electronic nicotine vapor produces differential effects on CeA neuronal activity and on specific body functions and behaviors like thermoregulation and locomotion.
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Radke AK, Sneddon EA, Frasier RM, Hopf FW. Recent Perspectives on Sex Differences in Compulsion-Like and Binge Alcohol Drinking. Int J Mol Sci 2021; 22:ijms22073788. [PMID: 33917517 PMCID: PMC8038761 DOI: 10.3390/ijms22073788] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/29/2022] Open
Abstract
Alcohol use disorder remains a substantial social, health, and economic problem and problem drinking levels in women have been increasing in recent years. Understanding whether and how the underlying mechanisms that drive drinking vary by sex is critical and could provide novel, more targeted therapeutic treatments. Here, we examine recent results from our laboratories and others which we believe provide useful insights into similarities and differences in alcohol drinking patterns across the sexes. Findings for binge intake and aversion-resistant, compulsion-like alcohol drinking are considered, since both are likely significant contributors to alcohol problems in humans. We also describe studies regarding mechanisms that may underlie sex differences in maladaptive alcohol drinking, with some focus on the importance of nucleus accumbens (NAcb) core and shell regions, several receptor types (dopamine, orexin, AMPA-type glutamate), and possible contributions of sex hormones. Finally, we discuss how stressors such as early life stress and anxiety-like states may interact with sex differences to contribute to alcohol drinking. Together, these findings underscore the importance and critical relevance of studying female and male mechanisms for alcohol and co-morbid conditions to gain a true and clinically useful understanding of addiction and neuropsychiatric mechanisms and treatment.
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Affiliation(s)
- Anna K. Radke
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH 45040, USA;
- Correspondence:
| | - Elizabeth A. Sneddon
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH 45040, USA;
| | - Raizel M. Frasier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (R.M.F.); (F.W.H.)
| | - Frederic W. Hopf
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (R.M.F.); (F.W.H.)
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15
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Abstract
Animal models of addictive behaviors are useful for uncovering neural mechanisms involved in the development of dependence and for identifying risk factors for drug abuse. One such risk factor is biological sex, which strongly moderates drug self-administration behavior in rodents. Female rodents are more likely to acquire drug self-administration behaviors, consume higher amounts of drug, and reinstate drug-seeking behavior more readily. Despite this female vulnerability, preclinical addiction research has largely been done in male animals. The study of sex differences in rodent models of addictive behavior is increasing, however, as more investigators are choosing to include both male and female animals in experiments. This commentary is meant to serve as an introductory guide for preclinical investigators new to the study of sex differences in addiction. We provide an overview of self-administration models, a broad view of female versus male self-administration behaviors, and suggestions for study design and implementation. Inclusion of female subjects in preclinical addiction research is timely, as problem drug and alcohol use in women is increasing. With proper attention, design, and analysis, the study of sex differences in addiction has the potential to uncover novel neural mechanisms and lead to greater translational success for addiction research. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Anna K. Radke
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, Ohio
| | - Elizabeth A. Sneddon
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, Ohio
| | - Sean C. Monroe
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, Ohio
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16
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Sneddon EA, Ramsey OR, Thomas A, Radke AK. Increased Responding for Alcohol and Resistance to Aversion in Female Mice. Alcohol Clin Exp Res 2020; 44:1400-1409. [PMID: 32472651 DOI: 10.1111/acer.14384] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND More women are being diagnosed with alcohol use disorder (AUD), are increasing the amount of alcohol they are drinking, and are partaking in risky drinking behaviors. Compulsive drinking which persists despite negative consequences is a hallmark of AUD. Preclinical aversion-resistant models suggest that females may be more vulnerable to the rewarding effects of alcohol such that they show increased compulsivity when drinking is punished with quinine, a bitter tastant. METHODS Male and female C57BL/6J mice were trained in an operant response task on a first-order fixed ratio schedule. Experiment 1 tested responding for escalating concentrations (10 to 25%) of ethanol (EtOH). Experiment 2 assessed the effects of increasing concentrations of quinine (100, 250, or 500 μM) on responding for 10% EtOH followed by a 48-hour 2-bottle choice quinine preference test. Experiment 3 investigated the effects of increasing concentrations of quinine (100, 250, or 500 μM) on responding for 2.5% sucrose. RESULTS Experiment 1 revealed that females respond more than males for 15% EtOH. Experiment 2 showed that females tolerate higher concentrations of quinine in EtOH than males. Males reduced responding for 10% EtOH when adulterated with 250 or 500 µM of quinine, while females did not reduce responding at any concentration of quinine. Males and females also exhibited similar preference for quinine in a 2-bottle drinking task. Experiment 3 demonstrated that both males and females reduced responding for 2.5% sucrose when quinine (100, 250, or 500 μM) was added. CONCLUSIONS Females respond more for EtOH at higher concentrations and continue to respond for 10% EtOH at all concentrations of quinine, suggesting that female mice are more motivated to respond for EtOH in an operant self-administration paradigm than males. Understanding behavioral and mechanistic sex differences in responding for alcohol will allow for the advancement of treatments for women with AUD.
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Affiliation(s)
- Elizabeth A Sneddon
- From the Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, Ohio, USA
| | - Olivia R Ramsey
- From the Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, Ohio, USA
| | - Annemarie Thomas
- From the Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, Ohio, USA
| | - Anna K Radke
- From the Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, Ohio, USA
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