Dorsomedial prefrontal hypoexcitability underlies lost empathy in frontotemporal dementia

Empathic pain: Underlying neural mechanism

Empathy is usually regarded as the ability to perceive the emotional state of others, which is an altruistic motivation to promote prosocial behavior and thus plays a key role in human life and social development. Empathic pain-the capacity to feel and understand the pain of others-constitutes a significant aspect in the study of empathy behaviors. For an extended duration, investigations into empathic pain have predominantly centered on human neuroimaging studies. Fortunately, recent advancements have witnessed the utilization of animal models in the exploration of the fundamental neural underpinnings of empathic pain. There is substantial evidence implicating multiple brain regions and neural networks in the generation and maintenance of empathic pain. Nevertheless, further elucidation of the neural mechanisms underlying empathic pain is warranted. This review provides a concise overview of prior studies on the neural mechanisms of empathic pain, outlining the pertinent brain regions, neural pathways, synaptic mechanisms, and associated molecules while also delving into future prospects.

Prosocial Helping Behavior: Conceptual Issues and Neural Mechanisms

Prosocial helping behavior, characterized by voluntary actions taken to benefit others, plays a vital role in promoting cooperation and maintaining social bonds across human and animal social groups. In this review, we examine key conceptual issues surrounding prosocial behavior, focusing specifically on targeted helping and comforting actions. We outline the behavioral paradigms used to study these two types of prosocial behaviors and summarize recent insights into their underlying neural mechanisms. Drawing on findings across species and with an emphasis on rodent models, we discuss how these behaviors are regulated by molecularly and anatomically defined neural systems and how distinct neuronal populations and circuits may differentially regulate targeted helping and comforting behaviors. Lastly, we discuss the clinical relevance of this research by addressing the implications of prosocial deficits in psychiatric disorders.

The neural basis of affective empathy: What is known from rodents

Empathy is the cornerstone of social interactions between conspecies for human beings and other social animals. Human beings with empathy defects might either suffer unpleasant or failed social interactions as ASD patients, or even display antisocial behaviors. To find efficient cure for empathy defects, first of all, the neural mechanisms underpinning various empathy behaviors should be well studied and understood. And the research in the field of affective empathy thrives fast in recent years. It is necessary to review the important contributions in this field, especially for understanding the delicate neural mechanisms of diverse forms of affective empathy. Here, we have summarized the characteristics of various types of affective empathy. We also discuss the distinctions between empathy for pain and fear, as well as instinctive and experienced empathy. Our analysis further highlights the findings in the complex neural mechanisms and potential brain regions underlying different affective empathy behaviors. Above all, this work is expected to help enhance our comprehension of behavioral dynamics and neural basis of affective empathy along with its role in emotional regulation and social behavior.

A Prefrontal Cortex-Nucleus Accumbens Circuit Attenuates Cocaine-conditioned Place Preference Memories

The infralimbic (IL) subregion of the prefrontal cortex (PFC), via its descending projection to the nucleus accumbens (NAc), inhibits cue-induced drug seeking and reinstatement, but the underlying mechanisms are not fully understood. Here we show that the activity of IL layer 5 pyramidal neurons projecting to the NAc shell (IL-NAcSh neurons) suppresses cocaine-associated memories. Following repeated cocaine exposures in a conditioned place preference paradigm, IL-NAcSh neurons anatomically traced by fluorescent Retrobeads undergo prolonged decrease of membrane excitability, lasting for at least 15 days after cocaine withdrawal. This persistent IL-NAcSh neuron hypoexcitability is accompanied by an increase in the rheobase, an increase in the afterhyperpolarization potential, and a decrease in the membrane input resistance. This cocaine induced neuroadapation in intrinsic excitability is not observed in prelimibic cortex neurons projecting to the NAc core (PL-NAcCo neurons), a separate descending circuit thought to promote cue-triggered drug seeking. Chemogenetic restoration of IL-NAcSh neuron activity extinguishes both the acquisition and retention of cocaine conditioned place preference memories. Our results provide direct support for the notion that the IL-NAcSh circuit serves to extinct drug associated memories and restoring the drug impaired excitability of IL-NAcSh neurons has the potential to mitigate drug-cue association memories and drug seeking.

Neural control of sex differences in affiliative and prosocial behaviors

Social interactions are vital for various taxa and species. Prosocial and affiliative dynamics within a group and between individuals are not only pleasurable and rewarding, but also appear to actively contribute to well-being, cognitive performance, and disease prevention. Moreover, disturbances in acting or being prosocial can represent a major burden for an individual and their affective partners. These disruptions are evident across a spectrum of neuropsychiatric conditions, including depression and autism spectrum disorders. Importantly, interactive patterns of prosocial and affiliative behavior can vary with sex. The fact that genders are differentially affected by neuropsychiatric disorders associated with social impairment underscores the high importance of this research in uncovering the underlying neural correlates and mechanisms. This review focuses on elucidating sex-related differences in prosocial and affiliative behaviors and their potential association with sexually different neural correlates. Specifically, we aim to shed light on the complex interplay between sex, behavior, and neurobiology in affiliative and prosocial interaction patterns.

A Prefrontal Cortex-Nucleus Accumbens Circuit Attenuates Cocaine-conditioned Place Preference Memories

The infralimbic (IL) subregion of the prefrontal cortex (PFC), via its descending projection to the nucleus accumbens (NAc), inhibits cue-induced drug seeking and reinstatement, but the underlying mechanisms are not fully understood. Here we show that the intrinsic membrane excitability of IL layer 5 pyramidal neurons projecting to the NAc shell (IL-NAcSh neurons) suppresses cocaine-associated memories. Following repeated cocaine exposures in a conditioned place preference paradigm, IL-NAcSh neurons anatomically traced by fluorescent retrobeads undergo prolonged decrease of membrane excitability, lasting for at least 15 days after cocaine withdrawal. This persistent IL-NAcSh neuron hypoexcitability was accompanied by an increase in the rheobase, an increase in the afterhyperpolarization potential, and a decrease in the membrane input resistance. This cocaine induced neuroadapation in intrinsic excitability was not observed in prelimibic cortex neurons projecting to the NAc core (PL-NAcCo neurons), a separate descending circuit thought to promote cue-triggered drug seeking. Chemogenetic restoration of IL-NAcSh neuron activity extinguishes both the acquisition and retention of cocaine conditioned place preference memories. Our results provide direct support for the notion that the IL-NAcSh circuit serves to extinct drug associated memories and restoring the drug impaired excitability of IL-NAcSh neurons has the potential to mitigate drug-cue association memories and drug seeking.

The Effect of Repetitive Transcranial Magnetic Stimulation of the Dorsolateral Prefrontal Cortex on the Amyotrophic Lateral Sclerosis Patients With Cognitive Impairment: A Double-Blinded, Randomized, and Sham Control Trial

BACKGROUND

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. A large number of ALS patients have cognitive impairment. In this double-blinded, randomized, and sham-controlled study, we aimed to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on ALS patients with cognitive impairment.

METHODS

A total of 90 ALS patients with cognitive impairment were recruited from two cohorts; 80 participants were randomly assigned in a 1:1 ratio to receive 10 Hz rTMS or sham treatment on the bilateral dorsolateral prefrontal cortices (DLPFC) for 4 consecutive weeks. The patients were assessed by ECAS and ALSFRS-R scales. The Zarit care burden scale was administered to caregivers of ALS patients. The primary outcome measured was the rate of decline in the total ECAS score between pretreatment, 6 months post-treatment, and 12 months post-treatment. Secondary outcomes included the group difference in the slope of the Zarit score, ALSFRS-R total score, and the neurofilament light chain plasma levels.

RESULTS

The ECAS total score in the intention-to-treat population significantly changed from 79.74 ± 6.39 to 81.98 ± 6.51 and 79.22 ± 6.50 with rTMS intervention at the 6-month and 12-month follow-ups, respectively (p = 0.031, p = 0.042). The Zarit score also significantly decreased from 57.65 ± 3.42 to 52.24 ± 3.34 and 56.42 ± 3.41 at the 3-month and 6-month post-treatment time points, respectively (p = 0.003, p = 0.014). No significant differences were observed between the groups for other secondary endpoints. However, there was a trend of decreasing NF-L level rates in the treatment group over the first 6 months' follow-up.

CONCLUSIONS

rTMS could yield short-term positive effects on the ALS patients subgroup with cognitive impairment and alleviate caregivers' burden. No improvement was observed in the severity of ALS and ALS plasma biomarkers.

The role of the prefrontal cortex in modulating aggression in humans and rodents

Accumulating evidence suggests that the prefrontal cortex (PFC) plays an important role in aggression. However, the findings regarding the key neural mechanisms and molecular pathways underlying the modulation of aggression by the PFC are relatively scattered, with many inconsistencies and areas that would benefit from exploration. Here, we highlight the relationship between the PFC and aggression in humans and rodents and describe the anatomy and function of the human PFC, along with homologous regions in rodents. At the molecular level, we detail how the major neuromodulators of the PFC impact aggression. At the circuit level, this review provides an overview of known and potential subcortical projections that regulate aggression in rodents. Finally, at the disease level, we review the correlation between PFC alterations and heightened aggression in specific human psychiatric disorders. Our review provides a framework for PFC modulation of aggression, resolves several intriguing paradoxes from previous studies, and illuminates new avenues for further study.

The Underestimated Role of Iron in Frontotemporal Dementia: A Narrative Review

The term frontotemporal dementia (FTD) comprises a group of neurodegenerative disorders characterized by the progressive degeneration of the frontal and temporal lobes of the brain with language impairment and changes in cognitive, behavioral and executive functions, and in some cases motor manifestations. A high proportion of FTD cases are due to genetic mutations and inherited in an autosomal-dominant manner with variable penetrance depending on the implicated gene. Iron is a crucial microelement that is involved in several cellular essential functions in the whole body and plays additional specialized roles in the central nervous system (CNS) mainly through its redox-cycling properties. Such a feature may be harmful under aerobic conditions, since it may lead to the generation of highly reactive hydroxyl radicals. Dysfunctions of iron homeostasis in the CNS are indeed involved in several neurodegenerative disorders, although it is still challenging to determine whether the dyshomeostasis of this essential but harmful metal is a direct cause of neurodegeneration, a contributor factor or simply a consequence of other neurodegenerative mechanisms. Unlike many other neurodegenerative disorders, evidence of the dysfunction in brain iron homeostasis in FTD is still scarce; nonetheless, the recent literature intriguingly suggests its possible involvement. The present review aims to summarize what is currently known about the contribution of iron dyshomeostasis in FTD based on clinical, imaging, histological, biochemical and molecular studies, further suggesting new perspectives and offering new insights for future investigations on this underexplored field of research.

Medial prefrontal cortex circuitry and social behaviour in autism

Autism spectrum disorder (ASD) has proven to be highly enigmatic due to the diversity of its underlying genetic causes and the huge variability in symptom presentation. Uncovering common phenotypes across people with ASD and pre-clinical models allows us to better understand the influence on brain function of the many different genetic and cellular processes thought to contribute to ASD aetiology. One such feature of ASD is the convergent evidence implicating abnormal functioning of the medial prefrontal cortex (mPFC) across studies. The mPFC is a key part of the 'social brain' and may contribute to many of the changes in social behaviour observed in people with ASD. Here we review recent evidence for mPFC involvement in both ASD and social behaviours. We also highlight how pre-clinical mouse models can be used to uncover important cellular and circuit-level mechanisms that may underly atypical social behaviours in ASD. This article is part of the Special Issue on "PFC circuit function in psychiatric disease and relevant models".

Prosocial behaviors in rodents

Prosocial behaviors (i.e., actions that benefit others) are central for social interactions in humans and other animals, by fostering social bonding and cohesion. To study prosociality in rodents, scientists have developed behavioral paradigms where animals can display actions that benefit conspecifics in distress or need. These paradigms have provided insights into the role of social interactions and transfer of emotional states in the expression of prosociality, and increased knowledge of its neural bases. However, prosociality levels are variable: not all tested animals are prosocial. Such variation has been linked to differences in animals' ability to process another's state as well as to contextual factors. Moreover, evidence suggests that prosocial behaviors involve the orchestrated activity of multiple brain regions and neuromodulators. This review aims to synthesize findings across paradigms both at the level of behavior and neural mechanisms. Growing evidence confirms that these processes can be studied in rodents, and intense research in the past years is rapidly advancing our knowledge. We discuss a strong bias in the field towards the study of these processes in negative valence contexts (e.g., pain, fear, stress), which should be taken as an opportunity to open new venues for future research.

The effect of psilocybin on empathy and prosocial behavior: a proposed mechanism for enduring antidepressant effects

Psilocybin is a serotonergic psychedelic shown to have enduring antidepressant effects. Currently, the mechanism for its enduring effects is not well understood. Empathy and prosocial behavior may be important for understanding the therapeutic benefit of psilocybin. In this article we review the effect of psilocybin on empathy and prosocial behavior. Moreover, we propose that psilocybin may induce a positive feedback loop involving empathy and prosocial behavior which helps explain the observed, enduring antidepressant effects.

Cortical regulation of helping behaviour towards others in pain

Humans and animals exhibit various forms of prosocial helping behaviour towards others in need1-3. Although previous research has investigated how individuals may perceive others' states4,5, the neural mechanisms of how they respond to others' needs and goals with helping behaviour remain largely unknown. Here we show that mice engage in a form of helping behaviour towards other individuals experiencing physical pain and injury-they exhibit allolicking (social licking) behaviour specifically towards the injury site, which aids the recipients in coping with pain. Using microendoscopic imaging, we found that single-neuron and ensemble activity in the anterior cingulate cortex (ACC) encodes others' state of pain and that this representation is different from that of general stress in others. Furthermore, functional manipulations demonstrate a causal role of the ACC in bidirectionally controlling targeted allolicking. Notably, this behaviour is represented in a population code in the ACC that differs from that of general allogrooming, a distinct type of prosocial behaviour elicited by others' emotional stress. These findings advance our understanding of the neural coding and regulation of helping behaviour.

Methylone produces antidepressant-relevant actions and prosocial effects

Methylone (3,4-methylenedioxy-N-methylcathinone) is a rapid-acting entactogen that has been shown to have significant benefits in patients with post-traumatic stress disorder and major depressive disorder and is well tolerated in phase 1 clinical trials. A recent preclinical study reported that methylone produced robust antidepressant-like actions in naïve rats. However, its antidepressant effects on various stress-related psychopathologies and other neuropsychological actions remain unclear. In the present study, we examined the antidepressant-relevant effects of methylone in learned helplessness (LH) and social defeat stress C57BL/6J male mouse models and further explored its sociability-relevant neuropsychological actions. Our results indicate that methylone produces antidepressant-relevant effects on the helpless phenotype, LH-evoked depressive-like behaviors, and psychosocial stress-induced social avoidance, and induced depressive-like behaviors. In addition, methylone was found to enhance social preference and increase various social behaviors, including social contact, sniffing, allogrooming, and following. Moreover, methylone appeared to elevate empathy-like phenotypes and was also found to increase helping-like behavior. Overall, the present results suggest that methylone plays an antidepressant-like role in various stress-relevant psychopathologies and could be an ideal antidepressant candidate. In addition, novel findings on the elevated tendencies of social preference and empathy-like and helping-like phenotypes reveal that methylone may have potential application in patients with social deficits.

Understanding Others' Distress Through Past Experiences: The Role of Memory Engram Cells in Observational Fear

For individuals to survive and function in society, it is essential that they recognize, interact with, and learn from other conspecifics. Observational fear (OF) is the well-conserved empathic ability of individuals to understand the other's aversive situation. While it is widely known that factors such as prior similar aversive experience and social familiarity with the demonstrator facilitate OF, the neural circuit mechanisms that explicitly regulate experience-dependent OF (Exp OF) were unclear. In this review, we examine the neural circuit mechanisms that regulate OF, with an emphasis on rodent models, and then discuss emerging evidence for the role of fear memory engram cells in the regulation of Exp OF. First, we examine the neural circuit mechanisms that underlie Naive OF, which is when an observer lacks prior experiences relevant to OF. In particular, the anterior cingulate cortex to basolateral amygdala (BLA) neural circuit is essential for Naive OF. Next, we discuss a recent study that developed a behavioral paradigm in mice to examine the neural circuit mechanisms that underlie Exp OF. This study found that fear memory engram cells in the BLA of observers, which form during a prior similar aversive experience with shock, are reactivated by ventral hippocampal neurons in response to shock delivery to the familiar demonstrator to elicit Exp OF. Finally, we discuss the implications of fear memory engram cells in Exp OF and directions of future research that are of both translational and basic interest.

Neural mechanisms of comforting: Prosocial touch and stress buffering

Comforting is a crucial form of prosocial behavior that is important for maintaining social unity and improving the physical and emotional well-being of social species. It is often expressed through affiliative social touch toward someone in distress, providing relief for their distressed state. In the face of increasing global distress, these actions are paramount to the continued improvement of individual welfare and the collective good. Understanding the neural mechanisms responsible for promoting actions focused on benefitting others is particularly important and timely. Here, we review prosocial comforting behavior, emphasizing synthesizing recent studies carried out using rodent models. We discuss its underlying behavioral expression and motivations, and then explore both the neurobiology of prosocial comforting in a helper animal and the neurobiology of stress relief following social touch in a recipient as part of a feedback loop interaction.

A physiological cause to empathy deficits in a mouse model of FTD

Loss of empathy is a core behavioral symptom of frontotemporal dementia (FTD). In this issue of Neuron, a study by Phillips et al.1 reveals that hypoactivity of dorsomedial prefrontal cortex is causally linked to empathy deficits in a mouse model of FTD.