1
|
Hofe IV, Stricker BH, Vernooij MW, Ikram MK, Ikram MA, Wolters FJ. Benzodiazepine use in relation to long-term dementia risk and imaging markers of neurodegeneration: a population-based study. BMC Med 2024; 22:266. [PMID: 38951846 PMCID: PMC11218055 DOI: 10.1186/s12916-024-03437-5] [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: 11/11/2023] [Accepted: 05/22/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Benzodiazepine use is common, particularly in older adults. Benzodiazepines have well-established acute adverse effects on cognition, but long-term effects on neurodegeneration and dementia risk remain uncertain. METHODS We included 5443 cognitively healthy (MMSE ≥ 26) participants from the population-based Rotterdam Study (57.4% women, mean age 70.6 years). Benzodiazepine use from 1991 until baseline (2005-2008) was derived from pharmacy dispensing records, from which we determined drug type and cumulative dose. Benzodiazepine use was defined as prescription of anxiolytics (ATC-code: N05BA) or sedative-hypnotics (ATC-code: N05CD) between inception of pharmacy records and study baseline. Cumulative dose was calculated as the sum of the defined daily doses for all prescriptions. We determined the association with dementia risk until 2020 using Cox regression. Among 4836 participants with repeated brain MRI, we further determined the association of benzodiazepine use with changes in neuroimaging markers using linear mixed models. RESULTS Of all 5443 participants, 2697 (49.5%) had used benzodiazepines at any time in the 15 years preceding baseline, of whom 1263 (46.8%) used anxiolytics, 530 (19.7%) sedative-hypnotics, and 904 (33.5%) used both; 345 (12.8%) participants were still using at baseline assessment. During a mean follow-up of 11.2 years, 726 participants (13.3%) developed dementia. Overall, use of benzodiazepines was not associated with dementia risk compared to never use (HR [95% CI]: 1.06 [0.90-1.25]), irrespective of cumulative dose. Risk estimates were somewhat higher for any use of anxiolytics than for sedative-hypnotics (HR 1.17 [0.96-1.41] vs 0.92 [0.70-1.21]), with strongest associations for high cumulative dose of anxiolytics (HR [95% CI] 1.33 [1.04-1.71]). In imaging analyses, current use of benzodiazepine was associated cross-sectionally with lower brain volumes of the hippocampus, amygdala, and thalamus and longitudinally with accelerated volume loss of the hippocampus and to a lesser extent amygdala. However, imaging findings did not differ by type of benzodiazepines or cumulative dose. CONCLUSIONS In this population-based sample of cognitively healthy adults, overall use of benzodiazepines was not associated with increased dementia risk, but potential class-dependent adverse effects and associations with subclinical markers of neurodegeneration may warrant further investigation.
Collapse
Affiliation(s)
- Ilse Vom Hofe
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Alzheimer Centre Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
- Department of Radiology & Nuclear Medicine, Alzheimer Centre Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands.
| |
Collapse
|
2
|
Ekinci O, Ekinci A. Short-term, but not long-term, beneficial effects of concomitant benzodiazepine use on clinical course in patients with schizophrenia. Int Clin Psychopharmacol 2022; 37:143-150. [PMID: 35045532 DOI: 10.1097/yic.0000000000000392] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aims to examine possible differences in the effect on the course characteristics of the disease in cases of no use, short-term use and long-term use of benzodiazepines in patients with schizophrenia. In this retrospective observational study, the sample comprised patients with schizophrenia who were admitted to our psychiatric clinics from January 2015 to January 2019. Patients were also retrospectively tracked from the date of the first admission during the specified time until the end of the observation period (24 months) for clinical course characteristics. Data for 1710 patients with schizophrenia were included in the analyses. Patients with short-term benzodiazepines use had fewer psychiatric hospitalizations and shorter lengths of stay at psychiatric services than patients with no use or long-term use. Rates of antipsychotic drug discontinuation and suicidal behavior were also significantly lower among short-term benzodiazepines users than among those with no use or long-term use. In conclusion, our study indicates that short-term benzodiazepines use is associated with a better clinical course in patients with schizophrenia. Future studies should evaluate the effects of different benzodiazepines use patterns on disease prognosis with longer-term follow-up and prospective methodology and should concomitantly examine psychopathological variables.
Collapse
Affiliation(s)
- Okan Ekinci
- Department of Psychiatry, Usak University, Usak Merkez, Turkey
| | - Asli Ekinci
- Usak Education and Research Hospital, Psychiatry Department, Usak, Turkey
| |
Collapse
|
3
|
Furukawa T, Nikaido Y, Shimoyama S, Masuyama N, Notoya A, Ueno S. Impaired Cognitive Function and Hippocampal Changes Following Chronic Diazepam Treatment in Middle-Aged Mice. Front Aging Neurosci 2021; 13:777404. [PMID: 34899279 PMCID: PMC8664496 DOI: 10.3389/fnagi.2021.777404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/04/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Gamma-aminobutyric acid (GABA) type A receptors are positively allosterically modulated by benzodiazepine binding, leading to a potentiated response to GABA. Diazepam (DZP, a benzodiazepine) is widely prescribed for anxiety, epileptic discharge, and insomnia, and is also used as a muscle relaxant and anti-convulsant. However, some adverse effects - such as tolerance, dependence, withdrawal effects, and impairments in cognition and learning - are elicited by the long-term use of DZP. Clinical studies have reported that chronic DZP treatment increases the risk of dementia in older adults. Furthermore, several studies have reported that chronic DZP administration may affect neuronal activity in the hippocampus, dendritic spine structure, and cognitive performance. However, the effects of chronic DZP administration on cognitive function in aged mice is not yet completely understood. Methods: A behavioral test, immunohistochemical analysis of neurogenic and apoptotic markers, dendritic spine density analysis, and long-term potentiation (LTP) assay of the hippocampal CA1 and CA3 were performed in both young (8 weeks old) and middle-aged (12 months old) mice to investigate the effects of chronic DZP administration on cognitive function. The chronic intraperitoneal administration of DZP was performed by implanting an osmotic minipump. To assess spatial learning and memory ability, the Morris water maze test was performed. Dendritic spines were visualized using Lucifer yellow injection into the soma of hippocampal neurons, and spine density was analyzed. Moreover, the effects of exercise on DZP-induced changes in spine density and LTP in the hippocampus were assessed. Results: Learning performance was impaired by chronic DZP administration in middle-aged mice but not in young mice. LTP was attenuated by DZP administration in the CA1 of young mice and the CA3 of middle-aged mice. The spine density of hippocampal neurons was decreased by chronic DZP administration in the CA1 of both young and middle-aged mice as well as in the CA3 of middle-aged mice. Neither neurogenesis nor apoptosis in the hippocampus was affected by chronic DZP administration. Conclusion: The results of this study suggest that the effects of chronic DZP are different between young and middle-aged mice. The chronic DZP-induced memory retrieval performance impairment in middle-aged mice can likely be attributed to decreased LTP and dendritic spine density in hippocampal neurons in the CA3. Notably, prophylactic exercise suppressed the adverse effects of chronic DZP on LTP and spine maintenance in middle-aged mice.
Collapse
Affiliation(s)
- Tomonori Furukawa
- Department of Neurophysiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoshikazu Nikaido
- Department of Frailty Research and Prevention, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shuji Shimoyama
- Department of Neurophysiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Research Center for Child Mental Development, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Nozomu Masuyama
- Department of Neurophysiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Ayaka Notoya
- Department of Neurophysiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shinya Ueno
- Department of Neurophysiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Research Center for Child Mental Development, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| |
Collapse
|
4
|
Huzian O, Baka J, Csakvari E, Dobos N, Leranth C, Siklos L, Duman RS, Farkas T, Hajszan T. Stress Resilience is Associated with Hippocampal Synaptoprotection in the Female Rat Learned Helplessness Paradigm. Neuroscience 2021; 459:85-103. [PMID: 33524494 DOI: 10.1016/j.neuroscience.2021.01.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/11/2021] [Accepted: 01/21/2021] [Indexed: 12/28/2022]
Abstract
The synaptogenic hypothesis of major depressive disorder implies that preventing the onset of depressive-like behavior also prevents the loss of hippocampal spine synapses. By applying the psychoactive drugs, diazepam and fluoxetine, we investigated whether blocking the development of helpless behavior by promoting stress resilience in the rat learned helplessness paradigm is associated with a synaptoprotective action in the hippocampus. Adult ovariectomized and intact female Sprague-Dawley rats (n = 297) were treated with either diazepam, fluoxetine, or vehicle, exposed to inescapable footshocks or sham stress, and tested in an active escape task to assess helpless behavior. Escape-evoked corticosterone secretion, as well as remodeling of hippocampal spine synapses at a timepoint representing the onset of escape testing were also analyzed. In ovariectomized females, treatment with diazepam prior to stress exposure prevented helpless behavior, blocked the loss of hippocampal spine synapses, and muted the corticosterone surge evoked by escape testing. Although fluoxetine stimulated escape performance and hippocampal synaptogenesis under non-stressed conditions, almost all responses to fluoxetine were abolished following exposure to inescapable stress. Only a much higher dose of fluoxetine was capable of partly reproducing the strong protective actions of diazepam. Importantly, these protective actions were retained in the presence of ovarian hormones. Our findings indicate that stress resilience is associated with the preservation of spine synapses in the hippocampus, raising the possibility that, besides synaptogenesis, hippocampal synaptoprotection is also implicated in antidepressant therapy.
Collapse
Affiliation(s)
- Orsolya Huzian
- Institute of Biophysics, Biological Research Center, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Judith Baka
- Institute of Biophysics, Biological Research Center, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Eszter Csakvari
- Institute of Biophysics, Biological Research Center, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Nikoletta Dobos
- Institute of Biophysics, Biological Research Center, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Csaba Leranth
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States; Department of Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States
| | - Laszlo Siklos
- Institute of Biophysics, Biological Research Center, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Ronald S Duman
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06508, United States; Department of Pharmacology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, United States
| | - Tamas Farkas
- Department of Physiology, Anatomy, and Neuroscience, University of Szeged Faculty of Science and Informatics, Kozep Fasor 52, 6726 Szeged, Hungary
| | - Tibor Hajszan
- Institute of Biophysics, Biological Research Center, Temesvari Krt 62, 6726 Szeged, Hungary; Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States.
| |
Collapse
|
5
|
Prevot TD, Sumitomo A, Tomoda T, Knutson DE, Li G, Mondal P, Banasr M, Cook JM, Sibille E. Reversal of Age-Related Neuronal Atrophy by α5-GABAA Receptor Positive Allosteric Modulation. Cereb Cortex 2021; 31:1395-1408. [PMID: 33068001 PMCID: PMC7786363 DOI: 10.1093/cercor/bhaa310] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 12/30/2022] Open
Abstract
Aging is associated with reduced brain volume, altered neural activity, and neuronal atrophy in cortical-like structures, comprising the frontal cortex and hippocampus, together contributing to cognitive impairments. Therapeutic efforts aimed at reversing these deficits have focused on excitatory or neurotrophic mechanisms, although recent findings show that reduced dendritic inhibition mediated by α5-subunit containing GABA-A receptors (α5-GABAA-Rs) occurs during aging and contributes to cognitive impairment. Here, we aimed to confirm the beneficial effect on working memory of augmenting α5-GABAA-R activity in old mice and tested its potential at reversing age-related neuronal atrophy. We show that GL-II-73, a novel ligand with positive allosteric modulatory activity at α5-GABAA-R (α5-PAM), increases dendritic branching complexity and spine numbers of cortical neurons in vitro. Using old mice, we confirm that α5-PAM reverses age-related working memory deficits and show that chronic treatment (3 months) significantly reverses age-related dendritic shrinkage and spine loss in frontal cortex and hippocampus. A subsequent 1-week treatment cessation (separate cohort) resulted in loss of efficacy on working memory but maintained morphological neurotrophic effects. Together, the results demonstrate the beneficial effect on working memory and neurotrophic efficacy of augmenting α5-GABAA-R function in old mice, suggesting symptomatic and disease-modifying potential in age-related brain disorders.
Collapse
Affiliation(s)
- Thomas D Prevot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
| | - Akiko Sumitomo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
| | - Toshifumi Tomoda
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
| | - Daniel E Knutson
- Department of Chemistry and Biochemistry, University of Wisconsin–Milwaukee, Milwaukee, WI 53211, USA
| | - Guanguan Li
- Department of Chemistry and Biochemistry, University of Wisconsin–Milwaukee, Milwaukee, WI 53211, USA
| | - Prithu Mondal
- Department of Chemistry and Biochemistry, University of Wisconsin–Milwaukee, Milwaukee, WI 53211, USA
| | - Mounira Banasr
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - James M Cook
- Department of Chemistry and Biochemistry, University of Wisconsin–Milwaukee, Milwaukee, WI 53211, USA
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
| |
Collapse
|
6
|
Understanding the effects of chronic benzodiazepine use in depression: a focus on neuropharmacology. Int Clin Psychopharmacol 2020; 35:243-253. [PMID: 32459725 DOI: 10.1097/yic.0000000000000316] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Benzodiazepines are frequently prescribed on an ongoing basis to individuals with depression, mainly to alleviate anxiety or insomnia, despite current guideline recommendations that continuous use should not exceed 4 weeks. Currently, there are no efficacy trials published beyond 8 weeks. Several antidepressant trials demonstrate that the concomitant use of a benzodiazepine is associated with poorer depressive outcomes and functional status; however, it is unclear why this is the case. Patients with depression receiving a benzodiazepine may reflect a more ill or high anxiety group, although even within anxiety disorders, the use of a benzodiazepine is associated with poorer outcomes. The neuroadaptive consequences of long-term benzodiazepine use may be a factor underlying these findings. Chronic benzodiazepine use results in decreased gamma-aminobutyric acid and monoaminergic function, as well as interference with neurogenesis, which are all purported to play a role in antidepressant efficacy. This review will discuss the oppositional neuropharmacological interactions between chronic benzodiazepine use and antidepressant mechanism of action, which could result in reduced antidepressant efficacy and function in depression.
Collapse
|
7
|
Huhtaniska S, Korkala I, Heikka T, Björnholm L, Lehtiniemi H, Hulkko AP, Moilanen J, Tohka J, Manjón J, Coupé P, Kiviniemi V, Isohanni M, Koponen H, Murray GK, Miettunen J, Jääskeläinen E. Antipsychotic and benzodiazepine use and brain morphology in schizophrenia and affective psychoses - Systematic reviews and birth cohort study. Psychiatry Res Neuroimaging 2018; 281:43-52. [PMID: 30219591 DOI: 10.1016/j.pscychresns.2018.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 08/23/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
The aim of this paper was to investigate differences in brain structure volumes between schizophrenia and affective psychoses, and whether cumulative lifetime antipsychotic or benzodiazepine doses relate to brain morphology in these groups. We conducted two systematic reviews on the topic and investigated 44 schizophrenia cases and 19 with affective psychoses from the Northern Finland Birth Cohort 1966. The association between lifetime antipsychotic and benzodiazepine dose and brain MRI scans at the age of 43 was investigated using linear regression. Intracranial volume, sex, illness severity, and antipsychotic/benzodiazepine doses were used as covariates. There were no differences between the groups in brain structure volumes. In schizophrenia, after adjusting for benzodiazepine dose and symptoms, a negative association between lifetime antipsychotic dose and the nucleus accumbens volume remained. In affective psychoses, higher lifetime benzodiazepine dose associated with larger volumes of total gray matter and hippocampal volume after controlling for antipsychotic use and symptoms. It seems that in addition to antipsychotics, the severity of symptoms and benzodiazepine dose are also associated with brain structure volumes. These results suggest, that benzodiazepine effects should also be investigated also independently and not only as a confounder.
Collapse
Affiliation(s)
- Sanna Huhtaniska
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland.
| | - Iikka Korkala
- Center for Life Course Health Research, University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Tuomas Heikka
- Center for Life Course Health Research, University of Oulu, Finland
| | - Lassi Björnholm
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Heli Lehtiniemi
- Center for Life Course Health Research, University of Oulu, Finland
| | - Anja P Hulkko
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Jani Moilanen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Jussi Tohka
- AI Virtanen Institute for Molecular Sciences, University of Eastern Finland, Finland
| | - José Manjón
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Spain
| | - Pierrick Coupé
- Laboratoire Bordelais de Recherche en Informatique, Unité Mixte de Recherche CNRS (UMR 5800), PICTURA Research Group, France
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Matti Isohanni
- Center for Life Course Health Research, University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
| | - Hannu Koponen
- University of Helsinki, Helsinki University Hospital, Psychiatry, Helsinki, Finland
| | - Graham K Murray
- University of Cambridge, Department of Psychiatry, United Kingdom; University of Cambridge, Behavioural and Clinical Neuroscience Institute, United Kingdom
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Erika Jääskeläinen
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
| |
Collapse
|
8
|
Verstraelen P, Van Dyck M, Verschuuren M, Kashikar ND, Nuydens R, Timmermans JP, De Vos WH. Image-Based Profiling of Synaptic Connectivity in Primary Neuronal Cell Culture. Front Neurosci 2018; 12:389. [PMID: 29997468 PMCID: PMC6028601 DOI: 10.3389/fnins.2018.00389] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/22/2018] [Indexed: 12/04/2022] Open
Abstract
Neurological disorders display a broad spectrum of clinical manifestations. Yet, at the cellular level, virtually all these diseases converge into a common phenotype of dysregulated synaptic connectivity. In dementia, synapse dysfunction precedes neurodegeneration and cognitive impairment by several years, making the synapse a crucial entry point for the development of diagnostic and therapeutic strategies. Whereas high-resolution imaging and biochemical fractionations yield detailed insight into the molecular composition of the synapse, standardized assays are required to quickly gauge synaptic connectivity across large populations of cells under a variety of experimental conditions. Such screening capabilities have now become widely accessible with the advent of high-throughput, high-content microscopy. In this review, we discuss how microscopy-based approaches can be used to extract quantitative information about synaptic connectivity in primary neurons with deep coverage. We elaborate on microscopic readouts that may serve as a proxy for morphofunctional connectivity and we critically analyze their merits and limitations. Finally, we allude to the potential of alternative culture paradigms and integrative approaches to enable comprehensive profiling of synaptic connectivity.
Collapse
Affiliation(s)
- Peter Verstraelen
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Michiel Van Dyck
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Marlies Verschuuren
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Rony Nuydens
- Janssen Research and Development, Janssen Pharmaceutica N.V., Beerse, Belgium
| | - Jean-Pierre Timmermans
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Winnok H. De Vos
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
- Cell Systems and Imaging, Department of Molecular Biotechnology, Ghent University, Ghent, Belgium
| |
Collapse
|
9
|
Huhtaniska S, Jääskeläinen E, Heikka T, Moilanen JS, Lehtiniemi H, Tohka J, Manjón JV, Coupé P, Björnholm L, Koponen H, Veijola J, Isohanni M, Kiviniemi V, Murray GK, Miettunen J. Long-term antipsychotic and benzodiazepine use and brain volume changes in schizophrenia: The Northern Finland Birth Cohort 1966 study. Psychiatry Res Neuroimaging 2017; 266:73-82. [PMID: 28618327 DOI: 10.1016/j.pscychresns.2017.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/12/2017] [Accepted: 05/19/2017] [Indexed: 11/22/2022]
Abstract
High doses of antipsychotics have been associated with loss in cortical and total gray matter in schizophrenia. However, previous imaging studies have not taken benzodiazepine use into account, in spite of evidence suggesting adverse effects such as cognitive impairment and increased mortality. In this Northern Finland Birth Cohort 1966 study, 69 controls and 38 individuals with schizophrenia underwent brain MRI at the ages of 34 and 43 years. At baseline, the average illness duration was over 10 years. Brain structures were delineated using an automated volumetry system, volBrain, and medication data on cumulative antipsychotic and benzodiazepine doses were collected using medical records and interviews. We used linear regression with intracranial volume and sex as covariates; illness severity was also taken into account. Though both medication doses associated to volumetric changes in subcortical structures, after adjusting for each other and the average PANSS total score, higher scan-interval antipsychotic dose associated only to volume increase in lateral ventricles and higher benzodiazepine dose associated with volume decrease in the caudate nucleus. To our knowledge, there are no previous studies reporting associations between benzodiazepine dose and brain structural changes. Further studies should focus on how these observations correspond to cognition and functioning.
Collapse
Affiliation(s)
- Sanna Huhtaniska
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland.
| | - Erika Jääskeläinen
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O. Box 26, FIN-90029 Oulu, Finland
| | - Tuomas Heikka
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland
| | - Jani S Moilanen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O. Box 26, FIN-90029 Oulu, Finland
| | - Heli Lehtiniemi
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland
| | - Jussi Tohka
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, FIN-70211 Kuopio, Finland
| | - José V Manjón
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Pierrick Coupé
- Laboratoire Bordelais de Recherche en Informatique, Unité Mixte de Recherche CNRS (UMR 5800), PICTURA Research Group, France
| | - Lassi Björnholm
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland
| | - Hannu Koponen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, University of Helsinki, Finland
| | - Juha Veijola
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O. Box 26, FIN-90029 Oulu, Finland
| | - Matti Isohanni
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O. Box 26, FIN-90029 Oulu, Finland
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, P.O. Box 50, FIN-90029 Oulu, Finland
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Box 189, Cambridge CB2 2QQ, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge CB2 3EB, UK
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland
| |
Collapse
|
10
|
Furukawa T, Shimoyama S, Miki Y, Nikaido Y, Koga K, Nakamura K, Wakabayashi K, Ueno S. Chronic diazepam administration increases the expression of Lcn2 in the CNS. Pharmacol Res Perspect 2017; 5:e00283. [PMID: 28596835 PMCID: PMC5461642 DOI: 10.1002/prp2.283] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/03/2016] [Accepted: 11/11/2016] [Indexed: 12/17/2022] Open
Abstract
Benzodiazepines (BZDs), which bind with high affinity to gamma-aminobutyric acid type A receptors (GABAA-Rs) and potentiate the effects of GABA, are widely prescribed for anxiety, insomnia, epileptic discharge, and as anticonvulsants. The long-term use of BZDs is limited due to adverse effects such as tolerance, dependence, withdrawal effects, and impairments in cognition and learning. Additionally, clinical reports have shown that chronic BZD treatment increases the risk of Alzheimer's disease. Unusual GABAA-R subunit expression and GABAA-R phosphorylation are induced by chronic BZD use. However, the gene expression and signaling pathways related to these effects are not completely understood. In this study, we performed a microarray analysis to investigate the mechanisms underlying the effect of chronic BZD administration on gene expression. Diazepam (DZP, a BZD) was chronically administered, and whole transcripts in the brain were analyzed. We found that the mRNA expression levels were significantly affected by chronic DZP administration and that lipocalin 2 (Lcn2) mRNA was the most upregulated gene in the cerebral cortex, hippocampus, and amygdala. Lcn2 is known as an iron homeostasis-associated protein. Immunostained signals of Lcn2 were detected in neuron, astrocyte, microglia, and Lcn2 protein expression levels were consistently upregulated. This upregulation was observed without proinflammatory genes upregulation, and was attenuated by chronic treatment of deferoxamine mesylate (DFO), iron chelator. Our results suggest that chronic DZP administration regulates transcription and upregulates Lcn2 expression levels without an inflammatory response in the mouse brain. Furthermore, the DZP-induced upregulation of Lcn2 expression was influenced by ambient iron.
Collapse
Affiliation(s)
- Tomonori Furukawa
- Department of Neurophysiology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Shuji Shimoyama
- Research Center for Child Mental Development Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Yasuo Miki
- Department of Neuropathology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Yoshikazu Nikaido
- Department of Neurophysiology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Kohei Koga
- Department of Neurophysiology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Kazuhiko Nakamura
- Research Center for Child Mental Development Hirosaki University Graduate School of Medicine Hirosaki Japan.,Department of Neuropsychiatry Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Koichi Wakabayashi
- Department of Neuropathology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Shinya Ueno
- Department of Neurophysiology Hirosaki University Graduate School of Medicine Hirosaki Japan.,Research Center for Child Mental Development Hirosaki University Graduate School of Medicine Hirosaki Japan
| |
Collapse
|
11
|
Kaur A, Singla N, Dhawan DK. Low dose X-irradiation mitigates diazepam induced depression in rat brain. Regul Toxicol Pharmacol 2016; 80:82-90. [PMID: 27316553 DOI: 10.1016/j.yrtph.2016.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/02/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
Abstract
Depression is considered as one of the most prevalent health ailments. Various anti-depressant drugs have been used to provide succour to this ailment, but with little success and rather have resulted in many side effects. On the other hand, low dose of ionizing radiations are reported to exhibit many beneficial effects on human body by stimulating various biological processes. The present study was conducted to investigate the beneficial effects of low doses of X-rays, if any, during diazepam induced depression in rats. Female Sprague Dawley rats were segregated into four different groups viz: Normal control, Diazepam treated, X-irradiated and Diazepam + X-irradiated. Depression model was created in rats by subjecting them to diazepam treatment at a dosage of 2 mg/kg b.wt./day for 3 weeks. The skulls of animals belonging to X-irradiated and Diazepam + X-irradiated rats were X-irradiated with a single fraction of 0.5 Gy, given twice a day for 3 days, thereby delivered dose of 3 Gy. Diazepam treated animals showed significant alterations in the neurobehavior and neuro-histoarchitecture, which were improved after X-irradiation. Further, diazepam exposure significantly decreased the levels of neurotransmitters and acetylcholinesterase activity, but increased the monoamine oxidase activity in brain. Interestingly, X-rays exposure to diazepam treated rats increased the levels of neurotransmitters, acetylcholinesterase activity and decreased the monoamine oxidase activity. Further, depressed rats also showed increased oxidative stress with altered antioxidant parameters, which were normalized on X-rays exposure. The present study, suggests that low dose of ionizing radiations, shall prove to be an effective intervention and a novel therapy in controlling depression and possibly other brain related disorders.
Collapse
Affiliation(s)
- Amandeep Kaur
- Department of Biophysics, Panjab University, Chandigarh, 160014, India
| | - Neha Singla
- Department of Biophysics, Panjab University, Chandigarh, 160014, India.
| | - D K Dhawan
- Department of Biophysics, Panjab University, Chandigarh, 160014, India.
| |
Collapse
|