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In vivo correlation of serotonin transporter and 1B receptor availability in the human brain: a PET study. Neuropsychopharmacology 2022; 47:1863-1868. [PMID: 35821068 PMCID: PMC9372190 DOI: 10.1038/s41386-022-01369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
Synaptic serotonin levels in the brain are regulated by active transport into the bouton by the serotonin transporter, and by autoreceptors, such as the inhibitory serotonin (5-HT) 1B receptor which, when activated, decreases serotonin release. Animal studies have shown a regulatory link between the two proteins. Evidence of such coupling could translate to an untapped therapeutic potential in augmenting the effect of selective serotonin reuptake inhibitors through pharmacological modulation of 5-HT1B receptors. Here we will for the first time in vivo examine the relationship between 5-HT1B receptors and serotonin transporters in the living human brain. Seventeen healthy individuals were examined with PET twice, using the radioligands [11C]AZ10419369 and [11C]MADAM for quantification of the 5-HT1B receptor and the 5-HT transporter, respectively. The binding potential was calculated for a set of brain regions, and the correlations between the binding estimates of the two radioligands were studied. [11C]AZ10419369 and [11C]MADAM binding was positively correlated in all examined brain regions. In most cortical regions the correlation was strong, e.g., frontal cortex, r(15) = 0.64, p = 0.01 and parietal cortex, r(15) = 0.8, p = 0.0002 while in most subcortical regions, negligible correlations was observed. Though the correlation estimates in cortex should be interpreted with caution due to poor signal to noise ratio of [11C]MADAM binding in these regions, it suggests a link between two key proteins involved in the regulation of synaptic serotonin levels. Our results indicate a need for further studies to address the functional importance of 5-HT1B receptors in treatment with drugs that inhibit serotonin reuptake.
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Veldman ER, Varrone A, Varnäs K, Svedberg MM, Cselényi Z, Tiger M, Gulyás B, Halldin C, Lundberg J. Serotonin 1B receptor density mapping of the human brainstem using positron emission tomography and autoradiography. J Cereb Blood Flow Metab 2022; 42:630-641. [PMID: 34644198 PMCID: PMC8943614 DOI: 10.1177/0271678x211049185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The serotonin 1B (5-HT1B) receptor has lately received considerable interest in relation to psychiatric and neurological diseases, partly due to findings based on quantification using Positron Emission Tomography (PET). Although the brainstem is an important structure in this regard, PET radioligand binding quantification in brainstem areas often shows poor reliability. This study aims to improve PET quantification of 5-HT1B receptor binding in the brainstem.Volumes of interest (VOIs) were selected based on a 3D [3H]AZ10419369 Autoradiography brainstem model, which visualized 5-HT1B receptor distribution in high resolution. Two previously developed VOI delineation methods were tested and compared to a conventional manual method. For a method based on template data, a [11C]AZ10419369 PET template was created by averaging parametric binding potential (BPND) images of 52 healthy subjects. VOIs were generated based on a predefined volume and BPND thresholding and subsequently applied to test-retest [11C]AZ10419369 parametric BPND images of 8 healthy subjects. For a method based on individual subject data, VOIs were generated directly on each individual parametric image.Both methods showed improved reliability compared to a conventional manual VOI. The VOIs created with [11C]AZ10419369 template data can be automatically applied to future PET studies measuring 5-HT1B receptor binding in the brainstem.
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Affiliation(s)
- Emma R Veldman
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Andrea Varrone
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Katarina Varnäs
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Marie M Svedberg
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden.,Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - Zsolt Cselényi
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden.,PET Science Centre, Personalized Medicine and Biosamples, R&D, AstraZeneca, Stockholm, Sweden
| | - Mikael Tiger
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Balázs Gulyás
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Christer Halldin
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Johan Lundberg
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
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Thalamic dopamine D2-receptor availability in schizophrenia: a study on antipsychotic-naive patients with first-episode psychosis and a meta-analysis. Mol Psychiatry 2022; 27:1233-1240. [PMID: 34759359 PMCID: PMC9054658 DOI: 10.1038/s41380-021-01349-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 12/16/2022]
Abstract
Pharmacological and genetic evidence support a role for an involvement of the dopamine D2-receptor (D2-R) in the pathophysiology of schizophrenia. Previous molecular imaging studies have suggested lower levels of D2-R in thalamus, but results are inconclusive. The objective of the present study was to use improved methodology to compare D2-R density in whole thalamus and thalamic subregions between first-episode psychosis patients and healthy controls. Differences in thalamocortical connectivity was explored based on the D2-R results. 19 antipsychotic-naive first-episode psychosis patients and 19 age- and sex-matched healthy controls were examined using high-resolution Positron Emission Tomography (PET) and the high-affinity D2-R radioligand [11C]FLB457. The main outcome was D2-R binding potential (BPND) in thalamus, and it was predicted that patients would have lower binding. Diffusion tensor imaging (DTI) was performed in a subgroup of 11 patients and 15 controls. D2-R binding in whole thalamus was lower in patients compared with controls (Cohen's dz = -0.479, p = 0.026, Bayes Factor (BF) > 4). Among subregions, lower BPND was observed in the ROI representing thalamic connectivity to the frontal cortex (Cohen's dz = -0.527, p = 0.017, BF > 6). A meta-analysis, including the sample of this study, confirmed significantly lower thalamic D2-R availability in patients. Exploratory analyses suggested that patients had lower fractional anisotropy values compared with controls (Cohen's d = -0.692, p = 0.036) in the inferior thalamic radiation. The findings support the hypothesis of a dysregulation of thalamic dopaminergic neurotransmission in schizophrenia, and it is hypothesized that this could underlie a disturbance of thalamocortical connectivity.
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Brumberg J, Kerstens V, Cselényi Z, Svenningsson P, Sundgren M, Fazio P, Varrone A. Simplified quantification of [ 18F]FE-PE2I PET in Parkinson's disease: Discriminative power, test-retest reliability and longitudinal validity during early peak and late pseudo-equilibrium. J Cereb Blood Flow Metab 2021; 41:1291-1300. [PMID: 32955955 PMCID: PMC8138335 DOI: 10.1177/0271678x20958755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Quantification of dopamine transporter (DAT) availability with [18F]FE-PE2I PET enables the detection of presynaptic dopamine deficiency and provides a potential progression marker for Parkinson`s disease (PD). Simplified quantification is feasible, but the time window of short acquisition protocols may have a substantial impact on the reliability of striatal binding estimates. Dynamic [18F]FE-PE2I PET data of cross-sectional (33 PD patients, 24 controls), test-retest (9 patients), and longitudinal (12 patients) cohorts were used to assess the variability and reliability of specific binding ratios (SBR) measured during early peak and late pseudo-equilibrium. Receiver operating characteristics area under the curve (PD vs. controls) was high for early (0.996) and late (0.991) SBR. Early SBR provided more favourable effect size, absolute variability, and standard error of measurement than late SBR (caudate: 1.29 vs. 1.23; 6.9% vs. 9.8%; 0.09 vs. 0.20; putamen: 1.75 vs. 1.67; 7.7% vs. 14.0%; 0.08 vs. 0.17). The annual percentage change was comparable for both time windows (-7.2%-8.5%), but decline was significant only for early SBR. Whereas early and late [18F]FE-PE2I PET acquisitions have similar discriminative power to separate PD patients and controls, the early peak equilibrium acquisition can be recommended if [18F]FE-PE2I is used to measure longitudinal changes of DAT availability.
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Affiliation(s)
- Joachim Brumberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.,Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Vera Kerstens
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Zsolt Cselényi
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.,AstraZeneca Translational Science Centre at Karolinska Institutet PET CoE, Stockholm, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Section Neuro, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Mathias Sundgren
- Department of Clinical Neuroscience, Section Neuro, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Patrik Fazio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Varrone
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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Serotonin transporter availability increases in patients recovering from a depressive episode. Transl Psychiatry 2021; 11:264. [PMID: 33972499 PMCID: PMC8110529 DOI: 10.1038/s41398-021-01376-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/24/2021] [Accepted: 04/13/2021] [Indexed: 02/03/2023] Open
Abstract
Molecular imaging studies have shown low cerebral concentration of serotonin transporter in patients suffering from depression, compared to healthy control subjects. Whether or not this difference also is present before disease onset and after remission (i.e. a trait), or only at the time of the depressive episode (i.e. a state) remains to be explored. We examined 17 patients with major depressive disorder with positron emission tomography using [11C]MADAM, a radioligand that binds to the serotonin transporter, before and after treatment with internet-based cognitive behavioral therapy. In all, 17 matched healthy control subjects were examined once. Cerebellum was used as reference to calculate the binding potential. Differences before and after treatment, as well as between patients and controls, were assessed in a composite cerebral region and in the median raphe nuclei. All image analyses and confirmatory statistical tests were preregistered. Depression severity decreased following treatment (p < 0.001). [11C]MADAM binding in patients increased in the composite region after treatment (p = 0.01), while no change was observed in the median raphe (p = 0.51). No significant difference between patients at baseline and healthy controls were observed in the composite region (p = 0.97) or the median raphe (p = 0.95). Our main finding was that patients suffering from a depressive episode show an overall increase in cerebral serotonin transporter availability as symptoms are alleviated. Our results suggest that previously reported cross-sectional molecular imaging findings of the serotonin transporter in depression most likely reflect the depressive state, rather than a permanent trait. The finding adds new information on the pathophysiology of major depressive disorder.
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Ros T, Kwiek J, Andriot T, Michela A, Vuilleumier P, Garibotto V, Ginovart N. PET Imaging of Dopamine Neurotransmission During EEG Neurofeedback. Front Physiol 2021; 11:590503. [PMID: 33584328 PMCID: PMC7873858 DOI: 10.3389/fphys.2020.590503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/09/2020] [Indexed: 11/13/2022] Open
Abstract
Neurofeedback (NFB) is a brain-based training method that enables users to control their own cortical oscillations using real-time feedback from the electroencephalogram (EEG). Importantly, no investigations to date have directly explored the potential impact of NFB on the brain's key neuromodulatory systems. Our study's objective was to assess the capacity of NFB to induce dopamine release as revealed by positron emission tomography (PET). Thirty-two healthy volunteers were randomized to either EEG-neurofeedback (NFB) or EEG-electromyography (EMG), and scanned while performing self-regulation during a single session of dynamic PET brain imaging using the high affinity D2/3 receptor radiotracer, [18F]Fallypride. NFB and EMG groups down-regulated cortical alpha power and facial muscle tone, respectively. Task-induced effects on endogenous dopamine release were estimated in the frontal cortex, anterior cingulate cortex, and thalamus, using the linearized simplified reference region model (LSRRM), which accounts for time-dependent changes in radiotracer binding following task initiation. Contrary to our hypothesis of a differential effect for NFB vs. EMG training, significant dopamine release was observed in both training groups in the frontal and anterior cingulate cortex, but not in thalamus. Interestingly, a significant negative correlation was observed between dopamine release in frontal cortex and pre-to-post NFB change in spontaneous alpha power, suggesting that intra-individual changes in brain state (i.e., alpha power) could partly result from changes in neuromodulatory tone. Overall, our findings constitute the first direct investigation of neurofeedback's effect on the endogenous release of a key neuromodulator, demonstrating its feasibility and paving the way for future studies using this methodology.
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Affiliation(s)
- Tomas Ros
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Jessica Kwiek
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Theo Andriot
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Abele Michela
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Patrik Vuilleumier
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, Geneva University Hospitals, Geneva, Switzerland
| | - Nathalie Ginovart
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Tjerkaski J, Cervenka S, Farde L, Matheson GJ. Kinfitr - an open-source tool for reproducible PET modelling: validation and evaluation of test-retest reliability. EJNMMI Res 2020; 10:77. [PMID: 32642865 PMCID: PMC7343683 DOI: 10.1186/s13550-020-00664-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/25/2020] [Indexed: 01/26/2023] Open
Abstract
Background In positron emission tomography (PET) imaging, binding is typically estimated by fitting pharmacokinetic models to the series of measurements of radioactivity in the target tissue following intravenous injection of a radioligand. However, there are multiple different models to choose from and numerous analytical decisions that must be made when modelling PET data. Therefore, it is important that analysis tools be adapted to the specific circumstances, and that analyses be documented in a transparent manner. Kinfitr, written in the open-source programming language R, is a tool developed for flexible and reproducible kinetic modelling of PET data, i.e. performing all steps using code which can be publicly shared in analysis notebooks. In this study, we compared outcomes obtained using kinfitr with those obtained using PMOD: a widely used commercial tool. Results Using previously collected test-retest data obtained with four different radioligands, a total of six different kinetic models were fitted to time-activity curves derived from different brain regions. We observed good correspondence between the two kinetic modelling tools both for binding estimates and for microparameters. Likewise, no substantial differences were observed in the test-retest reliability estimates between the two tools. Conclusions In summary, we showed excellent agreement between the open-source R package kinfitr, and the widely used commercial application PMOD. We, therefore, conclude that kinfitr is a valid and reliable tool for kinetic modelling of PET data.
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Affiliation(s)
- Jonathan Tjerkaski
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE-171 76, Stockholm, Sweden.
| | - Simon Cervenka
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
| | - Lars Farde
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
| | - Granville James Matheson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
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Cselényi Z, Jucaite A, Kristensson C, Stenkrona P, Ewing P, Varrone A, Johnström P, Schou M, Vazquez-Romero A, Moein MM, Bolin M, Siikanen J, Grybäck P, Larsson B, Halldin C, Grime K, Eriksson UG, Farde L. Quantification and reliability of [ 11C]VC - 002 binding to muscarinic acetylcholine receptors in the human lung - a test-retest PET study in control subjects. EJNMMI Res 2020; 10:59. [PMID: 32495011 PMCID: PMC7270393 DOI: 10.1186/s13550-020-00634-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/22/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The radioligand [11C]VC-002 was introduced in a small initial study long ago for imaging of muscarinic acetylcholine receptors (mAChRs) in human lungs using positron emission tomography (PET). The objectives of the present study in control subjects were to advance the methodology for quantification of [11C]VC-002 binding in lung and to examine the reliability using a test-retest paradigm. This work constituted a self-standing preparatory step in a larger clinical trial aiming at estimating mAChR occupancy in the human lungs following inhalation of mAChR antagonists. METHODS PET measurements using [11C]VC-002 and the GE Discovery 710 PET/CT system were performed in seven control subjects at two separate occasions, 2-19 days apart. One subject discontinued the study after the first measurement. Radioligand binding to mAChRs in lung was quantified using an image-derived arterial input function. The total distribution volume (VT) values were obtained on a regional and voxel-by-voxel basis. Kinetic one-tissue and two-tissue compartment models (1TCM, 2TCM), analysis based on linearization of the compartment models (multilinear Logan) and image analysis by data-driven estimation of parametric images based on compartmental theory (DEPICT) were applied. The test-retest repeatability of VT estimates was evaluated by absolute variability (VAR) and intraclass correlation coefficients (ICCs). RESULTS The 1TCM was the statistically preferred model for description of [11C]VC-002 binding in the lungs. Low VAR (< 10%) across analysis methods indicated good reliability of the PET measurements. The VT estimates were stable after 60 min. CONCLUSIONS The kinetic behaviour and good repeatability of [11C]VC-002 as well as the novel lung image analysis methodology support its application in applied studies on drug-induced mAChR receptor occupancy and the pathophysiology of pulmonary disorders. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03097380, registered: 31 March 2017.
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Affiliation(s)
- Zsolt Cselényi
- PET Science Centre, Precision Medicine, R&D, AstraZeneca, Stockholm, Sweden.
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden.
| | - Aurelija Jucaite
- PET Science Centre, Precision Medicine, R&D, AstraZeneca, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | | | - Per Stenkrona
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Pär Ewing
- BioPharmaceuticals R&D, AstraZeneca, Göteborg, Sweden
| | - Andrea Varrone
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Peter Johnström
- PET Science Centre, Precision Medicine, R&D, AstraZeneca, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Magnus Schou
- PET Science Centre, Precision Medicine, R&D, AstraZeneca, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Ana Vazquez-Romero
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Mohammad Mahdi Moein
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Martin Bolin
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Jonathan Siikanen
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Pär Grybäck
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Bengt Larsson
- BioPharmaceuticals R&D, AstraZeneca, Göteborg, Sweden
| | - Christer Halldin
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Ken Grime
- BioPharmaceuticals R&D, AstraZeneca, Göteborg, Sweden
| | | | - Lars Farde
- PET Science Centre, Precision Medicine, R&D, AstraZeneca, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
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9
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A randomized placebo-controlled PET study of ketamine´s effect on serotonin 1B receptor binding in patients with SSRI-resistant depression. Transl Psychiatry 2020; 10:159. [PMID: 32475989 PMCID: PMC7261801 DOI: 10.1038/s41398-020-0844-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/26/2020] [Accepted: 05/01/2020] [Indexed: 12/11/2022] Open
Abstract
The glutamate N-methyl-D-aspartate receptor antagonist ketamine has a rapid antidepressant effect. Despite large research efforts, ketamine's mechanism of action in major depressive disorder (MDD) has still not been determined. In rodents, the antidepressant properties of ketamine were found to be dependent on both the α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) and the serotonin (5-HT)1B receptor. Low 5-HT1B receptor binding in limbic brain regions is a replicated finding in MDD. In non-human primates, AMPA-dependent increase in 5-HT1B receptor binding in the ventral striatum (VST) has been demonstrated after ketamine infusion. Thirty selective serotonin reuptake inhibitor-resistant MDD patients were recruited via advertisement and randomized to double-blind monotherapy with 0.5 mg/kg ketamine or placebo infusion. The patients were examined with the 5-HT1B receptor selective radioligand [11C]AZ10419369 and positron emission tomography (PET) before and 24-72 h after treatment. 5-HT1B receptor binding did not significantly alter in patients treated with ketamine compared with placebo. An increase in 5-HT1B receptor binding with 16.7 % (p = 0.036) was found in the hippocampus after one ketamine treatment. 5-HT1B receptor binding in VST at baseline correlated with MDD symptom ratings (r = -0.426, p = 0.019) and with reduction of depressive symptoms with ketamine (r = -0.644, p = 0.002). In conclusion, reduction of depressive symptoms in MDD patients after ketamine treatment is correlated inversely with baseline 5-HT1B receptor binding in VST. Further studies examining the role of 5-HT1B receptors in the antidepressant mechanism of action of ketamine should be conducted, homing in on the 5-HT1B receptor as an MDD treatment response marker.
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Stenkrona P, Matheson GJ, Halldin C, Cervenka S, Farde L. D1-Dopamine Receptor Availability in First-Episode Neuroleptic Naive Psychosis Patients. Int J Neuropsychopharmacol 2019; 22:415-425. [PMID: 30958880 PMCID: PMC6600463 DOI: 10.1093/ijnp/pyz017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/12/2019] [Accepted: 04/05/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Positron emission tomography studies examining differences in D1-dopamine receptor binding between control subjects and patients with schizophrenia have been inconsistent, reporting higher, lower, and no difference in the frontal cortex. Exposure to antipsychotic medication has been suggested to be a likely source of this heterogeneity, and thus there is a need for studies of patients at early stages of the disorder who have not been exposed to such drugs. METHODS Here, we compared 17 healthy control subjects and 18 first-episode neuroleptic naive patients with schizophrenia or schizophreniform psychosis using positron emission tomography and the D1-dopamine receptor radioligand [11C]SCH23390. RESULTS We observed a statistically significant difference in the dorsolateral prefrontal cortex. Contrary to our expectations, patients had less D1-dopamine receptor availability with a moderate effect size. In a Bayesian analysis, we show that the data are over 50 times more likely to have occurred under the decrease as opposed to the increase hypothesis. This effect was not global, as our analysis showed that the null hypothesis was preferred over either hypothesis in the striatum. CONCLUSIONS This investigation represents the largest single sample of neuroleptic-naive patients examined for D1-dopamine receptor availability using PET and suggests a reduction of prefrontal D1-dopamine receptor density in the pathophysiology of schizophrenia. However, further work will be required to reach a consensus.
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Affiliation(s)
- Per Stenkrona
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden,Correspondence: Per Stenkrona, MD, Karolinska Institutet, Department of Clinical Neuroscience Karolinska University Hospital, R5:02 SE-171 76 Stockholm, Sweden ()
| | - Granville J Matheson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Christer Halldin
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Simon Cervenka
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Lars Farde
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden,PET Science Centre, Precision Medicine, R&D Oncology, AstraZeneca, Karolinska Institutet, Sweden
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11
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Kautzky A, James GM, Philippe C, Baldinger-Melich P, Kraus C, Kranz GS, Vanicek T, Gryglewski G, Hartmann AM, Hahn A, Wadsak W, Mitterhauser M, Rujescu D, Kasper S, Lanzenberger R. Epistasis of HTR1A and BDNF risk genes alters cortical 5-HT1A receptor binding: PET results link genotype to molecular phenotype in depression. Transl Psychiatry 2019; 9:5. [PMID: 30664620 PMCID: PMC6341100 DOI: 10.1038/s41398-018-0308-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 02/07/2023] Open
Abstract
Alterations of the 5-HT1A receptor and BDNF have consistently been associated with affective disorders. Two functional single nucleotide polymorphisms (SNPs), rs6295 of the serotonin 1A receptor gene (HTR1A) and rs6265 of brain-derived neurotrophic factor gene (BDNF), may impact transcriptional regulation and expression of the 5-HT1A receptor. Here we investigated interaction effects of rs6295 and rs6265 on 5-HT1A receptor binding. Forty-six healthy subjects were scanned with PET using the radioligand [carbonyl-11C]WAY-100635. Genotyping was performed for rs6265 and rs6295. Subjects showing a genotype with at least three risk alleles (G of rs6295 or A of rs6265) were compared to control genotypes. Cortical surface binding potential (BPND) was computed for 32 cortical regions of interest (ROI). Mixed model was applied to study main and interaction effects of ROI and genotype. ANOVA was used for post hoc analyses. Individuals with the risk genotypes exhibited an increase in 5-HT1A receptor binding by an average of 17% (mean BPND 3.56 ± 0.74 vs. 2.96 ± 0.88). Mixed model produced an interaction effect of ROI and genotype on BPND and differences could be demonstrated in 10 ROI post hoc. The combination of disadvantageous allelic expression of rs6295 and rs6265 may result in a 5-HT1A receptor profile comparable to affective disorders as increased 5-HT1A receptor binding is a well published phenotype of depression. Thus, epistasis between BDNF and HTR1A may contribute to the multifactorial risk for affective disorders and our results strongly advocate further research on this genetic signature in affective disorders.
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Affiliation(s)
- Alexander Kautzky
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Gregory M. James
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Cecile Philippe
- 0000 0000 9259 8492grid.22937.3dDivision of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria
| | - Pia Baldinger-Melich
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Christoph Kraus
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Georg S. Kranz
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Thomas Vanicek
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Gregor Gryglewski
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Annette M. Hartmann
- 0000 0001 0679 2801grid.9018.0University Clinic for Psychiatry, Psychotherapy and Psychosomatic, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Andreas Hahn
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Wolfgang Wadsak
- 0000 0000 9259 8492grid.22937.3dDivision of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria ,grid.499898.dCenter for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Markus Mitterhauser
- 0000 0000 9259 8492grid.22937.3dDivision of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria ,Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria
| | - Dan Rujescu
- 0000 0001 0679 2801grid.9018.0University Clinic for Psychiatry, Psychotherapy and Psychosomatic, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Siegfried Kasper
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria.
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12
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Marcoux A, Burgos N, Bertrand A, Teichmann M, Routier A, Wen J, Samper-González J, Bottani S, Durrleman S, Habert MO, Colliot O. An Automated Pipeline for the Analysis of PET Data on the Cortical Surface. Front Neuroinform 2018; 12:94. [PMID: 30618699 PMCID: PMC6296445 DOI: 10.3389/fninf.2018.00094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/23/2018] [Indexed: 12/14/2022] Open
Abstract
We present a fully automatic pipeline for the analysis of PET data on the cortical surface. Our pipeline combines tools from FreeSurfer and PETPVC, and consists of (i) co-registration of PET and T1-w MRI (T1) images, (ii) intensity normalization, (iii) partial volume correction, (iv) robust projection of the PET signal onto the subject's cortical surface, (v) spatial normalization to a template, and (vi) atlas statistics. We evaluated the performance of the proposed workflow by performing group comparisons and showed that the approach was able to identify the areas of hypometabolism characteristic of different dementia syndromes: Alzheimer's disease (AD) and both the semantic and logopenic variants of primary progressive aphasia. We also showed that these results were comparable to those obtained with a standard volume-based approach. We then performed individual classifications and showed that vertices can be used as features to differentiate cognitively normal and AD subjects. This pipeline is integrated into Clinica, an open-source software platform for neuroscience studies available at www.clinica.run.
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Affiliation(s)
- Arnaud Marcoux
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France
| | - Ninon Burgos
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France
| | - Anne Bertrand
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France.,AP-HP, Departments of Neuroradiology and Neurology, Pitié-Salpétriére Hospital, Paris, France
| | - Marc Teichmann
- Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Institut du Cerveau et de la Moelle épinière, ICM, FrontLab, Paris, France.,Department of Neurology, National Reference Center for "PPA and rare dementias", Institute for Memory and Alzheimer's Disease, Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Alexandre Routier
- Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France.,Institut du Cerveau et de la Moelle épinière, ICM, FrontLab, Paris, France
| | - Junhao Wen
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France
| | - Jorge Samper-González
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France
| | - Simona Bottani
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France
| | - Stanley Durrleman
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France
| | - Marie-Odile Habert
- AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France.,Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC Univ Paris 06, Inserm U 1146, CNRS UMR 7371, Paris, France.,Centre Acquisition et Traitement des Images, Paris, France
| | - Olivier Colliot
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Inserm, U 1127, Paris, France.,CNRS, UMR 7225, Paris, France.,Sorbonne Université, Paris, France.,Inria, Aramis Project-Team, Paris, France.,AP-HP, Departments of Neuroradiology and Neurology, Pitié-Salpétriére Hospital, Paris, France
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13
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Mak E, Donaghy PC, McKiernan E, Firbank MJ, Lloyd J, Petrides GS, Thomas AJ, O'Brien JT. Beta amyloid deposition maps onto hippocampal and subiculum atrophy in dementia with Lewy bodies. Neurobiol Aging 2018; 73:74-81. [PMID: 30339962 DOI: 10.1016/j.neurobiolaging.2018.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
Although dementia with Lewy bodies (DLB) is a synucleinopathy, it is frequently accompanied by beta amyloid (Aβ) accumulation. Elucidating the relationships of Aβ with gray matter atrophy in DLB may yield insights regarding the contributions of comorbid Alzheimer's disease to its disease progression. Twenty healthy controls and 25 DLB subjects underwent clinical assessment, [18F]-Florbetapir, and 3T magnetic resonance imaging. FreeSurfer was used to estimate cortical thickness and subcortical volumes, and PetSurfer was used to quantify [18F]-Florbetapir standardized uptake value ratio. Principal component analysis was used to identify the dominant Aβ component for correlations with regional cortical thickness, hippocampal subfields, and subcortical structures. Relative to healthy controls, the DLB group demonstrated increased Aβ in widespread regions encompassing the frontal and temporoparietal cortices, whereas cortical thinning was restricted to the temporal lobe. Among DLB subjects, the Aβ component was significantly associated with more severe hippocampal and subiculum atrophy. These findings may reflect an early process of superimposed AD-like atrophy in DLB, thereby conferring support for the therapeutic potential of anti-Aβ interventions in people with DLB.
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Affiliation(s)
- Elijah Mak
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paul C Donaghy
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | | | - Michael J Firbank
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Jim Lloyd
- Nuclear Medicine Department, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - George S Petrides
- Nuclear Medicine Department, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alan J Thomas
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
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14
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Stenkrona P, Matheson GJ, Cervenka S, Sigray PP, Halldin C, Farde L. [ 11C]SCH23390 binding to the D 1-dopamine receptor in the human brain-a comparison of manual and automated methods for image analysis. EJNMMI Res 2018; 8:74. [PMID: 30069645 PMCID: PMC6070454 DOI: 10.1186/s13550-018-0416-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/27/2018] [Indexed: 11/22/2022] Open
Abstract
Background The D1-dopamine receptor radioligand [11C]SCH23390 has been frequently used in PET studies. In drug-naïve patients with schizophrenia, the findings have been inconsistent, with decreases, increases, and no change in the frontal cortex D1-dopamine receptors. While these discrepancies are likely primarily due to a lack of statistical power in these studies, we speculated that an additional explanation may be the differences due to methods of image analysis between studies, affecting reliability as well as bias between groups. Methods Fifteen healthy subjects underwent two PET measurements with [11C]SCH23390 on the same day. The binding potential (BPND) was compared using a 95% confidence interval following manual and automated delineation of a region of interest (ROI) as well as with and without frame-by-frame realignment. Results Automated target region delineation produced lower BPND values, while automated delineation of the reference region yielded higher BPND values. However, no significant differences were observed for repeatability using automated and manual delineation methods. Frame-by-frame realignment generated higher BPND values and improved repeatability. Conclusions The results suggest that the choice of ROI delineation method is not an important factor for reliability, whereas the improved results following movement correction confirm its importance in PET image analysis. Realignment is therefore especially important for measurements in patient populations such as schizophrenia or Parkinson’s disease, where motion artifacts may be more prevalent. Electronic supplementary material The online version of this article (10.1186/s13550-018-0416-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Per Stenkrona
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska University Hospital, Karolinska Institutet, R5:02, S-171 76, Stockholm, Sweden. .,Stockholm County Council, Stockholm, Sweden.
| | - Granville J Matheson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska University Hospital, Karolinska Institutet, R5:02, S-171 76, Stockholm, Sweden.,Stockholm County Council, Stockholm, Sweden
| | - Simon Cervenka
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska University Hospital, Karolinska Institutet, R5:02, S-171 76, Stockholm, Sweden.,Stockholm County Council, Stockholm, Sweden
| | - Pontus Plavén Sigray
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska University Hospital, Karolinska Institutet, R5:02, S-171 76, Stockholm, Sweden.,Stockholm County Council, Stockholm, Sweden
| | - Christer Halldin
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska University Hospital, Karolinska Institutet, R5:02, S-171 76, Stockholm, Sweden.,Stockholm County Council, Stockholm, Sweden
| | - Lars Farde
- PET Science Centre, Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Karolinska Institutet, Stockholm, Sweden
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15
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Abstract
The dopamine (DA) system is considered to be centrally involved in the pathophysiology of several major psychiatric disorders. Using positron emission tomography (PET), aberrations in dopamine D2/D3-receptors (D2-R) levels and uptake of the DA precursor FDOPA have been shown for schizophrenia, substance abuse and depression. Radioligands for the dopamine D1-receptor (D1-R) have been available for more than three decades, however this receptor subtype has received much less attention in psychiatry research. Here, studies investigating D1-R in psychiatric patients in comparison to healthy control subjects are summarized. Although small sample sizes, medication effects and heterogeneous methods of quantification limit the conclusions that can be drawn, the data is suggestive of higher levels of cortical D1-R in drug naïve patients with psychosis, and lower D1-R in patients with affective disorders. Data sharing and reanalysis using harmonized methodology are important next steps towards clarifying the role of D1-R in these disorders.
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Affiliation(s)
- Simon Cervenka
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden.
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