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Rice SM, Nelson B, Amminger GP, Francey SM, Phillips LJ, Simmons MB, Ross M, Yuen HP, Yung AR, O'Gorman K, McGorry PD, Wood SJ, Berger GE. An open label pilot trial of low-dose lithium for young people at ultra-high risk for psychosis. Early Interv Psychiatry 2024; 18:859-868. [PMID: 38600049 DOI: 10.1111/eip.13526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/11/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
AIM Lithium, even at low doses, appears to offer neuroprotection against a wide variety of insults. In this controlled pilot, we examined the safety (i.e., side-effect profile) of lithium in a sample of young people identified at ultra-high risk (UHR) for psychosis. The secondary aim was to explore whether lithium provided a signal of clinical efficacy in reducing transition to psychosis compared with treatment as usual (TAU). METHODS Young people attending the PACE clinic at Orygen, Melbourne, were prescribed a fixed dose (450 mg) of lithium (n = 25) or received TAU (n = 78). The primary outcome examined side-effects, with transition to psychosis, functioning and measures of psychopathology assessed as secondary outcomes. RESULTS Participants in both groups were functionally compromised (lithium group GAF = 56.6; monitoring group GAF = 56.9). Side-effect assessment indicated that lithium was well-tolerated. 64% (n = 16) of participants in the lithium group were lithium-adherent to week 12. Few cases transitioned to psychosis across the study period; lithium group 4% (n = 1); monitoring group 7.7% (n = 6). There was no difference in time to transition to psychosis between the groups. No group differences were observed in other functioning and symptom domains, although all outcomes improved over time. CONCLUSIONS With a side-effect profile either comparable to, or better than UHR antipsychotic trials, lithium might be explored for further research with UHR young people. A definitive larger trial is needed to determine the efficacy of lithium in this cohort.
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Affiliation(s)
- Simon M Rice
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - G Paul Amminger
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shona M Francey
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa J Phillips
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Magenta B Simmons
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Margaret Ross
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alison R Yung
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kieran O'Gorman
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick D McGorry
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen J Wood
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Gregor E Berger
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
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Manchia M, Paribello P, Pinna M, Steardo L, Carpiniello B, Pinna F, Pisanu C, Squassina A, Hajek T. Lithium and its effects: does dose matter? Int J Bipolar Disord 2024; 12:23. [PMID: 38914810 PMCID: PMC11196441 DOI: 10.1186/s40345-024-00345-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Decades of clinical research have demonstrated the efficacy of lithium in treating acute episodes (both manic and depressive), as well as in preventing recurrences of bipolar disorder (BD). Specific to lithium is its antisuicidal effect, which appears to extend beyond its mood-stabilizing properties. Lithium's clinical effectiveness is, to some extent, counterbalanced by its safety and tolerability profile. Indeed, monitoring of lithium levels is required by its narrow therapeutic index. There is consensus that adequate serum levels should be above 0.6 mEq/L to achieve clinical effectiveness. However, few data support the choice of this threshold, and increasing evidence suggests that lithium might have clinical and molecular effects at much lower concentrations. CONTENT This narrative review is aimed at: (1) reviewing and critically interpreting the clinical evidence supporting the use of the 0.6 mEq/L threshold, (2) reporting a narrative synthesis of the evidence supporting the notion that lithium might be effective in much lower doses. Among these are epidemiological studies of lithium in water, evidence on the antisuicidal, anti-aggressive, and neuroprotective effects, including efficacy in preventing cognitive impairment progression, Alzheimer's disease (AD), and amyotrophic lateral sclerosis (ALS), of lithium; and (3) revieweing biological data supporting clinically viable uses of lithium at low levels with the delineation of a mechanistic hypothesis surrounding its purported mechanism of action. The study selection was based on the authors' preference, reflecting the varied and extensive expertise on the review subject, further enriched with an extensive pearl-growing strategy for relevant reviews and book sections. CONCLUSIONS Clinical and molecular effects of lithium are numerous, and its effects also appear to have a certain degree of specificity related to the dose administered. In sum, the clinical effects of lithium are maximal for mood stabilisation at concentrations higher than 0.6 mEq/l. However, lower levels may be sufficient for preventing depressive recurrences in older populations of patients, and microdoses could be effective in decreasing suicide risk, especially in patients with BD. Conversely, lithium's ability to counteract cognitive decline appears to be exerted at subtherapeutic doses, possibly corresponding to its molecular neuroprotective effects. Indeed, lithium may reduce inflammation and induce neuroprotection even at doses several folds lower than those commonly used in clinical settings. Nevertheless, findings surrounding its purported mechanism of action are missing, and more research is needed to investigate the molecular targets of low-dose lithium adequately.
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Affiliation(s)
- Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada, Italy.
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Martina Pinna
- Unit of Forensic Psychiatry, Health Agency of Cagliari, Cagliari, Italy
| | - Luca Steardo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Claudia Pisanu
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Holton KM, Chan SY, Brockmeier AJ, Öngür D, Hall MH. Exploring the influence of functional architecture on cortical thickness networks in early psychosis - A longitudinal study. Neuroimage 2023; 274:120127. [PMID: 37086876 DOI: 10.1016/j.neuroimage.2023.120127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/24/2023] Open
Abstract
Cortical thickness reductions differ between individuals with psychotic disorders and comparison subjects even in early stages of illness. Whether these reductions covary as expected by functional network membership or simply by spatial proximity has not been fully elucidated. Through orthonormal projective non-negative matrix factorization, cortical thickness measurements in functionally-annotated regions from MRI scans of early-stage psychosis and matched healthy controls were reduced in dimensionality into features capturing positive covariance. Rather than matching the functional networks, the covarying regions in each feature displayed a more localized spatial organization. With Bayesian belief networks, the covarying regions per feature were arranged into a network topology to visualize the dependency structure and identify key driving regions. The features demonstrated diagnosis-specific differences in cortical thickness distributions per feature, identifying reduction-vulnerable spatial regions. Differences in key cortical thickness features between psychosis and control groups were delineated, as well as those between affective and non-affective psychosis. Clustering of the participants, stratified by diagnosis and clinical variables, characterized the clinical traits that define the cortical thickness patterns. Longitudinal follow-up revealed that in select clusters with low baseline cortical thickness, clinical traits improved over time. Our study represents a novel effort to characterize brain structure in relation to functional networks in healthy and clinical populations and to map patterns of cortical thickness alterations among ESP patients onto clinical variables for a better understanding of brain pathophysiology.
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Affiliation(s)
- Kristina M Holton
- Computational Neural Information Engineering Lab, University of Delaware, 139 The Green, Newark, DE 19716, USA.
| | - Shi Yu Chan
- Psychosis Neurobiology Laboratory, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Division of Psychotic Disorders, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Austin J Brockmeier
- Computational Neural Information Engineering Lab, University of Delaware, 139 The Green, Newark, DE 19716, USA
| | - Dost Öngür
- Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Division of Psychotic Disorders, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Mei-Hua Hall
- Psychosis Neurobiology Laboratory, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Division of Psychotic Disorders, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA.
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Hong N, Park JS, Kim HJ. Synapto-protective effect of lithium on HIV-1 Tat-induced synapse loss in rat hippocampal cultures. Anim Cells Syst (Seoul) 2021; 26:1-9. [PMID: 35308128 PMCID: PMC8928815 DOI: 10.1080/19768354.2021.2018044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Human immunodeficiency virus type I (HIV-1) infection of the CNS produces synapse loss which correlates with cognitive decline in patients with HIV-associated neurocognitive disorders (HAND). Lithium is mood stabilizer of unknown mechanism used to treat bipolar disorder and is known to exhibit neuroprotective properties. Here, we studied the effects of lithium on HIV-1 Tat-induced synapses between rat hippocampal neurons. The number of synapses was quantified to detect clusters of the scaffold protein postsynaptic density 95 (PSD95) which is clustered at glutamatergic synapses on cultured rat hippocampal neurons in vitro. Lithium protected synapses from HIV-1 Tat-induced synapse loss and subsequent neuronal death. This synaptic protection was prevented by both the activation of NMDA receptor leading to intracellular signaling and the regulatory pathway of lithium including inositol depletion and glycogen synthase kinase-3β (GSK-3β). These results suggest that mood stabilizers might be effective drugs to treat neurodegenerative disorders including HAND.
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Affiliation(s)
- Namgue Hong
- Department of Physiology, College of Medicine, Dankook University, Cheonan, Republic of Korea
- Department of Medical Laser, Graduate School, Dankook University, Cheonan, Republic of Korea
- Medical Laser Research Center, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Jeong-Soo Park
- Department of Biochemistry, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Hee Jung Kim
- Department of Physiology, College of Medicine, Dankook University, Cheonan, Republic of Korea
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Abstract
Lithium is widely used in the treatment of bipolar disorder. Here we describe the syndrome of irreversible lithium-effectuated neurotoxicity in a patient within therapeutic doses and levels, which persisted after discontinuation of Lithium. A 50-year-old gentleman with Bipolar disorder presented with symptoms of Mania following drug default. Lithium was initiated as a mood stabilizer. On day 4, the patient developed abdominal pain, itching, and sore throat. On day 5, lithium levels were 0.9 mEq/L. Subsequently, the patient was noted to have slurring of speech, dysarthria, past pointing, and dysdiadochokinesis. Lithium was withdrawn on day 7. When lithium was re-introduced at a lower dose, the neurological symptoms re-appeared after 2 days and lithium was discontinued. Mild degree of slurring of speech persisted at 2-month follow-up. The patient had no history of side effects with antipsychotics in the past or current episode. In the absence of predisposing factors, Lithium has resulted in neurotoxicity at therapeutic doses and levels. Slurring of speech persisted despite adequate dose of anticholinergics. In addition to presumed neuroprotective effects of lithium, it can produce neurotoxic symptoms at therapeutic doses and levels.
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Bergamelli E, Del Fabro L, Delvecchio G, D’Agostino A, Brambilla P. The Impact of Lithium on Brain Function in Bipolar Disorder: An Updated Review of Functional Magnetic Resonance Imaging Studies. CNS Drugs 2021; 35:1275-1287. [PMID: 34773217 PMCID: PMC9537229 DOI: 10.1007/s40263-021-00869-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 11/13/2022]
Abstract
Lithium remains a gold standard treatment for bipolar disorder (BD), and functional magnetic resonance imaging (fMRI) studies have contributed to clarifying its impact on neural circuitries in affected individuals. However, the specific neurobiological mechanisms through which lithium exerts its effects on brain function are not fully understood. In this review, we aimed to summarize the results of recent fMRI studies evaluating the impact of lithium on brain functional activity and connectivity in patients diagnosed with BD. We performed a literature search of available sources found in the PubMed database reported in English since 2016, when the last available review on this topic was published. Five fMRI studies in resting-state condition and six studies performed during the execution of emotional tasks met the inclusion criteria. Overall, the available evidence supports normalizing effects of lithium on brain activity and connectivity. Most of these studies reported a normalization in prefrontal regions and interconnected areas involved in emotion regulation and processing, regardless of the task employed. Importantly, lithium treatment showed distinct patterns of activity/connectivity changes compared with other treatments. Finally, lithium modulation of neural circuitries was found to be associated with clinical improvement in BD. These results are consistent with the hypothesis that selective abnormalities in neural circuitries supporting emotion processing and regulation improve during lithium treatment in BD. However, the heterogeneity of the examined studies regarding study design, sample selection, and analysis methods might limit the generalizability of the findings and lead to difficulties in comparing the results. Therefore, in future studies, larger cohorts and homogeneous experimental tasks are needed to further corroborate these findings.
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Affiliation(s)
- Emilio Bergamelli
- grid.415093.a0000 0004 1793 3800Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, Milan, Italy
| | - Lorenzo Del Fabro
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Armando D’Agostino
- grid.415093.a0000 0004 1793 3800Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, Milan, Italy
| | - Paolo Brambilla
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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7
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Mancuso L, Fornito A, Costa T, Ficco L, Liloia D, Manuello J, Duca S, Cauda F. A meta-analytic approach to mapping co-occurrent grey matter volume increases and decreases in psychiatric disorders. Neuroimage 2020; 222:117220. [PMID: 32777357 DOI: 10.1016/j.neuroimage.2020.117220] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022] Open
Abstract
Numerous studies have investigated grey matter (GM) volume changes in diverse patient groups. Reports of disorder-related GM reductions are common in such work, but many studies also report evidence for GM volume increases in patients. It is unclear whether these GM increases and decreases are independent or related in some way. Here, we address this question using a novel meta-analytic network mapping approach. We used a coordinate-based meta-analysis of 64 voxel-based morphometry studies of psychiatric disorders to calculate the probability of finding a GM increase or decrease in one region given an observed change in the opposite direction in another region. Estimating this co-occurrence probability for every pair of brain regions allowed us to build a network of concurrent GM changes of opposing polarity. Our analysis revealed that disorder-related GM increases and decreases are not independent; instead, a GM change in one area is often statistically related to a change of opposite polarity in other areas, highlighting distributed yet coordinated changes in GM volume as a function of brain pathology. Most regions showing GM changes linked to an opposite change in a distal area were located in salience, executive-control and default mode networks, as well as the thalamus and basal ganglia. Moreover, pairs of regions showing coupled changes of opposite polarity were more likely to belong to different canonical networks than to the same one. Our results suggest that regional GM alterations in psychiatric disorders are often accompanied by opposing changes in distal regions that belong to distinct functional networks.
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Affiliation(s)
- Lorenzo Mancuso
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Alex Fornito
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University,Victoria, Australia; Monash Biomedical Imaging, Monash University,Victoria, Australia
| | - Tommaso Costa
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy.
| | - Linda Ficco
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Donato Liloia
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Jordi Manuello
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Sergio Duca
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Franco Cauda
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
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Integrative analysis of lithium treatment associated effects on brain structure and peripheral gene expression reveals novel molecular insights into mechanism of action. Transl Psychiatry 2020; 10:103. [PMID: 32251271 PMCID: PMC7136209 DOI: 10.1038/s41398-020-0784-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/23/2020] [Accepted: 03/09/2020] [Indexed: 12/20/2022] Open
Abstract
Lithium is a highly effective medication for bipolar disorder, but its mechanism of action remains unknown. In this study, brain MRI scans and blood samples for gene expression (total of 110 scans and 109 blood samples) were collected from 21 bipolar subjects before and after 2 and 8 weeks of lithium monotherapy and at the same time-points from untreated 16 healthy controls. We used linear mixed-effects models to identify brain structural features and genes with expression changed after lithium treatment, with correction for multiple testing, and correlated their concurrent changes to identify molecular pathways associated with lithium effects. There are significant increases in gray matter fraction, global cortical thickness, and the frontal and parietal cortices after 8 weeks of lithium treatment (corrected p < 0.05). Volume increases were also seen for putamen, hippocampus, thalamic nuclei, and thalamic substructures. Several genes showed significant expression changes, and 14 gene pathways were identified for the present integration analysis. Of these, nine pathways had significant correlations with structural changes (FDR < 0.05). Three neurotrophy-related pathways (GDNF family of ligands, NFAT immune-response, and p53-signaling pathway) correlated with structural changes in multiple regions. Mediation analysis showed that the sphingomyelin metabolism pathway is associated with HAM-D change (p < 0.01), and this effect is mediated via the volume of mediodorsal thalamus (p < 0.03). In summary, the integration of lithium effects on brain structural and peripheral gene expression changes revealed effects on several neurotrophic molecular pathways, which provides further insights into the mechanism of lithium action.
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Britzolaki A, Saurine J, Klocke B, Pitychoutis PM. A Role for SERCA Pumps in the Neurobiology of Neuropsychiatric and Neurodegenerative Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1131:131-161. [PMID: 31646509 DOI: 10.1007/978-3-030-12457-1_6] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Calcium (Ca2+) is a fundamental regulator of cell fate and intracellular Ca2+ homeostasis is crucial for proper function of the nerve cells. Given the complexity of neurons, a constellation of mechanisms finely tunes the intracellular Ca2+ signaling. We are focusing on the sarco/endoplasmic reticulum (SR/ER) calcium (Ca2+)-ATPase (SERCA) pump, an integral ER protein. SERCA's well established role is to preserve low cytosolic Ca2+ levels ([Ca2+]cyt), by pumping free Ca2+ ions into the ER lumen, utilizing ATP hydrolysis. The SERCA pumps are encoded by three distinct genes, SERCA1-3, resulting in 12 known protein isoforms, with tissue-dependent expression patterns. Despite the well-established structure and function of the SERCA pumps, their role in the central nervous system is not clear yet. Interestingly, SERCA-mediated Ca2+ dyshomeostasis has been associated with neuropathological conditions, such as bipolar disorder, schizophrenia, Parkinson's disease and Alzheimer's disease. We summarize here current evidence suggesting a role for SERCA in the neurobiology of neuropsychiatric and neurodegenerative disorders, thus highlighting the importance of this pump in brain physiology and pathophysiology.
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Affiliation(s)
- Aikaterini Britzolaki
- Department of Biology & Center for Tissue Regeneration and Engineering at Dayton (TREND), University of Dayton, Dayton, OH, USA
| | - Joseph Saurine
- Department of Biology & Center for Tissue Regeneration and Engineering at Dayton (TREND), University of Dayton, Dayton, OH, USA
| | - Benjamin Klocke
- Department of Biology & Center for Tissue Regeneration and Engineering at Dayton (TREND), University of Dayton, Dayton, OH, USA
| | - Pothitos M Pitychoutis
- Department of Biology & Center for Tissue Regeneration and Engineering at Dayton (TREND), University of Dayton, Dayton, OH, USA.
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Rouhani M, Ramshini S, Omidi M. The Psychiatric Drug Lithium Increases DNA Damage and Decreases Cell Survival in MCF-7 and MDA-MB-231 Breast Cancer Cell Lines Expos ed to Ionizing Radiation. Curr Mol Pharmacol 2019; 12:301-310. [DOI: 10.2174/1874467212666190503151753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/25/2019] [Accepted: 04/04/2019] [Indexed: 01/24/2023]
Abstract
Background:
Breast cancer is the most common cancer among women. Radiation therapy
is used for treating almost every stage of breast cancer. A strategy to reduce irradiation side effects and
to decrease the recurrence of cancer is concurrent use of radiation and radiosensitizers. We studied the
effect of the antimanic drug lithium on radiosensitivity of estrogen-receptor (ER)-positive MCF-7 and
ER-negative, invasive, and radioresistant MDA-MB-231 breast cancer cell lines.
Methods:
MCF-7 and MDA-MB-231 breast cancer cell lines were treated with 30 mM and 20 mM
concentrations of lithium chloride (LiCl), respectively. These concentrations were determined by
MTT viability assay. Growth curves were depicted and comet assay was performed for control and
LiCl-treated cells after exposure to X-ray. Total and phosphorylated inactive levels of glycogen
synthase kinase-3beta (GSK-3β) protein were determined by ELISA assay for control and treated
cells.
Results:
Treatment with LiCl decreased cell proliferation after exposure to X-ray as indicated by
growth curves of MCF-7 and MDA-MB-231 cell lines within six days following radiation. Such
treatment increased the amount of DNA damages represented by percent DNA in Tails of comets at
0, 1, 4, and even 24 hours after radiation in both studied cell lines. The amount of active GSK-3β
was increased in LiCl-treated cells in ER-positive and ER-negative breast cancer cell lines.
Conclusion:
Treatment with LiCl that increased the active GSK-3β protein, increased DNA damages
and decreased survival independent of estrogen receptor status in breast cancer cells exposed to
ionizing radiation.
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Affiliation(s)
- Maryam Rouhani
- Department of Biological Sciences, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan 45137-66731, Iran
| | - Samira Ramshini
- Department of Biological Sciences, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan 45137-66731, Iran
| | - Maryam Omidi
- Department of Biological Sciences, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan 45137-66731, Iran
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11
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Spielberg JM, Matyi MA, Karne H, Anand A. Lithium monotherapy associated longitudinal effects on resting state brain networks in clinical treatment of bipolar disorder. Bipolar Disord 2019; 21:361-371. [PMID: 30421491 PMCID: PMC8593846 DOI: 10.1111/bdi.12718] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Lithium is one of the most effective and specific treatments for bipolar disorder (BP), but the neural mechanisms by which lithium impacts symptoms remain unclear. Past research has been limited by a reliance on cross-sectional designs, which does not allow for identification of within-person changes due to lithium and has not examined communication between brain regions (ie, networks). In the present study, we prospectively investigated the lithium monotherapy associated effects in vivo on the brain connectome in medication-free BP patients. In particular, we examined the within-person impact of lithium treatment on connectome indices previously linked to mania and depression in bipolar disorder. METHODS Thirty-nine medication-free subjects - 26 BP (13 (hypo)manic and 13 depressed) and 13 closely matched healthy controls (HC) - were included. fMRI data were obtained at 3 timepoints: baseline, after 2 weeks, and after 8 weeks (total of 117 scans: 78 BP and 39 HC scans). BP subjects were clinically treated with lithium for 8 weeks while HC were scanned at the same time points but not treated. Graph theory metrics and repeated measures GLM were used to analyze lithium treatment associated effects. RESULTS Consistent with hypotheses, lithium treatment was associated with a normalizing effect on mania-related connectome indices. Furthermore, shifts in both mania- and depression-related connectome indices were proportional to symptom change. Finally, lithium treatment-associated impact on amygdala function differed depending on baseline mood. CONCLUSIONS Present findings provide deeper insight into the therapeutic neural mechanisms associated with lithium treatment.
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Affiliation(s)
| | - Melanie A. Matyi
- Department of Psychological and Brain Sciences, University of Delaware
| | - Harish Karne
- Center for Behavioral Health, Cleveland Clinic Foundation
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic Foundation,Corresponding Author: Amit Anand, M.D., Cleveland Clinic Main Campus, Mail Code P57, 9500 Euclid Avenue, Cleveland, OH 44195, Phone: 216.636.5860,
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Vaseghi S, Babapour V, Nasehi M, Zarrindast MR. The role of CA1 CB1 receptors on lithium-induced spatial memory impairment in rats. EXCLI JOURNAL 2018; 17:916-934. [PMID: 30564071 PMCID: PMC6295625 DOI: 10.17179/excli2018-1511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 08/27/2018] [Indexed: 02/06/2023]
Abstract
Lithium, a glycogen synthase kinase-3β (GSK-3β) inhibitor, prevents cannabinoid withdrawal syndrome, but there is limited data exploring the interaction between lithium and cannabinoid system on memory processes. The present study aimed to test the interaction between dorsal hippocampal (CA1 region) cannabinoid system and lithium on spatial memory in rats. Spatial memory was assessed in Morris Water Maze (MWM) apparatus by a single training session of eight trials. The results showed that pre-training intra-CA1 microinjection of ACPA, the cannabinoid type 1 receptor (CB1r) agonist, at doses of 0.001, 0.01 or 1 µg/rat, or AM251, the cannabinoid type 1 receptor (CB1r) antagonist, at doses of 1, 10 or 100 ng/rat, increased escape latency and traveled distance to the platform, suggesting a spatial learning impairment, whereas intraperitoneal administration of lithium (0.5, 1 or 5 mg/kg) had no effect on spatial learning. Also, rats that received lithium plus a lower dose of ACPA (0.001 µg/rat) or AM251 (1 ng/rat) had successful performance in the MWM. In the probe test, the results showed that pre-training administration of lithium (5 mg/kg) and ACPA (0.01 or 1 µg/rat) but not AM251 (at all doses used) impaired spatial memory retrieval. Also, lower dose of ACPA (0.001 µg/rat) or AM251 (1 ng/rat) potentiated the effect of ineffective doses of lithium (0.5 and 1 mg/kg) on spatial memory retrieval, while restored the effect of effective dose of lithium (5 mg/kg). In conclusion, cannabinoids may have a dual effect on lithium-induced spatial memory impairment in rats.
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Affiliation(s)
- Salar Vaseghi
- Department of Physiology, Faculty of Veterinary Science, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Vahab Babapour
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Institute for Cognitive Science Studies (ICSS), Tehran, Iran.,Department of Neuroendocrinology, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Hirjak D, Meyer-Lindenberg A, Fritze S, Sambataro F, Kubera KM, Wolf RC. Motor dysfunction as research domain across bipolar, obsessive-compulsive and neurodevelopmental disorders. Neurosci Biobehav Rev 2018; 95:315-335. [PMID: 30236781 DOI: 10.1016/j.neubiorev.2018.09.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/08/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
Although genuine motor abnormalities (GMA) are frequently found in schizophrenia, they are also considered as an intrinsic feature of bipolar, obsessive-compulsive, and neurodevelopmental disorders with early onset such as autism, ADHD, and Tourette syndrome. Such transnosological observations strongly suggest a common neural pathophysiology. This systematic review highlights the evidence on GMA and their neuroanatomical substrates in bipolar, obsessive-compulsive, and neurodevelopmental disorders. The data lends support for a common pattern contributing to GMA expression in these diseases that seems to be related to cerebello-thalamo-cortical, fronto-parietal, and cortico-subcortical motor circuit dysfunction. The identified studies provide first evidence for a motor network dysfunction as a correlate of early neurodevelopmental deviance prior to clinical symptom expression. There are also first hints for a developmental risk factor model of these mental disorders. An in-depth analysis of motor networks and related patho-(physiological) mechanisms will not only help promoting Research Domain Criteria (RDoC) Motor System construct, but also facilitate the development of novel psychopharmacological models, as well as the identification of neurobiologically plausible target sites for non-invasive brain stimulation.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
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Mohammad Jafari R, Ghahremani MH, Rahimi N, Shadboorestan A, Rashidian A, Esmaeili J, Ejtemaei Mehr S, Dehpour AR. The anticonvulsant activity and cerebral protection of chronic lithium chloride via NMDA receptor/nitric oxide and phospho-ERK. Brain Res Bull 2018; 137:1-9. [DOI: 10.1016/j.brainresbull.2017.10.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 02/08/2023]
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Lithium monotherapy associated clinical improvement effects on amygdala-ventromedial prefrontal cortex resting state connectivity in bipolar disorder. J Affect Disord 2018; 225:4-12. [PMID: 28772145 PMCID: PMC5844774 DOI: 10.1016/j.jad.2017.06.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 06/08/2017] [Accepted: 06/20/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study, for the first time, investigated lithium monotherapy associated effects on amygdala- ventromedial prefrontal cortex (vMPFC) resting-state functional connectivity and correlation with clinical improvement in bipolar disorder (BP) METHODS: Thirty-six medication-free subjects - 24 BP (12 hypomanic BPM) and 12 depressed (BPD)) and 12 closely matched healthy controls (HC), were included. BP subjects were treated with lithium and scanned at baseline, after 2 weeks and 8 weeks. HC were scanned at same time points but were not treated. The effect of lithium was studied for the BP group as a whole using two way (group, time) ANOVA while regressing out effects of state. Next, correlation between changes in amygdala-vMPFC resting-state connectivity and clinical global impression (CGI) of severity and improvement scale scores for overall BP illness was calculated. An exploratory analysis was also conducted for the BPD and BPM subgroups separately. RESULTS Group by time interaction revealed that lithium monotherapy in patients was associated with increase in amygdala-medial OFC connectivity after 8 weeks of treatment (p = 0.05 (cluster-wise corrected)) compared to repeat testing in healthy controls. Increased amygdala-vMPFC connectivity correlated with clinical improvement at week 2 and week 8 as measured with the CGI-I scale. LIMITATIONS The results pertain to open-label treatment and do not account for non-treatment related improvement effects. Only functional connectivity was measured which does not give information regarding one regions effect on the other. CONCLUSIONS Lithium monotherapy in BP is associated with modulation of amygdala-vMPFC connectivity which correlates with state-independent global clinical improvement.
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Roux M, Dosseto A. From direct to indirect lithium targets: a comprehensive review of omics data. Metallomics 2017; 9:1326-1351. [DOI: 10.1039/c7mt00203c] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Metal ions are critical to a wide range of biological processes.
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Affiliation(s)
| | - Anthony Dosseto
- Wollongong Isotope Geochronology Laboratory
- School of Earth & Environmental Sciences
- University of Wollongong
- Wollongong
- Australia
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Hong N, Choi YS, Kim SY, Kim HJ. Neuroprotective effect of lithium after pilocarpine-induced status epilepticus in mice. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2016; 21:125-131. [PMID: 28066149 PMCID: PMC5214904 DOI: 10.4196/kjpp.2017.21.1.125] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 11/29/2016] [Accepted: 12/01/2016] [Indexed: 01/25/2023]
Abstract
Status epilepticus is the most common serious neurological condition triggered by abnormal electrical activity, leading to severe and widespread cell loss in the brain. Lithium has been one of the main drugs used for the treatment of bipolar disorder for decades, and its anticonvulsant and neuroprotective properties have been described in several neurological disease models. However, the therapeutic mechanisms underlying lithium's actions remain poorly understood. The muscarinic receptor agonist pilocarpine is used to induce status epilepticus, which is followed by hippocampal damage. The present study was designed to investigate the effects of lithium post-treatment on seizure susceptibility and hippocampal neuropathological changes following pilocarpine-induced status epilepticus. Status epilepticus was induced by administration of pilocarpine hydrochloride (320 mg/kg, i.p.) in C57BL/6 mice at 8 weeks of age. Lithium (80 mg/kg, i.p.) was administered 15 minutes after the pilocarpine injection. After the lithium injection, status epilepticus onset time and mortality were recorded. Lithium significantly delayed the onset time of status epilepticus and reduced mortality compared to the vehicle-treated group. Moreover, lithium effectively blocked pilocarpine-induced neuronal death in the hippocampus as estimated by cresyl violet and Fluoro-Jade B staining. However, lithium did not reduce glial activation following pilocarpine-induced status epilepticus. These results suggest that lithium has a neuroprotective effect and would be useful in the treatment of neurological disorders, in particular status epilepticus.
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Affiliation(s)
- Namgue Hong
- Department of Physiology, College of Medicine, Dankook University, Cheonan 31116, Korea.; Department of Medical Laser, Graduate School, Dankook University, Cheonan 31116, Korea
| | - Yun-Sik Choi
- Department of Pharmaceutical Science and Technology, College of Health and Medical Science, Catholic University of Daegu, Gyeongsan 38430, Korea
| | - Seong Yun Kim
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Hee Jung Kim
- Department of Physiology, College of Medicine, Dankook University, Cheonan 31116, Korea
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Lopes-Ramos CM, Pereira TC, Dogini DB, Gilioli R, Lopes-Cendes I. Lithium carbonate and coenzyme Q10 reduce cell death in a cell model of Machado-Joseph disease. ACTA ACUST UNITED AC 2016; 49:e5805. [PMID: 27878228 PMCID: PMC5188859 DOI: 10.1590/1414-431x20165805] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 09/26/2016] [Indexed: 01/09/2023]
Abstract
Machado-Joseph disease (MJD) or spinocerebellar ataxia type 3 (SCA3) is an autosomal dominant neurodegenerative disorder caused by expansion of the polyglutamine domain of the ataxin-3 (ATX3) protein. MJD/SCA3 is the most frequent autosomal dominant ataxia in many countries. The mechanism underlying MJD/SCA3 is thought to be mainly related to protein misfolding and aggregation leading to neuronal dysfunction followed by cell death. Currently, there are no effective treatments for patients with MJD/SCA3. Here, we report on the potential use of lithium carbonate and coenzyme Q10 to reduce cell death caused by the expanded ATX3 in cell culture. Cell viability and apoptosis were evaluated by MTT assay and by flow cytometry after staining with annexin V-FITC/propidium iodide. Treatment with lithium carbonate and coenzyme Q10 led to a significant increase in viability of cells expressing expanded ATX3 (Q84). In addition, we found that the increase in cell viability resulted from a significant reduction in the proportion of apoptotic cells. Furthermore, there was a significant change in the expanded ATX3 monomer/aggregate ratio after lithium carbonate and coenzyme Q10 treatment, with an increase in the monomer fraction and decrease in aggregates. The safety and tolerance of both drugs are well established; thus, our results indicate that lithium carbonate and coenzyme Q10 are good candidates for further in vivo therapeutic trials.
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Affiliation(s)
- C M Lopes-Ramos
- Departamento de Genética Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - T C Pereira
- Departamento de Biologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - D B Dogini
- Departamento de Genética Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - R Gilioli
- Centro Multidisciplinar para Investigação Biológica, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - I Lopes-Cendes
- Departamento de Genética Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
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Mury FB, da Silva WC, Barbosa NR, Mendes CT, Bonini JS, Sarkis JES, Cammarota M, Izquierdo I, Gattaz WF, Dias-Neto E. Lithium activates brain phospholipase A2 and improves memory in rats: implications for Alzheimer's disease. Eur Arch Psychiatry Clin Neurosci 2016; 266:607-18. [PMID: 26661385 DOI: 10.1007/s00406-015-0665-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/30/2015] [Indexed: 02/07/2023]
Abstract
Phospholipase A2 (Pla2) is required for memory retrieval, and its inhibition in the hippocampus has been reported to impair memory acquisition in rats. Moreover, cognitive decline and memory deficits showed to be reduced in animal models after lithium treatment, prompting us to evaluate possible links between Pla2, lithium and memory. Here, we evaluated the possible modulation of Pla2 activity by a long-term treatment of rats with low doses of lithium and its impact in memory. Wistar rats were trained for the inhibitory avoidance task, treated with lithium for 100 days and tested for perdurability of long-term memory. Hippocampal samples were used for quantifying the expression of 19 brain-expressed Pla2 genes and for evaluating the enzymatic activity of Pla2 using group-specific radio-enzymatic assays. Our data pointed to a significant perdurability of long-term memory, which correlated with increased transcriptional and enzymatic activities of certain members of the Pla2 family (iPla2 and sPla2) after the chronic lithium treatment. Our data suggest new possible targets of lithium, add more information on its pharmacological activity and reinforce the possible use of low doses of lithium for the treatment of neurodegenerative conditions such as the Alzheimer's disease.
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Affiliation(s)
- Fábio B Mury
- Laboratório de Neurociências (LIM27), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, Rua Ovídio Pires de Campos, 785, 05403-010, São Paulo, SP, Brazil
- Pós-Graduação Interunidades em Biotecnologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Weber C da Silva
- Centro de Memória, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Departamento de Farmácia, Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | - Nádia R Barbosa
- Laboratório de Neurociências (LIM27), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, Rua Ovídio Pires de Campos, 785, 05403-010, São Paulo, SP, Brazil
| | - Camila T Mendes
- Laboratório de Neurociências (LIM27), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, Rua Ovídio Pires de Campos, 785, 05403-010, São Paulo, SP, Brazil
- Pós-Graduação Interunidades em Biotecnologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Juliana S Bonini
- Centro de Memória, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Departamento de Farmácia, Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | - Jorge Eduardo Souza Sarkis
- Instituto de Pesquisas Energéticas e Nucleares-IPEN-CNEN/SP, Grupo de Caracterização Química e Isotópica, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Martin Cammarota
- Laboratório de Pesquisa de Memória, Instituto do Cérebro, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Ivan Izquierdo
- Centro de Memória, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Wagner F Gattaz
- Laboratório de Neurociências (LIM27), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, Rua Ovídio Pires de Campos, 785, 05403-010, São Paulo, SP, Brazil.
| | - Emmanuel Dias-Neto
- Laboratório de Neurociências (LIM27), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, Rua Ovídio Pires de Campos, 785, 05403-010, São Paulo, SP, Brazil.
- Laboratório de Genômica Médica, Centro Internacional de Pesquisas, AC Camargo Cancer Center, São Paulo, SP, Brazil.
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Anand A, McClintick JN, Murrell J, Karne H, Nurnberger JI, Edenberg HJ. Effects of Lithium Monotherapy for Bipolar Disorder on Gene Expression in Peripheral Lymphocytes. MOLECULAR NEUROPSYCHIATRY 2016; 2:115-123. [PMID: 27867936 DOI: 10.1159/000446348] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/20/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study investigated the effect of lithium monotherapy on peripheral lymphocyte gene expression in bipolar disorder (BD). METHOD Twenty-two medication-free bipolar subjects (11 hypomanic, 11 depressed) were started on lithium monotherapy. Closely matched healthy subjects (n = 15) were included as controls but did not receive treatment. Blood RNA samples were collected at baseline and after 2 and 8 weeks of treatment. RNA expression was measured using the Affymetrix GeneChip® Human Gene 1.0 ST Array followed by Ingenuity pathways analysis. The results for the contrast of weeks 2 and 8 were not significantly different and were combined. RESULTS In BD subjects, 56 genes showed significant (false discovery rate <0.1) expression changes from baseline; the effect sizes and directions for all of these were similar at weeks 2 and 8. Among these were immune-related genes (IL5RA, MOK, IFI6, and RFX2), purinergic receptors (P2RY14, P2RY2, and ADORA3) and signal transduction-related genes (CAMK1 and PIK3R6). Pathway and upstream regulator analysis also revealed that lithium altered several immune- and signal transduction-related functions. Differentially expressed genes did not correlate with week 8 clinical response, but other genes involved in protein synthesis and degradation did. CONCLUSION Peripheral gene expression may serve as a biomarker of lithium effect.
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Affiliation(s)
- Amit Anand
- Center for Behavioral Health, Cleveland Clinic, Cleveland, Ohio, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Ind., USA
| | - Jeanette N McClintick
- Department of Biochemistry and Molecular Biology and Center for Medical Genomics, Indiana University School of Medicine, Indianapolis, Ind., USA
| | - Jill Murrell
- Department of Biochemistry and Molecular Biology and Center for Medical Genomics, Indiana University School of Medicine, Indianapolis, Ind., USA
| | - Harish Karne
- Center for Behavioral Health, Cleveland Clinic, Cleveland, Ohio, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Ind., USA
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Ind., USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology and Center for Medical Genomics, Indiana University School of Medicine, Indianapolis, Ind., USA
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Lithium protects against methamphetamine-induced neurotoxicity in PC12 cells via Akt/GSK3β/mTOR pathway. Biochem Biophys Res Commun 2015; 465:368-73. [PMID: 26271595 DOI: 10.1016/j.bbrc.2015.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 08/02/2015] [Indexed: 01/10/2023]
Abstract
Methamphetamine (MA) is neurotoxic, especially in dopaminergic neurons. Long-lasting exposure to MA causes psychosis and increases the risk of Parkinson's disease. Lithium (Li) is a known mood stabilizer and has neuroprotective effects. Previous studies suggest that MA exposure decreases the phosphorylation of Akt/GSK3β pathway in vivo, whereas Li facilitates the phosphorylation of Akt/GSK3β pathway. Moreover, GSK3β and mTOR are implicated in the locomotor sensitization induced by psychostimulants and mTOR plays a critical role in MA induced toxicity. However, the effect of MA on Akt/GSK3β/mTOR pathway has not been fully investigated in vitro. Here, we found that MA exposure significantly dephosphorylated Akt/GSK3β/mTOR pathway in PC12 cells. In addition, Li remarkably attenuated the dephosphorylation effect of MA exposure on Akt/GSK3β/mTOR pathway. Furthermore, Li showed obvious protective effects against MA toxicity and LY294002 (Akt inhibitor) suppressed the protective effects of Li. Together, MA exposure dephosphorylates Akt/GSK3β/mTOR pathway in vitro, while lithium protects against MA-induced neurotoxicity via phosphorylation of Akt/GSK3β/mTOR pathway.
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Hayashi A, Le Gal K, Södersten K, Vizlin-Hodzic D, Ågren H, Funa K. Calcium-dependent intracellular signal pathways in primary cultured adipocytes and ANK3 gene variation in patients with bipolar disorder and healthy controls. Mol Psychiatry 2015; 20:931-40. [PMID: 25311363 PMCID: PMC4759096 DOI: 10.1038/mp.2014.104] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/11/2014] [Accepted: 07/23/2014] [Indexed: 02/08/2023]
Abstract
Bipolar disorder (BD) is a chronic psychiatric disorder of public health importance affecting >1% of the Swedish population. Despite progress, patients still suffer from chronic mood switches with potential severe consequences. Thus, early detection, diagnosis and initiation of correct treatment are critical. Cultured adipocytes from 35 patients with BD and 38 healthy controls were analysed using signal pathway reporter assays, that is, protein kinase C (PKC), protein kinase A (PKA), mitogen-activated protein kinases (extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK)), Myc, Wnt and p53. The levels of activated target transcriptional factors were measured in adipocytes before and after stimulation with lithium and escitalopram. Variations were analysed in the loci of 25 different single-nucleotide polymorphisms (SNPs). Activation of intracellular signals in several pathways analysed were significantly higher in patients than in healthy controls upon drug stimulation, especially with escitalopram stimulation of PKC, JNK and Myc, as well as lithium-stimulated PKC, whereas no meaningful difference was observed before stimulation. Univariate analyses of contingency tables for 80 categorical SNP results versus diagnoses showed a significant link with the ANK3 gene (rs10761482; likelihood ratio χ(2)=4.63; P=0.031). In a multivariate ordinal logistic fit for diagnosis, a backward stepwise procedure selected ANK3 as the remaining significant predictor. Comparison of the escitalopram-stimulated PKC activity and the ANK3 genotype showed them to add their share of the diagnostic variance, with no interaction (15% of variance explained, P<0.002). The study is cross-sectional with no longitudinal follow-up. Cohorts are relatively small with no medication-free patients, and there are no 'ill patient' controls. It takes 3 to 4 weeks of culture to expand adipocytes that may change epigenetic profiles but remove the possibility of medication effects. Abnormalities in the reactivity of intracellular signal pathways to stimulation and the ANK3 genotype may be associated with pathogenesis of BD. Algorithms using biological patterns such as pathway reactivity together with structural genetic SNP data may provide opportunities for earlier detection and effective treatment of BD.
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Affiliation(s)
- A Hayashi
- Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - K Le Gal
- Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - K Södersten
- Sahlgrenska Academy, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - D Vizlin-Hodzic
- Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - H Ågren
- Sahlgrenska Academy, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrenska Academy, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska University Hospital, SE 41685 Gothenburg, Sweden. E-mail:
| | - K Funa
- Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden,Sahlgrenska Cancer Center, University of Gothenburg, Medicinaregatan 1G, SE 40530 Gothenburg, Sweden. E-mail:
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Kishore BK, Carlson NG, Ecelbarger CM, Kohan DE, Müller CE, Nelson RD, Peti-Peterdi J, Zhang Y. Targeting renal purinergic signalling for the treatment of lithium-induced nephrogenic diabetes insipidus. Acta Physiol (Oxf) 2015; 214:176-88. [PMID: 25877068 PMCID: PMC4430398 DOI: 10.1111/apha.12507] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/08/2015] [Indexed: 12/26/2022]
Abstract
Lithium still retains its critical position in the treatment of bipolar disorder by virtue of its ability to prevent suicidal tendencies. However, chronic use of lithium is often limited by the development of nephrogenic diabetes insipidus (NDI), a debilitating condition. Lithium-induced NDI is due to resistance of the kidney to arginine vasopressin (AVP), leading to polyuria, natriuresis and kaliuresis. Purinergic signalling mediated by extracellular nucleotides (ATP/UTP), acting via P2Y receptors, opposes the action of AVP on renal collecting duct (CD) by decreasing the cellular cAMP and thus AQP2 protein levels. Taking a cue from this phenomenon, we discovered the potential involvement of ATP/UTP-activated P2Y2 receptor in lithium-induced NDI in rats and showed that P2Y2 receptor knockout mice are significantly resistant to Li-induced polyuria, natriuresis and kaliuresis. Extension of these studies revealed that ADP-activated P2Y12 receptor is expressed in the kidney, and its irreversible blockade by the administration of clopidogrel bisulphate (Plavix(®)) ameliorates Li-induced NDI in rodents. Parallel in vitro studies showed that P2Y12 receptor blockade by the reversible antagonist PSB-0739 sensitizes CD to the action of AVP. Thus, our studies unravelled the potential beneficial effects of targeting P2Y2 or P2Y12 receptors to counter AVP resistance in lithium-induced NDI. If established in further studies, our findings may pave the way for the development of better and safer methods for the treatment of NDI by bringing a paradigm shift in the approach from the current therapies that predominantly counter the anti-AVP effects to those that enhance the sensitivity of the kidney to AVP action.
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Affiliation(s)
- B. K. Kishore
- Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
- Nephrology Research, Department of Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Center on Aging, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - N. G. Carlson
- Center on Aging, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
- Department of Neurobiology and Anatomy, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
- Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah, USA
| | - C. M. Ecelbarger
- Department of Medicine, Georgetown University, Washington, District of Columbia, USA
- Center for the Study of Sex Differences in Health, Aging, and Disease, Georgetown University, Washington, District of Columbia, USA
| | - D. E. Kohan
- Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
- Nephrology Research, Department of Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah, USA
| | - C. E. Müller
- PharmaCenter Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I, University of Bonn, Bonn, Germany
| | - R. D. Nelson
- Department of Paediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - J. Peti-Peterdi
- Department of Physiology and Biophysics, and Zilkha Neurogenetic Institute, University of Southern California, Los Angeles, California, USA
| | - Y. Zhang
- Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
- Nephrology Research, Department of Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah, USA
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Payandemehr B, Bahremand A, Ebrahimi A, Nasrabady SE, Rahimian R, Bahremand T, Sharifzadeh M, Dehpour AR. Protective effects of lithium chloride on seizure susceptibility: Involvement of α2-adrenoceptor. Pharmacol Biochem Behav 2015; 133:37-42. [PMID: 25824982 DOI: 10.1016/j.pbb.2015.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 03/19/2015] [Accepted: 03/21/2015] [Indexed: 11/26/2022]
Abstract
For more than 60years, lithium has been the mainstay in the treatment of mental disorders as a mood stabilizer. In addition to the antimanic and antidepressant responses, lithium also shows some anticonvulsant properties. In spite of the ascertained neuroprotective effects of this alkali metal, the underlying mechanisms through which lithium regulates behavior are still poorly understood. Among different targets, some authors suggest neuromodulatory effects of lithium are the consequences of interaction of this agent with the brain neurotransmitters including adrenergic system. In order to study the involvement of α2-adrenergic system in anticonvulsant effect of lithium, we used a model of clonic seizure induced by pentylenetetrazole (PTZ) in male NMRI mice. Injection of a single effective dose of lithium chloride (30mg/kg, i.p.) significantly increased the seizure threshold (p<0.01). The anticonvulsant effect of an effective dose of lithium was prevented by pre-treatment with low and per se non-effective dose of clonidine [α2-adrenoceptor agonist] (0.05, 0.1 and 0.25mg/kg). On the other hand, yohimbine [α2-adrenoceptor antagonist] augmented the anticonvulsant effect of sub-effective dose of lithium (10mg/kgi.p.) at relatively low doses (0.1, 0.5, 1 and 2.5mg/kg). Moreover, UK14304 [a potent and selective α2-adrenoceptor agonist] (0.05 and 0.1mg/kg) and RX821008 [a potent and selective α2D-adrenoceptor antagonist] (0.05, 0.1 and 0.25mg/kg) repeated the same results confirming that these modulatory effects are conducted specifically through the α2D-adrenoceptors. In summary, our findings demonstrated that α2-adrenoceptor pathway could be involved in the anticonvulsant properties of lithium chloride in the model of chemically induced clonic seizure.
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Affiliation(s)
- Borna Payandemehr
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Bahremand
- Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada
| | - Ali Ebrahimi
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ebrahimi Nasrabady
- Motor Neuron Center, College of Physicians and Surgeons, Columbia University Medical Center, NY, USA
| | - Reza Rahimian
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Taraneh Bahremand
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sharifzadeh
- Department of Pharmacology and Toxicology, Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran" to the Ahmad reza Dehpour.
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25
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Shioya A, Saito Y, Arima K, Kakuta Y, Yuzuriha T, Tanaka N, Murayama S, Tamaoka A. Neurodegenerative changes in patients with clinical history of bipolar disorders. Neuropathology 2015; 35:245-53. [DOI: 10.1111/neup.12191] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/27/2014] [Accepted: 11/28/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Ayako Shioya
- Department of Pathology and Laboratory Medicine National Center Hospital, National Center of Neurology and Psychiatry Tokyo Japan
- Department of Neurology Graduate School of Comprehensive Human Science University of Tsukuba Ibaraki Japan
| | - Yuko Saito
- Department of Pathology and Laboratory Medicine National Center Hospital, National Center of Neurology and Psychiatry Tokyo Japan
| | - Kunimasa Arima
- Department of Psychiatry National Center Hospital, National Center of Neurology and Psychiatry Tokyo Japan
| | - Yukio Kakuta
- Department of Pathology Yokohama Rosai Hospital Kanagawa Japan
| | | | - Noriko Tanaka
- Biostatistics Section, Department of Clinical Research and Informatics Clinical Science Center National Center for Global Health and Medicine Tokyo Japan
| | - Shigeo Murayama
- Brain Bank for Aging Research Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Akira Tamaoka
- Department of Neurology Graduate School of Comprehensive Human Science University of Tsukuba Ibaraki Japan
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Bcl-2 associated with severity of manic symptoms in bipolar patients in a manic phase. Psychiatry Res 2015; 225:305-8. [PMID: 25563670 DOI: 10.1016/j.psychres.2014.12.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 11/18/2014] [Accepted: 12/14/2014] [Indexed: 01/26/2023]
Abstract
B cell lymphoma protein-2 (Bcl-2) may contribute to the pathophysiology of bipolar disorder, and may be involved in the therapeutic action of anti-manic drugs. The aim of this study was to investigate serum levels of Bcl-2 in bipolar patients in a manic phase, and evaluate the Bcl-2 changes after treatment. We consecutively enrolled 23 bipolar inpatients in a manic phase and 40 healthy subjects; 20 bipolar patients were followed up with treatment. Serum Bcl-2 levels were measured with assay kits. All 20 patients were evaluated by examining the correlation between Bcl-2 levels and Young Mania Rating Scale (YMRS) scores, using Spearman׳s correlation coefficients. The serum Bcl-2 levels in bipolar patients in a manic phase were higher than in healthy subjects, but without a significant difference. The YMRS scores were significantly negatively associated with serum Bcl-2 levels (p=0.042). Bcl-2 levels of the 20 bipolar patients were measured at the end of treatment. Using the Wilcoxon Signed Rank test, we found no significant difference in the Bcl-2 levels of bipolar patients after treatment. Our results suggest that Bcl-2 levels might be an indicator of severity of manic symptoms in bipolar patients in a manic phase.
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27
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Qu N, Zhou XY, Han L, Wang L, Xu JX, Zhang T, Chu J, Chen Q, Wang JZ, Zhang Q, Tian Q. Combination of PPT with LiCl Treatment Prevented Bilateral Ovariectomy-Induced Hippocampal-Dependent Cognition Deficit in Rats. Mol Neurobiol 2014; 53:894-904. [DOI: 10.1007/s12035-014-9050-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 12/02/2014] [Indexed: 12/17/2022]
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Zhang L, Li K, Sun R, Zhang Y, Ji J, Huang P, Yang H, Tian Y. Minocycline ameliorates cognitive impairment induced by whole-brain irradiation: an animal study. Radiat Oncol 2014; 9:281. [PMID: 25498371 PMCID: PMC4271325 DOI: 10.1186/s13014-014-0281-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 11/28/2014] [Indexed: 12/11/2022] Open
Abstract
Background It has been long recognized that cranial irradiation used for the treatment of primary and metastatic brain tumor often causes neurological side-effects such as intellectual impairment, memory loss and dementia, especially in children patients. Our previous study has demonstrated that whole-brain irradiation (WBI) can cause cognitive decline in rats. Minocycline is an antibiotic that has shown neuroprotective properties in a variety of experimental models of neurological diseases. However, whether minocycline can ameliorate cognitive impairment induced by ionizing radiation (IR) has not been tested. Thus this study aimed to demonstrate the potential implication of minocycline in the treatment of WBI-induced cognitive deficits by using a rat model. Methods Sprague Dawley rats were cranial irradiated with electron beams delivered by a linear accelerator with a single dose of 20 Gy. Minocycline was administered via oral gavages directly into the stomach before and after irradiation. The open field test was used to assess the anxiety level of rats. The Morris water maze (MWM) was used to assess the spatial learning and memory of rats. The level of apoptosis in hippocampal neurons was measured using immunohistochemistry for caspase-3 and relative markers for mature neurons (NeuN) or for newborn neurons (Doublecortin (DCX)). Neurogenesis was determined by BrdU incorporation method. Results Neither WBI nor minocycline affected the locomotor activity and anxiety level of rats. However, compared with the sham-irradiated controls, WBI caused a significant loss of learning and memory manifest as longer latency to reach the hidden platform in the MWM task. Minocycline intervention significantly improved the memory retention of irradiated rats. Although minocycline did not rescue neurogenesis deficit caused by WBI 2 months post-IR, it did significantly decreased WBI-induced apoptosis in the DCX positive neurons, thereby resulting in less newborn neuron depletion 12 h after irradiation. Conclusions Minocycline significantly inhibits WBI-induced neuron apoptosis, leading to less newborn neurons loss shortly after irradiation. In the long run, minocycline improves the cognitive performance of rats post WBI. The results indicate a potential clinical implication of minocycline as an effective adjunct in radiotherapy for brain tumor patients.
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Affiliation(s)
- Liyuan Zhang
- Department of Radiotherapy and Oncology, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, Jiangsu Province, 215123, PR China.
| | - Kun Li
- Department of Radiotherapy and Oncology, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Department of Medical Oncology, Affiliated Hospital of Taishan Medical University, Taian, Shandong Province, 271000, PR China.
| | - Rui Sun
- Department of Radiotherapy and Oncology, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China.
| | - Yuan Zhang
- Department of Radiotherapy and Oncology, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China.
| | - JianFeng Ji
- Department of Radiotherapy and Oncology, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China.
| | - Peigeng Huang
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 100 Blossom Street, Boston, MA, 02114, USA.
| | - Hongying Yang
- Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, Jiangsu Province, 215123, PR China. .,School of Radiation Medicine and Protection, Medical College of Soochow University/School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu Province, 215123, PR China.
| | - Ye Tian
- Department of Radiotherapy and Oncology, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases, Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China. .,Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, Jiangsu Province, 215123, PR China.
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Tang LR, Liu CH, Jing B, Ma X, Li HY, Zhang Y, Li F, Wang YP, Yang Z, Wang CY. Voxel-based morphometry study of the insular cortex in bipolar depression. Psychiatry Res 2014; 224:89-95. [PMID: 25218414 DOI: 10.1016/j.pscychresns.2014.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 03/11/2014] [Accepted: 08/08/2014] [Indexed: 11/30/2022]
Abstract
Bipolar depression (BD) is a common psychiatric illness characterized by deficits in emotional and cognitive processing. Abnormalities in the subregions of the insula are common findings in neuroanatomical studies of patients with bipolar disorder. However, the specific relationships between morphometric changes in specific insular subregions and the pathogenesis of BD are not clear. In this study, structural magnetic resonance imaging (MRI) was used to investigate gray matter volume abnormalities in the insular subregion in 27 patients with BD and in 27 age and sex-matched controls. Using DARTEL (diffeomorphic anatomical registration through exponentiated lie algebra) for voxel-based morphometry (VBM), we examined changes in regional gray matter volumes of the insula in patients with BD. As compared with healthy controls, the BD patients showed decreased gray matter volumes in the right posterior insula and left ventral anterior insula and increased gray matter volumes in the left dorsal anterior insula. Consistent with the emerging theory of insular interference as a contributor to emotional-cognitive dysregulation, the current findings suggest that the insular cortex may be involved in the neural substrates of BD.
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Affiliation(s)
- Li-Rong Tang
- Center of the Treatment in Depressive Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Chun-Hong Liu
- Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing 100088, China
| | - Bin Jing
- School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
| | - Xin Ma
- Center of the Treatment in Depressive Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing 100088, China.
| | - Hai-Yun Li
- School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
| | - Yu Zhang
- Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Feng Li
- Center of the Treatment in Depressive Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Center of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing 100088, China
| | - Yu-Ping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; Beijing Key Laboratory of Neuromodulation, Capital Medical University, Beijing 100053, China
| | - Zhi Yang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Chuan-Yue Wang
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing 100088, China; Center of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing 100088, China
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Liechti FD, Stüdle N, Theurillat R, Grandgirard D, Thormann W, Leib SL. The mood-stabilizer lithium prevents hippocampal apoptosis and improves spatial memory in experimental meningitis. PLoS One 2014; 9:e113607. [PMID: 25409333 PMCID: PMC4237452 DOI: 10.1371/journal.pone.0113607] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 10/28/2014] [Indexed: 12/20/2022] Open
Abstract
Pneumococcal meningitis is associated with high morbidity and mortality rates. Brain damage caused by this disease is characterized by apoptosis in the hippocampal dentate gyrus, a morphological correlate of learning deficits in experimental paradigms. The mood stabilizer lithium has previously been found to attenuate brain damage in ischemic and inflammatory diseases of the brain. An infant rat model of pneumococcal meningitis was used to investigate the neuroprotective and neuroregenerative potential of lithium. To assess an effect on the acute disease, LiCl was administered starting five days prior to intracisternal infection with live Streptococcus pneumoniae. Clinical parameters were recorded, cerebrospinal fluid (CSF) was sampled, and the animals were sacrificed 42 hours after infection to harvest the brain and serum. Cryosections of the brains were stained for Nissl substance to quantify brain injury. Hippocampal gene expression of Bcl-2, Bax, p53, and BDNF was analyzed. Lithium concentrations were measured in serum and CSF. The effect of chronic lithium treatment on spatial memory function and cell survival in the dentate gyrus was evaluated in a Morris water maze and by quantification of BrdU incorporation after LiCl treatment during 3 weeks following infection. In the hippocampus, LiCl significantly reduced apoptosis and gene expression of Bax and p53 while it increased expression of Bcl-2. IL-10, MCP-1, and TNF were significantly increased in animals treated with LiCl compared to NaCl. Chronic LiCl treatment improved spatial memory in infected animals. The mood stabilizer lithium may thus be a therapeutic alternative to attenuate neurofunctional deficits as a result of pneumococcal meningitis.
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Affiliation(s)
- Fabian D. Liechti
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Nicolas Stüdle
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Regula Theurillat
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Denis Grandgirard
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Wolfgang Thormann
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Stephen L. Leib
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
- Biology Division, Spiez Laboratory, Swiss Federal Office for Civil Protection, Spiez, Switzerland
- * E-mail:
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Oruch R, Elderbi MA, Khattab HA, Pryme IF, Lund A. Lithium: A review of pharmacology, clinical uses, and toxicity. Eur J Pharmacol 2014; 740:464-73. [DOI: 10.1016/j.ejphar.2014.06.042] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/20/2014] [Accepted: 06/20/2014] [Indexed: 01/10/2023]
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Mauer S, Vergne D, Ghaemi SN. Standard and trace-dose lithium: a systematic review of dementia prevention and other behavioral benefits. Aust N Z J Psychiatry 2014; 48:809-18. [PMID: 24919696 DOI: 10.1177/0004867414536932] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Dementia is a major public health issue, with notably high rates in persons with mood illnesses. Lithium has been shown to have considerable neuroprotective effects, even in trace or low doses. The aim of this review is to summarize the current understanding of lithium benefits in trace or low doses in dementia prevention and for other behavioral or medical benefits. METHODS A systematic review identified 24 clinical, epidemiological, and biological reports that met inclusion criteria of assessing lithium in standard or low doses for dementia or other behavioral or medical benefits. RESULTS Five out of seven epidemiological studies found an association between standard-dose lithium and low dementia rates. Nine out of 11 epidemiological studies, usually of drinking water sources, found an association between trace-dose lithium and low suicide/homicide/mortality and crime rates. All four small randomized clinical trials of lithium for Alzheimer's dementia have found at least some clinical or biological benefits versus placebo. Only one small randomized clinical trial (RCT) of trace lithium has been conducted, assessing mood symptoms in former substance abusers, and found benefit with lithium versus placebo. CONCLUSIONS Lithium, in both standard and trace doses, appears to have biological benefits for dementia, suicide, and other behavioral outcomes. Further RCT research of trace lithium in dementia is warranted.
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Affiliation(s)
- Sivan Mauer
- Mood Disorders Program, Department of Psychiatry, Tufts Medical Center, Boston, MA, USA
| | - Derick Vergne
- Mood Disorders Program, Department of Psychiatry, Tufts Medical Center, Boston, MA, USA Tufts University School of Medicine, Boston, MA, USA
| | - S Nassir Ghaemi
- Mood Disorders Program, Department of Psychiatry, Tufts Medical Center, Boston, MA, USA Tufts University School of Medicine, Boston, MA, USA
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Woodward ND. The course of neuropsychological impairment and brain structure abnormalities in psychotic disorders. Neurosci Res 2014; 102:39-46. [PMID: 25152315 DOI: 10.1016/j.neures.2014.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 08/07/2014] [Accepted: 08/13/2014] [Indexed: 01/07/2023]
Abstract
Neuropsychological impairment and abnormalities in brain structure are commonly observed in psychotic disorders, including schizophrenia and bipolar disorder. Shared deficits in neuropsychological functioning and abnormalities in brain structure suggest overlapping neuropathology between schizophrenia and bipolar disorder which has important implications for psychiatric nosology, treatment, and our understanding of the etiology of psychotic illnesses. However, the emergence and trajectory of brain dysfunction in psychotic disorders is less well understood. Differences in the course and progression of neuropsychological impairment and brain abnormalities among psychotic disorders may point to unique neuropathological processes. This article reviews the course of neuropsychological impairment and brain structure abnormalities in schizophrenia and bipolar disorder.
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Affiliation(s)
- Neil D Woodward
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, United States.
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Plotnikov EY, Silachev DN, Zorova LD, Pevzner IB, Jankauskas SS, Zorov SD, Babenko VA, Skulachev MV, Zorov DB. Lithium salts — Simple but magic. BIOCHEMISTRY (MOSCOW) 2014; 79:740-9. [DOI: 10.1134/s0006297914080021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Rodrigues R, Petersen RB, Perry G. Parallels between major depressive disorder and Alzheimer's disease: role of oxidative stress and genetic vulnerability. Cell Mol Neurobiol 2014; 34:925-49. [PMID: 24927694 DOI: 10.1007/s10571-014-0074-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/14/2014] [Indexed: 12/19/2022]
Abstract
The thesis of this review is that oxidative stress is the central factor in major depressive disorder (MDD) and Alzheimer's disease (AD). The major elements involved are inflammatory cytokines, the hypothalamic-pituitary axis, the hypothalamic-pituitary gonadal, and arginine vasopressin systems, which induce glucocorticoid and "oxidopamatergic" cascades when triggered by psychosocial stress, severe life-threatening events, and mental-affective and somatic diseases. In individuals with a genomic vulnerability to depression, these cascades may result in chronic depression-anxiety-stress spectra, resulting in MDD and other known depressive syndromes. In contrast, in subjects with genomic vulnerability to AD, oxidative stress-induced brain damage triggers specific antioxidant defenses, i.e., increased levels of amyloid-β (Aβ) and aggregation of hyper-phosphorylated tau, resulting in paired helical filaments and impaired functions related to the ApoEε4 isoform, leading to complex pathological cascades culminating in AD. Surprisingly, all the AD-associated molecular pathways mentioned in this review have been shown to be similar or analogous to those found in depression, including structural damage, i.e., hippocampal and frontal cortex atrophy. Other interacting molecular signals, i.e., GSK-3β, convergent survival factors (brain-derived neurotrophic factor and heat shock proteins), and transition redox metals are also mentioned to emphasize the vast array of intermediates that could interact via comparable mechanisms in both MDD and AD.
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Affiliation(s)
- Roberto Rodrigues
- College of Sciences, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA,
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Honarmand AR, Pourtabatabaei N, Rahimi N, Dehpour AR, Javadi-Paydar M. Suppression of memory acquisition following co-administration of lithium and atorvastatin through nitric oxide pathway in mice. Pharmacol Biochem Behav 2014; 122:203-11. [PMID: 24708995 DOI: 10.1016/j.pbb.2014.03.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/28/2014] [Accepted: 03/27/2014] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of this study was to investigate the interactive effect of lithium and atorvastatin on cognitive performance and the role of NO as a potential mechanism involved in this interaction. MATERIALS AND METHODS Memory performance was evaluated in a two-trial recognition Y-maze test and a step-through passive avoidance task in mice. Lithium (5, 10, 20 or 40 mg/kg, i.p.) and atorvastatin (1 mg/kg, p.o.) were administered 1 h before each trial, L-NAME, a non-specific NO synthase inhibitor (3, 10 mg/kg, i.p.); aminoguanidine, a specific inducible NO synthase (iNOS) inhibitor (100 mg/kg); and L-arginine, a NO precursor (750 mg/kg) were administered 30 min before training sessions. The level of plasma NO end-products (NOx) was determined using Griess reagent protocol. RESULTS 1) Lithium (40 mg/kg) impaired the acquisition of spatial recognition memory; 2) lithium did not affect the retrieval phase of spatial memory; 3) atorvastatin (1 mg/kg) significantly impaired the memory performance, when co-administered with the sub-effective dose of lithium (10 mg/kg), but did not affect the status when administered with lithium (5 mg/kg); 4) L-NAME (10 mg/kg) and aminoguanidine (100 mg/kg) dramatically decreased memory performance in mice received sub-effective doses of both lithium (5 mg/kg) and atorvastatin (1 mg/kg); 5) L-arginine (750 mg/kg) improved the memory acquisition in mice administered lithium (10 mg/kg) and atorvastatin (1 mg/kg); 6) lithium did not affect the cognitive performance in the passive avoidance test. All results were compatible and confirmed with in vitro determination of plasma NOx levels. CONCLUSIONS Lithium, dose dependently, impaired acquisition phase of spatial recognition memory. Lithium and atorvastatin co-administration impaired spatial recognition memory mediating by nitrergic pathway. In addition to L-arginine, our data from L-NAME and aminoguanidine also support the involvement of NO pathway in this interaction.
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Affiliation(s)
- Amir Reza Honarmand
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Brain and Spinal Cord Injury Repair Research Center, Tehran University of Medical Sciences, Iran
| | - Nasim Pourtabatabaei
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Brain and Spinal Cord Injury Repair Research Center, Tehran University of Medical Sciences, Iran
| | - Nastaran Rahimi
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Experimental Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Experimental Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrak Javadi-Paydar
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Brain and Spinal Cord Injury Repair Research Center, Tehran University of Medical Sciences, Iran.
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Balter V, Vigier N. Natural variations of lithium isotopes in a mammalian model. Metallomics 2014; 6:582-6. [DOI: 10.1039/c3mt00295k] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Dachs E, Piedrafita L, Hereu M, Esquerda J, Calderó J. Chronic treatment with lithium does not improve neuromuscular phenotype in a mouse model of severe spinal muscular atrophy. Neuroscience 2013; 250:417-33. [DOI: 10.1016/j.neuroscience.2013.07.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/26/2013] [Accepted: 07/11/2013] [Indexed: 12/12/2022]
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Abstract
A large body of evidence from molecular, cellular and human studies suggests that lithium may enhance synaptic plasticity, which may be associated with its therapeutic efficacy. However, only a small number of studies have directly assessed this. To determine whether lithium treatment alters structural synaptic plasticity, this study examined the effect of 4 wk lithium treatment on the amount and distribution of dendrites in the dentate gyrus (DG) and hippocampal area CA1 of young adult rats. Following 4 wk lithium or control chow feeding, animals were decapitated, the hippocampi were prepared and stained using a rapid Golgi staining technique and the amount and distribution of the dendritic branching was evaluated using Sholl analyses (method of concentric circles). In the DG, lithium treatment increased the amount and distribution of dendritic branches in the proximal half of dendritic trees of the granule cells and reduced branching in the distal half. In area CA1, the same treatment also increased the number of dendritic branches in the proximal half of apical dendritic trees of CA1 pyramidal cells and reduced branching in the distal half of apical dendritic trees but had no effect on basilar dendritic trees. The lithium treatment altered the total density of dendritic trees in neither the DG nor area CA1. These findings suggest that, in the DG and apical CA1, chronic lithium treatment rearranges neuronal morphology to increase dendritic branching and distribution to where major afferent input is received.
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Krystal JH, Sanacora G, Duman RS. Rapid-acting glutamatergic antidepressants: the path to ketamine and beyond. Biol Psychiatry 2013; 73:1133-41. [PMID: 23726151 PMCID: PMC3671489 DOI: 10.1016/j.biopsych.2013.03.026] [Citation(s) in RCA: 311] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 03/18/2013] [Accepted: 03/20/2013] [Indexed: 12/31/2022]
Abstract
Traditional antidepressants require many weeks to reveal their therapeutic effects. However, the widely replicated observation that a single subanesthetic dose of the N-methyl-D-aspartate glutamate receptor antagonist ketamine produced meaningful clinical improvement within hours, suggested that rapid-acting antidepressants might be possible. The ketamine studies stimulated a new generation of basic antidepressant research that identified new neural signaling mechanisms in antidepressant response and provided a conceptual framework linking a group of novel antidepressant mechanisms. This article presents the path that led to the testing of ketamine, considers its promise as an antidepressant, and reviews novel treatment mechanisms that are emerging from this line of research.
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Affiliation(s)
- John H. Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, Clinical Neuroscience Division, VA National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT,for correspondence: Department of Psychiatry, Yale University School of Medicine, Suite #901, 300 George St, New Haven, CT 06511; , tel: 203-785-6396, fax: 203-785-6196
| | - Gerard Sanacora
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT
| | - Ronald S. Duman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, Clinical Neuroscience Division, VA National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT
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Maupin KA, Droscha CJ, Williams BO. A Comprehensive Overview of Skeletal Phenotypes Associated with Alterations in Wnt/β-catenin Signaling in Humans and Mice. Bone Res 2013; 1:27-71. [PMID: 26273492 DOI: 10.4248/br201301004] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/20/2013] [Indexed: 12/23/2022] Open
Abstract
The Wnt signaling pathway plays key roles in differentiation and development and alterations in this signaling pathway are causally associated with numerous human diseases. While several laboratories were examining roles for Wnt signaling in skeletal development during the 1990s, interest in the pathway rose exponentially when three key papers were published in 2001-2002. One report found that loss of the Wnt co-receptor, Low-density lipoprotein related protein-5 (LRP5), was the underlying genetic cause of the syndrome Osteoporosis pseudoglioma (OPPG). OPPG is characterized by early-onset osteoporosis causing increased susceptibility to debilitating fractures. Shortly thereafter, two groups reported that individuals carrying a specific point mutation in LRP5 (G171V) develop high-bone mass. Subsequent to this, the causative mechanisms for these observations heightened the need to understand the mechanisms by which Wnt signaling controlled bone development and homeostasis and encouraged significant investment from biotechnology and pharmaceutical companies to develop methods to activate Wnt signaling to increase bone mass to treat osteoporosis and other bone disease. In this review, we will briefly summarize the cellular mechanisms underlying Wnt signaling and discuss the observations related to OPPG and the high-bone mass disorders that heightened the appreciation of the role of Wnt signaling in normal bone development and homeostasis. We will then present a comprehensive overview of the core components of the pathway with an emphasis on the phenotypes associated with mice carrying genetically engineered mutations in these genes and clinical observations that further link alterations in the pathway to changes in human bone.
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Affiliation(s)
- Kevin A Maupin
- Program for Skeletal Pathobiology and Center for Tumor Metastasis, Van Andel Research Institute , 333 Bostwick NE, Grand Rapids, MI 49503, USA
| | - Casey J Droscha
- Program for Skeletal Pathobiology and Center for Tumor Metastasis, Van Andel Research Institute , 333 Bostwick NE, Grand Rapids, MI 49503, USA
| | - Bart O Williams
- Program for Skeletal Pathobiology and Center for Tumor Metastasis, Van Andel Research Institute , 333 Bostwick NE, Grand Rapids, MI 49503, USA
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Dallaspezia S, Poletti S, Lorenzi C, Pirovano A, Colombo C, Benedetti F. Influence of an interaction between lithium salts and a functional polymorphism in SLC1A2 on the history of illness in bipolar disorder. Mol Diagn Ther 2013; 16:303-9. [PMID: 23023733 DOI: 10.1007/s40291-012-0004-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a recurrent and disabling illness, characterized by periods of depression and mania. The history of the illness differs widely between patients, with episode frequency emerging as a strong predictor of poor illness outcome. Lithium salts are the first-choice long-term mood-stabilizing therapy, but not all patients respond equally to the treatment. Evidence suggests that alterations in glutamatergic systems may contribute to the pathophysiology of depression. Moreover, glutamate signaling is involved in brain development and synaptic plasticity, both of which are modified in individuals affected by BD, and has been implicated in the etiology of the disorder. The inactivation of glutamate is handled by a series of molecular glutamate transporters (excitatory amino acid transporters [EAATs]), among which EAAT2/SLC1A2 is responsible for up to 95% of extracellular glutamate clearance. A functional single-nucleotide polymorphism at -181 bp from the transcription start site of the SLC1A2 gene has been described. This T-to-G (DNA forward strand) polymorphism, commonly known as SLC1A2 -181A>C, affects transporter expression, with the variant G allele inducing a 30% reduction in promoter activity compared with the T allele. OBJECTIVE The aims of the study were to investigate if factors affecting glutamate function, such as SLC1A2 -181A>C (rs4354668), could affect recurrence of illness in BD, and if they interact with lithium salt treatment. METHODS We performed an observational study in our university hospital in Milan. We enrolled 110 subjects (76 females, 34 males) affected by BD type I. The exclusion criteria were other diagnoses on Axis I, mental retardation on Axis II, a history of epilepsy, and major medical and neurologic disorders. Fifty-four patients had been treated with lithium salts for more than 6 months. Patients were genotyped for SLC1A2 -181A>C by polymerase chain reaction-restriction fragment length polymorphism, and the influence of genotype on BD episode recurrence rates, and the interaction between the single nucleotide polymorphism and lithium treatment, were analyzed. RESULTS The SLC1A2 -181A>C genotype significantly influenced the total recurrence of episodes, with T/T homozygotes showing a significantly lower frequency of episodes (F = 3.26; p = 0.042), and an interaction between lithium treatment and genotype (F = 3.77; p = 0.026) was found to influence the history of the illness. CONCLUSION According to our results, the glutamatergic system could be hypothesized to exert some influence on the history of illness in BD. The SLC1A2 functional polymorphism was shown to significantly influence the total episode recurrence rate, with wild-type T homozygotes presenting the lowest number of episodes, G homozygotes reporting the highest number, and heterozygotes showing an intermediate phenotype. We confirmed the efficacy of lithium treatment in reducing the recurrence of illness in BD, and we found an interaction between lithium treatment and the SLC1A2 -181A>C genotype, confirming previous studies reporting an interaction between lithium salts and the glutamatergic system.
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Affiliation(s)
- Sara Dallaspezia
- Department of Clinical Neurosciences, Istituto Scientifico Ospedale San Raffaele, San Raffaele Turro, Milan, Italy.
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Neuroprotective effects of chronic exposure of SH-SY5Y to low lithium concentration involve glycolysis stimulation, extracellular pyruvate accumulation and resistance to oxidative stress. Int J Neuropsychopharmacol 2013; 16:365-76. [PMID: 22436355 DOI: 10.1017/s1461145712000132] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Recent studies suggest that lithium protects neurons from death induced by a wide array of neurotoxic insults, stimulates neurogenesis and could be used to prevent age-related neurodegenerative diseases. In this study, SH-SY5Y human neuronal cells were cultured in the absence (Con) or in the presence (Li+) of a low lithium concentration (0.5 mm Li2CO3, i.e. 1 mm lithium ion) for 25-50 wk. In the course of treatment, growth rate of Con and Li+ cells was regularly analysed using Alamar Blue dye. Resistance to oxidative stress was investigated by evaluating: (1) the adverse effects of high concentrations of lithium (4-8 mm) or glutamate (20-90 mm) on cell growth rate; (2) the levels of lipid peroxidation (TBARS) and total glutathione; (3) the expression levels of the anti-apoptotic Bcl-2 protein. In addition, glucose metabolism was investigated by analysing selected metabolites in culture media and cell extracts by 1H-NMR spectroscopy. As compared to Con, Li+ cells multiplied faster and were more resistant to stress, as evidenced by a lower dose-dependent decrease of Alamar Blue reduction and dose-dependent increase of TBARS levels induced by toxic doses of lithium and glutamate. Total glutathione content and Bcl-2 level were increased in Li+ cells. Glucose consumption and glycolytic activity were enhanced in Li+ cells and an important release of pyruvate was observed. We conclude that chronic exposure to lithium induces adaptive changes in metabolism of SH-SY5Y cells involving a higher cell growth rate and a better resistance to oxidative stress.
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GSK-3β Polymorphism Discriminates Bipolar Disorder and Schizophrenia: A Systematic Meta-Analysis. Mol Neurobiol 2013; 48:404-11. [DOI: 10.1007/s12035-013-8414-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 01/24/2013] [Indexed: 01/31/2023]
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Kishore BK, Ecelbarger CM. Lithium: a versatile tool for understanding renal physiology. Am J Physiol Renal Physiol 2013; 304:F1139-49. [PMID: 23408166 DOI: 10.1152/ajprenal.00718.2012] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
By virtue of its unique interactions with kidney cells, lithium became an important research tool in renal physiology and pathophysiology. Investigators have uncovered the intricate relationships of lithium with the vasopressin and aldosterone systems, and the membrane channels or transporters regulated by them. While doing so, their work has also led to 1) questioning the role of adenylyl cyclase activity and prostaglandins in lithium-induced suppression of aquaporin-2 gene transcription; 2) unraveling the role of purinergic signaling in lithium-induced polyuria; and 3) highlighting the importance of the epithelial sodium channel (ENaC) in lithium-induced nephrogenic diabetes insipidus (NDI). Lithium-induced remodeling of the collecting duct has the potential to shed new light on collecting duct remodeling in disease conditions, such as diabetes insipidus. The finding that lithium inhibits glycogen synthase kinase-3β (GSK3β) has opened an avenue for studies on the role of GSK3β in urinary concentration, and GSK isoforms in renal development. Finally, proteomic and metabolomic profiling of the kidney and urine in rats treated with lithium is providing insights into how the kidney adapts its metabolism in conditions such as acquired NDI and the multifactorial nature of lithium-induced NDI. This review provides state-of-the-art knowledge of lithium as a versatile tool for understanding the molecular physiology of the kidney, and a comprehensive view of how this tool is challenging some of our long-standing concepts in renal physiology, often with paradigm shifts, and presenting paradoxical situations in renal pathophysiology. In addition, this review points to future directions in research where lithium can lead the renal community.
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Affiliation(s)
- Bellamkonda K Kishore
- Nephrology Research (151M) VA SLC Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148, USA.
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Intracerebroventricular administration of ouabain alters synaptic plasticity and dopamine release in rat medial prefrontal cortex. J Neural Transm (Vienna) 2013; 120:1191-9. [DOI: 10.1007/s00702-013-0973-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/04/2013] [Indexed: 12/29/2022]
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Kim HK, Andreazza AC. The relationship between oxidative stress and post-translational modification of the dopamine transporter in bipolar disorder. Expert Rev Neurother 2012; 12:849-59. [PMID: 22853792 DOI: 10.1586/ern.12.64] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bipolar disorder (BD) has been consistently associated with altered levels of oxidative stress markers, although the cause and consequences of these alterations remain to be elucidated. One of the main hypotheses regarding the pathogenesis of mania involves increased dopaminergic transmission. In this review, the authors aim to discuss a potential mechanism by which increased oxidative stress inhibits the uptake of dopamine through the post-translational modification of the dopamine transporter and its implications for BD. Within the next 5 years, the authors believe that the mechanisms of dopamine transporter oxidation and its impact on the pathophysiology of BD will be elucidated, which may open avenues for the development of more specific interventions for the treatment of this debilitating illness.
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Soeiro-de-Souza MG, Dias VV, Figueira ML, Forlenza OV, Gattaz WF, Zarate CA, Machado-Vieira R. Translating neurotrophic and cellular plasticity: from pathophysiology to improved therapeutics for bipolar disorder. Acta Psychiatr Scand 2012; 126:332-41. [PMID: 22676371 PMCID: PMC3936785 DOI: 10.1111/j.1600-0447.2012.01889.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Bipolar disorder (BD) likely involves, at a molecular and cellular level, dysfunctions of critical neurotrophic, cellular plasticity and resilience pathways and neuroprotective processes. Therapeutic properties of mood stabilizers are presumed to result from a restoration of the function of these altered pathways and processes through a wide range of biochemical and molecular effects. We aimed to review the altered pathways and processes implicated in BD, such as neurotrophic factors, mitogen-activated protein kinases, Bcl-2, phosphoinositol signaling, intracellular calcium and glycogen synthase kinase-3. METHODS We undertook a literature search of recent relevant journal articles, book chapter and reviews on neurodegeneration and neuroprotection in BD. Search words entered were 'brain-derived neurotrophic factor,''Bcl-2,''mitogen-activated protein kinases,''neuroprotection,''calcium,''bipolar disorder,''mania,' and 'depression.' RESULTS The most consistent and replicated findings in the pathophysiology of BD may be classified as follows: i) calcium dysregulation, ii) mitochondrial/endoplasmic reticulum dysfunction, iii) glial and neuronal death/atrophy and iv) loss of neurotrophic/plasticity effects in brain areas critically involved in mood regulation. In addition, the evidence supports that treatment with mood stabilizers; in particular, lithium restores these pathophysiological changes. CONCLUSION Bipolar disorder is associated with impairments in neurotrophic, cellular plasticity and resilience pathways as well as in neuroprotective processes. The evidence supports that treatment with mood stabilizers, in particular lithium, restores these pathophysiological changes. Studies that attempt to prevent (intervene before the onset of the molecular and cellular changes), treat (minimize severity of these deficits over time), and rectify (reverse molecular and cellular deficits) are promising therapeutic strategies for developing improved treatments for bipolar disorder.
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Affiliation(s)
- M. G. Soeiro-de-Souza
- Mood Disorders Unit (GRUDA), Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - V. V. Dias
- Mood Disorders Unit (GRUDA), Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - M. L. Figueira
- Bipolar Disorder Research Program, Hospital Santa Maria, Faculty of Medicine, University of Lisbon, (FMUL), Lisbon, Portugal
| | - O. V. Forlenza
- Laboratory of Neuroscience LIM-27, Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - W. F. Gattaz
- Laboratory of Neuroscience LIM-27, Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - C. A. Zarate
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - R. Machado-Vieira
- Laboratory of Neuroscience LIM-27, Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo (HC-FMUSP), São Paulo, Brazil
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Quiroz JA, Manji HK. Enhancing synaptic plasticity and cellular resilience to develop novel, improved treatments for mood disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22034240 PMCID: PMC3181673 DOI: 10.31887/dcns.2002.4.1/jquiroz] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
There is mounting evidence that recurrent mood disorders - once considered “good prognosis diseases”- are, in fact, often very severe and life-threatening illnesses. Furthermore, although mood disorders have traditionally been conceptualized as neurochemical disorders, there is now evidence from a variety of sources demonstrating regional reductions in central nervous system (CNS) volume, as well as reductions in the numbers and/or sizes ofglia and neurons in discrete brain areas. Although the precise cellular mechanisms underlying these morphometric changes remain to be fully elucidated, the data suggest that mood disorders are associated with impairments of synaptic plasticity and cellular resilience. In this context, it is noteworthy that there is increasing preclinical evidence that antidepressants regulate the function of the glutamatergic system. Moreover, although clearly preliminary, the available clinical data suggest that attenuation of N-methyl-D-aspartate (NMDA) function has antidepressant effects. Recent preclinical and clinical studies have shown that signaling pathways involved in regulating cell survival and cell death are long-term targets for the actions of antidepressant agents. Antidepressants and mood stabilizers indirectly regulate a number of factors involved in cell survival pathways, including cyclic adenosine monophosphate (cAMP) response element binding protein (CREB), brain-derived neurotrophic factor (BDNF), the antiapoptotic protein bcl-2, and mitogen-activated protein (MAP) kinases, and may thus bring about some of their delayed long-term beneficial effects via underappreciated neurotrophic effects. There is much promise for the future development of treatments that more directly target molecules in critical CNS signaling pathways regulating synaptic plasticity and cellular resilience. These will represent improved long-term treatments for mood disorders.
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Affiliation(s)
- Jorge A Quiroz
- Laboratory of Molecular Pathophysiology, National Institute of Mental Health, Bethesda, Md, USA
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Sani G, Napoletano F, Forte AM, Kotzalidis GD, Panaccione I, Porfiri GM, Simonetti A, Caloro M, Girardi N, Telesforo CL, Serra G, Romano S, Manfredi G, Savoja V, Tamorri SM, Koukopoulos AE, Serata D, Rapinesi C, Casale AD, Nicoletti F, Girardi P. The wnt pathway in mood disorders. Curr Neuropharmacol 2012; 10:239-253. [PMID: 23449817 PMCID: PMC3468878 DOI: 10.2174/157015912803217279] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 03/13/2012] [Accepted: 03/24/2012] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To review the evidence of the involvement of the Wnt signalling pathway in mood disorders and in the action of drugs used to treat these disorders. METHODS We performed a careful PubMed search using as keywords all possible terms relevant to the Wnt pathway and crossing them with each of four areas, i.e., developmental effects, behavioural effects, mood disorders, and drugs used in their treatment. Papers were selected on the basis of their content and their data used for discussion. RESULTS Neurodevelopmental and behavioural data point to the possibility of involvement of the Wnt pathway in the pathophysiology of mood disorders. Clinical and post-mortem data are not sufficient to corroborate a definite role for Wnt alterations in any mood disorder. Combining genetic and pharmacological data, we may state that glycogen synthase kinase is the key molecule in bipolar disorder, as it is connected with many other signalling pathways that were shown to be involved in mood disorders, while Wnt molecules in the hippocampus appear to be mainly involved in depressive disorders. CONCLUSIONS Altered Wnt signalling may play a role in the pathophysiology of mood disorders, although not a central one. It is premature to draw conclusions regarding the possible usefulness of Wnt manipulations in the treatment of mood disorders.
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Affiliation(s)
- Gabriele Sani
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | - Flavia Napoletano
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Alberto Maria Forte
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- NEUROMED, Pozzilli, Isernia, Italy
| | - Giorgio D Kotzalidis
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Isabella Panaccione
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- NEUROMED, Pozzilli, Isernia, Italy
| | - Giulio Maria Porfiri
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Alessio Simonetti
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | - Matteo Caloro
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Nicoletta Girardi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Carla Ludovica Telesforo
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Giulia Serra
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | - Silvia Romano
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Giovanni Manfredi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Valeria Savoja
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Stefano Maria Tamorri
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Alexia E Koukopoulos
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | - Daniele Serata
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Chiara Rapinesi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- Department of Neuropsychiatry, Villa Rosa, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy
| | - Antonio Del Casale
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Ferdinando Nicoletti
- NEUROMED, Pozzilli, Isernia, Italy
- Department of Neuropharmacology, Sapienza University, School of Medicine and Pharmacy, Rome, Italy
| | - Paolo Girardi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
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