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Azmy Nabeh O, Amr A, Faoosa AM, Esmat E, Osama A, Khedr AS, Amin B, Saud AI, Elmorsy SA. Emerging Perspectives on the Impact of Diabetes Mellitus and Anti-Diabetic Drugs on Premenstrual Syndrome. A Narrative Review. Diabetes Ther 2024; 15:1279-1299. [PMID: 38668996 PMCID: PMC11096298 DOI: 10.1007/s13300-024-01585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
Diabetes mellitus (DM) and premenstrual syndrome (PMS) are global health challenges. Both disorders are often linked to a range of physical and psychological symptoms that significantly impact the quality of life of many women. Yet, the exact relation between DM and PMS is not clear, and the management of both conditions poses a considerable challenge. In this review, we aimed to investigate the interplay between DM, anti-diabetic drugs, and the different theories and symptoms of PMS. Female sex hormones are implicated in the pathophysiology of PMS and can also impair blood glucose control. In addition, patients with diabetes face a higher susceptibility to anxiety and depression disorders, with a significant number of patients experiencing symptoms such as fatigue and difficulty concentrating, which are reported in patients with PMS as well. Complications related to diabetic medications, such as hypoglycemia (with sulfonylurea) and fluid retention (with thiazolidinediones) may also mediate PMS-like symptoms. DM can, in addition, disturb the normal gut microbiota (GM), with a consequent loss of beneficial GM metabolites that guard against PMS, particularly the short-chain fatty acids and serotonin. Among the several available anti-diabetic drugs, those (1) with an anti-inflammatory potential, (2) that can preserve the beneficial GM, and (3) possessing a lower risk for hypoglycemia, might have a favorable outcome in PMS women. Yet, well-designed clinical trials are needed to investigate the anti-diabetic drug(s) of choice for patients with diabetes and PMS.
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Affiliation(s)
- Omnia Azmy Nabeh
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Alaa Amr
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Eshraka Esmat
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alaa Osama
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Basma Amin
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alaa I Saud
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
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2
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Lyu H, Zhao M, Xu P, Li Y, Jiang C, Zhao H, Shen W, Hu X, Wang K, Xu Y, Huang M. Gender differences in brain region activation during verbal fluency task as detected by fNIRS in patients with depression. World J Biol Psychiatry 2024; 25:141-150. [PMID: 37998167 DOI: 10.1080/15622975.2023.2287735] [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: 07/24/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Gender plays a role in the mechanisms of depression, but fewer studies have focused on gender differences in the abnormal activation of brain regions when patients perform specific cognitive tasks. METHODS A total of 110 major depressive disorder (MDD) patients and 106 healthy controls were recruited. The relative change in oxygen-haemoglobin (oxy-Hb) concentration during the verbal fluency task were measured by a 52-channel near-infra-red spectroscopy (NIRS) system. Differences in brain region activation between patients and healthy controls and between genders of depression patients were compared. RESULTS MDD patients demonstrated significantly decreased [oxy-Hb] changes in the right inferior frontal gyrus (p = 0.043) compared to healthy controls. A marked increase in leftward functional language lateralisation in the inferior frontal gyrus was observed in the MDD group in contrast to the HC group (p = 0.039). Furthermore, female patients in the MDD group exhibited significant reductions in [oxy-Hb] changes in the right frontal region (specifically, the superior and middle frontal gyrus; p = 0.037) compared with male patients. CONCLUSIONS Gender impacts depression-related brain activation during cognitive tasks, potentially influencing depression's pathogenesis.
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Affiliation(s)
- Hailong Lyu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Miaomiao Zhao
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Pengfeng Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Ying Li
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Chaonan Jiang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Haoyang Zhao
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Wenjing Shen
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Department of Psychiatry, The Second People's Hospital of Lishui, Lishui, China
| | - Xiaohan Hu
- Department of Psychiatry, Wen Zhou seventh People's Hospital, Wenzhou, China
| | - Kaiqi Wang
- Department of Psychiatry, Ningbo Psychiatric Hospital, Ningbo, China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
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3
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Bäckström T, Turkmen S, Das R, Doverskog M, Blackburn TP. The GABA system, a new target for medications against cognitive impairment-Associated with neuroactive steroids. J Intern Med 2023; 294:281-294. [PMID: 37518841 DOI: 10.1111/joim.13705] [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] [Indexed: 08/01/2023]
Abstract
The prevalence of cognitive dysfunction, dementia, and neurodegenerative disorders such as Alzheimer's disease (AD) is increasing in parallel with an aging population. Distinct types of chronic stress are thought to be instrumental in the development of cognitive impairment in central nervous system (CNS) disorders where cognitive impairment is a major unmet medical need. Increased GABAergic tone is a mediator of stress effects but is also a result of other factors in CNS disorders. Positive GABA-A receptor modulating stress and sex steroids (steroid-PAMs) such as allopregnanolone (ALLO) and medroxyprogesterone acetate can provoke impaired cognition. As such, ALLO impairs memory and learning in both animals and humans. In transgenic AD animal studies, continuous exposure to ALLO at physiological levels impairs cognition and increases degenerative AD pathology, whereas intermittent ALLO injections enhance cognition, indicating pleiotropic functions of ALLO. We have shown that GABA-A receptor modulating steroid antagonists (GAMSAs) can block the acute negative cognitive impairment of ALLO on memory in animal studies and in patients with cognitive impairment due to hepatic encephalopathy. Here we describe disorders affected by steroid-PAMs and opportunities to treat these adverse effects of steroid-PAMs with novel GAMSAs.
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Affiliation(s)
| | - Sahruh Turkmen
- Department of Clinical Sciences, University of Umeå, Umeå, Sweden
| | - Roshni Das
- Department of Clinical Sciences, University of Umeå, Umeå, Sweden
- Umecrine Cognition AB, Solna, Sweden
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Yulug B, Altay O, Li X, Hanoglu L, Cankaya S, Lam S, Velioglu HA, Yang H, Coskun E, Idil E, Nogaylar R, Ozsimsek A, Bayram C, Bolat I, Oner S, Tozlu OO, Arslan ME, Hacimuftuoglu A, Yildirim S, Arif M, Shoaie S, Zhang C, Nielsen J, Turkez H, Borén J, Uhlén M, Mardinoglu A. Combined metabolic activators improve cognitive functions in Alzheimer's disease patients: a randomised, double-blinded, placebo-controlled phase-II trial. Transl Neurodegener 2023; 12:4. [PMID: 36703196 PMCID: PMC9879258 DOI: 10.1186/s40035-023-00336-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is associated with metabolic abnormalities linked to critical elements of neurodegeneration. We recently administered combined metabolic activators (CMA) to the AD rat model and observed that CMA improves the AD-associated histological parameters in the animals. CMA promotes mitochondrial fatty acid uptake from the cytosol, facilitates fatty acid oxidation in the mitochondria, and alleviates oxidative stress. METHODS Here, we designed a randomised, double-blinded, placebo-controlled phase-II clinical trial and studied the effect of CMA administration on the global metabolism of AD patients. One-dose CMA included 12.35 g L-serine (61.75%), 1 g nicotinamide riboside (5%), 2.55 g N-acetyl-L-cysteine (12.75%), and 3.73 g L-carnitine tartrate (18.65%). AD patients received one dose of CMA or placebo daily during the first 28 days and twice daily between day 28 and day 84. The primary endpoint was the difference in the cognitive function and daily living activity scores between the placebo and the treatment arms. The secondary aim of this study was to evaluate the safety and tolerability of CMA. A comprehensive plasma metabolome and proteome analysis was also performed to evaluate the efficacy of the CMA in AD patients. RESULTS We showed a significant decrease of AD Assessment Scale-cognitive subscale (ADAS-Cog) score on day 84 vs day 0 (P = 0.00001, 29% improvement) in the CMA group. Moreover, there was a significant decline (P = 0.0073) in ADAS-Cog scores (improvement of cognitive functions) in the CMA compared to the placebo group in patients with higher ADAS-Cog scores. Improved cognitive functions in AD patients were supported by the relevant alterations in the hippocampal volumes and cortical thickness based on imaging analysis. Moreover, the plasma levels of proteins and metabolites associated with NAD + and glutathione metabolism were significantly improved after CMA treatment. CONCLUSION Our results indicate that treatment of AD patients with CMA can lead to enhanced cognitive functions and improved clinical parameters associated with phenomics, metabolomics, proteomics and imaging analysis. Trial registration ClinicalTrials.gov NCT04044131 Registered 17 July 2019, https://clinicaltrials.gov/ct2/show/NCT04044131.
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Affiliation(s)
- Burak Yulug
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Ozlem Altay
- grid.5037.10000000121581746Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Xiangyu Li
- grid.5037.10000000121581746Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Lutfu Hanoglu
- grid.411781.a0000 0004 0471 9346Department of Neurology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Seyda Cankaya
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Simon Lam
- grid.13097.3c0000 0001 2322 6764Centre for Host-Microbiome Interaction’s, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK
| | - Halil Aziz Velioglu
- grid.4714.60000 0004 1937 0626Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden ,grid.411781.a0000 0004 0471 9346Functional Imaging and Cognitive-Affective Neuroscience Lab, Istanbul Medipol University, Istanbul, Turkey
| | - Hong Yang
- grid.5037.10000000121581746Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Ebru Coskun
- grid.411781.a0000 0004 0471 9346Department of Neurology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ezgi Idil
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Rahim Nogaylar
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Ahmet Ozsimsek
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Cemil Bayram
- grid.411445.10000 0001 0775 759XDepartment of Medical Pharmacology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Ismail Bolat
- grid.411445.10000 0001 0775 759XDepartment of Pathology, Veterinary Faculty, Ataturk University, Erzurum, Turkey
| | - Sena Oner
- grid.448691.60000 0004 0454 905XDepartment of Molecular Biology and Genetics, Faculty of Science, Erzurum Technical University, Erzurum, Turkey
| | - Ozlem Ozdemir Tozlu
- grid.448691.60000 0004 0454 905XDepartment of Molecular Biology and Genetics, Faculty of Science, Erzurum Technical University, Erzurum, Turkey
| | - Mehmet Enes Arslan
- grid.448691.60000 0004 0454 905XDepartment of Molecular Biology and Genetics, Faculty of Science, Erzurum Technical University, Erzurum, Turkey
| | - Ahmet Hacimuftuoglu
- grid.411445.10000 0001 0775 759XDepartment of Medical Pharmacology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Serkan Yildirim
- grid.411445.10000 0001 0775 759XDepartment of Pathology, Veterinary Faculty, Ataturk University, Erzurum, Turkey
| | - Muhammad Arif
- grid.5037.10000000121581746Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Saeed Shoaie
- grid.5037.10000000121581746Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden ,grid.13097.3c0000 0001 2322 6764Centre for Host-Microbiome Interaction’s, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK
| | - Cheng Zhang
- grid.5037.10000000121581746Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden ,grid.207374.50000 0001 2189 3846School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Jens Nielsen
- grid.5371.00000 0001 0775 6028Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Hasan Turkez
- grid.411445.10000 0001 0775 759XDepartment of Medical Biology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Jan Borén
- grid.8761.80000 0000 9919 9582Department of Molecular and Clinical Medicine, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mathias Uhlén
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden.
| | - Adil Mardinoglu
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden. .,Centre for Host-Microbiome Interaction's, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
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5
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The role of ovarian hormones in the pathophysiology of perimenopausal sleep disturbances: A systematic review. Sleep Med Rev 2022; 66:101710. [PMID: 36356400 DOI: 10.1016/j.smrv.2022.101710] [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: 05/02/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Sleep disturbance is a common clinical concern throughout the menopausal transition. However, the pathophysiology and causes of these sleep disturbances remain poorly understood, making it challenging to provide appropriate therapy. Our goal was to i) review the literature about the influence of ovarian hormones on sleep in perimenopausal women, ii) summarize the potential underlying pathophysiology of menopausal sleep disturbances and iii) evaluate the implications of these findings for the therapeutic approach to sleep disturbances in the context of menopause. A systematic literature search using the databases Embase, MEDLINE and Cochrane Library was conducted. Keywords relating to ovarian hormones, sleep disturbances and menopause were used. Ultimately, 86 studies were included. Study Quality Assessment Tools of the National Institutes of Health were used for quality assessment. Results from good-quality studies demonstrated that the postmenopausal decline in estrogen and progesterone contributes to sleep disturbances in women and that timely treatment with estrogen and/or progesterone therapy improved overall sleep quality. Direct and indirect effects of both hormones acting in the central nervous system and periphery, as well as via secondary effects (e.g. reduction in vasomotor symptoms), can contribute to improvements in sleep. To strengthen external validity, studies examining neurobiological pathways are needed.
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Das R, Ragagnin G, Sjöstedt J, Johansson M, Haage D, Druzin M, Johansson S, Bäckström T. Medroxyprogesterone acetate positively modulates specific GABA A-receptor subtypes - affecting memory and cognition. Psychoneuroendocrinology 2022; 141:105754. [PMID: 35395561 DOI: 10.1016/j.psyneuen.2022.105754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/14/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022]
Abstract
Medroxyprogesterone acetate (MPA) is a progestin widely used in humans as hormone replacement therapy and at other indications. Many progestin metabolites, as the progesterone metabolite allopregnanolone, have GABAA-receptor modulatory effects and are known to affect memory, learning, appetite, and mood. In women, 4 years chronic treatment with MPA doubles the frequency of dementia and in rats, MPA causes cognitive impairment related to the GABAergic system. Activation of the membrane bound GABAA receptor results in a chloride ion flux that can be studied by whole-cell patch-clamp electrophysiological recordings. The purpose of this study was to clarify the modulatory effects of MPA and specific MPA metabolites, with structures like known GABAA-receptor modulators, on different GABAA-receptor subtypes. An additional aim was to verify the results as steroid effects on GABA response in single cells taken from rat hypothalamus. HEK-293 cell-lines permanently expressing the recombinant human GABAA-receptor subtype α1β2γ2L or α5β3γ2L or α2β3γ2S were created. The MPA metabolites 3α5α-MPA,3β5α-MPA and 3β5β-MPA were synthesised and purified for electrophysiological patch-clamp measurements with a Dynaflow system. The effects of MPA and tetrahydrodeoxycorticosterone were also studied. None of the studied MPA metabolites affected the responses mediated by α1β2γ2L or α5β3γ2L GABAA receptors. Contrary, MPA clearly acted both as a positive modulator and as a direct activator of the α5β3γ2L and α2β3γ2S GABAA receptors. However, in concentrations up to 10 μM, MPA was inactive at the α1β2γ2L GABAA receptor. In the patch-clamp recordings from dissociated cells of the preoptic area in rats, MPA increased the amplitude of responses to GABA. In addition, MPA alone without added GABA, evoked a current response. In conclusion, MPA acts as a positive modulator of specific GABAA receptor subtypes expressed in HEK cells and at native GABA receptors in single cells from the hypothalamic preoptic area.
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Affiliation(s)
- Roshni Das
- Department of Integrative medical biology, Umeå University, SE-901 87 Umeå, Sweden; Umecrine AB, Norrlands University Hospital Umeå, Building 6 M 4th floor, Sweden
| | - Gianna Ragagnin
- Umeå Neurosteroid Research Center, Department of Clinical sciences, Umeå University, SE-901 85 Umeå, Sweden
| | - Jessica Sjöstedt
- Umeå Neurosteroid Research Center, Department of Clinical sciences, Umeå University, SE-901 85 Umeå, Sweden
| | - Maja Johansson
- Umeå Neurosteroid Research Center, Department of Clinical sciences, Umeå University, SE-901 85 Umeå, Sweden; Umecrine AB, Norrlands University Hospital Umeå, Building 6 M 4th floor, Sweden
| | - David Haage
- Umeå Neurosteroid Research Center, Department of Clinical sciences, Umeå University, SE-901 85 Umeå, Sweden; Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden; Umecrine AB, Norrlands University Hospital Umeå, Building 6 M 4th floor, Sweden
| | - Michael Druzin
- Department of Integrative medical biology, Umeå University, SE-901 87 Umeå, Sweden
| | - Staffan Johansson
- Department of Integrative medical biology, Umeå University, SE-901 87 Umeå, Sweden
| | - Torbjörn Bäckström
- Umeå Neurosteroid Research Center, Department of Clinical sciences, Umeå University, SE-901 85 Umeå, Sweden; Umecrine AB, Norrlands University Hospital Umeå, Building 6 M 4th floor, Sweden.
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Cote S, Butler R, Michaud V, Lavallee E, Croteau E, Mendrek A, Lepage J, Whittingstall K. The regional effect of serum hormone levels on cerebral blood flow in healthy nonpregnant women. Hum Brain Mapp 2021; 42:5677-5688. [PMID: 34480503 PMCID: PMC8559491 DOI: 10.1002/hbm.25646] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 12/15/2022] Open
Abstract
Sex hormones estrogen (EST) and progesterone (PROG) have received increased attention for their important physiological action outside of reproduction. While studies have shown that EST and PROG have significant impacts on brain function, their impact on the cerebrovascular system in humans remains largely unknown. To address this, we used a multi-modal magnetic resonance imaging (MRI) approach to investigate the link between serum hormones in the follicular phase and luteal phase of the menstrual cycle (MC) with measures of cerebrovascular function (cerebral blood flow [CBF]) and structure (intracranial artery diameter). Fourteen naturally cycling women were recruited and assessed at two-time points of their MC. CBF was derived from pseudo-continuous arterial spin labeling while diameters of the internal carotid and basilar artery was assessed using time of flight magnetic resonance angiography, blood samples were performed after the MRI. Results show that PROG and EST had opposing and spatially distinct effects on CBF: PROG correlated negatively with CBF in anterior brain regions (r = -.86, p < .01), while EST correlations were positive, yet weak and most prominent in posterior areas (r = .78, p < .01). No significant correlations between either hormone or intracranial artery diameter were observed. These results show that EST and PROG have opposing and regionally distinct effects on CBF and that this relationship is likely not due to interactions with large intracranial arteries. Considering that CBF in healthy women appears tightly linked to their current hormonal state, future studies should consider assessing MC-related hormone fluctuations in the design of functional MRI studies in this population.
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Affiliation(s)
- Samantha Cote
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
| | - Russell Butler
- Faculty of Arts and Sciences, Department of Computer ScienceBishop's UniversitySherbrookeQuebecCanada
| | - Vincent Michaud
- Department of Diagnostic RadiologyUniversity of SherbrookeSherbrookeQuebecCanada
| | - Eric Lavallee
- Sherbrooke Molecular Imaging Center (CIMS), Sherbrooke University Hospital Research Center (CR‐CHUS)SherbrookeQuebecCanada
| | - Etienne Croteau
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Sherbrooke Molecular Imaging Center (CIMS), Sherbrooke University Hospital Research Center (CR‐CHUS)SherbrookeQuebecCanada
| | - Adrianna Mendrek
- Faculty of Arts and Sciences, Department of PsychologyBishop's UniversitySherbrookeQuebecCanada
| | - Jean‐Francois Lepage
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Faculty of Medicine and Health Sciences, Department of PediatricsUniversity of SherbrookeSherbrookeQuebecCanada
| | - Kevin Whittingstall
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Department of Diagnostic RadiologyUniversity of SherbrookeSherbrookeQuebecCanada
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8
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Liu XJ, Wang HJ, Wang XY, Ning YX, Gao J. GABABR1 in DRN mediated GABA to regulate 5-HT expression in multiple brain regions in male rats with high and low aggressive behavior. Neurochem Int 2021; 150:105180. [PMID: 34509561 DOI: 10.1016/j.neuint.2021.105180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 11/21/2022]
Abstract
The identity of the mechanism that controls aggressive behavior in rodents is unclear. Serotonin (5-HT) and GABA are associated with aggressive behavior in rodents. However, the regulatory relationship between these chemicals in the different brain regions of rats has not been fully defined. This study aimed to clarify the role of GABABR1 in DRN-mediated GABA to regulate 5-HT expression in multiple brain regions in male rats with high and low aggressive behavior. Rat models of highly and less aggressive behavior were established through social isolation plus resident intruder. On this basis, GABA content in the DRN and 5-HT contents in the PFC, hypothalamus, hippocampus and DRN were detected using ELISA. Co-expression of 5-HT and GB1 in the DRN was detected by immunofluorescence and immunoelectron microscopy at the tissue and subcellular levels, respectively. GB1-specific agonist baclofen and GB1-specific inhibitor CGP35348 were injected into the DRN by stereotaxic injection. Changes in 5-HT levels in the PFC, hypothalamus and hippocampus were detected afterward. After modeling, rats with highly aggressive behavior exhibited higher aggressive behavior scores, shorter latencies of aggression, and higher total distances in the open field test than rats with less aggressive behavior. The contents of 5-HT in the PFC, hypothalamus and hippocampus of rats with high and low aggressive behavior (no difference between the two groups) were significantly decreased, but the change in GABA content in the DRN was the opposite. GB1 granules could be found on synaptic membranes containing 5-HT granules, which indicated that 5-HT neurons in the DRN co-expressed with GB1, which also occurred in double immunofluorescence results. At the same time, we found that the expression of GB1 in the DRN of rats with high and low aggressive behavior was significantly increased, and the expression of GB1 in the DRN of rats with low aggressive behavior was significantly higher than that in rats with high aggressive behavior. Nevertheless, the expression of 5-HT in DRN was opposite in these two groups. After microinjection of baclofen into the DRN, the 5-HT contents in the PFC, hypothalamus and hippocampus of rats in each group decreased significantly. In contrast, the 5-HT contents in the PFC, hypothalamus and hippocampus of rats in each group increased significantly after injection with CGP35348. The significant increase in GABA in the DRN combined with the significant increase in GB1 in the DRN further mediated the synaptic inhibition effect, which reduced the 5-HT level of 5-HT neurons in the DRN, resulting in a significant decrease in 5-HT levels in the PFC, hypothalamus and hippocampus. Therefore, GB1-mediated GABA regulation of 5-HT levels in the PFC, hypothalamus and hippocampus is one of the mechanisms of highly and less aggressive behavior originating in the DRN. The increased GB1 level in the DRN of LA-behavior rats exhibited a greater degree of change than in the HA-group rats, which indicated that differently decreased 5-HT levels in the DRN may be the internal mechanisms of high and low aggression behaviors.
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Affiliation(s)
- Xiao-Ju Liu
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Hai-Juan Wang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, People's Republic of China
| | - Xiao-Yu Wang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Yin-Xia Ning
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China
| | - Jie Gao
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, People's Republic of China.
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Bäckström T, Ekberg K, Hirschberg AL, Bixo M, Epperson CN, Briggs P, Panay N, O'Brien S. A randomized, double-blind study on efficacy and safety of sepranolone in premenstrual dysphoric disorder. Psychoneuroendocrinology 2021; 133:105426. [PMID: 34597899 DOI: 10.1016/j.psyneuen.2021.105426] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/11/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
Women with premenstrual dysphoric disorder (PMDD) experience mood symptoms related to the increase in progesterone and the neuroactive steroid allopregnanolone. Our hypothesis is that allopregnanolone is the symptom provoking factor. The rationale for the present study was to treat PMDD patients with the GABAA receptor modulating steroid antagonist, sepranolone (isoallopregnanolone). Patients (n = 206) with PMDD from 12 European centers were randomized in a parallel double-blind study and treated with placebo, sepranolone 10 mg and 16 mg. Patients administered sepranolone subcutaneously every 48 h during the 14 premenstrual days of three consecutive menstrual cycles. After obtaining informed consent, the PMDD diagnosis was confirmed according to DSM-5 and verified with two menstrual cycles of daily symptom ratings using the Daily Record of Severity of Problems (DRSP) scale in an eDiary. Inclusion and exclusion criteria stipulated that the women should be essentially healthy, not pregnant, have no ongoing psychiatric disorder or take interfering medications, and have regular menstrual cycles. The study's primary endpoint was the Total symptom score (Sum21, the score for all 21 symptom questions in the DRSP). In the prespecified statistical analysis the average score of the 5 worst premenstrual days in treatment cycles 2 and 3 were subtracted from the corresponding average score in the two diagnostic cycles. The treatment effects were tested using analysis of variance in a hierarchal order starting with the combined active sepranolone treatments vs. placebo. The prespecified analysis of Sum21 showed a large treatment effect of all three treatments but no statistically significant difference to placebo. However, the ratings of distress showed a significant treatment effect of sepranolone compared to placebo (p = 0.037) and the ratings of impairment showed a trend to greater treatment effect of sepranolone compared to placebo. Many women with PMDD had symptoms during a longer period than the late luteal phase. It has previously been shown that 9 premenstrual days may be more representative for comparison of PMDD symptom periods than the 5 worst premenstrual days. A post hoc analysis was undertaken in the per protocol population investigating the treatment effect during 9 premenstrual days in the third treatment cycle. The Sum21 results of this analysis showed that the sepranolone 10 mg was significantly better than placebo (p = 0.008). Similar significant treatment effects were found for the impairment and distress scores. A significantly larger number of individuals experienced no or minimal symptoms (Sum21 <42 points) with the 10 mg sepranolone treatment compared to placebo (p = 0.020). The results indicate that there is an attenuating effect by sepranolone on symptoms, impairment, and distress in women with PMDD especially by the 10 mg dosage. Sepranolone was well tolerated, and no safety concerns were identified.
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Affiliation(s)
- Torbjörn Bäckström
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Sweden.
| | - Karin Ekberg
- Asarina Pharma AB Clinical Research & Development c/o COBIS, Ole Maaloes Vej 3, 2200 Kobenhavn N, Denmark
| | | | - Marie Bixo
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Sweden
| | - C Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
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10
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Canlı M, Çelik EE, Kocadağlı T, Kanmaz EÖ, Gökmen V. Formation of Bioactive Tyrosine Derivatives during Sprouting and Fermenting of Selected Whole Grains. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:12517-12526. [PMID: 34652133 DOI: 10.1021/acs.jafc.1c05064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sprouting is a popular method in cereal processing because sprouted grains are accepted to have high nutritional value. The increased proteolytic activity by sprouting increases the free amino acids in grains. It was hypothesized that an increased amount of tyrosine can be utilized by microorganisms during fermentation to form higher amounts of bioactive tyrosine derivatives. Sprouting increased the tyrosine and tyramine contents considerably, but increases and decreases in l-3,4-dihydroxyphenylalanine (l-DOPA) and dopamine were specific to the cereal. More tyramine, l-DOPA, and dopamine formation was observed during sourdough fermentation than that in yeast fermentation. As a result of the combined application of sprouting (48 h at 20 °C) and sourdough fermentation (36 h at 30 °C), the amounts of dopamine, l-DOPA, and tyramine found in rye were 27, 50, and 136 mg/kg, respectively. Cereal products rich in dopamine and l-DOPA can thus be produced as functional food ingredients with their positive effects on human health and mood.
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Affiliation(s)
- Merve Canlı
- Food Quality and Safety (FoQuS) Research Group, Department of Food Engineering, Hacettepe University, 06800 Beytepe, Ankara, Turkey
| | - Ecem Evrim Çelik
- Food Quality and Safety (FoQuS) Research Group, Department of Food Engineering, Hacettepe University, 06800 Beytepe, Ankara, Turkey
| | - Tolgahan Kocadağlı
- Food Quality and Safety (FoQuS) Research Group, Department of Food Engineering, Hacettepe University, 06800 Beytepe, Ankara, Turkey
| | - Evrim Özkaynak Kanmaz
- Department of Nutrition and Dietetics, Artvin Çoruh University, 08100 Seyitler, Artvin, Turkey
| | - Vural Gökmen
- Food Quality and Safety (FoQuS) Research Group, Department of Food Engineering, Hacettepe University, 06800 Beytepe, Ankara, Turkey
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11
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Manna SSS. Possible influence of neurosteroids in the anxiolytic effects of alpha-casozepine. Med Hypotheses 2021; 155:110655. [PMID: 34392107 DOI: 10.1016/j.mehy.2021.110655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 06/08/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022]
Abstract
Alpha-casozepine (α CZP), a tryptic hydrolysate of milk casein is a decapeptide shown to promote sleep and produce anxiolytic or anticonvulsant activity. Intriguingly, studies indicate structural similarities to benzodiazepine (BZD)-like molecules (e.g., diazepam), resulting in positive modulation of γ-aminobutyric acid A type (GABAA) receptors. However, some unexplained anomalous behaviour of α-CZP includes 1) 1000 times less affinity for BZD site on GABAA receptor in vitro conditions, whereas in vivo it showed 10-fold increased affinity when compared to diazepam; 2) anxiolytic effects were observed only in stressed conditions and 3) unlike diazepam, it failed to exhibit dependence or habituation. Interestingly, neurosteroids like allopregnanolone or its analogues that are synthesized de novo have both genomic and non-genomic actions. The rapid nongenomic neuronal inhibition of these compounds is mediated by GABAA receptors through autocrine and paracrine actions. Studies have shown that changes in the levels of neurosteroids during acute (rise) and chronic stress (decreased), consequently, altering the senetivity of GABAA receptor subunits. Neurosteroids even at low concentration (nanomolar range) potentiate the response of GABA indirectly, while at higher concentrations they directly activate the receptor-channel complex. Interestingly, coadministration of neurosteroids and BZPs has shown not only to prevent the development of tolerance of BZP and augmented recovery from BZP withdrawal anxiety and hyperactivity in mice. The combination also produced synergetic anxiolytic effects. Taken together, the evidence suggests possible implications of neurosteroids in the actions of CZP via BZD receptors. The present hypothesis brings out the possible role of neurosteroids and the various factors that might participate in CZP-induce anxiolytic effects.
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Affiliation(s)
- Shyamshree S S Manna
- Dr. B. C. Roy College of Pharmacy Allied Health Sciences, Dr Meghnad Saha Sarani, Bidhannagar, Durgapur 713206, West Bengal, India.
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12
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Schweizer-Schubert S, Gordon JL, Eisenlohr-Moul TA, Meltzer-Brody S, Schmalenberger KM, Slopien R, Zietlow AL, Ehlert U, Ditzen B. Steroid Hormone Sensitivity in Reproductive Mood Disorders: On the Role of the GABA A Receptor Complex and Stress During Hormonal Transitions. Front Med (Lausanne) 2021; 7:479646. [PMID: 33585496 PMCID: PMC7873927 DOI: 10.3389/fmed.2020.479646] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/20/2020] [Indexed: 12/16/2022] Open
Abstract
Women worldwide are two to three times more likely to suffer from depression in their lifetime than are men. Female risk for depressive symptoms is particularly high during the reproductive years between menarche and menopause. The term “Reproductive Mood Disorders” refers to depressive disorders triggered by hormonal fluctuations during reproductive transitions including the perimenarchal phase, the pre-menstrual phase, pregnancy, the peripartum period and the perimenopausal transition. Here we focus on reproductive mood disorders manifesting in adult life. We propose a research agenda that draws together several reproductive mood disorders and investigates which genetic, endocrinological, neural, and psychosocial factors can explain depressive symptoms during phases of hormonal transitions in women. Based on current research it is assumed that some women experience an increased sensitivity to not only fluctuations in reproductive steroids (estrogen and progesterone), but also stress-related steroids. We integrate both dynamics into the concept of “steroid hormone sensitivity,” expanding on the concept of “reproductive hormone sensitivity.” We suggest that a differential response of the stress steroid system including corticosteroids, neurosteroids, like allopregnanolone and the GABA-A Receptor complex, as well as a differential (epi)genetic risk in serotonergic and GABAergic signaling, are moderators or mediators between changes in the reproductive steroid system and the physiological, affective, and cognitive outcomes manifesting in reproductive mood disorders. We point to the lack of research on the role of psychosocial factors in increasing a woman's stress level and at some point also the sensitivity of her stress steroid system within the etiology of Reproductive Mood Disorders. Drawing together the evidence on various reproductive mood disorders we seek to present a basis for the development of more effective pharmacological, social, and psychological treatment interventions and prevention strategies for women susceptible to these disorders. This could pave the way for new research as well as medical and psychological teaching and practice- such as a new type of Practice for Gynecological Psychoneuroendocrinology- with the aim of working on and ultimately offering more integrative forms of support not yet available to women suffering from depression during hormonal transitions. In medical history women have been left alone with this integrative challenge.
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Affiliation(s)
- Sophie Schweizer-Schubert
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany.,Practice for Psychoendocrinology and Psychotherapy, Heilbronn, Germany
| | | | - Tory A Eisenlohr-Moul
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | | | - Katja M Schmalenberger
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Radoslaw Slopien
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna-Lena Zietlow
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ulrike Ehlert
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Beate Ditzen
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
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13
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Liu F, Huang J, Hei G, Wu R, Liu Z. Effects of sulforaphane on cognitive function in patients with frontal brain damage: study protocol for a randomised controlled trial. BMJ Open 2020; 10:e037543. [PMID: 33067279 PMCID: PMC7569949 DOI: 10.1136/bmjopen-2020-037543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Many patients with frontal brain damage show serious cognitive function deficits, which hamper their quality of life and result in poor clinical outcomes. Preclinical research has shown that sulforaphane can significantly improve spatial localisation and working memory impairment after brain injury. The primary aim of this double-blind randomised controlled clinical trial is to assess the efficacy of sulforaphane for improving cognitive function in patients with frontal brain damage. METHODS AND ANALYSIS Ninety eligible patients will be randomly allocated to an active treatment or a placebo group in a 2:1 ratio. Participants will undergo a series of cognitive and neuropsychiatric tests at baseline (week 0) and after 12 weeks to determine the effect of sulforaphane on cognition. Magnetic resonance spectrum of the brain will be studied using the 3T MRIs of the brain to detect brain metabolites markers, including N-acetyl aspartate, glutamate (Glu), glutathione (GSH) and γ-aminobutyric acid (GABA). Blood brain-derived neurotrophic factor, Glu, GSH and GABA levels and gut microbiota will also be assessed over this period. This study will also evaluate long-term outcomes of brain trauma, brain tumours and cerebrovascular disease via exploratory analyses. The primary outcome will be the difference in scores of a battery of cognitive tests after 12 weeks of sulforaphane treatment. The secondary outcomes will be changes in the Functional Activities Questionnaire (FAQ), the Patient Health Questionnaire (PHQ-9), the Self-Rating Anxiety Scale, the changes in T1-weighted MRI and resting-state functional MRI findings, and changes in brain and blood metabolic markers and gut microbiota at weeks 0 and 12. We expect that sulforaphane will yield favourable results in treating memory and learning deficits for patients with frontal brain damage. Cognitive functional treatment may also improve brain trauma, brain tumours and cerebrovascular outcomes. ETHICS AND DISSEMINATION The study protocol has been approved by the Medical Ethics committee of the Xiangya Hospital of Central South University (No. 2017121019). The results will be disseminated in peer-reviewed journals and at international conferences. TRIAL REGISTRATION NUMBER This trial was registered on Clinicaltrials.gov on 31 January 2020 (NCT04252261). The protocol version is V.1.0 (20 December 2019).
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Affiliation(s)
- Fangkun Liu
- Department of Neurosurgery, Central South University (CSU), 410008, Changsha, Hunan, China
| | - Jing Huang
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, 410011, Changsha, Hunan, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, 410011, Changsha, Hunan, China
| | - Gangrui Hei
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, 410011, Changsha, Hunan, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, 410011, Changsha, Hunan, China
| | - Renrong Wu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, 410011, Changsha, Hunan, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, 410011, Changsha, Hunan, China
| | - Zhixiong Liu
- Department of Neurosurgery, Central South University (CSU), 410008, Changsha, Hunan, China
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Sex and the serotonergic underpinnings of depression and migraine. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:117-140. [PMID: 33008520 DOI: 10.1016/b978-0-444-64123-6.00009-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Most psychiatric disorders demonstrate sex differences in their prevalence and symptomatology, and in their response to treatment. These differences are particularly pronounced in mood disorders. Differences in sex hormone levels are among the most overt distinctions between males and females and are thus an intuitive underpinning for these clinical observations. In fact, treatment with estrogen and testosterone was shown to exert antidepressant effects, which underscores this link. Changes to monoaminergic signaling in general, and serotonergic transmission in particular, are understood as central components of depressive pathophysiology. Thus, modulation of the serotonin system may serve as a mechanism via which sex hormones exert their clinical effects in mental health disorders. Over the past 20 years, various experimental approaches have been applied to identify modes of influence of sex and sex hormones on the serotonin system. This chapter provides an overview of different molecular components of the serotonin system, followed by a review of studies performed in animals and in humans with the purpose of elucidating sex hormone effects. Particular emphasis will be placed on studies performed with positron emission tomography, a method that allows for human in vivo molecular imaging and, therefore, assessment of effects in a clinically representative context. The studies addressed in this chapter provide a wealth of information on the interaction between sex, sex hormones, and serotonin in the brain. In general, they offer evidence for the concept that the influence of sex hormones on various components of the serotonin system may serve as an underpinning for the clinical effects these hormones demonstrate.
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15
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Traish AM. Post-finasteride syndrome: a surmountable challenge for clinicians. Fertil Steril 2020; 113:21-50. [PMID: 32033719 DOI: 10.1016/j.fertnstert.2019.11.030] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 12/28/2022]
Abstract
Post-finasteride syndrome (PFS) is a constellation of serious adverse side effects manifested in clinical symptoms that develop and persist in patients during and/or after discontinuing finasteride treatment in men with pattern hair loss (androgenetic alopecia) or benign prostatic hyperplasia. These serious adverse side effects include persistent or irreversible sexual, neurological, physical and mental side effects. To date, there are no evidence-based effective treatments for PFS. Although increasing number of men report persistent side effects, the medical community has yet to recognize this syndrome nor are there any specific measures to address this serious and debilitating symptoms. Here we evaluate the scientific and clinical evidence in the contemporary medical literature to address the very fundamental question: Is PFS a real clinical condition caused by finasteride use or are the reported symptoms only incidentally associated with but not caused by finasteride use? One key indisputable clinical evidence noted in all reported studies with finasteride and dutasteride was that use of these drugs is associated with development of sexual dysfunction, which may persist in a subset of men, irrespective of age, drug dose or duration of study. Also, increased depression, anxiety and suicidal ideation in a subset of men treated with these drugs were commonly reported in a number of studies. It is important to note that many clinical studies suffer from incomplete or inadequate assessment of adverse events and often limited or inaccurate data reporting regarding harm. Based on the existing body of evidence in the contemporary clinical literature, the author believes that finasteride and dutasteride induce a constellation of persistent sexual, neurological and physical adverse side effects, in a subset of men. These constellations of symptoms constitute the basis for PFS in individuals predisposed to epigenetic susceptibility. Indeed, delineating the pathophysiological mechanisms underlying PFS will be of paramount importance to the understanding of this syndrome and to development of potential novel therapeutic modalities.
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Affiliation(s)
- Abdulmaged M Traish
- Department of Urology, Boston University School of Medicine, Boston, Massachusetts.
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16
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GABA-A receptor modulating steroids in acute and chronic stress; relevance for cognition and dementia? Neurobiol Stress 2019; 12:100206. [PMID: 31921942 PMCID: PMC6948369 DOI: 10.1016/j.ynstr.2019.100206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/13/2019] [Accepted: 12/18/2019] [Indexed: 01/10/2023] Open
Abstract
Cognitive dysfunction, dementia and Alzheimer's disease (AD) are increasing as the population worldwide ages. Therapeutics for these conditions is an unmet need. This review focuses on the role of the positive GABA-A receptor modulating steroid allopregnanolone (APα), it's role in underlying mechanisms for impaired cognition and of AD, and to determine options for therapy of AD. On one hand, APα given intermittently promotes neurogenesis, decreases AD-related pathology and improves cognition. On the other, continuous exposure of APα impairs cognition and deteriorates AD pathology. The disparity between these two outcomes led our groups to analyze the mechanisms underlying the difference. We conclude that the effects of APα depend on administration pattern and that chronic slightly increased APα exposure is harmful to cognitive function and worsens AD pathology whereas single administrations with longer intervals improve cognition and decrease AD pathology. These collaborative assessments provide insights for the therapeutic development of APα and APα antagonists for AD and provide a model for cross laboratory collaborations aimed at generating translatable data for human clinical trials.
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17
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Griksiene R, Arnatkeviciute A, Monciunskaite R, Koenig T, Ruksenas O. Mental rotation of sequentially presented 3D figures: sex and sex hormones related differences in behavioural and ERP measures. Sci Rep 2019; 9:18843. [PMID: 31827215 PMCID: PMC6906480 DOI: 10.1038/s41598-019-55433-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/20/2019] [Indexed: 11/24/2022] Open
Abstract
Mental rotation of 3D objects demonstrates one of the largest sex differences. We investigated sex and sex hormones-related differences in behaviour and event related potentials (ERP) using a modified Shepard and Metzler task composed of sequentially presented 3D figures in 29 men and 32 women. We demonstrated a significant increase in response time and decrease in both accuracy and positivity of the parietal ERP with increasing angular disparity between the figures. Higher angular disparity evoked an increase of global field power (GFP) from 270 to 460 ms and different activation topographies from 470 to 583 ms with lower parietal, but higher left frontal positivity. Flatter slopes in higher angular disparity condition suggest distinct strategies being implemented depending on the difficulty of the rotation. Men performed the task more accurately than women. Performance accuracy in women tended to be negatively related to estradiol while the response time tended to increase with increasing progesterone. There were no associations with testosterone. Women demonstrated higher GFP and an increased positivity over the parietal scalp area, while men showed higher activation in the left frontal cortex. Together these findings indicate dynamic angular disparity- and sex-related differences in brain activity during mental rotation of 3D figures.
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Affiliation(s)
- Ramune Griksiene
- Department of Neurobiology and Biophysics, Vilnius University, Vilnius, Lithuania.
| | | | - Rasa Monciunskaite
- Department of Neurobiology and Biophysics, Vilnius University, Vilnius, Lithuania
| | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Osvaldas Ruksenas
- Department of Neurobiology and Biophysics, Vilnius University, Vilnius, Lithuania
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Monciunskaite R, Malden L, Lukstaite I, Ruksenas O, Griksiene R. Do oral contraceptives modulate an ERP response to affective pictures? Biol Psychol 2019; 148:107767. [PMID: 31509765 DOI: 10.1016/j.biopsycho.2019.107767] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/23/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022]
Abstract
Indications exist that use of oral contraceptives affects women's socio-emotional behaviour, brain function and, cognitive abilities, but the information is still scarce and ambiguous. We aimed to examine affective processing of visual stimuli between oral contraceptive users (OC, n = 33) and naturally cycling women (NC, n = 37) using the event-related potential (ERP) method. The main findings are: (i) emotionally arousing stimuli elicited significantly enlarged late positive potential (LPP) amplitudes compared to neutral stimuli, (ii) anti-androgenic OC users demonstrated diminished brain reactivity to visual stimuli, and (iii) significantly blunted reaction to highly unpleasant images. In addition, a positive relationship between GFP evoked by the highly unpleasant and highly pleasant visual emotional stimuli and progesterone was observed in NC women, while OC users demonstrated a trend of negative relationship between GFP and progesterone level. These findings suggest possible modulations of affective processing of visual stimuli when hormonal contraceptives are used.
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Affiliation(s)
- R Monciunskaite
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania.
| | - L Malden
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - I Lukstaite
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - O Ruksenas
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - R Griksiene
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
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Lumley L, Miller D, Muse WT, Marrero‐Rosado B, de Araujo Furtado M, Stone M, McGuire J, Whalley C. Neurosteroid and benzodiazepine combination therapy reduces status epilepticus and long-term effects of whole-body sarin exposure in rats. Epilepsia Open 2019; 4:382-396. [PMID: 31440720 PMCID: PMC6698686 DOI: 10.1002/epi4.12344] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/26/2019] [Accepted: 05/19/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Our objective was to evaluate the protective efficacy of the neurosteroid pregnanolone (3α-hydroxy-5β pregnan-20-one), a GABAA receptor-positive allosteric modulator, as an adjunct to benzodiazepine therapy against the chemical warfare nerve agent (CWNA) sarin (GB), using whole-body exposure, an operationally relevant route of exposure to volatile GB. METHODS Rats implanted with telemetry transmitters for the continuous measurement of cortical electroencephalographic (EEG) activity were exposed for 60 minutes to 3.0 LCt50 of GB via whole-body exposure. At the onset of toxic signs, rats were administered an intramuscular injection of atropine sulfate (2 mg/kg) and the oxime HI-6 (93.6 mg/kg) to increase survival rate and, 30 minutes after seizure onset, treated subcutaneously with diazepam (10 mg/kg) and intravenously with pregnanolone (4 mg/kg) or vehicle. Animals were evaluated for GB-induced status epilepticus (SE), spontaneous recurrent seizures (SRS), impairment in spatial memory acquisition, and brain pathology, and treatment groups were compared. RESULTS Delayed dual therapy with pregnanolone and diazepam reduced time in SE in GB-exposed rats compared to those treated with delayed diazepam monotherapy. The combination therapy of pregnanolone with diazepam also prevented impairment in the Morris water maze and reduced the neuronal loss and neuronal degeneration, evaluated at one and three months after exposure. SIGNIFICANCE Neurosteroid administration as an adjunct to benzodiazepine therapy offers an effective means to treat benzodiazepine-refractory SE, such as occurs following delayed treatment of GB exposure. This study is the first to present data on the efficacy of delayed pregnanolone and diazepam dual therapy in reducing seizure activity, performance deficits and brain pathology following an operationally relevant route of exposure to GB and supports the use of a neurosteroid as an adjunct to standard anticonvulsant therapy for the treatment of CWNA-induced SE.
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Affiliation(s)
- Lucille Lumley
- US Army Medical Research Institute of Chemical DefenseAberdeen Proving GroundMaryland
| | - Dennis Miller
- US Army Combat Capabilities Development Command Chemical Biological CenterAberdeen Proving GroundMaryland
| | - William T. Muse
- US Army Combat Capabilities Development Command Chemical Biological CenterAberdeen Proving GroundMaryland
| | - Brenda Marrero‐Rosado
- US Army Medical Research Institute of Chemical DefenseAberdeen Proving GroundMaryland
| | | | - Michael Stone
- US Army Medical Research Institute of Chemical DefenseAberdeen Proving GroundMaryland
| | - Jeffrey McGuire
- US Army Combat Capabilities Development Command Chemical Biological CenterAberdeen Proving GroundMaryland
| | - Christopher Whalley
- US Army Combat Capabilities Development Command Chemical Biological CenterAberdeen Proving GroundMaryland
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20
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Allopregnanolone reversion of estrogen and progesterone memory impairment: interplay with serotonin release. J Neural Transm (Vienna) 2019; 126:1321-1328. [DOI: 10.1007/s00702-019-02052-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022]
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21
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Dynamic protein changes in the perihaemorrhagic zone of Surgically Treated Intracerebral Haemorrhage Patients. Sci Rep 2019; 9:3181. [PMID: 30816204 PMCID: PMC6395593 DOI: 10.1038/s41598-019-39499-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/10/2019] [Indexed: 02/06/2023] Open
Abstract
The secondary injury cascades exacerbating the initial brain injury following intracerebral haemorrhage (ICH) are incompletely understood. We used dual microdialysis (MD) catheters placed in the perihaemorrhagic zone (PHZ) and in seemingly normal cortex (SNX) at time of surgical ICH evacuation in ten patients (range 26–70 years). Routine interstitial MD markers (including glucose and the lactate/pyruvate ratio) were analysed and remaining microdialysate was analysed by two-dimensional gel electrophoresis (2-DE) and nano-liquid chromatography tandem mass spectrometry (nLC-MS/MS). Two time intervals were analysed; median 2–10 hours post-surgery (time A) and median 68–76 hours post-ICH onset (time B). Using 2-DE, we quantified 232 ± 31 different protein spots. Two proteins differed between the MD catheters at time A, and 12 proteins at time B (p < 0.05). Thirteen proteins were significantly altered between time A and time B in the SNX and seven proteins in the PHZ, respectively. Using nLC-MS/MS ca 800 proteins were identified out of which 76 were present in all samples. At time A one protein was upregulated and two downregulated, and at time B, seven proteins were upregulated, and four downregulated in the PHZ compared to the SNX. Microdialysis-based proteomics is feasible for study of secondary injury mechanisms and discovery of biomarkers after ICH.
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Abstract
Introduction: Premenstrual dysphoric disorder (PMDD) is a distressing disorder amongst women of reproductive age group with significant implication in the productivity and quality of life of women who suffer from it. It is generally neglected as it is mostly undifferentiated from premenstrual symptoms—milder presentation of the same spectrum of problem but of lesser intensity and impairment. Objective: Here, in this article, we aim to highlight various studies and the research done on PMDD in the context of Indian women. Method: Reviewing the last 40 years’ database including Medline (PUBMED), Cochrane Library, EMBASE, Trip, Psych INFO, CINAHL, the Allied and Complementary Medicine Database (AMED), and the British Nursing Index. Results: PMDD is a troublesome disorder, often underdiagnosed. A thorough history including menstrual and sexual history, conducting a thorough physical examination, assessing the comorbidities, and finally using a proper and structured treatment protocol for managing the condition are recommended. Sertraline is the most widely studied drug which is found to be effective in PMDD.
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Affiliation(s)
- Dahuja Malvika
- Shaikh-ul-Hind Maulana Mahmood Hasan Medical College, Saharanpur, Uttar Pradesh, India
| | - Agarwal Supriya
- Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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Sumner RL, McMillan RL, Shaw AD, Singh KD, Sundram F, Muthukumaraswamy SD. Peak visual gamma frequency is modified across the healthy menstrual cycle. Hum Brain Mapp 2018; 39:3187-3202. [PMID: 29665216 PMCID: PMC6055613 DOI: 10.1002/hbm.24069] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 12/14/2022] Open
Abstract
Fluctuations in gonadal hormones over the course of the menstrual cycle are known to cause functional brain changes and are thought to modulate changes in the balance of cortical excitation and inhibition. Animal research has shown this occurs primarily via the major metabolite of progesterone, allopregnanolone, and its action as a positive allosteric modulator of the GABAA receptor. Our study used EEG to record gamma oscillations induced in the visual cortex using stationary and moving gratings. Recordings took place during twenty females’ mid‐luteal phase when progesterone and estradiol are highest, and early follicular phase when progesterone and estradiol are lowest. Significantly higher (∼5 Hz) gamma frequency was recorded during the luteal compared to the follicular phase for both stimuli types. Using dynamic causal modeling, these changes were linked to stronger self‐inhibition of superficial pyramidal cells in the luteal compared to the follicular phase. In addition, the connection from inhibitory interneurons to deep pyramidal cells was found to be stronger in the follicular compared to the luteal phase. These findings show that complex functional changes in synaptic microcircuitry occur across the menstrual cycle and that menstrual cycle phase should be taken into consideration when including female participants in research into gamma‐band oscillations.
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Affiliation(s)
- Rachael L Sumner
- School of Psychology, The University of Auckland, Auckland, 1142, New Zealand
| | - Rebecca L McMillan
- School of Pharmacy, The University of Auckland, Auckland, 1142, New Zealand
| | - Alexander D Shaw
- CUBRIC, School of Psychology, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Krish D Singh
- CUBRIC, School of Psychology, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Fred Sundram
- Department of Psychological Medicine, The University of Auckland, Auckland, 1142, New Zealand
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Barker TH, Kind KL, Groves PD, Howarth GS, Whittaker AL. Oestrous phase cyclicity influences judgment biasing in rats. Behav Processes 2018; 157:678-684. [PMID: 29653156 DOI: 10.1016/j.beproc.2018.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 11/19/2022]
Abstract
The identification of cognitive bias has become an important measure of animal welfare. Negative cognitive biases develop from a tendency for animals to process novel information pessimistically. Judgment-bias testing is the commonplace methodology to detect cognitive biases. However, concerns with these methods have been frequently-reported; one of which being the discrepancy between male and female cognitive expression. The current study assessed the factors of social status and oestrus, to investigate whether oestrous cycle rotation, or subordination stress encouraged an increase in pessimistic responses. Female Sprague-Dawley rats (n = 24) were trained on an active-choice judgment bias paradigm. Responses to the ambiguous probe were recorded as optimistic or pessimistic. Oestrous phase was determined by assessing vaginal cytology in stained vaginal cell smears. Rats in the dioestrous phase and those rats considered to be subordinate demonstrated an increased percentage of pessimistic responses. However, no interaction between these factors was observed. This suggests that oestrous cyclicity can influence the judgment biases of female animals; a previously unreported finding. On this basis, researchers should be encouraged to account for both oestrous phase cyclicity and social status as an additional fixed effect in study design.
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Affiliation(s)
- Timothy Hugh Barker
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy Campus, Roseworthy, South Australia, Australia.
| | - Karen Lee Kind
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy Campus, Roseworthy, South Australia, Australia
| | - Peta Danielle Groves
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy Campus, Roseworthy, South Australia, Australia
| | - Gordon Stanley Howarth
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy Campus, Roseworthy, South Australia, Australia; Gastroenterology Department, Children, Youth and Women's Health Service, Adelaide, South Australia, Australia
| | - Alexandra Louise Whittaker
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy Campus, Roseworthy, South Australia, Australia
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25
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Waller JA, Nygaard SH, Li Y, du Jardin KG, Tamm JA, Abdourahman A, Elfving B, Pehrson AL, Sánchez C, Wernersson R. Neuroplasticity pathways and protein-interaction networks are modulated by vortioxetine in rodents. BMC Neurosci 2017; 18:56. [PMID: 28778148 PMCID: PMC5543755 DOI: 10.1186/s12868-017-0376-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 07/21/2017] [Indexed: 01/29/2023] Open
Abstract
Background The identification of biomarkers that predict susceptibility to major depressive disorder and treatment response to antidepressants is a major challenge. Vortioxetine is a novel multimodal antidepressant that possesses pro-cognitive properties and differentiates from other conventional antidepressants on various cognitive and plasticity measures. The aim of the present study was to identify biological systems rather than single biomarkers that may underlie vortioxetine’s treatment effects. Results We show that the biological systems regulated by vortioxetine are overlapping between mouse and rat in response to distinct treatment regimens and in different brain regions. Furthermore, analysis of complexes of physically-interacting proteins reveal that biomarkers involved in transcriptional regulation, neurodevelopment, neuroplasticity, and endocytosis are modulated by vortioxetine. A subsequent qPCR study examining the expression of targets in the protein–protein interactome space in response to chronic vortioxetine treatment over a range of doses provides further biological validation that vortioxetine engages neuroplasticity networks. Thus, the same biology is regulated in different species and sexes, different brain regions, and in response to distinct routes of administration and regimens. Conclusions A recurring theme, based on the present study as well as previous findings, is that networks related to synaptic plasticity, synaptic transmission, signal transduction, and neurodevelopment are modulated in response to vortioxetine treatment. Regulation of these signaling pathways by vortioxetine may underlie vortioxetine’s cognitive-enhancing properties. Electronic supplementary material The online version of this article (doi:10.1186/s12868-017-0376-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jessica A Waller
- External Sourcing and Scientific Excellence, Lundbeck Research U.S.A., Paramus, NJ, 07652, USA
| | | | - Yan Li
- External Sourcing and Scientific Excellence, Lundbeck Research U.S.A., Paramus, NJ, 07652, USA
| | | | - Joseph A Tamm
- In Vitro Biology, Lundbeck Research U.S.A., Paramus, NJ, 07652, USA
| | | | - Betina Elfving
- Translational Neuropsychiatry Unit, Aarhus University, 8240, Risskov, Denmark
| | - Alan L Pehrson
- External Sourcing and Scientific Excellence, Lundbeck Research U.S.A., Paramus, NJ, 07652, USA
| | - Connie Sánchez
- External Sourcing and Scientific Excellence, Lundbeck Research U.S.A., Paramus, NJ, 07652, USA.
| | - Rasmus Wernersson
- Intomics A/S, Diplomvej 377, 2800, Lyngby, Denmark. .,Center for Biological Sequence Analysis, Technical University of Denmark, 2800, Lyngby, Denmark.
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Armbruster D, Kirschbaum C, Strobel A. The not-so-bitter pill: Effects of combined oral contraceptives on peripheral physiological indicators of emotional reactivity. Horm Behav 2017; 94:97-105. [PMID: 28676251 DOI: 10.1016/j.yhbeh.2017.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 06/28/2017] [Accepted: 06/29/2017] [Indexed: 02/07/2023]
Abstract
Combined oral contraceptives (COC) are used by millions of women worldwide. Although findings are not entirely consistent, COC have been found to impact on brain function and, thus, to modulate affective processes. Here, we investigated electro-physiological responses to emotional stimuli in free cycling women in both the early follicular and late luteal phase as well as in COC users. Skin conductance response (SCR), startle reflex, corrugator and zygomaticus activity were assessed. COC users showed reduced overall startle magnitude and SCR amplitude, but heightened overall zygomaticus activity, although effect sizes were small. Thus, COC users displayed reduced physiological reactions indicating negative affect and enhanced physiological responses signifying positive affect. In free cycling women, endogenous 17β-estradiol levels were associated with fear potentiated startle in both cycle phases as well as with SCR and zygomaticus activity during the follicular phase. Testosterone was associated with corrugator and zygomaticus activity during the luteal phase, while progesterone levels correlated with corrugator activity in the follicular phase. To the contrary, in COC users, endogenous hormones were not associated with electro-physiological measures. The results further underscore the importance of considering COC use in psychophysiological studies on emotional processing.
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Affiliation(s)
- Diana Armbruster
- Personality and Individual Differences, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany.
| | - Clemens Kirschbaum
- Biological Psychology, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany
| | - Alexander Strobel
- Personality and Individual Differences, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany
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Lee SS, Han KD, Joo YH. Association of perceived tinnitus with duration of hormone replacement therapy in Korean postmenopausal women: a cross-sectional study. BMJ Open 2017; 7:e013736. [PMID: 28698314 PMCID: PMC5541493 DOI: 10.1136/bmjopen-2016-013736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The purpose of this study was to determine the relationship between hormone replacement therapy (HRT) and tinnitus in South Korea using data from the Korea National Health and Nutrition Examination Surveys (KNHANES) (2010-2012). STUDY DESIGN Cross-sectional analysis of a nationwide health survey. METHODS KNHANES is a nationally representative cross-sectional survey of South Korea population. Only postmenopausal women aged 19-65 years were included in the study (n=2736). Auditory function was evaluated using pure-tone audiometric testing according to established KNHANES protocols. Subjects were questioned about their experience with tinnitus. Exogenous hormone-related factors included the starting age and duration of HRT. RESULTS The overall prevalence of tinnitus was 22.2% among postmenopausal women. (1) Tinnitus severity was significantly higher in women using HRT (p=0.0024) and (2) significantly lower in women who breast fed their children (p=0.0386). (3) According to logistic regression models, the longer duration of HRT was significantly associated with increasing tinnitus (OR=1.323, 95% CI 1.007 to 1.737, p=0.0441). CONCLUSION A longer duration of HRT was associated with developing tinnitus in Korean postmenopausal women. Further experimental and epidemiological researches are needed to elucidate the causal relationship between HRT and tinnitus.
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Affiliation(s)
- Seong-Su Lee
- Department of Internal Medicine, Catholic University of Korea, Division of Endocrinology and Metabolism, Seoul, Korea
| | - Kyung-do Han
- Department of Biostatistics, Catholic University of Korea, Seoul, Korea
| | - Young-Hoon Joo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Marques DA, de Carvalho D, da Silva GSF, Szawka RE, Anselmo-Franci JA, Bícego KC, Gargaglioni LH. Influence of estrous cycle hormonal fluctuations and gonadal hormones on the ventilatory response to hypoxia in female rats. Pflugers Arch 2017; 469:1277-1286. [PMID: 28660294 DOI: 10.1007/s00424-017-2022-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/18/2017] [Accepted: 06/19/2017] [Indexed: 12/12/2022]
Abstract
Sex hormones may influence many physiological processes. Recently, we demonstrated that hormonal fluctuations of cycling female rats do not affect respiratory parameters during hypercapnia. However, it is still unclear whether sex hormones and hormonal fluctuations that occur during the estrous cycle can affect breathing during a hypoxic challenge. Our study aimed to evaluate respiratory, metabolic, and thermal responses to hypoxia in female rats on different days of the estrous cycle (proestrus, estrus, metestrus, and diestrus) and in ovariectomized rats that received replacement with oil (OVX), estradiol (OVX + E2), or a combination of estradiol and progesterone (OVX + E2P). Ventilation (V E), tidal volume (V T), respiratory frequency (fR), oxygen consumption (VO2), and V E/VO2 were not different during the estrous cycle in normoxia or hypoxia. Body temperature (Tb) was higher during estrus, but decreased similarly in all groups during hypoxia. Compared with intact females in estrus, gonadectomized rats also had lower Tb in normoxia, but not in hypoxia. OVX rats experienced a significant drop in the ventilatory response to hypoxia, but hormonal replacement did not restore values to the levels of an intact animal. Our data demonstrate that the different phases of the estrous cycle do not alter ventilation during normoxia and hypoxia, but OVX animals display lower ventilatory responses to hypoxia compared with ovary-intact rats. Because estradiol and progesterone replacement did not cause significant differences in ventilation, our findings suggest that a yet-to-be-defined non-steroidal ovarian hormone is likely to stimulate the ventilatory responses to hypoxia in females.
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Affiliation(s)
- Danuzia A Marques
- Department of Animal Morphology and Physiology, São Paulo State University, UNESP FCAV at Jaboticabal, São Paulo, Brazil
| | | | - Glauber S F da Silva
- Department of Animal Morphology and Physiology, São Paulo State University, UNESP FCAV at Jaboticabal, São Paulo, Brazil
| | - Raphael E Szawka
- Department of Physiology and Biophysics, Institute of Biological Sciences, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Janete A Anselmo-Franci
- Department of Morphology, Stomatology and Physiology, Dental School of Ribeirao Preto, University of São Paulo, São Paulo, Brazil
| | - Kênia C Bícego
- Department of Animal Morphology and Physiology, São Paulo State University, UNESP FCAV at Jaboticabal, São Paulo, Brazil
| | - Luciane H Gargaglioni
- Department of Animal Morphology and Physiology, São Paulo State University, UNESP FCAV at Jaboticabal, São Paulo, Brazil.
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Eggert L, Kleinstäuber M, Hiller W, Witthöft M. Emotional interference and attentional processing in premenstrual syndrome. J Behav Ther Exp Psychiatry 2017; 54:77-87. [PMID: 27404734 DOI: 10.1016/j.jbtep.2016.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 06/16/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Premenstrual syndrome (PMS) is characterized by menstrual cycle-related affective, behavioral, and/or somatic symptoms. By applying the emotional Stroop task (EST) the current study examined if changes in processing emotional information, which have been demonstrated in affective disorders, are also present in PMS. METHODS Via online screening, telephone interviews, and daily records over two months 55 women for the PMS group (on the basis of the specific inclusion criteria and a prospectively confirmed PMS) and 55 'non-PMS' controls were recruited. All participants completed three emotional Stroop tasks (EST) with neutral and negative word, picture, and facial stimuli, during the follicular and luteal phase of the menstrual cycle. RESULTS Mixed 2 × 2 univariate analyses of variance and post-hoc comparisons showed primarily a greater emotional Stroop effect with respect to picture and facial stimuli in the luteal menstrual cycle phase in women with PMS, compared to the control group. No significant group differences were observed for word stimuli. With respect to the facial stimuli, a kind of paradox effect was revealed (Stroop facilitation) in the PMS group. LIMITATIONS This study provides important information regarding cognitive processes in women suffering from PMS that have to be interpreted in the light of the following limitations: a limited representativeness of the sample, the determination of menstrual cycle phases based on symptom diaries but not hormone levels, and a limited interpretability of our results as causal relationships. CONCLUSIONS Our findings are in line with the assumption that alterations in cognitive-emotional processes are associated with PMS. Further research on the etiology of PMS should focus more on cognitive-emotional processing and its interaction with biological changes relating to the menstrual cycle.
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Affiliation(s)
- Lisa Eggert
- Johannes Gutenberg-University Mainz, Department of Clinical Psychology and Psychotherapy, Wallstr. 3, D-55122 Mainz, Germany
| | - Maria Kleinstäuber
- Philipps-University Marburg, Department of Clinical Psychology and Psychotherapy, Germany.
| | - Wolfgang Hiller
- Johannes Gutenberg-University Mainz, Department of Clinical Psychology and Psychotherapy, Wallstr. 3, D-55122 Mainz, Germany
| | - Michael Witthöft
- Johannes Gutenberg-University Mainz, Department of Clinical Psychology and Psychotherapy, Wallstr. 3, D-55122 Mainz, Germany
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30
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Nguyen TV, Ducharme S, Karama S. Effects of Sex Steroids in the Human Brain. Mol Neurobiol 2016; 54:7507-7519. [PMID: 27822715 DOI: 10.1007/s12035-016-0198-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/11/2016] [Indexed: 02/01/2023]
Abstract
Sex steroids are thought to play a critical developmental role in shaping both cortical and subcortical structures in the human brain. Periods of profound changes in sex steroids invariably coincide with the onset of sex differences in mental health vulnerability, highlighting the importance of sex steroids in determining sexual differentiation of the brain. Yet, most of the evidence for the central effects of sex steroids relies on non-human studies, as several challenges have limited our understanding of these effects in humans: the lack of systematic assessment of the human sex steroid metabolome, the different developmental trajectories of specific sex steroids, the impact of genetic variation and epigenetic changes, and the plethora of interactions between sex steroids, sex chromosomes, neurotransmitters, and other hormonal systems. Here we review how multimodal strategies may be employed to bridge the gap between the basic and clinical understanding of sex steroid-related changes in the human brain.
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Affiliation(s)
- Tuong-Vi Nguyen
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, QC, H3A 1A1, Canada.,Department of Obstetrics-Gynecology, McGill University Health Centre, McGill University, Montreal, QC, H3A 1A1, Canada
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, QC, H3A 1A1, Canada.,McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, H3A 2B4, Canada
| | - Sherif Karama
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, H3A 2B4, Canada. .,Department of Psychiatry, Douglas Mental Health University Institute, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
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31
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Griskova-Bulanova I, Griksiene R, Voicikas A, Ruksenas O. Go and NoGo: modulation of electrophysiological correlates by female sex steroid hormones. Psychopharmacology (Berl) 2016; 233:2607-15. [PMID: 27137197 DOI: 10.1007/s00213-016-4311-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
RATIONALE The behavioral and electrophysiological responses in a Go/NoGo task are objective measures of executive functioning that may be impaired in clinical conditions. Prior to the wider application of Go/NoGo tasks in clinics, it is tempting to evaluate factors causing modulation of the responses. OBJECTIVE We aimed to evaluate the effect of different levels of female sex steroids on Go/NoGo task-related ERPs in healthy females. METHODS Thirty-four young healthy females performed an equiprobable (50/50) auditory Go/NoGo task. Amplitudes and latencies of N2 and P3 peaks from Fz, Cz, and Pz electrodes were evaluated. 17β-estradiol and progesterone levels in saliva samples were measured. Electrophysiological measures were correlated to 17β-estradiol and progesterone concentrations. RESULTS The diverse pattern of modulation of P3 latencies was shown: higher levels of 17β-estradiol contributed to Go-P3 latency prolongation, and higher levels of progesterone contributed to NoGo-P3 latency shortening. Higher levels of 17β-estradiol were associated with more negative frontal N2 amplitude in both conditions. CONCLUSIONS The relationship between electrophysiological correlates of executive functioning to individual hormonal levels points to a broader range of variation sources in healthy subjects which might mask or pronounce between-group differences in clinical studies.
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Affiliation(s)
- Inga Griskova-Bulanova
- Department of Neurobiology and Biophysics, Faculty of Natural Sciences, Vilnius University, Sauletekio 7, LT-10222, Vilnius, Lithuania.
| | - Ramune Griksiene
- Department of Neurobiology and Biophysics, Faculty of Natural Sciences, Vilnius University, Sauletekio 7, LT-10222, Vilnius, Lithuania
| | - Aleksandras Voicikas
- Department of Neurobiology and Biophysics, Faculty of Natural Sciences, Vilnius University, Sauletekio 7, LT-10222, Vilnius, Lithuania
| | - Osvaldas Ruksenas
- Department of Neurobiology and Biophysics, Faculty of Natural Sciences, Vilnius University, Sauletekio 7, LT-10222, Vilnius, Lithuania
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Emotion Regulation in Women with Premenstrual Syndrome (PMS): Explicit and Implicit Assessments. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9788-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Agusti A, Llansola M, Hernández-Rabaza V, Cabrera-Pastor A, Montoliu C, Felipo V. Modulation of GABAA receptors by neurosteroids. A new concept to improve cognitive and motor alterations in hepatic encephalopathy. J Steroid Biochem Mol Biol 2016; 160:88-93. [PMID: 26307490 DOI: 10.1016/j.jsbmb.2015.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 08/14/2015] [Accepted: 08/19/2015] [Indexed: 12/28/2022]
Abstract
Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome affecting patients with liver diseases, mainly those with liver cirrhosis. The mildest form of HE is minimal HE (MHE), with mild cognitive impairment, attention deficit, psychomotor slowing and impaired visuo-motor and bimanual coordination. MHE may progress to clinical HE with worsening of the neurological alterations which may lead to reduced consciousness and, in the worse cases, may progress to coma and death. HE affects several million people in the world and is a serious health, social and economic problem. There are no specific treatments for the neurological alterations in HE. The mechanisms underlying the cognitive and motor alterations in HE are beginning to be clarified in animal models. These studies have allowed to design and test in animal models of HE new therapeutic approaches which have successfully restored cognitive and motor function in rats with HE. In this article we review the evidences showing that.
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Affiliation(s)
- Ana Agusti
- Fundación Investigación Hospital Clínico de Valencia. Instituto de Investigación Sanitaria-INCLIVA, Valencia, Spain
| | - Marta Llansola
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | | | - Andrea Cabrera-Pastor
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Carmina Montoliu
- Fundación Investigación Hospital Clínico de Valencia. Instituto de Investigación Sanitaria-INCLIVA, Valencia, Spain
| | - Vicente Felipo
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain.
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Psychosocial Profile of Women with Premenstrual Syndrome and Healthy Controls: A Comparative Study. Int J Behav Med 2016; 23:752-763. [DOI: 10.1007/s12529-016-9564-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone? SCHIZOPHRENIA RESEARCH AND TREATMENT 2016; 2016:1942828. [PMID: 27747103 PMCID: PMC5055965 DOI: 10.1155/2016/1942828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 08/04/2016] [Accepted: 08/17/2016] [Indexed: 01/10/2023]
Abstract
Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP) patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p = 0.03). Progesterone levels were inversely associated with the severity of positive symptoms (p = 0.007). Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders.
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Differential role of estrogen receptor modulators in depression-like behavior and memory impairment in rats with postmenopausal diabetes. Menopause 2015; 22:1117-24. [DOI: 10.1097/gme.0000000000000435] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Allen AM, al'Absi M, Lando H, Allen SS. Allopregnanolone association with psychophysiological and cognitive functions during acute smoking abstinence in premenopausal women. Exp Clin Psychopharmacol 2015; 23:22-8. [PMID: 25643026 PMCID: PMC4394732 DOI: 10.1037/a0038747] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nicotine response may predict susceptibility to smoking relapse. Allopregnanolone, a neuroactive steroid metabolized from progesterone, has been shown to be associated with several symptoms of nicotine response. We sought to explore the association between allopregnanolone and response to nicotine during acute smoking abstinence in premenopausal women. Participants completed 2 nicotine-response laboratory sessions, 1 in their follicular (low allopregnanolone) and 1 in their luteal (high allopregnanolone) menstrual phase, on the fourth day of biochemically confirmed smoking abstinence. During the laboratory sessions, participants self-administered a nicotine nasal spray and completed a timed series of cardiovascular, cognitive, and subjective assessments of response to nicotine. The relationships of allopregnanolone with baseline values and change scores of outcome measures were assessed using covariance pattern modeling. Study participants (N = 77) had a mean age of 29.9 (SD = 6.8) years and smoked an average of 12.2 (SD = 4.9) cigarettes per day. Allopregnanolone concentration measured before nicotine administration was positively associated with systolic (β = 0.85, p = .04) and diastolic blood pressure (β = 1.19, p < .001) and self-report of physical symptoms (β = 0.58, p < .001), dizziness (β = 0.88, p < .01), jitteriness (β = 0.90, p = .04), and pleasantness (β = 2.05, p = .04). Allopregnanolone also had significant positive associations with change in cognition following nicotine nasal spray administration, specifically discriminability as a measure of attention (β = 1.15, p = .05) and response bias as a measure of impulsivity (β = 0.13, p = .02). These data suggest that allopregnanolone may be related to cardiovascular and subjective physical state during acute smoking abstinence, as well as cognitive response to nicotine.
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Affiliation(s)
| | - Mustafa al'Absi
- Department of Behavioral Sciences, Medical School, University of Minnesota
| | - Harry Lando
- Department of Family Medicine & Community Health
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Relative Contribution of Nuclear and Membrane Progesterone Receptors in Respiratory Control. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 860:261-7. [DOI: 10.1007/978-3-319-18440-1_30] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Narenji SA, Naghdi N, Azadmanesh K, Edalat R. 3α-diol administration decreases hippocampal PKA (II) mRNA expression and impairs Morris water maze performance in adult male rats. Behav Brain Res 2014; 280:149-59. [PMID: 25451551 DOI: 10.1016/j.bbr.2014.11.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/15/2014] [Accepted: 11/22/2014] [Indexed: 11/18/2022]
Abstract
The effect of testosterone and its metabolites on learning and memory has been the subject of many studies. This study used the Morris water maze task to investigate the effect of intra-hippocampal injection of 3α-diol (one of the metabolites of testosterone) on acquisition stage of spatial memory in adult male rats. During the experiment we observed that 3α-diol, significantly impaired Morris water maze performance in treated rat's compared with controls. Because signaling event mediated by protein kinase A (PKA) especially PKA (II) are critical for many neuronal functions such as learning and memory, the hippocampus was analyzed for mRNA expression of PKA (II) using TaqMan real time RT-PCR. The results indicated that the transcription levels of PKA (II) were significantly decreased in animals treated with 3α-diol compared with controls. Thus, the findings suggest that administration of 3α-diol in hippocampus of adult male rats impairs memory function, possibly via down-regulation of PKA.
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Affiliation(s)
| | - Nasser Naghdi
- Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran 13164, Iran
| | - Kayhan Azadmanesh
- Department of Virology, Pasteur Institute of Iran, Tehran 13164, Iran
| | - Rosita Edalat
- Department of Virology, Pasteur Institute of Iran, Tehran 13164, Iran
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Regidor PA. Progesterone in Peri- and Postmenopause: A Review. Geburtshilfe Frauenheilkd 2014; 74:995-1002. [PMID: 25484373 DOI: 10.1055/s-0034-1383297] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 10/01/2014] [Accepted: 10/01/2014] [Indexed: 01/26/2023] Open
Abstract
Around 14.5 million peri- and postmenopausal women currently live in Germany. Moreover, approximately 450 000 women, each with a life expectancy of around 85 years, reach menopause every year in Germany. The challenge is therefore to find a therapy with few side effects which could improve the quality of life of women with menopausal symptoms. The aim of hormone therapy (HT) is to remedy hormone deficiencies using substances that offer the best trade-off between benefits and risks. This is where progesterone has a new and important role to play. Progesterone is one of the most important gestagens. Biologically effective progesterone formulations created with micronization techniques have been used in clinical practice since 1996. Nevertheless, up until 2003 preference was given to synthetic gestagens rather than progesterone. The increased breast cancer hazard ratio of 1.23 reported in the WHI study and of 2 given in the Million Women Study has been associated with the use of synthetic gestagens. In a comparison between synthetic gestagens and progesterone, the E3N Study showed that the transdermal administration of estrogen and progesterone did not lead to an increase in breast cancer rates (RR: 1.08). The administration of progesterone does not change the HDL/LDL cholesterol ratio. Because of its anti-mineralocorticoid effect, progesterone has no impact on carbohydrate metabolism, hemostasis, blood pressure, thrombogenicity and body weight. The administration of 200 mg/day progesterone over 12 days of a menstrual cycle or a daily administration of 100 mg combined with an estrogen are a safe and well-tolerated option to treat menopausal symptoms, with a better benefit risk profile compared to synthetic gestagens.
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Affiliation(s)
- P-A Regidor
- Praxis für Frauenheilkunde, München ; Velvian GmbH, Ismaning
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Abstract
Premenstrual dysphoric disorder (PMDD) is comprised of a cluster of affective, behavioral and somatic symptoms recurring monthly during the luteal phase of the menstrual cycle. The disorder affects 3-8% of menstruating women and represents the more severe and disabling end of the spectrum of premenstrual disorders, which includes premenstrual syndrome and premenstrual aggravation of underlying affective disorder. Rigorous and specific diagnostic criteria for PMDD were specified in the Diagnostic and Statistical Manual of Mental Disorders IV (1994) and reaffirmed in the Diagnostic and Statistical Manual of Mental Disorders V (2013) and, consequently, there has been a marked increase in well-designed, placebo-controlled studies evaluating treatment modalities. Although the exact pathogenesis of PMDD is still elusive, treatment of PMDD and severe premenstrual syndrome has centered on neuromodulation via serotonin reuptake inhibitor antidepressants, and ovulation suppression utilizing various contraceptive and hormonal preparations. Unlike the approach to the treatment of depression, serotonergic antidepressants need not be given daily, but can be effective when used cyclically, only in the luteal phase or even limited to the duration of the monthly symptoms. Less, well-substantiated alternative treatments, such as calcium supplementation, agnus castus (chasteberry), Hypericum perforatum (St John's wort) and cognitive/behavioral/relaxation therapies, may be useful adjuncts in the treatment of PMDD. This review provides an overview of current information on the treatment of PMDD.
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Affiliation(s)
- Andrea J Rapkin
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, University of California Los Angeles, 10833 Le Conte Avenue, Room 27-139 CHS, Los Angeles, CA 90095-1740, USA
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Seven A, Yüksel B, Kılıç S, Esen H, Keskin U, Ulubay M, Ozekinci M. Effect of injectable medroxyprogesterone acetate and etonogestrel implants on GABA-A and serotonin receptors in white and gray matter of the brain: experimental study in rats. Gynecol Endocrinol 2014; 30:320-4. [PMID: 24460500 DOI: 10.3109/09513590.2014.880417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to evaluate the time-dependent effect of progesterone-only contraceptives on the brain and to obtain an improved understanding of mood disorders experienced under this medication. A total of 66 Wistar albino rats were divided into three groups: etonogestrel (ENG) implant (group 1, n = 30); depot medroxyprogesterone acetate (MPA)-injectable (group 2, n = 30); and control (group 3, n = 6) groups. Groups 1 and 2 were each divided into five subgroups, which were examined every 10 d for up to 50 d after medication administration, to evaluate its time-dependent effect. There was no difference in terms of gamma-aminobutyric acid (GABA) and serotonin immunohistochemical staining in white and gray matter among the subgroups of group 1. In group 2, there was a significant decrease in serotonin receptor staining intensity in white and gray matter on day 50, when compared to the control group (p = 0.041). When the subgroups of group 2 were compared, there was a significant decrease in serotonin receptor staining intensity in white and gray matter on days 40 and 50 when compared to day 10. In conclusion, we showed that ENG and MPA have no effect on apoptosis and GABA-A receptors in the brain. We also showed that MPA has time-dependent effects on serotonin receptors, which may be a possible mechanism involved in mood disorders during long-term usage of injectable progesterone-only contraceptives.
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Affiliation(s)
- Ali Seven
- Department of Obstetrics and Gynaecology, Dumlupinar University, Faculty of Medicine , Kutahya , Turkey
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Yang F, Zhao H, Wang Z, Tao D, Xiao X, Niu Q, Wang Q, Li Y, Guo L, Li J, Li K, Xia J, Wang L, Shang X, Sang W, Shao C, Gan Z, He K, Zhao X, Tian T, Xu D, Gu D, Weng X, Li H, Tian J, Yang L, Li Q, Yang Q, Wang H, Dang Y, Dai L, Cui Y, Ye D, Cao J, Guo L, Kang Z, Liu J, Chen B, Liu J, Zhang J, Yang D, Jiao B, Yu F, Geng F, Li L, Yang H, Dai H, Wang H, Liu C, Liu H, Peng L, Wang X, Wei S, Liu X, Li C, Liu Z, Zhang Q, Di D, Flint J, Shi S, Kendler KS. Age at onset of recurrent major depression in Han Chinese women - a replication study. J Affect Disord 2014; 157:72-9. [PMID: 24581831 DOI: 10.1016/j.jad.2014.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/08/2014] [Accepted: 01/09/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND The relationship between age at onset (AAO) and major depression (MD) has been studied in US, European and Chinese populations. However, larger sample studies are needed to replicate and extend earlier findings. METHODS We re-examined the relationship between AAO and the clinical features of recurrent MD in Han Chinese women by analyzing the phase I (N=1848), phase II (N=4169) and total combined data (N=6017) from the CONVERGE project. Linear, logistic, multiple linear and multinomial logistic regression models were used to determine the association of AAO with continuous, binary and categorical variables. RESULTS The effect size of the association between AAO and clinical features of MD was quite similar in the phase I and phase II samples. These results confirmed that MD patients with earlier AAO tended to suffer more severe, recurrent and chronic illness and cases of MD with earlier AAO showed increased neuroticism, greater family history and psychiatric comorbidity. In addition, we showed that earlier AAO of MD in Han Chinese women was associated with premenstrual symptoms, postnatal depression, a highly authoritarian or cold childhood parental rearing style and a reduced probability for having melancholia. LIMITATIONS Data were collected retrospectively through interview and recall bias may have affected the results. CONCLUSIONS MD with earlier AAO in Han Chinese women shows a distinct set of clinical features which are similar to those reported in Western populations.
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Affiliation(s)
- Fuzhong Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Hongsu Zhao
- Zhejiang Traditional Chinese Medical Hospital, Hangzhou, Zhejiang, People's Republic of China
| | - Zhoubing Wang
- No. 4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China
| | - Danhong Tao
- Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Xue Xiao
- The First Hospital of China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China
| | - Qihui Niu
- No. 1 Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Qian Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Beijing, People's Republic of China
| | - Yajuan Li
- Xian Mental Health Center, Xian, Shaanxi, People's Republic of China
| | - Liyang Guo
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, People's Republic of China
| | - Jianying Li
- No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Kan Li
- Mental Hospital of Jiangxi Province, No. 43 Shangfang Road, Nanchang, Jiangxi, People's Republic of China
| | - Jing Xia
- ShengJing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Lina Wang
- Shandong Mental Health Center, Jinan, Shandong, People's Republic of China
| | - Xiaofang Shang
- Nanjing Brain Hospital, Nanjing, Jiangsu, People's Republic of China
| | - Wenhua Sang
- Hebei Mental Health Center, Baoding, Hebei, People's Republic of China
| | - Chunhong Shao
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Zhaoyu Gan
- No. 3 Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Kangmei He
- Shanghai Tongji University affiliated Tongji Hospital, Shanghai 200065, People's Republic of China
| | - Xiaochuan Zhao
- First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Tian Tian
- Tianjin Anding Hospital, Hexi District, Tianjin, People's Republic of China
| | - Dan Xu
- Shenzhen Kang Ning Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Danhua Gu
- Weihai Mental Health Center, Weihai, Shandong, People's Republic of China
| | - Xiaoqin Weng
- Psychiatric Hospital of Henan Province, No.388 Middle Jianshe Road, Xinxiang, Henan, People's Republic of China
| | - Haimin Li
- Mental Health Center of West China Hospital of Sichuan University, No. 28 South Dianxin Street, Wuhou District, Chengdu, Sichuan, People's Republic of China
| | - Jing Tian
- No. 1 Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Lijun Yang
- Jilin Brain Hospital, Siping, Jilin, People's Republic of China
| | - Qiang Li
- No. 1 Mental Health Center Affiliated Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Qingzhen Yang
- Chongqing Mental Health Center, Chongqing, People's Republic of China
| | - Hui Wang
- No. 1 Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yamei Dang
- Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), No. 36 Mingxin Road, Fangcun Avenue, Liwan District, Guangzhou, Guangdong, People's Republic of China
| | - Lei Dai
- Dalian No.7 Hospital & Dalian Mental Health Center, Dalian, Liaoning, People's Republic of China
| | - Yanping Cui
- No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, People's Republic of China
| | - Dong Ye
- Sichuan Mental Health Center, Mianyang, Sichuan, People's Republic of China
| | - Juling Cao
- No. 2 Hospital of Lanzhou University, No. 82, Cuiyingmen, Lanzhou, Gansu, People's Republic of China
| | - Li Guo
- The Fourth Military Medical University Affiliated Xijing Hospital, Xian, Shaanxi, People's Republic of China
| | - Zhen Kang
- Liaocheng No. 4 Hospital, Liaocheng, Shandong, People's Republic of China
| | - Jimeng Liu
- Ningbo Kang Ning Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Bin Chen
- Fuzhou Psychiatric Hospital, Cangshan District, Fuzhou, Fujian, People's Republic of China
| | - Jinhua Liu
- Suzhou Guangji Hospital, Suzhou, Jiangsu, People's Republic of China
| | - Jinling Zhang
- Mental Health Center of Shantou University, Shantou, Guangdong, People's Republic of China
| | - Donglin Yang
- Jining Psychiatric Hospital, Jining, Shandong, People's Republic of China
| | - Bin Jiao
- No. 2 Xiangya Hospital of Zhongnan University, Changsha, Hunan, People's Republic of China
| | - Fengyu Yu
- Harbin No. 1 Special Hospital, Harbin, Heilongjiang, People's Republic of China
| | - Feng Geng
- Anhui Mental Health Center, Hefei, Anhui, People's Republic of China
| | - Ling Li
- Changchun Mental Hospital, Changchun, Jilin, People's Republic of China
| | - Haiying Yang
- Huaian No. 3 Hospital, Huaian, Jiangsu, People's Republic of China
| | - Hong Dai
- Huzhou No. 3 Hospital, Huzhou, Zhejiang, People's Republic of China
| | - Hongli Wang
- Mudanjiang Psychiatric Hospital of Heilongjiang Province, Mudanjiang, Heilongjiang, People's Republic of China
| | - Caixing Liu
- Qingdao Mental Health Center, No. 299 Nanjing Road, Shibei District, Qingdao, Shandong, People's Republic of China
| | - Haijun Liu
- Tangshan No. 5 Hospital, Tangshan, Hebei, People's Republic of China
| | - Longyan Peng
- Daqing No. 3 Hospital of Heilongjiang Province, Daqing, Heilongjiang, People's Republic of China
| | - Xiaoping Wang
- Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Shaojun Wei
- Guangxi Longquanshan Hospital, Liuzhou, Guangxi, People's Republic of China
| | - Xiaojuan Liu
- Tianjin First Center Hospital, Tianjin, People's Republic of China
| | - Chang Li
- Wuhan Mental Health Center, Wuhan, Hubei, People's Republic of China
| | - Zhengrong Liu
- Anshan Psychiatric Rehabilitation Hospital, Anshan, Liaoning, People's Republic of China
| | - Qiwen Zhang
- Hainan Anning Hospital, Haikou, Hainan, People's Republic of China
| | - Dongchuan Di
- Mental Health Institute of Jining Medical College, Jining, Shandong, People's Republic of China
| | - Jonathan Flint
- Wellcome Trust Centre for Human Genetics, Oxford OX3 7BN, United Kingdom
| | - Shenxun Shi
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China.
| | - Kenneth S Kendler
- Virginia Commonwealth University, Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Box 980126, Richmond, VA 232980126, USA.
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Melcangi RC, Giatti S, Calabrese D, Pesaresi M, Cermenati G, Mitro N, Viviani B, Garcia-Segura LM, Caruso D. Levels and actions of progesterone and its metabolites in the nervous system during physiological and pathological conditions. Prog Neurobiol 2014; 113:56-69. [DOI: 10.1016/j.pneurobio.2013.07.006] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 07/17/2013] [Accepted: 07/31/2013] [Indexed: 12/12/2022]
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Allen AM, al’Absi M, Lando H, Hatsukami D, Allen SS. Menstrual phase, depressive symptoms, and allopregnanolone during short-term smoking cessation. Exp Clin Psychopharmacol 2013; 21:427-33. [PMID: 24059585 PMCID: PMC4574494 DOI: 10.1037/a0034075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preclinical literature indicates that allopregnanolone (ALLO), a neuroactive steroid metabolized from progesterone, may protect against drug abuse behaviors. It is important to understand how ALLO varies during smoking changes in clinical samples with depressive symptoms (DS) given they are at high risk of smoking relapse. The purpose of this article is to characterize changes in ALLO by menstrual phase during short-term smoking cessation among women with and without DS. At screening, study participants (n = 84) were classified as either having past or current DS (n = 48) or not (n = 36). In a controlled crossover trial design, participants completed 2 testing weeks in the follicular (F; low ALLO) and luteal (L; high ALLO) menstrual phases. During each testing week, blood samples were collected during ad libitum smoking and on the fourth day of biochemically verified smoking abstinence. Participants were, on average, 30.1 ± 6.7 years old, smoked 12.6 ± 5.7 cigarettes per day, and most (73%) were White. The change in ALLO during short-term smoking cessation varied significantly by menstrual phase such that it decreased by 10% in the follicular phase and increased by 31% in the luteal phase. There were no significant differences in ALLO levels by DS group. In premenopausal women, ALLO levels varied by menstrual phase and smoking status, but not DS. Given that other research has indicated L phase is associated with improved smoking cessation outcomes, an increase in ALLO during short-term cessation in the L phase may protect against relapse whereas a decrease in ALLO, as observed in the F phase, may increase risk for relapse.
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Affiliation(s)
- Alicia M. Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 256, Minneapolis, MN 55414, Phone: 612-624-0896
| | - Mustafa al’Absi
- Department of Behavioral Sciences, Medical School, University of Minnesota, Duluth, 1035 University Drive, 236 SMed, D601A, Duluth, MN 55812
| | - Harry Lando
- Department of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2 Street, 300 WBOB, Minneapolis, MN 55454
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, 717 Delaware Street SE, Room 256, Minneapolis, MN 55414
| | - Sharon S. Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 420 Delaware Street SE, Room A682, Minneapolis, MN 55455
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Castro B, Sánchez P, Torres JM, Ortega E. Effects of adult exposure to bisphenol a on genes involved in the physiopathology of rat prefrontal cortex. PLoS One 2013; 8:e73584. [PMID: 24066056 PMCID: PMC3774751 DOI: 10.1371/journal.pone.0073584] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 07/29/2013] [Indexed: 01/11/2023] Open
Abstract
Several neurological and behavioral dysfunctions have been reported in animals exposed to bisphenol A (BPA). However, little is known about the impact of adult exposure to BPA on brain physiopathology. Here, we focused on prefrontal cortex (PFC) of rats, because it is an important area for cognitive control, complex behaviors and is altered in many psychopathologies. Gamma-aminobutyric acid (GABA) and serotonin (5-HT) systems are essential for PFC function. Therefore, we examined the effects of adult exposure to BPA on 5α-Reductase (5α-R) and cytochrome P450 aromatase (P450arom), enzymes that synthesize GABAA receptor modulators, and tryptophan hydroxylase (Tph), the rate-limiting enzyme in 5-HT biosynthesis. To gain better understanding of BPA's action in the adult PFC, 84 genes involved in neurotoxicity were also analysed. Adult male and female rats were subcutaneously injected for 4 days with 50 µg/kg/day, the current reference safe dose for BPA. mRNA and protein levels of 5α-R, P450arom and Tph were quantified by real-time RT-PCR and Western blot. Genes linked to neurotoxicity were analyzed by PCR-Array technology. Adult exposure to BPA increased both P450arom and Tph2 expression in PFC of male and female, but decreased 5α-R1 expression in female. Moreover, we identified 17 genes related to PFC functions such as synaptic plasticity and memory, as potential targets of BPA. Our results provided new insights on the molecular mechanisms underlying BPA action in the physiopathology of PFC, but also raise the question about the safety of short-term exposure to it in the adulthood.
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Affiliation(s)
- Beatriz Castro
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Pilar Sánchez
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Jesús M. Torres
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Granada, Granada, Spain
- Institute of Neurosciences, Faculty of Medicine, University of Granada, Granada, Spain
- * E-mail: (JMT); (EO)
| | - Esperanza Ortega
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Granada, Granada, Spain
- Institute of Neurosciences, Faculty of Medicine, University of Granada, Granada, Spain
- * E-mail: (JMT); (EO)
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Li Y, Raaby KF, Sánchez C, Gulinello M. Serotonergic receptor mechanisms underlying antidepressant-like action in the progesterone withdrawal model of hormonally induced depression in rats. Behav Brain Res 2013; 256:520-8. [PMID: 24016840 DOI: 10.1016/j.bbr.2013.09.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 08/27/2013] [Accepted: 09/01/2013] [Indexed: 11/16/2022]
Abstract
Hormonally induced mood disorders such as premenstrual dysphoric disorder (PMDD) are characterized by a range of physical and affective symptoms including anxiety, irritability, anhedonia, social withdrawal and depression. Studies demonstrated rodent models of progesterone withdrawal (PWD) have a high level of constructive and descriptive validity to model hormonally-induced mood disorders in women. Here we evaluate the effects of several classes of antidepressants in PWD female Long-Evans rats using the forced swim test (FST) as a measure of antidepressant activity. The study included fluoxetine, duloxetine, amitriptyline and an investigational multimodal antidepressant, vortioxetine (5-HT(3), 5-HT(7) and 5-HT(1D) receptor antagonist; 5-HT(1B) receptor partial agonist; 5-HT(1A) receptor agonist; inhibitor of the serotonin transporter (SERT)). After 14 days of administration, amitriptyline and vortioxetine significantly reduced immobility in the FST whereas fluoxetine and duloxetine were ineffective. After 3 injections over 48 h, neither fluoxetine nor duloxetine reduced immobility, whereas amitriptyline and vortioxetine significantly reduced FST immobility during PWD. When administered acutely during PWD, the 5-HT(1A) receptor agonist, flesinoxan, significantly reduced immobility, whereas the 5-HT(1A) receptor antagonist, WAY-100635, increased immobility. The 5-HT(3) receptor antagonist, ondansetron, significantly reduced immobility, whereas the 5-HT(3) receptor agonist, SR-57227, increased immobility. The 5-HT(7) receptor antagonist, SB-269970, was inactive, although the 5-HT(7) receptor agonist, AS-19, significantly increased PWD-induced immobility. None of the compounds investigated (ondansetron, flesinoxan and SB-269970) improved the effect of fluoxetine during PWD. These data indicate that modulation of specific 5-HT receptor subtypes is critical for manipulating FST immobility in this model of hormone-induced depression.
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Affiliation(s)
- Yan Li
- External Sourcing and Scientific Excellence, Lundbeck Research USA, United States.
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Abstract
Hot flashes are very common in women in menopause and can have a detrimental effect on quality of life. Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Several nonhormonal therapies have been tested in randomized placebo-controlled trials including nonpharmacologic approaches and pharmacologic nonhormonal agents. Among them, two classes of nonhormonal medications have been demonstrated to effectively alleviate hot flashes: γ-aminobutyric acid (GABA) analogs and selective serotonin reuptake inhibitors (SSRIs). This article discusses the superior efficacy of the newer nonhormonal prescriptions for the treatment of hot flashes when compared with estrogen replacement therapy, and provides some recommendations regarding use of them in peri- and postmenopausal women.
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Affiliation(s)
- Atsushi Imai
- Department of Obstetrics and Gynecology, Matsunami General Hospital, Gifu, Japan.
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49
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Pang Y, Dong J, Thomas P. Characterization, neurosteroid binding and brain distribution of human membrane progesterone receptors δ and {epsilon} (mPRδ and mPR{epsilon}) and mPRδ involvement in neurosteroid inhibition of apoptosis. Endocrinology 2013; 154:283-95. [PMID: 23161870 PMCID: PMC3529379 DOI: 10.1210/en.2012-1772] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Three members of the progestin and adipoQ receptor (PAQR) family, PAQR-7, PAQR-8, and PAQR-5 [membrane progesterone (P4) receptor (PR) (mPR)α, mPRβ, and mPRγ], function as plasma mPRs coupled to G proteins in mammalian cells, but the characteristics of two other members, PAQR6 and PAQR9 (mPRδ and mPRε), remain unclear, because they have only been investigated in yeast expression systems. Here, we show that recombinant human mPRδ and mPRε expressed in MDA-MB-231 breast cancer cells display specific, saturable, high-affinity [(3)H]-P4 binding on the plasma membranes of transfected cells with equilibrium dissociation constants (K(d)s) of 2.71 and 2.85 nm, respectively, and low affinity for R5020, characteristics typical of mPRs. P4 treatment increased cAMP production as well as [(35)S]-guanosine 5'-triphosphate (GTP)γS binding to transfected cell membranes, which was immunoprecipitated with a stimulatory G protein antibody, suggesting both mPRδ and mPRε activate a stimulatory G protein (Gs), unlike other mPRs, which activate an inhibitory G protein (Gi). All five mPR mRNAs were detected in different regions of the human brain, but mPRδ showed greatest expression in many regions, including the forebrain, hypothalamus, amygdala, corpus callosum, and spinal cord, whereas mPRε was abundant in the pituitary gland and hypothalamus. Allopregnanolone and other neurosteroids bound to mPRδ and other mPRs and acted as agonists, activating second messengers and decreased starvation-induced cell death and apoptosis in mPRδ-transfected cells and in hippocampal neuronal cells at low nanomolar concentrations. The results suggest that mPRδ and mPRε function as mPRs coupled to G proteins and are potential intermediaries of nonclassical antiapoptotic actions of neurosteroids in the central nervous system.
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Affiliation(s)
- Yefei Pang
- University of Texas Marine Science Institute, 750 Channel View Drive, Port Aransas, TX 78373, USA
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50
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Caruso D, Barron AM, Brown MA, Abbiati F, Carrero P, Pike CJ, Garcia-Segura LM, Melcangi RC. Age-related changes in neuroactive steroid levels in 3xTg-AD mice. Neurobiol Aging 2012; 34:1080-9. [PMID: 23122920 DOI: 10.1016/j.neurobiolaging.2012.10.007] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 10/02/2012] [Accepted: 10/07/2012] [Indexed: 11/19/2022]
Abstract
Although neuroactive steroids exert neuroprotective actions in different experimental models of neurodegenerative diseases, including those of Alzheimer's disease (AD), their relationships with aged related physiologic and pathologic brain changes remain to be clarified. In this study the levels of pregnenolone, dehydroepiandrosterone, progesterone, dihydroprogesterone, tetrahydroprogesterone, isopregnanolone, testosterone, dihydrotestosterone, 5α-androstane-3α,17β-diol, 5α-androstane-3β,17β-diol, 17α-estradiol, and 17β-estradiol were assessed in the limbic region of young adult (7 months) and aged (24 months) male wild type and triple transgenic AD mice. Age related neuropathological changes in AD brains, such as β-amyloid accumulation and gliosis, were associated with modified levels of specific neuroactive steroids and particularly with changes in the levels of progesterone and testosterone metabolites. The altered levels of neuroactive steroids in aged AD brains might impact on the activation of neuroprotective signaling mediated by classic and nonclassic steroid receptors, like the gamma-aminobuttyric acid (GABA)-A receptor.
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Affiliation(s)
- Donatella Caruso
- Department of Pharmacological and Biomolecular Sciences, Center of Excellence on Neurodegenerative Diseases, Università degli Studi di Milano, Milano, Italy
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