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Wang H, Liu L, Zhou X, Guan Y, Li Y, Chen P, Duan R, Yang W, Rong X, Wu C, Yang J, Yang M, Jia Y, Hu J, Zhu X, Peng Y. Efficacy and safety of short-term edaravone or nerve growth factor add-on therapy for alcohol-related brain damage: A multi-centre randomised control trial. Addiction 2024; 119:717-729. [PMID: 38049955 DOI: 10.1111/add.16398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Abstract
AIMS To measure the therapeutic effect of an anti-oxidant, edaravone (EDV), or neurotrophic treatment with nerve growth factor (NGF) as an add-on treatment for alcohol-related brain damage (ARBD). DESIGN Multi-centre, randomised, single-blinded, comparative clinical trial. SETTING AND PARTICIPANTS One hundred and twenty-two inpatients recruited from seven hospitals in different regions of China, all diagnosed with ARBD and aged 18 to 65 years old; among them, only two were female. INTERVENTION AND COMPARATOR Patients were randomly assigned to receive one of three treatments for 2 weeks: 40 patients, treatment as usual (TAU: a combination of intramuscular injections of thiamine, intravenous infusions of other B vitamins with vitamin C and oral medication with vitamin E per day); 40, EDV add-on treatment to TAU (intravenous infusion with 30 mg of EDV twice per day); and 42, NGF add-on treatment to TAU (intramuscular injection of 20 μg of NGF per day). The patients underwent follow-up for 24 weeks. MEASUREMENTS The primary outcome was the composite score of executive cognitive function in the 2nd week after treatment, which was measured as the mean of the Z scores of the assessments, including the digit symbol substitute test (DSST), digit span memory test-forward (DST-F), digit span memory test-reverse (DST-R) and space span memory test (SSMT). The secondary outcomes were the composite scores at later follow-ups, the score for each component of cognitive function, global cognitive function measured by the Montreal Cognitive Assessment (MoCA), craving for alcohol and the safety of the therapies. FINDINGS EDV add-on treatment improved the composite score of executive cognitive function better than TAU in the 2nd week (adjusted mean difference: 0.24, 95% confidence interval 0.06 to 0.41; P = 0.008), but NGF add-on treatment did not (adjusted mean difference: 0.07, 95% confidence interval -0.09 to 0.24; P = 0.502). During the follow-up to 24 weeks, EDV add-on treatment improved the composite score of executive cognitive function and DST-R score better than TAU (both P < 0.01). Craving for alcohol was relieved in all three groups. No severe adverse events were observed. CONCLUSION The short-term addition of edaravone to supplementary therapy treatment for alcohol-related brain damage (ARBD) improved executive cognitive function in patients with ARBD.
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Affiliation(s)
- Hongxuan Wang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Liu
- Mental Health Centre, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuhui Zhou
- Hunan Provincial Brain Hospital, Changsha, China
| | - Yanzhong Guan
- Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, China
| | - Yanfei Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peiyun Chen
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ranran Duan
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weibian Yang
- Hongqi Hospital, Mudanjiang Medical University, Mudanjiang, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chengji Wu
- First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Jianzhong Yang
- Department of Psychiatry, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mei Yang
- Addiction Medicine Department, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yanjie Jia
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian Hu
- Mental Health Centre, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaofeng Zhu
- Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, China
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Gunther M, Jiang S, Maldonado JR. Dextroamphetamine as Adjunctive Pharmacotherapy for Aggression Secondary to Korsakoff Syndrome: A Case Report. J Acad Consult Liaison Psychiatry 2024:S2667-2960(24)00026-0. [PMID: 38417703 DOI: 10.1016/j.jaclp.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Affiliation(s)
- Matthew Gunther
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA.
| | - Shixie Jiang
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA; Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL
| | - Jose R Maldonado
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA
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McGregor R, Matzeu A, Thannickal TC, Wu F, Cornford M, Martin-Fardon R, Siegel JM. Sensitivity of Hypocretin System to Chronic Alcohol Exposure: A Human and Animal Study. Neuroscience 2023; 522:1-10. [PMID: 37121379 PMCID: PMC10681027 DOI: 10.1016/j.neuroscience.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/31/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
Human heroin addicts and mice administered morphine for a 2 week period show a greatly increased number of hypothalamic hypocretin (Hcrt or orexin) producing neurons with a concomitant reduction in Hcrt cell size. Male rats addicted to cocaine similarly show an increased number of detectable Hcrt neurons. These findings led us to hypothesize that humans with alcohol use disorder (AUD) would show similar changes. We now report that humans with AUD have a decreased number and size of detectable Hcrt neurons. In addition, the intermingled melanin concentrating hormone (MCH) neurons are reduced in size. We saw no change in the size and number of tuberomammillary histamine neurons in AUD. Within the Hcrt/MCH neuronal field we found that microglia cell size was increased in AUD brains. In contrast, male rats with 2 week alcohol exposure, sufficient to elicit withdrawal symptoms, show no change in the number or size of Hcrt, MCH and histamine neurons, and no change in the size of microglia. The present study indicates major differences between the response of Hcrt neurons to opioids and that to alcohol in human subjects with a history of substance abuse.
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Affiliation(s)
- Ronald McGregor
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA.
| | - Alessandra Matzeu
- The Scripps Research Institute, Department of Molecular Medicine, 10550 North Torrey Pines Road, SR-107, La Jolla, CA 92037, USA
| | - Thomas C Thannickal
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA
| | - Frank Wu
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA
| | - Marcia Cornford
- Department of Pathology, Harbor University of California, Los Angeles, Medical, Center, Torrance, CA 90509, USA
| | - Rémi Martin-Fardon
- The Scripps Research Institute, Department of Molecular Medicine, 10550 North Torrey Pines Road, SR-107, La Jolla, CA 92037, USA
| | - Jerome M Siegel
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA
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Xie L, Rungratanawanich W, Yang Q, Tong G, Fu E, Lu S, Liu Y, Akbar M, Song BJ, Wang X. Therapeutic strategies of small molecules in the microbiota-gut-brain axis for alcohol use disorder. Drug Discov Today 2023; 28:103552. [PMID: 36907319 PMCID: PMC10298843 DOI: 10.1016/j.drudis.2023.103552] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 03/13/2023]
Abstract
The microbiota-gut-brain axis (MGBA) is important in maintaining the structure and function of the central nervous system (CNS) and is regulated by the CNS environment and signals from the peripheral tissues. However, the mechanism and function of the MGBA in alcohol use disorder (AUD) are still not completely understood. In this review, we investigate the underlying mechanisms involved in the onset of AUD and/or associated neuronal deficits and create a foundation for better treatment (and prevention) strategies. We summarize recent reports focusing on the alteration of the MGBA in AUD. Importantly, we highlight the properties of small-molecule short-chain fatty acids (SCFAs), neurotransmitters, hormones, and peptides in the MGBA and discusses their usage as therapeutic agents against AUD.
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Affiliation(s)
- Lushuang Xie
- Departments of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Wiramon Rungratanawanich
- Section of Molecular Pharmacology and Toxicology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA
| | - Qiang Yang
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye, Hubei 435100, China
| | - Guoqiang Tong
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye, Hubei 435100, China
| | - Eric Fu
- Departments of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Shiguang Lu
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye, Hubei 435100, China
| | - Yuancai Liu
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye, Hubei 435100, China
| | - Mohammed Akbar
- Division of Neuroscience & Behavior, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA
| | - Byoung-Joon Song
- Section of Molecular Pharmacology and Toxicology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA.
| | - Xin Wang
- Departments of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Gupta R, Patel V, McGinnis SM, Silbersweig D, Miller MB, Feany MB, Daffner K, Gale SA. Case Study 4: A 68-Year-Old Woman With Progressive Cognitive Decline and Anxiety. J Neuropsychiatry Clin Neurosci 2023; 35:4-11. [PMID: 36633473 DOI: 10.1176/appi.neuropsych.20220151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Rishab Gupta
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
| | - Vihar Patel
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
| | - Scott M McGinnis
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
| | - David Silbersweig
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
| | - Michael B Miller
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
| | - Mel B Feany
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
| | - Kirk Daffner
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
| | - Seth A Gale
- Department of Psychiatry (Gupta, Silbersweig) and Division of Cognitive and Behavioral Neurology, Department of Neurology (McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School (McGinnis)
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6
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Mistarz N, Andersen K, Nielsen AS, Goudriaan AE, Michel TM, Skøt L, Anhøj SJ, Mellentin AI. Pharmacological compounds targeting emotional cognition in alcohol use disorder: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110535. [PMID: 35182608 DOI: 10.1016/j.pnpbp.2022.110535] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 01/15/2023]
Abstract
Non-emotional (e.g., executive functions) and emotional cognitive (e.g., facial emotion recognition) impairments are a well-known aspect of alcohol use disorder (AUD). These deficits may impede on treatment outcomes, increase the risk of relapse, and lead to socio-occupational disabilities. Previous systematic reviews have examined the effectiveness of cognitive enhancing pharmacological agents (CEPAs) targeting non-emotional, but not emotional, cognition in AUD. Our aim was to systematically review the effectiveness of CEPAs targeting emotional cognition in subclinical and clinical AUD populations. A qualitative synthesis of controlled trials was conducted, and the studies were assessed for risk of bias. Eight studies were eligible (15 ≤ ns ≤ 143), and they all had a moderate risk of bias. Modafinil and nalmefene were the most examined agents, with the findings suggesting a potential beneficial effect of the agents on implicit emotional domains (i.e., reward processing). Methodological shortcomings and heterogeneous findings across the studies do not allow inferences about the effectiveness of these compounds in AUD. Future studies should examine CEPAs targeting emotional cognition in more detail.
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Affiliation(s)
- Nicolaj Mistarz
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.
| | - Kjeld Andersen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anneke E Goudriaan
- Amsterdam University Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research, Department of Research, Arkin, Amsterdam, the Netherlands
| | - Tanja Maria Michel
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Lotte Skøt
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Simon Jesper Anhøj
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Angelina Isabella Mellentin
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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