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Nestor LJ, Luijten M, Ziauddeen H, Regenthal R, Sahakian BJ, Robbins TW, Ersche KD. The Modulatory Effects of Atomoxetine on Aberrant Connectivity During Attentional Processing in Cocaine Use Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:314-325. [PMID: 37619670 DOI: 10.1016/j.bpsc.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/14/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Cocaine use disorder is associated with cognitive deficits that reflect dysfunctional processing across neural systems. Because there are currently no approved medications, treatment centers provide behavioral interventions that have only short-term efficacy. This suggests that behavioral interventions are not sufficient by themselves to lead to the maintenance of abstinence in patients with cocaine use disorder. Self-control, which includes the regulation of attention, is critical for dealing with many daily challenges that would benefit from medication interventions that can ameliorate cognitive neural disturbances. METHODS To address this important clinical gap, we conducted a randomized, double-blind, placebo-controlled, crossover design study in patients with cocaine use disorder (n = 23) and healthy control participants (n = 28). We assessed the modulatory effects of acute atomoxetine (40 mg) on attention and conflict monitoring and their associated neural activation and connectivity correlates during performance on the Eriksen flanker task. The Eriksen flanker task examines basic attentional processing using congruent stimuli and the effects of conflict monitoring and response inhibition using incongruent stimuli, the latter of which necessitates the executive control of attention. RESULTS We found that atomoxetine improved task accuracy only in the cocaine group but modulated connectivity within distinct brain networks in both groups during congruent trials. During incongruent trials, the cocaine group showed increased task-related activation in the right inferior frontal and anterior cingulate gyri, as well as greater network connectivity than the control group across treatments. CONCLUSIONS The findings of the current study support a modulatory effect of acute atomoxetine on attention and associated connectivity in cocaine use disorder.
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Affiliation(s)
- Liam J Nestor
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Fiona Stanley and Fremantle Hospital Group, Perth, Australia
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf-Boehm-Institute of Pharmacology and Toxicology, Leipzig University, Leipzig, Germany
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Karen D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
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2
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Mohanty D, Alsaidan OA, Zafar A, Dodle T, Gupta JK, Yasir M, Mohanty A, Khalid M. Development of Atomoxetine-Loaded NLC In Situ Gel for Nose-to-Brain Delivery: Optimization, In Vitro, and Preclinical Evaluation. Pharmaceutics 2023; 15:1985. [PMID: 37514171 PMCID: PMC10386213 DOI: 10.3390/pharmaceutics15071985] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
The present study investigates the brain-targeted efficiency of atomoxetine (AXT)-loaded nanostructured lipid carrier (NLC)-laden thermosensitive in situ gel after intranasal administration. AXT-NLC was prepared by the melt emulsification ultrasonication method and optimized using the Box-Behnken design (BBD). The optimized formulation (AXT-NLC) exhibited particle size PDI, zeta potential, and entrapment efficiency (EE) of 108 nm, 0.271, -42.3 mV, and 84.12%, respectively. The morphology of AXT-NLC was found to be spherical, as confirmed by SEM analysis. DSC results displayed that the AXT was encapsulated within the NLC matrix. Further, optimized NLC (AXT-NLC13) was incorporated into a thermosensitive in situ gel using poloxamer 407 and carbopol gelling agent and evaluated for different parameters. The optimized in situ gel (AXT-NLC13G4) formulation showed excellent viscosity (2532 ± 18 Cps) at 37 °C and formed the gel at 28-34 °C. AXT-NLC13-G4 showed a sustained release of AXT (92.89 ± 3.98% in 12 h) compared to pure AXT (95.47 ± 2.76% in 4 h). The permeation flux through goat nasal mucosa of AXT from pure AXT and AXT-NLC13-G4 was 504.37 µg/cm2·h and 232.41 µg/cm2·h, respectively. AXT-NLC13-G4 intranasally displayed significantly higher absolute bioavailability of AXT (1.59-fold higher) than intravenous administration. AXT-NLC13-G4 intranasally showed 51.91% higher BTP than pure AXT (28.64%) when administered via the same route (intranasally). AXT-NLC13-G4 showed significantly higher BTE (207.92%) than pure AXT (140.14%) when administered intranasally, confirming that a high amount of the AXT reached the brain. With the disrupted performance induced by L-methionine, the AXT-NLC13-G4 showed significantly (p < 0.05) better activity than pure AXT as well as donepezil (standard). The finding concluded that NLC in situ gel is a novel carrier of AXT for improvement of brain delivery by the intranasal route and requires further investigation for more justification.
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Affiliation(s)
- Dibyalochan Mohanty
- Department of Pharmaceutics (Centre for Nanomedicine), School of Pharmacy, Anurag University, Hyderabad 500088, Telangana, India
| | - Omar Awad Alsaidan
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka 72341, Al-Jouf, Saudi Arabia
| | - Ameeduzzafar Zafar
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka 72341, Al-Jouf, Saudi Arabia
| | - Trishala Dodle
- Department of Pharmaceutics (Centre for Nanomedicine), School of Pharmacy, Anurag University, Hyderabad 500088, Telangana, India
| | - Jeetendra Kumar Gupta
- Institute of Pharmaceutical Research, GLA University Mathura, Chaumuhan 281406, Uttar Pradesh, India
| | - Mohd Yasir
- Department of Pharmacy, College of Health Sciences, Arsi University, Asella P.O. Box 396, Ethiopia
| | - Anshuman Mohanty
- Product Development, Innovation and Science, Amway Global Services India Pvt. Ltd., Gurugram 122001, Haryana, India
| | - Mohammad Khalid
- Department of Pharmacognosy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
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Abumelha HM, Alorabi AQ, Alessa H, Alamrani NA, Alharbi A, Keshk AA, El-Metwaly NM. Novel Iron Oxide Nanoparticle-Fortified Carbon Paste Electrode for the Sensitive Voltammetric Determination of Atomoxetine. ACS OMEGA 2023; 8:19006-19015. [PMID: 37273581 PMCID: PMC10233827 DOI: 10.1021/acsomega.3c01726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023]
Abstract
Herein, the fabrication and full characterization of a novel atomoxetine (ATX) voltammetric carbon paste electrode (CPE) fortified with iron oxide nanoparticles (FeONPs) is demonstrated. Modification of the carbon paste matrix with the metallic oxide nanostructure provides proper electrocatalytic activity against the oxidation of ATX molecules at the carbon paste surface, resulting in a noticeable improvement in the performance of the sensor. At the recommended pH value, ATX recorded an irreversible anodic peak at 1.17 V, following a diffusion-controlled reaction mechanism. Differential pulse voltammograms exhibited peak heights linearly correlated to the ATX content within a wide concentration range from 45 to 8680 ng mL-1, with the limit of detection reaching 11.55 ng mL-1. The electrooxidation mechanism of the ATX molecule was proposed to be the oxidation of the terminal amino group accompanied by the transfer of two electrons and two protons. The fabricated FeONPs/CPE sensors exhibited enhanced selectivity and sensitivity and therefore can be introduced for voltammetric assaying of atomoxetine-indifferent pharmaceutical and biological samples in the presence of its degradation products and metabolites.
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Affiliation(s)
- Hana M. Abumelha
- Department
of Chemistry, College of Science, Princess
Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Ali Q. Alorabi
- Department
of Chemistry, Faculty of Sciences, Al-Baha
University, P.O. Box 1988, Albaha 65799, Saudi Arabia
| | - Hussain Alessa
- Department
of Chemistry, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Nasser A. Alamrani
- Department
of Chemistry, College of Science, University
of Tabuk, Tabuk 71421, Saudi Arabia
| | - Arwa Alharbi
- Department
of Chemistry, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Ali A. Keshk
- Department
of Chemistry, College of Science, University
of Tabuk, Tabuk 71421, Saudi Arabia
| | - Nashwa M. El-Metwaly
- Department
of Chemistry, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia
- Department
of Chemistry, Faculty of Science, Mansoura
University, Mansoura 35516, Egypt
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4
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Zhukovsky P, Morein-Zamir S, Ziauddeen H, Fernandez-Egea E, Meng C, Regenthal R, Sahakian BJ, Bullmore ET, Robbins TW, Dalley JW, Ersche KD. Prefrontal Cortex Activation and Stopping Performance Underlie the Beneficial Effects of Atomoxetine on Response Inhibition in Healthy Volunteers and Those With Cocaine Use Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1116-1126. [PMID: 34508901 DOI: 10.1016/j.bpsc.2021.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Impaired response inhibition in individuals with cocaine use disorder (CUD) is hypothesized to depend on deficient noradrenergic signaling in corticostriatal networks. Remediation of noradrenergic neurotransmission with selective norepinephrine reuptake inhibitors such as atomoxetine may therefore have clinical utility to improve response inhibitory control in CUD. METHODS We carried out a randomized, double-blind, placebo-controlled, crossover study with 26 participants with CUD and 28 control volunteers investigating the neural substrates of stop-signal inhibitory control. The effects of a single dose of atomoxetine (40 mg) were compared with placebo on stop-signal reaction time performance and functional network connectivity using dynamic causal modeling. RESULTS We found that atomoxetine speeded Go response times in both control participants and those with CUD. Improvements in stopping efficiency on atomoxetine were conditional on baseline (placebo) stopping performance and were directly associated with increased inferior frontal gyrus activation. Further, stopping performance, task-based brain activation, and effective connectivity were similar in the 2 groups. Dynamic causal modeling of effective connectivity of multiple prefrontal and basal ganglia regions replicated and extended previous models of network function underlying inhibitory control to CUD and control volunteers and showed subtle effects of atomoxetine on prefrontal-basal ganglia interactions. CONCLUSIONS These findings demonstrate that atomoxetine improves response inhibition in a baseline-dependent manner in control participants and in those with CUD. Our results emphasize inferior frontal cortex function as a future treatment target owing to its key role in improving response inhibition in CUD.
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Affiliation(s)
- Peter Zhukovsky
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Sharon Morein-Zamir
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire and Peterborough Foundation Trust, Cambridge, United Kingdom
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire and Peterborough Foundation Trust, Cambridge, United Kingdom
| | - Chun Meng
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Ralf Regenthal
- Clinical Pharmacology Department, Leipzig University, Leipzig, Germany; Division of Clinical Pharmacology, Rudolf-Boehm-Institute of Pharmacology and Toxicology, Leipzig University, Leipzig, Germany
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Edward T Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire and Peterborough Foundation Trust, Cambridge, United Kingdom; GlaxoSmithKline, Immuno-Inflammation Therapeutic Area Unit, Stevenage, Hertfordshire, United Kingdom
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Jeffrey W Dalley
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Karen D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; Institut of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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5
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Beinhölzl N, Molloy EN, Zsido RG, Richter T, Piecha FA, Zheleva G, Scharrer U, Regenthal R, Villringer A, Okon-Singer H, Sacher J. The attention-emotion interaction in healthy female participants on oral contraceptives during 1-week escitalopram intake. Front Neurosci 2022; 16:809269. [PMID: 36161146 PMCID: PMC9500523 DOI: 10.3389/fnins.2022.809269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Previous findings in healthy humans suggest that selective serotonin reuptake inhibitors (SSRIs) modulate emotional processing via earlier changes in attention. However, many previous studies have provided inconsistent findings. One possible reason for such inconsistencies is that these studies did not control for the influence of either sex or sex hormone fluctuations. To address this inconsistency, we administered 20 mg escitalopram or placebo for seven consecutive days in a randomized, double-blind, placebo-controlled design to sixty healthy female participants with a minimum of 3 months oral contraceptive (OC) intake. Participants performed a modified version of an emotional flanker task before drug administration, after a single dose, after 1 week of SSRI intake, and after a 1-month wash-out period. Supported by Bayesian analyses, our results do not suggest a modulatory effect of escitalopram on behavioral measures of early attentional-emotional interaction in female individuals with regular OC use. While the specific conditions of our task may be a contributing factor, it is also possible that a practice effect in a healthy sample may mask the effects of escitalopram on the attentional-emotional interplay. Consequently, 1 week of escitalopram administration may not modulate attention toward negative emotional distractors outside the focus of attention in healthy female participants taking OCs. While further research in naturally cycling females and patient samples is needed, our results represent a valuable contribution toward the preclinical investigation of antidepressant treatment.
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Affiliation(s)
- Nathalie Beinhölzl
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- *Correspondence: Nathalie Beinhölzl,
| | - Eóin N. Molloy
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- University Clinic for Radiology and Nuclear Medicine, Otto Von Guericke University Magdeburg, Magdeburg, Germany
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
| | - Rachel G. Zsido
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Max Planck School of Cognition, Leipzig, Germany
| | - Thalia Richter
- Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Fabian A. Piecha
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Gergana Zheleva
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ulrike Scharrer
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf Boehm Institute of Pharmacology and Toxicology, University Leipzig, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Max Planck School of Cognition, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- Berlin School of Mind and Brain, MindBrainBody Institute, Charité—Berlin University of Medicine and Humboldt University Berlin, Berlin, Germany
| | - Hadas Okon-Singer
- Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Julia Sacher
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Max Planck School of Cognition, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Helios Park Hospital Leipzig, Leipzig, Germany
- Julia Sacher,
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Noradrenergic deficits contribute to apathy in Parkinson's disease through the precision of expected outcomes. PLoS Comput Biol 2022; 18:e1010079. [PMID: 35533200 PMCID: PMC9119485 DOI: 10.1371/journal.pcbi.1010079] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/19/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023] Open
Abstract
Apathy is a debilitating feature of many neuropsychiatric diseases, that is typically described as a reduction of goal-directed behaviour. Despite its prevalence and prognostic importance, the mechanisms underlying apathy remain controversial. Degeneration of the locus coeruleus-noradrenaline system is known to contribute to motivational deficits, including apathy. In healthy people, noradrenaline has been implicated in signalling the uncertainty of expectations about the environment. We proposed that noradrenergic deficits contribute to apathy by modulating the relative weighting of prior beliefs about action outcomes. We tested this hypothesis in the clinical context of Parkinson’s disease, given its associations with apathy and noradrenergic dysfunction. Participants with mild-to-moderate Parkinson’s disease (N = 17) completed a randomised double-blind, placebo-controlled, crossover study with 40 mg of the noradrenaline reuptake inhibitor atomoxetine. Prior weighting was inferred from psychophysical analysis of performance in an effort-based visuomotor task, and was confirmed as negatively correlated with apathy. Locus coeruleus integrity was assessed in vivo using magnetisation transfer imaging at ultra-high field 7T. The effect of atomoxetine depended on locus coeruleus integrity: participants with a more degenerate locus coeruleus showed a greater increase in prior weighting on atomoxetine versus placebo. The results indicate a contribution of the noradrenergic system to apathy and potential benefit from noradrenergic treatment of people with Parkinson’s disease, subject to stratification according to locus coeruleus integrity. More broadly, these results reconcile emerging predictive processing accounts of the role of noradrenaline in goal-directed behaviour with the clinical symptom of apathy and its potential pharmacological treatment. Apathy is a common and harmful consequence of many neuropsychiatric diseases. Its underlying causes are not fully understood, which prevents the development of new treatments. We approach the problem in a new way, modelling human behaviour in terms of the continuously updated interaction between sensory information and brain-based predictions or ‘priors’ about the consequences of our actions. We have previously shown that apathy is related to a loss of precision of these ‘priors’. We proposed that the precision is controlled by noradrenaline (like adrenaline, but made in the brain). We tested whether the noradrenaline-enhancing drug called atomoxetine can restore the priors’ precision in apathetic people. We enrolled participants with Parkinson’s disease, which is associated with both apathy and noradrenaline loss. We used ultra-high field MRI to measure individual differences in the integrity of specialist region called the locus coeruleus–the brain’s source of noradrenaline. We found that the effect of treatment with atomoxetine on prior precision depended on locus coeruleus integrity: Participants with a degenerated locus coeruleus had a more positive change in prior precision. Our results highlight how individual differences in neuroanatomy can predict the potential benefit of noradrenaline treatments in people suffering from apathy.
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Zsido RG, Molloy EN, Cesnaite E, Zheleva G, Beinhölzl N, Scharrer U, Piecha FA, Regenthal R, Villringer A, Nikulin VV, Sacher J. One‐week escitalopram intake alters the excitation–inhibition balance in the healthy female brain. Hum Brain Mapp 2022; 43:1868-1881. [PMID: 35064716 PMCID: PMC8933318 DOI: 10.1002/hbm.25760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Rachel G. Zsido
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- International Max Planck Research School NeuroCom Leipzig Germany
- Max Planck School of Cognition Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Eóin N. Molloy
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- International Max Planck Research School NeuroCom Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- University Clinic for Radiology and Nuclear Medicine, Otto von Guericke University Magdeburg Magdeburg Germany
| | - Elena Cesnaite
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Gergana Zheleva
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Nathalie Beinhölzl
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Ulrike Scharrer
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Clinic for Cognitive Neurology Leipzig University Leipzig Germany
| | - Fabian A. Piecha
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf Boehm Institute of Pharmacology and Toxicology Leipzig University Leipzig Germany
| | - Arno Villringer
- International Max Planck Research School NeuroCom Leipzig Germany
- Max Planck School of Cognition Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Clinic for Cognitive Neurology Leipzig University Leipzig Germany
- Berlin School of Mind and Brain Berlin Germany
| | - Vadim V. Nikulin
- International Max Planck Research School NeuroCom Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Julia Sacher
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- International Max Planck Research School NeuroCom Leipzig Germany
- Max Planck School of Cognition Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Clinic for Cognitive Neurology Leipzig University Leipzig Germany
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8
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O’Callaghan C, Hezemans FH, Ye R, Rua C, Jones PS, Murley AG, Holland N, Regenthal R, Tsvetanov KA, Wolpe N, Barker RA, Williams-Gray CH, Robbins TW, Passamonti L, Rowe JB. Locus coeruleus integrity and the effect of atomoxetine on response inhibition in Parkinson's disease. Brain 2021; 144:2513-2526. [PMID: 33783470 PMCID: PMC7611672 DOI: 10.1093/brain/awab142] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 03/09/2021] [Accepted: 03/23/2021] [Indexed: 11/23/2022] Open
Abstract
Cognitive decline is a common feature of Parkinson's disease, and many of these cognitive deficits fail to respond to dopaminergic therapy. Therefore, targeting other neuromodulatory systems represents an important therapeutic strategy. Among these, the locus coeruleus-noradrenaline system has been extensively implicated in response inhibition deficits. Restoring noradrenaline levels using the noradrenergic reuptake inhibitor atomoxetine can improve response inhibition in some patients with Parkinson's disease, but there is considerable heterogeneity in treatment response. Accurately predicting the patients who would benefit from therapies targeting this neurotransmitter system remains a critical goal, in order to design the necessary clinical trials with stratified patient selection to establish the therapeutic potential of atomoxetine. Here, we test the hypothesis that integrity of the noradrenergic locus coeruleus explains the variation in improvement of response inhibition following atomoxetine. In a double-blind placebo-controlled randomized crossover design, 19 patients with Parkinson's disease completed an acute psychopharmacological challenge with 40 mg of oral atomoxetine or placebo. A stop-signal task was used to measure response inhibition, with stop-signal reaction times obtained through hierarchical Bayesian estimation of an ex-Gaussian race model. Twenty-six control subjects completed the same task without undergoing the drug manipulation. In a separate session, patients and controls underwent ultra-high field 7 T imaging of the locus coeruleus using a neuromelanin-sensitive magnetization transfer sequence. The principal result was that atomoxetine improved stop-signal reaction times in those patients with lower locus coeruleus integrity. This was in the context of a general impairment in response inhibition, as patients on placebo had longer stop-signal reaction times compared to controls. We also found that the caudal portion of the locus coeruleus showed the largest neuromelanin signal decrease in the patients compared to controls. Our results highlight a link between the integrity of the noradrenergic locus coeruleus and response inhibition in patients with Parkinson's disease. Furthermore, they demonstrate the importance of baseline noradrenergic state in determining the response to atomoxetine. We suggest that locus coeruleus neuromelanin imaging offers a marker of noradrenergic capacity that could be used to stratify patients in trials of noradrenergic therapy and to ultimately inform personalized treatment approaches.
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Affiliation(s)
- Claire O’Callaghan
- Brain and Mind Centre and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney 2050, Australia
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Frank H Hezemans
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Rong Ye
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Catarina Rua
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge 04107, UK
| | - P Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Alexander G Murley
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Negin Holland
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf-Boehm-Institute for Pharmacology and Toxicology, University of Leipzig, Leipzig 69978, Germany
| | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Noham Wolpe
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
- Department of Physical Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roger A Barker
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
- Wellcome Trust—Medical Research Council Stem Cell Institute, University of Cambridge, Cambridge CB2 0AW, UK
| | - Caroline H Williams-Gray
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge CB2 3EA, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EA, UK
| | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - James B Rowe
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
- Cambridge University Hospitals NHS Trust, Cambridge, CB2 0QQ, UK
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Molloy EN, Zsido RG, Piecha FA, Beinhölzl N, Scharrer U, Zheleva G, Regenthal R, Sehm B, Nikulin VV, Möller HE, Villringer A, Sacher J, Mueller K. Decreased thalamo-cortico connectivity during an implicit sequence motor learning task and 7 days escitalopram intake. Sci Rep 2021; 11:15060. [PMID: 34301974 PMCID: PMC8302647 DOI: 10.1038/s41598-021-94009-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 07/05/2021] [Indexed: 11/12/2022] Open
Abstract
Evidence suggests that selective serotonin reuptake inhibitors (SSRIs) reorganize neural networks via a transient window of neuroplasticity. While previous findings support an effect of SSRIs on intrinsic functional connectivity, little is known regarding the influence of SSRI-administration on connectivity during sequence motor learning. To investigate this, we administered 20 mg escitalopram or placebo for 1-week to 60 healthy female participants undergoing concurrent functional magnetic resonance imaging and sequence motor training in a double-blind randomized controlled design. We assessed task-modulated functional connectivity with a psycho-physiological interaction (PPI) analysis in the thalamus, putamen, cerebellum, dorsal premotor, primary motor, supplementary motor, and dorsolateral prefrontal cortices. Comparing an implicit sequence learning condition to a control learning condition, we observed decreased connectivity between the thalamus and bilateral motor regions after 7 days of escitalopram intake. Additionally, we observed a negative correlation between plasma escitalopram levels and PPI connectivity changes, with higher escitalopram levels being associated with greater thalamo-cortico decreases. Our results suggest that escitalopram enhances network-level processing efficiency during sequence motor learning, despite no changes in behaviour. Future studies in more diverse samples, however, with quantitative imaging of neurochemical markers of excitation and inhibition, are necessary to further assess neural responses to escitalopram.
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Affiliation(s)
- Eóin N Molloy
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany.
- International Max Planck Research School NeuroCom, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Rachel G Zsido
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- International Max Planck Research School NeuroCom, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Max Planck School of Cognition, Leipzig, Germany
| | - Fabian A Piecha
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
| | - Nathalie Beinhölzl
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
| | - Ulrike Scharrer
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
| | - Gergana Zheleva
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf-Boehm-Institute of Pharmacology and Toxicology, Leipzig University, Leipzig, Germany
| | - Bernhard Sehm
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- Department of Neurology, University Hospital Halle (Saale), Halle, Germany
| | - Vadim V Nikulin
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russia
| | - Harald E Möller
- Nuclear Magnetic Resonance Methods and Development Group, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- International Max Planck Research School NeuroCom, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- MindBrainBody Institute, Berlin School of Mind and Brain, Charité-Berlin University of Medicine and Humboldt University Berlin, Berlin, Germany
- Clinic of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Julia Sacher
- Emotion and Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany.
- International Max Planck Research School NeuroCom, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Max Planck School of Cognition, Leipzig, Germany.
- Clinic of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany.
| | - Karsten Mueller
- Nuclear Magnetic Resonance Methods and Development Group, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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