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Varela RB, Boschen SL, Yates N, Houghton T, Blaha CD, Lee KH, Bennet KE, Kouzani AZ, Berk M, Quevedo J, Valvassori SS, Tye SJ. Anti-manic effect of deep brain stimulation of the ventral tegmental area in an animal model of mania induced by methamphetamine. Bipolar Disord 2024. [PMID: 38558302 DOI: 10.1111/bdi.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Treatment of refractory bipolar disorder (BD) is extremely challenging. Deep brain stimulation (DBS) holds promise as an effective treatment intervention. However, we still understand very little about the mechanisms of DBS and its application on BD. AIM The present study aimed to investigate the behavioural and neurochemical effects of ventral tegmental area (VTA) DBS in an animal model of mania induced by methamphetamine (m-amph). METHODS Wistar rats were given 14 days of m-amph injections, and on the last day, animals were submitted to 20 min of VTA DBS in two different patterns: intermittent low-frequency stimulation (LFS) or continuous high-frequency stimulation (HFS). Immediately after DBS, manic-like behaviour and nucleus accumbens (NAc) phasic dopamine (DA) release were evaluated in different groups of animals through open-field tests and fast-scan cyclic voltammetry. Levels of NAc dopaminergic markers were evaluated by immunohistochemistry. RESULTS M-amph induced hyperlocomotion in the animals and both DBS parameters reversed this alteration. M-amph increased DA reuptake time post-sham compared to baseline levels, and both LFS and HFS were able to block this alteration. LFS was also able to reduce phasic DA release when compared to baseline. LFS was able to increase dopamine transporter (DAT) expression in the NAc. CONCLUSION These results demonstrate that both VTA LFS and HFS DBS exert anti-manic effects and modulation of DA dynamics in the NAc. More specifically the increase in DA reuptake driven by increased DAT expression may serve as a potential mechanism by which VTA DBS exerts its anti-manic effects.
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Affiliation(s)
- Roger B Varela
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Suelen L Boschen
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurologic Surgery, Applied Computational Neurophysiology and Neuromodulation Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathanael Yates
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Tristan Houghton
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Charles D Blaha
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
| | - Kendall H Lee
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
| | - Kevin E Bennet
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
- Division of Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Geelong, Victoria, Australia
| | - Michael Berk
- School of Medicine, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - João Quevedo
- Faillace Department of Psychiatry and Behavioral Sciences, Center for Interventional Psychiatry, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, Texas, USA
- Faillace Department of Psychiatry and Behavioral Sciences, Center of Excellence on Mood Disorders, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
- Faillace Department of Psychiatry and Behavioral Sciences, Translational Psychiatry Program, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Susannah J Tye
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Department of Psychiatry and Psychology, Translational Neuroscience Laboratory, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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2
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Parikh SV, Vande Voort JL, Yocum AK, Achtyes E, Goes FS, Nykamp L, Singh B, Lopez-Vives D, Sera CE, Maixner D, Tarnal V, Severe J, Bartek S, Tye SJ, Rico J, Stoppel CJ, Becerra A, Smart L, Miller CR, Frye MA, Greden JF, Bobo WV. Clinical outcomes in the biomarkers of ketamine (Bio-K) study of open-label IV ketamine for refractory depression. J Affect Disord 2024; 348:143-151. [PMID: 38142892 DOI: 10.1016/j.jad.2023.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE We conducted an open-label clinical trial ("Bio-K") using IV ketamine for treatment-resistant depression to identify biomarkers linked to remission. Here, we report the clinical efficacy and side effect outcomes of Bio-K. METHODS Across 4 US sites, 75 patients ages 18-65 with treatment-refractory unipolar or bipolar depression received 3 IV ketamine infusions over an 11-day period. Key exclusion criteria were psychotic symptoms, significant substance abuse, unstable medical conditions, and any use of cannabis. Pre-existing antidepressant medication was maintained. Primary outcome was remission as measured by Montgomery-Asberg Depression Rating Scale (MADRS), with secondary outcome of 50 % reduction in Beck Suicide Scale score. Safety monitoring and varying durations of infusions were also key parameters. RESULTS Using remission as MADRS score <10, after 3 infusions 52 % achieved remission, with 67 % achieving response. Of those achieving response after a single infusion, 66 % (22 of 33) reached remission after 3 infusions, while 40 % (16 of 40) non-responders after the first infusion went on to achieve remission after 3 infusions. Only 20 % of non-responders after 2 infusions achieved remission. Most (81 %) participants had significant suicidal ideation at baseline; of these, two-thirds (67 %) experienced at least a 50 % reduction in suicidality. Side effects were minimal. Uniquely, we had three different types of infusion categories, with individuals receiving: (1) slow (100-min) infusions only or (2) regular (40-min) infusions only or (3) a mix of infusion durations. These three infusion groups showed comparable safety and efficacy. Exploration of clinical factors revealed no link between BMI, age, or gender to remission. CONCLUSIONS The consistency of outcomes across 4 clinical sites and across multiple instruments, suggests high acute efficacy and safety of IV ketamine for serious depressive episodes. Duration of infusion did not alter outcomes. Meaningfully, 40 % of non-responders after a single infusion did reach remission subsequently, while only 20 % of non-responders after 2 infusions achieved remission, suggesting early response is suggestive for eventual remission. Our data on varying ketamine infusion duration adds novel insights into the clinical administration of this new treatment for refractory and severe patients. Our limitations included a lack of a control group, necessitating caution about conclusions of efficacy, balanced by the utility of reporting "real-world" outcomes across multiple clinical sites. We could also not separately analyze results for bipolar disorder due to small numbers. Together, the Bio-K clinical results are promising and provide significant sample sizes for forthcoming biological markers analyses.
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Affiliation(s)
| | | | | | - Eric Achtyes
- Pine Rest Christian Mental Health Services, Michigan State University, USA; Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | | | - Louis Nykamp
- Pine Rest Christian Mental Health Services, Michigan State University, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Jose Rico
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Cynthia J Stoppel
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - LeAnn Smart
- Pine Rest Christian Mental Health Services, Michigan State University, USA
| | | | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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3
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Nuñez NA, Coombes BJ, Beaupre LM, Ozerdem A, Resendez MG, Romo-Nava F, Bond DJ, Veldic M, Singh B, Moore KM, Betcher HK, Kung S, Prieto ML, Fuentes M, Ercis M, Miola A, Sanchez Ruiz JA, Jenkins G, Batzler A, Leung JG, Cuellar-Barboza A, Tye SJ, McElroy SL, Biernacka JM, Frye MA. Pharmacogenomic overlap between antidepressant treatment response in major depression & antidepressant associated treatment emergent mania in bipolar disorder. Transl Psychiatry 2024; 14:93. [PMID: 38351009 PMCID: PMC10864308 DOI: 10.1038/s41398-024-02798-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
There is increasing interest in individualizing treatment selection for more than 25 regulatory approved treatments for major depressive disorder (MDD). Despite an inconclusive efficacy evidence base, antidepressants (ADs) are prescribed for the depressive phase of bipolar disorder (BD) with oftentimes, an inadequate treatment response and or clinical concern for mood destabilization. This study explored the relationship between antidepressant response in MDD and antidepressant-associated treatment emergent mania (TEM) in BD. We conducted a genome-wide association study (GWAS) and polygenic score analysis of TEM and tested its association in a subset of BD-type I patients treated with SSRIs or SNRIs. Our results did not identify any genome-wide significant variants although, we found that a higher polygenic score (PGS) for antidepressant response in MDD was associated with higher odds of TEM in BD. Future studies with larger transdiagnostic depressed cohorts treated with antidepressants are encouraged to identify a neurobiological mechanism associated with a spectrum of depression improvement from response to emergent mania.
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Affiliation(s)
- Nicolas A Nuñez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Manuel Gardea Resendez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - David J Bond
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Marin Veldic
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Balwinder Singh
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Katherine M Moore
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Hannah K Betcher
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Simon Kung
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Miguel L Prieto
- Department of Psychiatry, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
| | - Manuel Fuentes
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mete Ercis
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Alessandro Miola
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Gregory Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Anthony Batzler
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Susannah J Tye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Queensland Brain Institute, The University of Queensland, St. Lucia, QLD, Australia
| | - Susan L McElroy
- Lindner Center of HOPE/University of Cincinnati, Cincinnati, OH, USA
| | - Joanna M Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
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4
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Corva DM, Doeven EH, Parke B, Adams SD, Tye SJ, Hashemi P, Berk M, Kouzani AZ. SmartFSCV: An Artificial Intelligence Enabled Miniaturised FSCV Device Targeting Serotonin. IEEE Open J Eng Med Biol 2024; 5:75-85. [PMID: 38487099 PMCID: PMC10939322 DOI: 10.1109/ojemb.2024.3356177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 03/17/2024] Open
Abstract
Goal: Dynamically monitoring serotonin in real-time within target brain regions would significantly improve the diagnostic and therapeutic approaches to a variety of neurological and psychiatric disorders. Current systems for measuring serotonin lack immediacy and portability and are bulky and expensive. Methods: We present a new miniaturised device, named SmartFSCV, designed to monitor dynamic changes of serotonin using fast-scan cyclic voltammetry (FSCV). This device outputs a precision voltage potential between -3 to +3 V, and measures current between -1.5 to +1.5 μA with nano-ampere accuracy. The device can output modifiable arbitrary waveforms for various measurements and uses an N-shaped waveform at a scan-rate of 1000 V/s for sensing serotonin. Results: Four experiments were conducted to validate SmartFSCV: static bench test, dynamic serotonin test and two artificial intelligence (AI) algorithm tests. Conclusions: These tests confirmed the ability of SmartFSCV to accurately sense and make informed decisions about the presence of serotonin using AI.
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Affiliation(s)
- Dean M. Corva
- School of EngineeringDeakin UniversityGeelongVIC3216Australia
| | - Egan H. Doeven
- School of Life and Environmental SciencesDeakin UniversityGeelongVIC3216Australia
| | - Brenna Parke
- Department of BioengineeringImperial College LondonSW7 2AZLondonU.K.
| | - Scott D. Adams
- School of EngineeringDeakin UniversityGeelongVIC3216Australia
| | - Susannah J. Tye
- Queensland Brain InstituteThe University of QueenslandSt. LuciaQLD4072Australia
| | - Parastoo Hashemi
- Department of BioengineeringImperial College LondonSW7 2AZLondonU.K.
| | - Michael Berk
- School of Medicine, IMPACTDeakin UniversityGeelongVIC3216Australia
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5
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Yuen J, Goyal A, Rusheen AE, Kouzani AZ, Berk M, Kim JH, Tye SJ, Abulseoud OA, Oesterle TS, Blaha CD, Bennet KE, Lee KH, Oh Y, Shin H. Oxycodone-induced dopaminergic and respiratory effects are modulated by deep brain stimulation. Front Pharmacol 2023; 14:1199655. [PMID: 37408764 PMCID: PMC10318172 DOI: 10.3389/fphar.2023.1199655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction: Opioids are the leading cause of overdose death in the United States, accounting for almost 70,000 deaths in 2020. Deep brain stimulation (DBS) is a promising new treatment for substance use disorders. Here, we hypothesized that VTA DBS would modulate both the dopaminergic and respiratory effect of oxycodone. Methods: Multiple-cyclic square wave voltammetry (M-CSWV) was used to investigate how deep brain stimulation (130 Hz, 0.2 ms, and 0.2 mA) of the rodent ventral segmental area (VTA), which contains abundant dopaminergic neurons, modulates the acute effects of oxycodone administration (2.5 mg/kg, i.v.) on nucleus accumbens core (NAcc) tonic extracellular dopamine levels and respiratory rate in urethane-anesthetized rats (1.5 g/kg, i.p.). Results: I.V. administration of oxycodone resulted in an increase in NAcc tonic dopamine levels (296.9 ± 37.0 nM) compared to baseline (150.7 ± 15.5 nM) and saline administration (152.0 ± 16.1 nM) (296.9 ± 37.0 vs. 150.7 ± 15.5 vs. 152.0 ± 16.1, respectively, p = 0.022, n = 5). This robust oxycodone-induced increase in NAcc dopamine concentration was associated with a sharp reduction in respiratory rate (111.7 ± 2.6 min-1 vs. 67.9 ± 8.3 min-1; pre- vs. post-oxycodone; p < 0.001). Continuous DBS targeted at the VTA (n = 5) reduced baseline dopamine levels, attenuated the oxycodone-induced increase in dopamine levels to (+39.0% vs. +95%), and respiratory depression (121.5 ± 6.7 min-1 vs. 105.2 ± 4.1 min-1; pre- vs. post-oxycodone; p = 0.072). Discussion: Here we demonstrated VTA DBS alleviates oxycodone-induced increases in NAcc dopamine levels and reverses respiratory suppression. These results support the possibility of using neuromodulation technology for treatment of drug addiction.
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Affiliation(s)
- Jason Yuen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Abhinav Goyal
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Aaron E. Rusheen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Abbas Z. Kouzani
- School of Engineering, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Jee Hyun Kim
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Susannah J. Tye
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Department of Psychiatry and Behavioral Science, Emory University, Atlanta, GA, United States
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | | | | | - Charles D. Blaha
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Kevin E. Bennet
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Division of Engineering, Mayo Clinic, Rochester, MN, United States
| | - Kendall H. Lee
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Yoonbae Oh
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Hojin Shin
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
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6
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Gardea-Resendez M, Coombes BJ, Veldic M, Tye SJ, Romo-Nava F, Ozerdem A, Prieto ML, Cuellar-Barboza A, Nunez NA, Singh B, Pendegraft RS, Miola A, McElroy SL, Biernacka JM, Morava E, Kozicz T, Frye MA. Antidepressants that increase mitochondrial energetics may elevate risk of treatment-emergent mania. Mol Psychiatry 2023; 28:1020-1026. [PMID: 36513812 PMCID: PMC10005962 DOI: 10.1038/s41380-022-01888-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022]
Abstract
Preclinical evidence suggests that antidepressants (ADs) may differentially influence mitochondrial energetics. This study was conducted to investigate the relationship between mitochondrial function and illness vulnerability in bipolar disorder (BD), specifically risk of treatment-emergent mania (TEM). Participants with BD already clinically phenotyped as TEM+ (n = 176) or TEM- (n = 516) were further classified whether the TEM associated AD, based on preclinical studies, increased (Mito+, n = 600) or decreased (Mito-, n = 289) mitochondrial electron transport chain (ETC) activity. Comparison of TEM+ rates between Mito+ and Mito- ADs was performed using generalized estimating equations to account for participants exposed to multiple ADs while adjusting for sex, age at time of enrollment into the biobank and BD type (BD-I/schizoaffective vs. BD-II). A total of 692 subjects (62.7% female, 91.4% White, mean age 43.0 ± 14.0 years) including 176 cases (25.3%) of TEM+ and 516 cases (74.7%) of TEM- with previous exposure to Mito+ and/or Mito- antidepressants were identified. Adjusting for age, sex and BD subtype, TEM+ was more frequent with antidepressants that increased (24.7%), versus decreased (13.5%) mitochondrial energetics (OR = 2.21; p = 0.000009). Our preliminary retrospective data suggests there may be merit in reconceptualizing AD classification, not solely based on monoaminergic conventional drug mechanism of action, but additionally based on mitochondrial energetics. Future prospective clinical studies on specific antidepressants and mitochondrial activity are encouraged. Recognizing pharmacogenomic investigation of drug response may extend or overlap to genomics of disease risk, future studies should investigate potential interactions between mitochondrial mechanisms of disease risk and drug response.
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Affiliation(s)
- Manuel Gardea-Resendez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Marin Veldic
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Susannah J Tye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.,Queensland Brain Institute, The University of Queensland, St. Lucia, QLD, Australia
| | - Francisco Romo-Nava
- Lindner Center of HOPE /Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, Mason, OH, USA
| | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Miguel L Prieto
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry, Facultad de Medicina, Universidad de los Andes, Santiago, Chile.,Mental Health Service, Clínica Universidad de los Andes, Santiago, Chile
| | | | - Nicolas A Nunez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Balwinder Singh
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Alessandro Miola
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Susan L McElroy
- Lindner Center of HOPE /Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, Mason, OH, USA
| | - Joanna M Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Eva Morava
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA.,Department of Anatomy, University of Pecs, Medical School, Pecs, Hungary
| | - Tamas Kozicz
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA.,Department of Anatomy, University of Pecs, Medical School, Pecs, Hungary.,Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
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7
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Yuen J, Goyal A, Rusheen AE, Kouzani AZ, Berk M, Kim JH, Tye SJ, Blaha CD, Bennet KE, Lee KH, Shin H, Oh Y. High frequency deep brain stimulation can mitigate the acute effects of cocaine administration on tonic dopamine levels in the rat nucleus accumbens. Front Neurosci 2023; 17:1061578. [PMID: 36793536 PMCID: PMC9922701 DOI: 10.3389/fnins.2023.1061578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
Cocaine's addictive properties stem from its capacity to increase tonic extracellular dopamine levels in the nucleus accumbens (NAc). The ventral tegmental area (VTA) is a principal source of NAc dopamine. To investigate how high frequency stimulation (HFS) of the rodent VTA or nucleus accumbens core (NAcc) modulates the acute effects of cocaine administration on NAcc tonic dopamine levels multiple-cyclic square wave voltammetry (M-CSWV) was used. VTA HFS alone decreased NAcc tonic dopamine levels by 42%. NAcc HFS alone resulted in an initial decrease in tonic dopamine levels followed by a return to baseline. VTA or NAcc HFS following cocaine administration prevented the cocaine-induced increase in NAcc tonic dopamine. The present results suggest a possible underlying mechanism of NAc deep brain stimulation (DBS) in the treatment of substance use disorders (SUDs) and the possibility of treating SUD by abolishing dopamine release elicited by cocaine and other drugs of abuse by DBS in VTA, although further studies with chronic addiction models are required to confirm that. Furthermore, we demonstrated the use of M-CSWV can reliably measure tonic dopamine levels in vivo with both drug administration and DBS with minimal artifacts.
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Affiliation(s)
- Jason Yuen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Abhinav Goyal
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Aaron E. Rusheen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Abbas Z. Kouzani
- School of Engineering, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Jee Hyun Kim
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Susannah J. Tye
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Charles D. Blaha
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Kevin E. Bennet
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Division of Engineering, Mayo Clinic, Rochester, MN, United States
| | - Kendall H. Lee
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Hojin Shin
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Yoonbae Oh
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
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Yuen J, Kouzani AZ, Berk M, Tye SJ, Rusheen AE, Blaha CD, Bennet KE, Lee KH, Shin H, Kim JH, Oh Y. Deep Brain Stimulation for Addictive Disorders-Where Are We Now? Neurotherapeutics 2022; 19:1193-1215. [PMID: 35411483 PMCID: PMC9587163 DOI: 10.1007/s13311-022-01229-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 10/18/2022] Open
Abstract
In the face of a global epidemic of drug addiction, neglecting to develop new effective therapies will perpetuate the staggering human and economic costs of substance use. This review aims to summarize and evaluate the preclinical and clinical studies of deep brain stimulation (DBS) as a novel therapy for refractory addiction, in hopes to engage and inform future research in this promising novel treatment avenue. An electronic database search (MEDLINE, EMBASE, Cochrane library) was performed using keywords and predefined inclusion criteria between 1974 and 6/18/2021 (registered on Open Science Registry). Selected articles were reviewed in full text and key details were summarized and analyzed to understand DBS' therapeutic potential and possible mechanisms of action. The search yielded 25 animal and 22 human studies. Animal studies showed that DBS of targets such as nucleus accumbens (NAc), insula, and subthalamic nucleus reduces drug use and seeking. All human studies were case series/reports (level 4/5 evidence), mostly targeting the NAc with generally positive outcomes. From the limited evidence in the literature, DBS, particularly of the NAc, appears to be a reasonable last resort option for refractory addictive disorders. We propose that future research in objective electrophysiological (e.g., local field potentials) and neurochemical (e.g., extracellular dopamine levels) biomarkers would assist monitoring the progress of treatment and developing a closed-loop DBS system. Preclinical literature also highlighted the prefrontal cortex as a promising DBS target, which should be explored in human research.
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Affiliation(s)
- Jason Yuen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong VIC 3216, Australia
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Geelong VIC 3216, Australia
| | - Michael Berk
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong VIC 3216, Australia
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, 4072, Australia
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, 55455, USA
- Department of Psychiatry, Emory University, Atlanta, GA, 30322, USA
| | - Aaron E Rusheen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Charles D Blaha
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kevin E Bennet
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
- Division of Engineering, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kendall H Lee
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA
| | - Hojin Shin
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Jee Hyun Kim
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong VIC 3216, Australia.
| | - Yoonbae Oh
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA.
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9
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Yuen J, Goyal A, Rusheen AE, Kouzani AZ, Berk M, Kim JH, Tye SJ, Blaha CD, Bennet KE, Lee KH, Oh Y, Shin H. Cocaine increases stimulation-evoked serotonin efflux in the nucleus accumbens. J Neurophysiol 2022; 127:714-724. [PMID: 34986049 PMCID: PMC8896999 DOI: 10.1152/jn.00420.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Although dopamine is the most implicated neurotransmitter in the mediation of the pathophysiology of addiction, animal studies show serotonin also plays a vital role. Cocaine is one of the most common illicit drugs globally, but the role of serotonin in its mechanism of action is insufficiently characterized. Consequently, we investigated the acute effects of the psychomotor stimulant cocaine on electrical stimulation-evoked serotonin (phasic) release in the nucleus accumbens core (NAcc) of urethane-anesthetized (1.5 g/kg ip) male Sprague-Dawley rats using N-shaped fast-scan cyclic voltammetry (N-FSCV). A single carbon fiber microelectrode was first implanted in the NAcc. Stimulation was applied to the medial forebrain bundle using 60 Hz, 2 ms, 0.2 mA, 2-s biphasic pulses before and after cocaine (2 mg/kg iv) was administered. Stimulation-evoked serotonin release significantly increased 5 min after cocaine injection compared with baseline (153 ± 21 nM vs. 257 ± 12 nM; P = 0.0042; n = 5) but was unaffected by saline injection (1 mL/kg iv; n = 5). N-FSCV's selective measurement of serotonin release in vivo was confirmed pharmacologically via administration of the selective serotonin reuptake inhibitor escitalopram (10 mg/kg ip) that effectively increased the signal in a separate group of rats (n = 5). Selectivity to serotonin was further confirmed in vitro in which dopamine was minimally detected by N-FSCV with a serotonin to dopamine response ratio of 1:0.04 (200 nM of serotonin:1 µM dopamine ratio; P = 0.0048; n = 5 electrodes). This study demonstrates a noteworthy influence of cocaine on serotonin dynamics, and confirms that N-FSCV can effectively and selectively measure phasic serotonin release in the NAcc.NEW & NOTEWORTHY Serotonin plays a vital role in drug addiction. Here, using N-shaped fast-scan cyclic voltammetry, we demonstrated the effect of cocaine on the phasic release of serotonin at the nucleus accumbens core. To the best of our knowledge, this has not previously been elucidated. Our results not only reinforce the role of serotonin in the mechanism of action of cocaine but also help to fill a gap in our knowledge and provide a baseline for future studies in cocaine addiction.
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Affiliation(s)
- Jason Yuen
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota,4IMPACT—the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Abhinav Goyal
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota,2Medical Scientist Training Program, Mayo Clinic, Rochester, Minnesota
| | - Aaron E. Rusheen
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota,2Medical Scientist Training Program, Mayo Clinic, Rochester, Minnesota
| | - Abbas Z. Kouzani
- 3School of Engineering, Deakin University, Geelong, Victoria, Australia
| | - Michael Berk
- 4IMPACT—the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Jee Hyun Kim
- 4IMPACT—the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Susannah J. Tye
- 6Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
| | - Charles D. Blaha
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Kevin E. Bennet
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota,7Division of Engineering, Mayo Clinic, Rochester, Minnesota
| | - Kendall H. Lee
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota,5Department of Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Yoonbae Oh
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota,5Department of Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Hojin Shin
- 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
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10
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Varela RB, Cararo JH, Tye SJ, Carvalho AF, Valvassori SS, Fries GR, Quevedo J. Contributions of epigenetic inheritance to the predisposition of major psychiatric disorders: theoretical framework, evidence, and implications. Neurosci Biobehav Rev 2022; 135:104579. [DOI: 10.1016/j.neubiorev.2022.104579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/10/2022] [Accepted: 02/11/2022] [Indexed: 02/08/2023]
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11
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Tye SJ, Borreggine K, Price JB, Sutor SL, Cuéllar-Barboza AB, McElroy SL, Biernacka JM, Frye MA. Dynamic insulin-stimulated mTOR/GSK3 signaling in peripheral immune cells: Preliminary evidence for an association with lithium response in bipolar disorder. Bipolar Disord 2022; 24:39-47. [PMID: 33864716 DOI: 10.1111/bdi.13081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION A key mechanism of lithium is the inhibition of glycogen synthase kinase-3β (GSK3β) and activation of mammalian target of rapamycin (mTOR), two contributors to insulin signaling. We explored the relationship between these markers and clinical response to lithium in bipolar disorder (BD). METHODS Thirty-four subjects with BD who had been taking lithium for ≥2 years and had a maintenance lithium Alda score defined as either high (≥7; n = 20) or low (≤2; n = 14) were included in the study. Baseline protein expression of GSK3β and mTOR (total and phosphorylated (p)) was obtained from a buffy coat. Peripheral blood mononuclear cells (PBMCs) from a subset of each group (n = 11) were stimulated with insulin (10 µg) and change in protein expression was determined using Western blot. RESULTS In buffy coat samples, significantly higher levels of pmTOR were present in subjects with an Alda score ≤2 (lithium non-responsive), relative to those with scores ≥7 (lithium-responsive). No differences were observed for pGSK3β. In contrast, functional PBMC responses to 5 min of insulin stimulation demonstrated robust increases in pGSK3β (87.05 ± 43.41%) and pmTOR (105.7 ± 66.48%) in the lithium responsive group only. This contrasted observed decreases in pGSK3β (34.08 ± 16.12%) and pmTOR (37.84 ± 14.39%) 5 mins post-insulin in non-responders. CONCLUSIONS Dynamic increases in pmTOR and pGSK3β post-insulin stimulation may reflect an immunometabolic state that facilitates lithium response. Further prospective analyses are needed to replicate and extend these preliminary findings and further investigate the role of insulin signaling in lithium response in BD.
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Affiliation(s)
- Susannah J Tye
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.,Queensland Brain Institute, The University of Queensland, St Lucia, Qld, Australia.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Kristin Borreggine
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - J Blair Price
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Shari L Sutor
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Alfredo B Cuéllar-Barboza
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry, Autonomous University of Nuevo Leon School of Medicine, Monterrey, Mexico
| | - Susan L McElroy
- Lindner Center of HOPE, Mason, OH, USA.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joanna M Biernacka
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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12
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Kruse JL, Olmstead R, Hellemann G, Breen EC, Tye SJ, Brooks JO, Wade B, Congdon E, Espinoza R, Narr KL, Irwin MR. Interleukin-8 and lower severity of depression in females, but not males, with treatment-resistant depression. J Psychiatr Res 2021; 140:350-356. [PMID: 34139457 PMCID: PMC8319139 DOI: 10.1016/j.jpsychires.2021.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/17/2021] [Accepted: 06/04/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION In cross-sectional studies of depressed patients, relationships between depression and levels of IL-8 are inconsistent, and have not been examined in relation to sex. Given identified sex differences in longitudinal data, it is important to evaluate sex-specific cross-sectional relationships between IL-8 and depressive symptoms, which may explain some inconsistency in the extant literature. It is further unknown whether IL-8 levels may relate to specific symptom profiles among depressed patients, with or without regard to sex. METHODS Among 108 patients with treatment resistant depression (50 females), we evaluated cross-sectional relationships between IL-8 and depression severity, as measured by the Hamilton Depression Rating Scale [HAM-D] Score, and examined sex-specific relationships, as well as relationships with depressive symptom profiles. Other inflammatory markers (IL-6, IL-10, TNF-α, CRP) were also explored in relation to HAM-D. RESULTS Higher IL-8 was associated with lower total HAM-D score (standardized β = -0.19, p = 0.049). Sex-specific effects were identified (IL-8 x sex interaction: p = 0.03), in which higher IL-8 related to lower HAM-D score in females (standardized β = -0.41, p = 0.004, effect size (sr2) = 0.17), but not males (standardized β = 0.02, p = 0.91). Among a subset of 94 patients (41 females) who had individual HAM-D items available, we evaluated relationships between IL-8 and HAM-D factor subscores. Across sexes, higher IL-8 was associated with lower anxiety/hypochondriasis subscores (standardized β = -0.31, p = 0.002; sex interaction: p = 0.99). Sex differences were identified for relationships between IL-8 and two other HAM-D factor subscores. CONCLUSIONS IL-8 may be related to anxiety symptoms across sexes, but may have a sex-specific relationship with other depressive symptoms. Further evaluation of sex-specific relationships between IL-8, depression symptom profiles, treatment response, and potential neurobiological correlates, may inform mechanisms of depression pathophysiology and aid in development of precision medicine strategies.
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Affiliation(s)
- Jennifer L Kruse
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States.
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Gerhard Hellemann
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Australia; Department of Psychiatry & Psychology, Mayo Clinic, United States; Department of Psychiatry, University of Minnesota, United States
| | - John O Brooks
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Benjamin Wade
- Department of Neurology, University of California at Los Angeles, Los Angeles, CA, United States
| | - Eliza Congdon
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Randall Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Katherine L Narr
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States; Department of Neurology, University of California at Los Angeles, Los Angeles, CA, United States
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
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13
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Kale RP, Nguyen TTL, Price JB, Yates NJ, Walder K, Berk M, Sillitoe RV, Kouzani AZ, Tye SJ. Mood Regulatory Actions of Active and Sham Nucleus Accumbens Deep Brain Stimulation in Antidepressant Resistant Rats. Front Hum Neurosci 2021; 15:644921. [PMID: 34349629 PMCID: PMC8326323 DOI: 10.3389/fnhum.2021.644921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
The antidepressant actions of deep brain stimulation (DBS) are associated with progressive neuroadaptations within the mood network, modulated in part, by neurotrophic mechanisms. We investigated the antidepressant-like effects of chronic nucleus accumbens (NAc) DBS and its association with change in glycogen synthase kinase 3 (GSK3) and mammalian target of rapamycin (mTOR) expression in the infralimbic cortex (IL), and the dorsal (dHIP) and ventral (vHIP) subregions of the hippocampus of antidepressant resistant rats. Antidepressant resistance was induced via daily injection of adrenocorticotropic hormone (ACTH; 100 μg/day; 15 days) and confirmed by non-response to tricyclic antidepressant treatment (imipramine, 10 mg/kg). Portable microdevices provided continuous bilateral NAc DBS (130 Hz, 200 μA, 90 μs) for 7 days. A control sham electrode group was included, together with ACTH- and saline-treated control groups. Home cage monitoring, open field, sucrose preference, and, forced swim behavioral tests were performed. Post-mortem levels of GSK3 and mTOR, total and phosphorylated, were determined with Western blot. As previously reported, ACTH treatment blocked the immobility-reducing effects of imipramine in the forced swim test. In contrast, treatment with either active DBS or sham electrode placement in the NAc significantly reduced forced swim immobility time in ACTH-treated animals. This was associated with increased homecage activity in the DBS and sham groups relative to ACTH and saline groups, however, no differences in locomotor activity were observed in the open field test, nor were any group differences seen for sucrose consumption across groups. The antidepressant-like actions of NAc DBS and sham electrode placements were associated with an increase in levels of IL and vHIP phospho-GSK3β and phospho-mTOR, however, no differences in these protein levels were observed in the dHIP region. These data suggest that early response to electrode placement in the NAc, irrespective of whether active DBS or sham, has antidepressant-like effects in the ACTH-model of antidepressant resistance associated with distal upregulation of phospho-GSK3β and phospho-mTOR in the IL and vHIP regions of the mood network.
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Affiliation(s)
- Rajas P Kale
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.,School of Engineering, Deakin University, Geelong, VIC, Australia
| | - Thanh Thanh L Nguyen
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.,Department of Biology and Psychology, Green Mountain College, Poultney, VT, United States
| | - J Blair Price
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.,Department of Neurosurgery Research, Mayo Clinic, Rochester, MN, United States
| | - Nathanael J Yates
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Ken Walder
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
| | - Michael Berk
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.,Orygen Youth Health Research Centre, The Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Roy V Sillitoe
- Department of Pathology and Immunology, Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Geelong, VIC, Australia
| | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.,Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,Department of Psychiatry, University of Minnesota, Houston, TX, United States.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
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14
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Yuen J, Goyal A, Rusheen AE, Kouzani AZ, Berk M, Kim JH, Tye SJ, Blaha CD, Bennet KE, Jang DP, Lee KH, Shin H, Oh Y. Cocaine-Induced Changes in Tonic Dopamine Concentrations Measured Using Multiple-Cyclic Square Wave Voltammetry in vivo. Front Pharmacol 2021; 12:705254. [PMID: 34295252 PMCID: PMC8290896 DOI: 10.3389/fphar.2021.705254] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/24/2021] [Indexed: 12/02/2022] Open
Abstract
For over 40 years, in vivo microdialysis techniques have been at the forefront in measuring the effects of illicit substances on brain tonic extracellular levels of dopamine that underlie many aspects of drug addiction. However, the size of microdialysis probes and sampling rate may limit this technique’s ability to provide an accurate assessment of drug effects in microneural environments. A novel electrochemical method known as multiple-cyclic square wave voltammetry (M-CSWV), was recently developed to measure second-to-second changes in tonic dopamine levels at microelectrodes, providing spatiotemporal resolution superior to microdialysis. Here, we utilized M-CSWV and fast-scan cyclic voltammetry (FSCV) to measure changes in tonic or phasic dopamine release in the nucleus accumbens core (NAcc) after acute cocaine administration. Carbon-fiber microelectrodes (CFM) and stimulating electrodes were implanted into the NAcc and medial forebrain bundle (MFB) of urethane anesthetized (1.5 g/kg i.p.) Sprague-Dawley rats, respectively. Using FSCV, depths of each electrode were optimized by determining maximal MFB electrical stimulation-evoked phasic dopamine release. Changes in phasic responses were measured after a single dose of intravenous saline or cocaine hydrochloride (3 mg/kg; n = 4). In a separate group, changes in tonic dopamine levels were measured using M-CSWV after intravenous saline and after cocaine hydrochloride (3 mg/kg; n = 5). Both the phasic and tonic dopamine responses in the NAcc were augmented by the injection of cocaine compared to saline control. The phasic and tonic levels changed by approximately x2.4 and x1.9, respectively. These increases were largely consistent with previous studies using FSCV and microdialysis. However, the minimal disruption/disturbance of neuronal tissue by the CFM may explain why the baseline tonic dopamine values (134 ± 32 nM) measured by M-CSWV were found to be 10-fold higher when compared to conventional microdialysis. In this study, we demonstrated phasic dopamine dynamics in the NAcc with acute cocaine administration. M-CSWV was able to record rapid changes in tonic levels of dopamine, which cannot be achieved with other current voltammetric techniques. Taken together, M-CSWV has the potential to provide an unprecedented level of physiologic insight into dopamine signaling, both in vitro and in vivo, which will significantly enhance our understanding of neurochemical mechanisms underlying psychiatric conditions.
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Affiliation(s)
- Jason Yuen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.,Deakin University, IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, VIC, Australia
| | - Abhinav Goyal
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.,Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Aaron E Rusheen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.,Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- Deakin University, IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, VIC, Australia
| | - Jee Hyun Kim
- Deakin University, IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, VIC, Australia
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Charles D Blaha
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Kevin E Bennet
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.,Division of Engineering, Mayo Clinic, Rochester, MN, United States
| | - Dong-Pyo Jang
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Kendall H Lee
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.,Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Hojin Shin
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Yoonbae Oh
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.,Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
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15
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Abstract
Inflammation is a critical factor contributing to the progressive neurodegenerative process observed in Parkinson's disease (PD). Microglia, the immune cells of the central nervous system, are activated early in PD pathogenesis and can both trigger and propagate early disease processes via innate and adaptive immune mechanisms such as upregulated immune cells and antibody-mediated inflammation. Downstream cytokines and gene regulators such as microRNA (miRNA) coordinate later disease course and mediate disease progression. Biomarkers signifying the inflammatory and neurodegenerative processes at play within the central nervous system are of increasing interest to clinical teams. To be effective, such biomarkers must achieve the highest sensitivity and specificity for predicting PD risk, confirming diagnosis, or monitoring disease severity. The aim of this review was to summarize the current preclinical and clinical evidence that suggests that inflammatory processes contribute to the initiation and progression of neurodegenerative processes in PD. In this article, we further summarize the data about main inflammatory biomarkers described in PD to date and their potential for regulation as a novel target for disease-modifying pharmacological strategies.
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Affiliation(s)
- Stellina Y H Lee
- Queensland Brain Institute, The University of Queensland, Saint Lucia, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Nathanael J Yates
- Queensland Brain Institute, The University of Queensland, Saint Lucia, Queensland, Australia.,School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Saint Lucia, Queensland, Australia.,Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
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16
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Roy AV, Thai M, Klimes-Dougan B, Schreiner MW, Mueller BA, Albott CS, Lim KO, Fiecas M, Tye SJ, Cullen KR. Brain entropy and neurotrophic molecular markers accompanying clinical improvement after ketamine: Preliminary evidence in adolescents with treatment-resistant depression. J Psychopharmacol 2021; 35:168-177. [PMID: 32643995 PMCID: PMC8569740 DOI: 10.1177/0269881120928203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Current theory suggests that treatment-resistant depression (TRD) involves impaired neuroplasticity resulting in cognitive and neural rigidity, and that clinical improvement may require increasing brain flexibility and adaptability. AIMS In this hypothesis-generating study, we sought to identify preliminary evidence of brain flexibility correlates of clinical change within the context of an open-label ketamine trial in adolescents with TRD, focusing on two promising candidate markers of neural flexibility: (a) entropy of resting-state functional magnetic resonance imaging (fMRI) signals; and (b) insulin-stimulated phosphorylation of mammalian target of rapamycin (mTOR) and glycogen synthase-3-beta (GSK3β) in peripheral blood mononuclear cells. METHODS We collected resting-state functional magnetic resonance imaging data and blood samples from 13 adolescents with TRD before and after a series of six ketamine infusions over 2 weeks. Usable pre/post ketamine data were available from 11 adolescents for imaging and from 10 adolescents for molecular signaling. We examined correlations between treatment response and changes in the central and peripheral flexibility markers. RESULTS Depression reduction correlated with increased nucleus accumbens entropy. Follow-up analyses suggested that physiological changes were associated with treatment response. In contrast to treatment non-responders (n=6), responders (n=5) showed greater increase in nucleus accumbens entropy after ketamine, together with greater post-treatment insulin/mTOR/GSK3β signaling. CONCLUSIONS These data provide preliminary evidence that changes in neural flexibility may underlie symptom relief in adolescents with TRD following ketamine. Future research with adequately powered samples is needed to confirm resting-state entropy and insulin-stimulated mTOR and GSK3β as brain flexibility markers and candidate targets for future clinical trials. CLINICAL TRIAL NAME Ketamine in adolescents with treatment-resistant depressionURL: https://clinicaltrials.gov/ct2/show/NCT02078817Registration number: NCT02078817.
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Affiliation(s)
- Abhrajeet V Roy
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Michelle Thai
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, USA
| | | | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Christina Sophia Albott
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Mark Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
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17
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Varela RB, Resende WR, Dal-Pont GC, Gava FF, Nadas GB, Tye SJ, Andersen ML, Quevedo J, Valvassori SS. Role of epigenetic regulatory enzymes in animal models of mania induced by amphetamine and paradoxical sleep deprivation. Eur J Neurosci 2020; 53:649-662. [PMID: 32735698 DOI: 10.1111/ejn.14922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/26/2020] [Accepted: 07/19/2020] [Indexed: 01/22/2023]
Abstract
It is known that bipolar disorder has a multifactorial aetiology where the interaction between genetic and environmental factors is responsible for its development. Because of this, epigenetics has been largely studied in psychiatric disorders. The present study aims to evaluate the effects of histone deacetylase inhibitors on epigenetic enzyme alterations in rats or mice submitted to animal models of mania induced by dextro-amphetamine or sleep deprivation, respectively. Adult male Wistar rats were subjected to 14 days of dextro-amphetamine administration, and from the eighth to the fourteenth day, the animals were treated with valproate and sodium butyrate in addition to dextro-amphetamine injections. Adult C57BL/6 mice received 7 days of valproate or sodium butyrate administration, being sleep deprived at the last 36 hr of the protocol. Locomotor and exploratory activities of rats and mice were evaluated in the open-field test, and histone deacetylase, DNA methyltransferase, and histone acetyltransferase activities were assessed in the frontal cortex, hippocampus, and striatum. Dextro-amphetamine and sleep deprivation induced hyperactivity and increased histone deacetylase and DNA methyltransferase activities in the animal's brain. Valproate and sodium butyrate were able to reverse hyperlocomotion induced by both animal models, as well as the alterations on histone deacetylase and DNA methyltransferase activities. There was a positive correlation between enzyme activities and number of crossings for both models. Histone deacetylase and DNA methyltransferase activities also presented a positive correlation between theirselves. These results suggest that epigenetics can play an important role in BD pathophysiology as well as in its treatment.
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Affiliation(s)
- Roger B Varela
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil.,Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Wilson R Resende
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gustavo C Dal-Pont
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Fernanda F Gava
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gabriella B Nadas
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil.,Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
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18
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Seshadri A, Clark MM, Kung S, Fuller-Tyszkiewicz M, Sood A, Dammen KC, Rico JA, Tye SJ, McGillivray J, Frye MA. Feasibility Study of Stress Management and Resiliency Training (SMART) in Patients With Major Depressive Disorder. Prim Care Companion CNS Disord 2020; 22. [PMID: 32369689 DOI: 10.4088/pcc.19m02556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/17/2020] [Indexed: 10/24/2022] Open
Abstract
Objective Stress is associated with the onset, maintenance, and recurrence of depression. This study investigated the feasibility of stress management and resiliency training (SMART) for enhancing resiliency in a group of patients with major depressive disorder. Methods In an open-label study, patients with major depressive disorder were invited to participate in an adjunctive 8-week group therapy of SMART (from June 2017 to June 2018) that encompassed attention training and practice of gratitude, compassion, higher meaning, acceptance, and forgiveness. The primary outcome measure was baseline-to-endpoint change in resilience as measured by the Connor Davidson Resilience Scale (CD-RISC). Secondary outcome measures included baseline-to-endpoint change in stress using the Perceived Stress Scale (PSS) and in depression using the 17-item Hamilton Depression Rating Scale (HDRS-17) and 9-item Patient Health Questionnaire (PHQ-9). Results Twenty-three participants enrolled in the study (mean ± SD age = 46 ± 13 years, female = 91%). Baseline ratings of mood were of mild-to-moderate symptom severity (mean HDRS-17 score = 14.5 and PHQ-9 score = 12), resilience (mean CD-RISC score = 53.8), and perceived stress (mean PSS score = 23.5). Of the participants, 74% were study completers (attended ≥ 6 sessions). In an intention-to-treat analysis, at study endpoint there was a significant improvement in resilience (mean CD-RISC score = 61.1, P = .03), reduction in perceived stress (mean PSS score = 19.4, P = .002), and improvement in depression (mean HDRS-17 score = 9.1 and PHQ-9 score = 7.6, both P < .001). Conclusions A resilience training program focused on wellness is feasible for patients who are currently symptomatic with major depressive disorder. A larger randomized controlled trial is needed to establish efficacy of this intervention and explore the long-term impact of stress management and resilience training in depression. Trial Registration ClinicalTrials.gov identifier: NCT03275961.
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Affiliation(s)
- Ashok Seshadri
- Department of Psychiatry and Psychology, Mayo Clinic, 1000 First Drive NW, Austin, Minnesota 55912. .,Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.,School of Psychology, Deakin University, Geelong, Melbourne, Australia
| | - Matthew M Clark
- Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Simon Kung
- Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Amit Sood
- Department of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Global Center for Resiliency and Wellbeing, Rochester, Minnesota, USA
| | - Kristina C Dammen
- Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jose A Rico
- Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Susannah J Tye
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Jane McGillivray
- School of Psychology, Deakin University, Geelong, Melbourne, Australia
| | - Mark A Frye
- Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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19
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Varela RB, Resende WR, Dal-Pont GC, Gava FF, Tye SJ, Quevedo J, Valvassori SS. HDAC inhibitors reverse mania-like behavior and modulate epigenetic regulatory enzymes in an animal model of mania induced by Ouabain. Pharmacol Biochem Behav 2020; 193:172917. [PMID: 32222371 DOI: 10.1016/j.pbb.2020.172917] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The etiology of bipolar disorder (BD) is multifactorial, involving both environmental and genetic factors. Current pharmacological treatment is associated with several side effects, which are the main reason patients discontinue treatment. Epigenetic alterations have been studied for their role in the pathophysiology of BD, as they bridge the gap between gene and environment. OBJECTIVE Evaluate the effects of histone deacetylase inhibitors on behavior and epigenetic enzymes activity in a rat model of mania induced by ouabain. METHODS Adult male rats were subjected to a single intracerebroventricular injection of ouabain (10-3 M) followed by 7 days of valproate (200 mg/kg) or sodium butyrate (600 mg/kg) administration. Locomotor and exploratory activities were evaluated in the open-field test. Histone deacetylase, DNA methyltransferase, and histone acetyltransferase activity were assessed in the frontal cortex, hippocampus, and striatum. RESULTS Ouabain induced hyperactivity in rats, which was reversed by valproate and sodium butyrate treatment. Ouabain did not alter the activity of any of the enzymes evaluated. However, valproate and sodium butyrate decreased the activity of histone deacetylase and DNA methyltransferase. Moreover, there was a positive correlation between these two enzymes. CONCLUSION These results suggest that targeting epigenetic mechanisms may play an important role in mania-like behavior management.
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Affiliation(s)
- Roger B Varela
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia; Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC) -, Criciúma, SC, Brazil
| | - Wilson R Resende
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC) -, Criciúma, SC, Brazil
| | - Gustavo C Dal-Pont
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC) -, Criciúma, SC, Brazil
| | - Fernanda F Gava
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC) -, Criciúma, SC, Brazil
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC) -, Criciúma, SC, Brazil; Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth) -, Houston, TX, USA; Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth) -, Houston, TX, USA; Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences -, Houston, TX, USA
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC) -, Criciúma, SC, Brazil.
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20
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Abstract
The ability to monitor neurochemical dynamics in target brain regions with a high degree of temporal resolution has assisted researchers in investigating the pathogenesis, and pathophysiology of a variety of neurological and psychiatric disorders. Current systems for neurochemical monitoring are bulky or expensive, limiting widespread exploration of this research field and preventing large-scale parallel experimentation. In this paper, we present a new miniaturized research platform, the TinyFSCV system, which can be used to monitor dynamic changes in neurochemicals through Fast-Scan Cyclic Voltammetry (FSCV). This system contains a precision voltage output circuit that can accurately output potentials between -0.55 to 2 V and scan a connected electrochemical cell at up to 400 V/s, the required speed to sense most neurochemicals with FSCV. In addition, the device includes precision current measurement circuity with a measurement range of -115 to [Formula: see text] capable of taking measurements at up to 56 KS/s. Four experiments are conducted to demonstrate the capability of the system. These consisted of: static bench tests, static ferrocene tests, and static and dynamic dopamine tests. These experiments demonstrate the ability of the miniaturized platform to accurately sense and measure neurochemicals. Ultimately, the TinyFSCV system is a platform that can enable large-scale, low-cost parallel experimentation to take place in the field of neurochemical monitoring. In addition, this device will increase the accessibility of neurochemical sensing, providing advanced tools and techniques to more researchers, and facilitating widespread exploration of the field of neurodynamics.
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21
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Adams SD, Bennet KE, Tye SJ, Berk M, Kouzani AZ. Development of a miniature device for emerging deep brain stimulation paradigms. PLoS One 2019; 14:e0212554. [PMID: 30789946 PMCID: PMC6383994 DOI: 10.1371/journal.pone.0212554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 02/05/2019] [Indexed: 11/18/2022] Open
Abstract
Deep brain stimulation (DBS) is a neuromodulatory approach for treatment of several neurological and psychiatric disorders. A new focus on optimising the waveforms used for stimulation is emerging regarding the mechanism of DBS treatment. Many existing DBS devices offer only a limited set of predefined waveforms, mainly rectangular, and hence are inapt for exploring the emerging paradigm. Advances in clinical DBS are moving towards incorporating new stimulation parameters, yet we remain limited in our capacity to test these in animal models, arguably a critical first step. Accordingly, there is a need for the development of new miniature, low-power devices to enable investigation into the new DBS paradigms in preclinical settings. The ideal device would allow for flexibility in the stimulation waveforms, while remaining suitable for chronic, tetherless, biphasic deep brain stimulation. In this work, we elucidate several key parameters in a DBS system, identify gaps in existing solutions, and propose a new device to support preclinical DBS. The device allows for a high degree of flexibility in the output waveform with easily altered shape, frequency, pulse-width and amplitude. The device is suitable for both traditional and modern stimulation schemes, including those using non-rectangular waveforms, as well as delayed feedback schemes. The device incorporates active charge balancing to ensure safe operation, and allows for simple production of custom biphasic waveforms. This custom waveform output is unique in the field of preclinical DBS devices, and could be advantageous in performing future DBS studies investigating new treatment paradigms. This tetherless device can be easily and comfortably carried by an animal in a back-mountable configuration. The results of in-vitro tests are presented and discussed.
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Affiliation(s)
- Scott D. Adams
- Deakin University, School of Engineering, Geelong, Victoria, Australia
| | - Kevin E. Bennet
- Division of Engineering, Mayo Clinic, Rochester, MN, United States of America
| | - Susannah J. Tye
- Queensland Brain Institute, the University of Queensland, St Lucia QLD, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT SRC, Barwon Health, Geelong, Victoria, Australia
| | - Abbas Z. Kouzani
- Deakin University, School of Engineering, Geelong, Victoria, Australia
- * E-mail:
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22
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Ahmed AT, Frye MA, Rush AJ, Biernacka JM, Craighead WE, McDonald WM, Bobo WV, Riva-Posse P, Tye SJ, Mayberg HS, Flavin DH, Skime MK, Jenkins GD, Wang L, Krishnan RR, Weinshilboum RM, Kaddurah-Daouk R, Dunlop BW. Mapping depression rating scale phenotypes onto research domain criteria (RDoC) to inform biological research in mood disorders. J Affect Disord 2018; 238:1-7. [PMID: 29807322 PMCID: PMC6374030 DOI: 10.1016/j.jad.2018.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/30/2018] [Accepted: 05/11/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Substantial research progress can be achieved if available clinical datasets can be mapped to the National Institute of Mental Health Research-Domain-Criteria (RDoC) constructs. This mapping would allow investigators to both explore more narrowly defined clinical phenotypes and the relationship of these phenotypes to biological markers and clinical outcomes approximating RDoC criteria. METHODS Using expert review and consensus, we defined four major depression phenotypes based on specific RDoC constructs. Having matched these constructs to individual items from the Hamilton Depression Rating Scale and Quick Inventory of Depressive Symptomatology, we identified subjects meeting criteria for each of these phenotypes from two large clinical trials of patients treated for major depression. In a post hoc analysis, we evaluated the overall treatment response based on the phenotypes: Core Depression (CD), Anxiety (ANX), and Neurovegetative Symptoms of Melancholia (NVSM) and Atypical Depression (NVSAD). RESULTS The phenotypes were prevalent (range 10.5-52.4%, 50% reduction range 51.9-82.9%) and tracked with overall treatment response. Although the CD phenotype was associated with lower rates of remission in both cohorts, this was mainly driven by baseline symptom severity. However, when controlling for baseline severity, patients with the ANX phenotype had a significantly lower rate of remission. LIMITATIONS The lack of replication between the studies of the phenotypes' treatment prediction value reflects important variability across studies that may limit generalizability. CONCLUSION Further work evaluating biological markers associated with these phenotypes is needed for further RDoC concept development.
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Affiliation(s)
- Ahmed T. Ahmed
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - A John Rush
- Department of Psychiatry, Duke University School of Medicine, Durham, Durham, NC,Texas Tech University, Health Sciences Center, Permian Basin, TX
| | | | - W. Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - William M. McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - William V. Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Susannah J. Tye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Helen S. Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | | | | | - Greg D. Jenkins
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Liewei Wang
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN
| | | | - Richard M. Weinshilboum
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN
| | - Rima Kaddurah-Daouk
- Department of Psychiatry, Duke University School of Medicine, Durham, Durham, NC
| | - Boadie W. Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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23
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Vande Voort JL, Morgan RJ, Kung S, Rasmussen KG, Rico J, Palmer BA, Schak KM, Tye SJ, Ritter MJ, Frye MA, Bobo WV. Corrigendum to "Continuation phase intravenous ketamine in adults with treatment-resistant depression" [J. Affect. Disord. 206 (2016) 300-304]. J Affect Disord 2018; 236:313. [PMID: 28967437 DOI: 10.1016/j.jad.2017.09.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jennifer L Vande Voort
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Robert J Morgan
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Simon Kung
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Keith G Rasmussen
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Jose Rico
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Brian A Palmer
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Kathryn M Schak
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Susannah J Tye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - Matthew J Ritter
- Department of Anesthesia, Mayo Clinic, Rochester, MN, United States
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States
| | - William V Bobo
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, United States.
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24
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Price JB, Bronars C, Erhardt S, Cullen KR, Schwieler L, Berk M, Walder K, McGee SL, Frye MA, Tye SJ. Bioenergetics and synaptic plasticity as potential targets for individualizing treatment for depression. Neurosci Biobehav Rev 2018; 90:212-220. [DOI: 10.1016/j.neubiorev.2018.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/07/2018] [Accepted: 04/03/2018] [Indexed: 02/07/2023]
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25
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Nguyen TTL, Chan LC, Borreginne K, Kale RP, Hu C, Tye SJ. A review of brain insulin signaling in mood disorders: From biomarker to clinical target. Neurosci Biobehav Rev 2018; 92:7-15. [PMID: 29758232 DOI: 10.1016/j.neubiorev.2018.05.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/08/2018] [Accepted: 05/08/2018] [Indexed: 12/16/2022]
Abstract
Patients with mood disorders are at increased risk for metabolic dysfunction. Co-occurrence of the two conditions is typically associated with a more severe disease course and poorer treatment outcomes. The specific pathophysiological mechanisms underlying this bidirectional relationship between mood and metabolic dysfunction remains poorly understood. However, it is likely that impairment of metabolic processes within the brain play a critical role. The insulin signaling pathway mediates metabolic homeostasis and is important in the regulation of neurotrophic and synaptic plasticity processes, including those involved in neurodegenerative diseases like Alzheimer's. Thus, insulin signaling in the brain may serve to link metabolic function and mood. Central insulin signaling is mediated through locally secreted insulin and widespread insulin receptor expression. Here we review the preclinical and clinical data addressing the relationships between central insulin signaling, cellular metabolism, neurotrophic processes, and mood regulation, including key points of mechanistic overlap. These relationships have important implications for developing biomarker-based diagnostics and precision medicine approaches to treat severe mood disorders.
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Affiliation(s)
- Thanh Thanh L Nguyen
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States; Department of Biology and Psychology, Green Mountain College, 1 Brennan Cir, Poultney, VT, 05764, United States
| | - Lily C Chan
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States
| | - Kristin Borreginne
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States
| | - Rajas P Kale
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States; School of Engineering, Deakin University, Waurn Ponds, VIC, 3216, Australia
| | - Chunling Hu
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States
| | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, United States; Department of Psychiatry, University of Minnesota, 3 Morrill Hall, 100 Church Street SE, Minneapolis, MN, 55454, United States; School of Psychology, Deakin University, Burwood, VIC, 3125, Australia; Queensland Brain Institute, The University of Queensland, St Lucia, QLD, 4072, Australia.
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26
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Yang J, Lopez Cervera R, Tye SJ, Ekker SC, Pierret C. Adolescent mental health education InSciEd Out: a case study of an alternative middle school population. J Transl Med 2018; 16:84. [PMID: 29615090 PMCID: PMC5883586 DOI: 10.1186/s12967-018-1459-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 03/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental illness contributes substantially to global disease burden, particularly when illness onset occurs during youth and help-seeking is delayed and/or limited. Yet, few mental health promotion interventions target youth, particularly those with or at high risk of developing mental illness ("at-risk" youth). Community-based translational research has the capacity to identify and intervene upon barriers to positive health outcomes. This is especially important for integrated care in at-risk youth populations. METHODS Here the Integrated Science Education Outreach (InSciEd Out) program delivered a novel school-based anti-stigma intervention in mental health to a cohort of seventh and eighth grade at-risk students. These students were assessed for changes in mental health knowledge, stigmatization, and help-seeking intentions via a classroom activity, surveys, and teacher interviews. Descriptive statistics and Cohen's d effect sizes were employed to assess pre-post changes. Inferential statistical analyses were also conducted on pilot results to provide a benchmark to inform future studies. RESULTS Elimination of mental health misconceptions (substance weakness p = 0.00; recovery p = 0.05; prevention p = 0.05; violent p = 0.05) was accompanied by slight gains in mental health literacy (d = 0.18) and small to medium improvements in help-seeking intentions (anxiety d = 0.24; depression d = 0.48; substance d = 0.43; psychosis d = 0.53). Within this particular cohort of students, stigma was exceptionally low at baseline and remained largely unchanged. Teacher narratives revealed positive teacher views of programming, increased student openness to talk about mental illness, and higher peer and self-acceptance of mental health diagnoses and help-seeking. CONCLUSIONS Curricular-based efforts focused on mental illness in an alternative school setting are feasible and integrated well into general curricula under the InSciEd Out framework. Preliminary data suggest the existence of unique help-seeking barriers in at-risk youth. Increased focus upon community-based programming has potential to bridge gaps in translation, bringing this critical population to clinical care in pursuit of improved mental health for all. Trial registration ClinicalTrials.gov, ID:NCT02680899. Registered 12 February 2016, https://clinicaltrials.gov/ct2/show/NCT02680899.
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Affiliation(s)
- Joanna Yang
- Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | | | - Susannah J Tye
- Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Stephen C Ekker
- Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA.,Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Chris Pierret
- Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA. .,Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA.
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Abstract
OBJECTIVE Electrical brain stimulation provides therapeutic benefits for patients with drug-resistant neurological disorders. It, however, has restricted access to cell-type selectivity which limits its treatment effectiveness. Optogenetics, in contrast, enables precise targeting of a specific cell type which can address the issue with electrical brain stimulation. It, nonetheless, disregards real-time brain responses in delivering optimized stimulation to target cells. Closed-loop optogenetics, on the other hand, senses the difference between normal and abnormal states of the brain, and modulates stimulation parameters to achieve the desired stimulation outcome. Current review articles on closed-loop optogenetics have focused on its theoretical aspects and potential benefits. A review of the recent progress in miniaturized closed-loop optogenetic stimulation devices is thus needed. APPROACH This paper presents a comprehensive study on the existing miniaturized closed-loop optogenetic stimulation devices and their internal components. MAIN RESULTS Hardware components of closed-loop optogenetic stimulation devices including electrode, light-guiding mechanism, optical source, neural recorder, and optical stimulator are discussed. Next, software modules of closed-loop optogenetic stimulation devices including feature extraction, classification, control, and stimulation parameter modulation are described. Then, the existing devices are categorized into open-loop and closed-loop groups, and the combined operation of their neural recorder, optical stimulator, and control approach is discussed. Finally, the challenges in the design and implementation of closed-loop optogenetic stimulation devices are presented, suggestions on how to tackle these challenges are given, and future directions for closed-loop optogenetics are stated. SIGNIFICANCE A generic architecture for closed-loop optogenetic stimulation devices involving both hardware and software perspectives is devised. A comprehensive investigation into the most current miniaturized and tetherless closed-loop optogenetic stimulation devices is given. A detailed comparison of the closed-loop optogenetic stimulation devices is presented.
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Affiliation(s)
- Epsy S Edward
- School of Engineering, Deakin University, Geelong, Victoria 3216, Australia
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Adams SD, Kouzani AZ, Tye SJ, Bennet KE, Berk M. An investigation into closed-loop treatment of neurological disorders based on sensing mitochondrial dysfunction. J Neuroeng Rehabil 2018; 15:8. [PMID: 29439744 PMCID: PMC5811973 DOI: 10.1186/s12984-018-0349-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 02/05/2018] [Indexed: 12/14/2022] Open
Abstract
Dynamic feedback based closed-loop medical devices offer a number of advantages for treatment of heterogeneous neurological conditions. Closed-loop devices integrate a level of neurobiological feedback, which allows for real-time adjustments to be made with the overarching aim of improving treatment efficacy and minimizing risks for adverse events. One target which has not been extensively explored as a potential feedback component in closed-loop therapies is mitochondrial function. Several neurodegenerative and psychiatric disorders including Parkinson's disease, Major Depressive disorder and Bipolar disorder have been linked to perturbations in the mitochondrial respiratory chain. This paper investigates the potential to monitor this mitochondrial function as a method of feedback for closed-loop neuromodulation treatments. A generic model of the closed-loop treatment is developed to describe the high-level functions of any system designed to control neural function based on mitochondrial response to stimulation, simplifying comparison and future meta-analysis. This model has four key functional components including: a sensor, signal manipulator, controller and effector. Each of these components are described and several potential technologies for each are investigated. While some of these candidate technologies are quite mature, there are still technological gaps remaining. The field of closed-loop medical devices is rapidly evolving, and whilst there is a lot of interest in this area, widespread adoption has not yet been achieved due to several remaining technological hurdles. However, the significant therapeutic benefits offered by this technology mean that this will be an active area for research for years to come.
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Affiliation(s)
- Scott D. Adams
- School of Engineering, Deakin University, Geelong, VIC 3216 Australia
| | - Abbas Z. Kouzani
- School of Engineering, Deakin University, Geelong, VIC 3216 Australia
| | - Susannah J. Tye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905 USA
| | - Kevin E. Bennet
- Division of Engineering, Mayo Clinic, Rochester, MN 55905 USA
| | - Michael Berk
- School of Medicine, Deakin University, Waurn Ponds, VIC 3216 Australia
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Parastarfeizabadi M, Kouzani AZ, Gibson I, Tye SJ. A miniature closed-loop deep brain stimulation device. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:1786-1789. [PMID: 28268674 DOI: 10.1109/embc.2016.7591064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper presents a miniature light-weight closed-loop deep brain stimulation (DBS) device that delivers on-demand stimulation current pulses by monitoring and analysing local field potentials. The device includes monitoring and DBS units, each designed and fabricated on a separate small round circuit board. The closed-loop DBS device has been successfully validated by injecting a pre-recorded neural signal into its input, and collecting and analysing its output. The monitoring unit has an amplification gain of 113 dB in frequency range of 0.7-50 Hz. The DBS unit gives on-demand stimulation current pulses of duration 90 μs, frequency 130 Hz, and amplitude 200 μA. The total weight of the device including a 3V coin battery is 1.41 g. The diameter of the device is 11.4 mm. This portable head-mountable device is suitable for use in pre-clinical trials with small laboratory animals.
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Morris G, Walder K, Carvalho AF, Tye SJ, Lucas K, Berk M, Maes M. The role of hypernitrosylation in the pathogenesis and pathophysiology of neuroprogressive diseases. Neurosci Biobehav Rev 2017; 84:453-469. [PMID: 28789902 DOI: 10.1016/j.neubiorev.2017.07.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 07/02/2017] [Accepted: 07/31/2017] [Indexed: 12/12/2022]
Abstract
There is a wealth of data indicating that de novo protein S-nitrosylation in general and protein transnitrosylation in particular mediates the bulk of nitric oxide signalling. These processes enable redox sensing and facilitate homeostatic regulation of redox dependent protein signalling, function, stability and trafficking. Increased S-nitrosylation in an environment of increasing oxidative and nitrosative stress (O&NS) is initially a protective mechanism aimed at maintaining protein structure and function. When O&NS becomes severe, mechanisms governing denitrosylation and transnitrosylation break down leading to the pathological state referred to as hypernitrosylation (HN). Such a state has been implicated in the pathogenesis and pathophysiology of several neuropsychiatric and neurodegenerative diseases and we investigate its potential role in the development and maintenance of neuroprogressive disorders. In this paper, we propose a model whereby the hypernitrosylation of a range of functional proteins and enzymes lead to changes in activity which conspire to produce at least some of the core abnormalities contributing to the development and maintenance of pathology in these illnesses.
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Affiliation(s)
- Gerwyn Morris
- Tir Na Nog, Bryn Road seaside 87, Llanelli, SA152LW, Wales, United Kingdom
| | - Ken Walder
- Deakin University, The Centre for Molecular and Medical Research, School of Medicine, P.O. Box 291, Geelong, 3220, Australia
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, 60430-040, Fortaleza, CE, Brazil
| | - Susannah J Tye
- Deakin University, The Centre for Molecular and Medical Research, School of Medicine, P.O. Box 291, Geelong, 3220, Australia; Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, 60430-040, Fortaleza, CE, Brazil; Deakin University, IMPACT Strategic Research Centre, School of Medicine, P.O. Box 281, Geelong, 3220, Australia; Orygen Youth Health Research Centre and the Centre of Youth Mental Health, The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Parkville, 3052, Australia
| | - Kurt Lucas
- Multiphase Chemistry Department, Max Planck Institute for Chemistry, 55128 Mainz, Germany
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, P.O. Box 281, Geelong, 3220, Australia; Orygen Youth Health Research Centre and the Centre of Youth Mental Health, The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Parkville, 3052, Australia.
| | - Michael Maes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, P.O. Box 281, Geelong, 3220, Australia; Department of Psychiatry, Chulalongkorn University, Faculty of Medicine, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
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Luthar SS, Curlee A, Tye SJ, Engelman JC, Stonnington CM. Fostering Resilience among Mothers under Stress: “Authentic Connections Groups” for Medical Professionals. Womens Health Issues 2017; 27:382-390. [DOI: 10.1016/j.whi.2017.02.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/27/2017] [Indexed: 01/12/2023]
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Morris G, Walder K, McGee SL, Dean OM, Tye SJ, Maes M, Berk M. A model of the mitochondrial basis of bipolar disorder. Neurosci Biobehav Rev 2017; 74:1-20. [DOI: 10.1016/j.neubiorev.2017.01.014] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 12/11/2022]
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Kouzani AZ, Kale RP, Zarate-Garza PP, Berk M, Walder K, Tye SJ. Validation of a Portable Low-Power Deep Brain Stimulation Device Through Anxiolytic Effects in a Laboratory Rat Model. IEEE Trans Neural Syst Rehabil Eng 2017; 25:1365-1374. [PMID: 28113945 DOI: 10.1109/tnsre.2016.2628760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Deep brain stimulation (DBS) devices deliver electrical pulses to neural tissue through an electrode. To study the mechanisms and therapeutic benefits of deep brain stimulation, murine preclinical research is necessary. However, conducting naturalistic long-term, uninterrupted animal behavioral experiments can be difficult with bench-top systems. The reduction of size, weight, power consumption, and cost of DBS devices can assist the progress of this research in animal studies. A low power, low weight, miniature DBS device is presented in this paper. This device consists of electronic hardware and software components including a low-power microcontroller, an adjustable current source, an n-channel metal-oxide-semiconductor field-effect transistor, a coin-cell battery, electrode wires and a software program to operate the device. Evaluation of the performance of the device in terms of battery lifetime and device functionality through bench and in vivo tests was conducted. The bench test revealed that this device can deliver continuous stimulation current pulses of strength [Formula: see text], width [Formula: see text], and frequency 130 Hz for over 22 days. The in vivo tests demonstrated that chronic stimulation of the nucleus accumbens (NAc) with this device significantly increased psychomotor activity, together with a dramatic reduction in anxiety-like behavior in the elevated zero-maze test.
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Vande Voort JL, Morgan RJ, Kung S, Rasmussen KG, Rico J, Palmer BA, Schak KM, Tye SJ, Ritter MJ, Frye MA, Bobo WV. Continuation phase intravenous ketamine in adults with treatment-resistant depression. J Affect Disord 2016; 206:300-304. [PMID: 27656788 DOI: 10.1016/j.jad.2016.09.008] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/07/2016] [Accepted: 09/09/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about the antidepressive effects of repeated intravenous ketamine infusions beyond the acute phase of treatment in patients with refractory depression. METHODS Twelve subjects with treatment-resistant non-psychotic unipolar or bipolar major depression and suicidal ideation were given repeated (up to 6) thrice-weekly acute-phase intravenous infusions of ketamine (0.5mg/kg, administered over 100min). Those who remitted during acute-phase treatment received continuation-phase treatment that consisted of 4 weekly ketamine infusions, followed by 4 weeks of post-continuation phase follow-up (during which no further ketamine infusions were administered). Clinical measures were assessed at baseline, at 24h following each infusion, at the last acute-phase observation, and during continuation and post-continuation follow-up (acute phase remitters only). RESULTS Of the 12 enrollees, 5 (41.7%) remitted and 7 (58.3%) responded to ketamine treatment during the acute-phase. All five subjects who remitted during the acute-phase experienced further depressive symptom improvement during continuation-phase treatment. Four subjects lost remission status during the post-continuation phase, but all were still classified as positive treatment responders at the end of the post-continuation phase. Adverse effects were generally mild and transient during acute- and continuation-phase treatment; however, one subject developed behavioral outbursts and suicide threats during follow-up while hospitalized, and one subject died by suicide several weeks after the end of follow-up. LIMITATIONS This was an uncontrolled feasibility study with a small sample size. CONCLUSIONS The continuation-phase administration of ketamine at weekly intervals to patients with treatment-resistant depression who remitted during acute-phase ketamine treatment can extend the duration of depressive symptom remission. The antidepressive effect of ketamine persisted for several weeks after the end of continuation-phase treatment. Our results highlight the need for close monitoring of subjects who are at high baseline risk for suicide but do not respond clinically to ketamine. CLINICALTRIALS. GOV IDENTIFIER NCT02094898.
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Affiliation(s)
- Jennifer L Vande Voort
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Robert J Morgan
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Simon Kung
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Keith G Rasmussen
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Jose Rico
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Brian A Palmer
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Kathryn M Schak
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Susannah J Tye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | | | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - William V Bobo
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA.
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Patten CA, Bronars CA, Vickers Douglas KS, Ussher MH, Levine JA, Tye SJ, Hughes CA, Brockman TA, Decker PA, DeJesus RS, Williams MD, Olson TP, Clark MM, Dieterich AM. Supervised, Vigorous Intensity Exercise Intervention for Depressed Female Smokers: A Pilot Study. Nicotine Tob Res 2016; 19:77-86. [PMID: 27613946 DOI: 10.1093/ntr/ntw208] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/06/2016] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Few studies have evaluated exercise interventions for smokers with depression or other psychiatric comorbidities. This pilot study evaluated the potential role of supervised vigorous exercise as a smoking cessation intervention for depressed females. METHODS Thirty adult women with moderate-severe depressive symptoms were enrolled and randomly assigned to 12 weeks of thrice weekly, in person sessions of vigorous intensity supervised exercise at a YMCA setting (EX; n = 15) or health education (HE; n = 15). All participants received behavioral smoking cessation counseling and nicotine patch therapy. Assessments were done in person at baseline, at the end of 12 weeks of treatment, and at 6 months post-target quit date. Primary end points were exercise adherence (proportion of 36 sessions attended) and biochemically confirmed 7-day point prevalence abstinence at Week 12. Biomarkers of inflammation were explored for differences between treatment groups and between women who smoked and those abstinent at Week 12. RESULTS Treatment adherence was high for both groups (72% for EX and 66% for HE; p = .55). The Week 12 smoking abstinence rate was higher for EX than HE (11/15 [73%] vs. 5/15 [33%]; p = .028), but no significant differences emerged at 6-month follow-up. Interleukin-6 levels increased more for those smoking than women abstinent at Week 12 (p = .040). CONCLUSIONS Vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. Innovative and cost-effective strategies to bolster long-term exercise adherence and smoking cessation need evaluation in this population. Inflammatory biomarkers could be examined in future research as mediators of treatment efficacy. IMPLICATIONS This preliminary study found that vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. This research addressed an important gap in the field. Despite decades of research examining exercise interventions for smoking cessation, few studies were done among depressed smokers or those with comorbid psychiatric disorders. A novel finding was increases in levels of a pro-inflammatory biomarker observed among women who smoked at the end of the intervention compared to those who did not.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN;
| | - Carrie A Bronars
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Michael H Ussher
- Population Health Research Institute, St. George's University of London, London, UK
| | | | | | | | | | - Paul A Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Ramona S DeJesus
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Mark D Williams
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Thomas P Olson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Abstract
This paper presents a closed-loop optogenetic stimulation device to achieve online modulation of neurons. The device is designed to be mountable on small rodents in pre-clinical settings. Considering the size of rodents and the need for portability, a single-piece self-contained device is developed which allows real-time photostimulation based on detected neuronal states. It consists of three components: a neural recorder, a control algorithm, and an optogenetic stimulator. The neural recorder which is realized by analogue circuitry measures the neural signal. The on-off control algorithm analyses the neural signal and controls the stimulation of the target neurons. The optogenetic stimulator performs sampling and digitization of the detected neural signal, runs the control algorithm, and manages the operation of the light source. The configurable neural recorder is capable of 64 dB amplification in the frequency range of 300 Hz to 6 KHz. The outcome of bench testing of the device is reported. The device is portable and headmountable which makes it suitable for use with small rodents in pre-clinical trials.
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Bobo WV, Vande Voort JL, Croarkin PE, Leung JG, Tye SJ, Frye MA. KETAMINE FOR TREATMENT-RESISTANT UNIPOLAR AND BIPOLAR MAJOR DEPRESSION: CRITICAL REVIEW AND IMPLICATIONS FOR CLINICAL PRACTICE. Depress Anxiety 2016; 33:698-710. [PMID: 27062450 DOI: 10.1002/da.22505] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 12/21/2022] Open
Abstract
There is an urgent need for more rapidly effective pharmacotherapies for major depressive disorder and bipolar disorder (BP) that are efficacious and tolerable for depressed patients who respond poorly to conventional treatments. Multiple controlled trials have now demonstrated a rapid, nonsustained antidepressive response to a single intravenous infusion of ketamine. Early controlled studies of intranasal or serial infusion therapy appear promising. The effective dose for depression is lower than the typical anesthetic doses, and side-effects are generally mild and transient. The data investigating the adjunctive use of concurrent ketamine in the course of electroconvulsive therapy (ECT) for depression do not suggest efficacy or tolerability. The therapeutic potential of ketamine has stimulated considerable excitement among clinicians, patients, and industry, and has led to the increasing use of ketamine as an off-label substitute for ECT and other antidepressive treatments. This clinical review of ketamine will assess the evidence-based use of ketamine and initial clinical implications of further development of a potentially novel treatment for rapid reduction of symptoms in depressed patients.
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Affiliation(s)
- William V Bobo
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota
| | | | - Paul E Croarkin
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota
| | - Jonathan G Leung
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota
| | - Susannah J Tye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota
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Veerabhadrappa R, Lim CP, Nguyen TT, Berk M, Tye SJ, Monaghan P, Nahavandi S, Bhatti A. Unified selective sorting approach to analyse multi-electrode extracellular data. Sci Rep 2016; 6:28533. [PMID: 27339770 PMCID: PMC4919792 DOI: 10.1038/srep28533] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 06/03/2016] [Indexed: 11/10/2022] Open
Abstract
Extracellular data analysis has become a quintessential method for understanding the neurophysiological responses to stimuli. This demands stringent techniques owing to the complicated nature of the recording environment. In this paper, we highlight the challenges in extracellular multi-electrode recording and data analysis as well as the limitations pertaining to some of the currently employed methodologies. To address some of the challenges, we present a unified algorithm in the form of selective sorting. Selective sorting is modelled around hypothesized generative model, which addresses the natural phenomena of spikes triggered by an intricate neuronal population. The algorithm incorporates Cepstrum of Bispectrum, ad hoc clustering algorithms, wavelet transforms, least square and correlation concepts which strategically tailors a sequence to characterize and form distinctive clusters. Additionally, we demonstrate the influence of noise modelled wavelets to sort overlapping spikes. The algorithm is evaluated using both raw and synthesized data sets with different levels of complexity and the performances are tabulated for comparison using widely accepted qualitative and quantitative indicators.
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Affiliation(s)
- R Veerabhadrappa
- Institute for Intelligent Systems Research and Innovation, Deakin University, Vic 3216, Australia
| | - C P Lim
- Institute for Intelligent Systems Research and Innovation, Deakin University, Vic 3216, Australia
| | - T T Nguyen
- Institute for Intelligent Systems Research and Innovation, Deakin University, Vic 3216, Australia
| | - M Berk
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Vic 3216, Australia
| | - S J Tye
- Department of Psychiatry &Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - P Monaghan
- Australian Animal Health Laboratory, CSIRO, Vic 3219, Australia
| | - S Nahavandi
- Institute for Intelligent Systems Research and Innovation, Deakin University, Vic 3216, Australia
| | - A Bhatti
- Institute for Intelligent Systems Research and Innovation, Deakin University, Vic 3216, Australia
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Kim Y, McGee S, Czeczor JK, Walker AJ, Kale RP, Kouzani AZ, Walder K, Berk M, Tye SJ. Nucleus accumbens deep-brain stimulation efficacy in ACTH-pretreated rats: alterations in mitochondrial function relate to antidepressant-like effects. Transl Psychiatry 2016; 6:e842. [PMID: 27327257 PMCID: PMC4931612 DOI: 10.1038/tp.2016.84] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 02/02/2016] [Accepted: 02/25/2016] [Indexed: 02/08/2023] Open
Abstract
Mitochondrial dysfunction has a critical role in the pathophysiology of mood disorders and treatment response. To investigate this, we established an animal model exhibiting a state of antidepressant treatment resistance in male Wistar rats using 21 days of adrenocorticotropic hormone (ACTH) administration (100 μg per day). First, the effect of ACTH treatment on the efficacy of imipramine (10 mg kg(-1)) was investigated alongside its effect on the prefrontal cortex (PFC) mitochondrial function. Second, we examined the mood-regulatory actions of chronic (7 day) high-frequency nucleus accumbens (NAc) deep-brain stimulation (DBS; 130 Hz, 100 μA, 90 μS) and concomitant PFC mitochondrial function. Antidepressant-like responses were assessed in the open field test (OFT) and forced swim test (FST) for both conditions. ACTH pretreatment prevented imipramine-mediated improvement in mobility during the FST (P<0.05). NAc DBS effectively improved FST mobility in ACTH-treated animals (P<0.05). No improvement in mobility was observed for sham control animals (P>0.05). Analyses of PFC mitochondrial function revealed that ACTH-treated animals had decreased capacity for adenosine triphosphate production compared with controls. In contrast, ACTH animals following NAc DBS demonstrated greater mitochondrial function relative to controls. Interestingly, a proportion (30%) of the ACTH-treated animals exhibited heightened locomotor activity in the OFT and exaggerated escape behaviors during the FST, together with general hyperactivity in their home-cage settings. More importantly, the induction of this mania-like phenotype was accompanied by overcompensative increased mitochondrial respiration. Manifestation of a DBS-induced mania-like phenotype in imipramine-resistant animals highlights the potential use of this model in elucidating mechanisms of mood dysregulation.
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Affiliation(s)
- Y Kim
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, Australia,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - S McGee
- Centre for Molecular and Medical Research, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC, Australia,Metabolism and Inflammation Program, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - J K Czeczor
- Centre for Molecular and Medical Research, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - A J Walker
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, Australia,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - R P Kale
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA,School of Engineering, Faculty of Science Engineering and Built Environment, Deakin University, Geelong, VIC, Australia
| | - A Z Kouzani
- School of Engineering, Faculty of Science Engineering and Built Environment, Deakin University, Geelong, VIC, Australia
| | - K Walder
- Centre for Molecular and Medical Research, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - M Berk
- Deakin University IMPACT Strategic Research Centre, School of Medicine, Faculty of Health, Geelong, VIC, Australia
| | - S J Tye
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, Australia,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA,Department of Psychiatry, University of Minnesota, Rochester, MN, USA,Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. E-mail:
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Abulseoud OA, Kasasbeh A, Min HK, Fields JA, Tye SJ, Goerss S, Knight EJ, Sampson SM, Klassen BT, Matsumoto JY, Stoppel C, Lee KH, Frye MA. Stimulation-Induced Transient Nonmotor Psychiatric Symptoms following Subthalamic Deep Brain Stimulation in Patients with Parkinson's Disease: Association with Clinical Outcomes and Neuroanatomical Correlates. Stereotact Funct Neurosurg 2016; 94:93-101. [PMID: 27093641 DOI: 10.1159/000445076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 02/29/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND The clinical and neurobiological underpinnings of transient nonmotor (TNM) psychiatric symptoms during the optimization of stimulation parameters in the course of subthalamic nucleus deep brain stimulation (STN-DBS) remain under intense investigation. METHODS Forty-nine patients with refractory Parkinson's disease underwent bilateral STN-DBS implants and were enrolled in a 24-week prospective, naturalistic follow-up study. Patients who exhibited TNM psychiatric manifestations during DBS parameter optimization were evaluated for potential associations with clinical outcome measures. RESULTS Twenty-nine TNM+ episodes were reported by 15 patients. No differences between TNM+ and TNM- groups were found in motor outcome. However, unlike the TNM- group, TNM+ patients did not report improvement in subsyndromal depression or quality of life. TNM+ episodes were more likely to emerge during bilateral monopolar stimulation of the medial STN. CONCLUSIONS The occurrence of TNM psychiatric symptoms during optimization of stimulation parameters was associated with the persistence of subsyndromal depression and with lower quality of life ratings at 6 months. The neurobiological underpinnings of TNM symptoms are investigated yet remain difficult to explain.
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Affiliation(s)
- Osama A Abulseoud
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn., USA
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Kim Y, Morath B, Hu C, Byrne LK, Sutor SL, Frye MA, Tye SJ. Antidepressant actions of lateral habenula deep brain stimulation differentially correlate with CaMKII/GSK3/AMPK signaling locally and in the infralimbic cortex. Behav Brain Res 2016; 306:170-7. [PMID: 26956153 DOI: 10.1016/j.bbr.2016.02.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 02/24/2016] [Accepted: 02/28/2016] [Indexed: 12/28/2022]
Abstract
High frequency deep brain stimulation (DBS) of the lateral habenula (LHb) reduces symptoms of depression in severely treatment-resistant individuals. Despite the observed therapeutic effects, the molecular underpinnings of DBS are poorly understood. This study investigated the efficacy of high frequency LHb DBS (130Hz; 200μA; 90μs) in an animal model of tricyclic antidepressant resistance. Further, we reported DBS mediated changes in Ca(2+)/calmodulin-dependent protein kinase (CaMKIIα/β), glycogen synthase kinase 3 (GSK3α/β) and AMP-activated protein kinase (AMPK) both locally and in the infralimbic cortex (IL). Protein expressions were then correlated to immobility time during the forced swim test (FST). Antidepressant actions were quantified via FST. Treatment groups comprised of animals treated with adrenocorticotropic hormone alone (ACTH; 100μg/day, 14days, n=7), ACTH with active DBS (n=7), sham DBS (n=8), surgery only (n=8) or control (n=8). Active DBS significantly reduced immobility in ACTH-treated animals (p<0.05). For this group, western blot results demonstrated phosphorylation status of LHb CaMKIIα/β and GSK3α/β significantly correlated to immobility time in the FST. Concurrently, we observed phosphorylation status of CaMKIIα/β, GSK3α/β, and AMPK in the IL to be negatively correlated with antidepressant actions of DBS. These findings suggest that activity dependent phosphorylation of CaMKIIα/β, and GSK3α/β in the LHb together with the downregulation of CaMKIIα/β, GSK3α/β, and AMPK in the IL, contribute to the antidepressant actions of DBS.
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Affiliation(s)
- Yesul Kim
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA; School of Psychology, Deakin University, Burwood, Victoria 3125, Australia
| | - Brooke Morath
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Chunling Hu
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Linda K Byrne
- School of Psychology, Deakin University, Burwood, Victoria 3125, Australia
| | - Shari L Sutor
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA; School of Psychology, Deakin University, Burwood, Victoria 3125, Australia; Department of Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA; Department of Psychiatry, University of Minnesota, Minneapolis, MN 55455, USA.
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Kale RP, Kouzani AZ, Berk J, Walder K, Berk M, Tye SJ. Electrical resistance increases at the tissue-electrode interface as an early response to nucleus accumbens deep brain stimulation. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016:1814-1817. [PMID: 28324953 DOI: 10.1109/embc.2016.7591071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The therapeutic actions of deep brain stimulation are not fully understood. The early inflammatory response of electrode implantation is associated with symptom relief without electrical stimulation, but is negated by anti-inflammatory drugs. Early excitotoxic necrosis and subsequent glial scarring modulate the conductivity of the tissue-electrode interface, which can provide some detail into the inflammatory response of individual patients. The feasibility of this was demonstrated by measuring resistance values across a bipolar electrode which was unilaterally implanted into the nucleus accumbens of a rat while receiving continuous deep brain stimulation with a portable back-mounted device using clinical parameters (130Hz, 200μA, 90μs) for 3 days. Daily resistance values rose significantly (p<;0.0001), while hourly resistance analysis demonstrated a plateau after an initial spike in resistance, which was then followed by a steady increase (p<;0.05; p<;0.0001). We discuss that the biphasic nature of the inflammatory response may contribute to these observations and conclude that this method may translate to a safe predictive screening for more effective clinical deep brain stimulation.
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Frye MA, Nassan M, Jenkins GD, Kung S, Veldic M, Palmer BA, Feeder SE, Tye SJ, Choi DS, Biernacka JM. Feasibility of investigating differential proteomic expression in depression: implications for biomarker development in mood disorders. Transl Psychiatry 2015; 5:e689. [PMID: 26645624 PMCID: PMC5068585 DOI: 10.1038/tp.2015.185] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/21/2015] [Accepted: 09/29/2015] [Indexed: 01/09/2023] Open
Abstract
The objective of this study was to determine whether proteomic profiling in serum samples can be utilized in identifying and differentiating mood disorders. A consecutive sample of patients with a confirmed diagnosis of unipolar (UP n=52) or bipolar depression (BP-I n=46, BP-II n=49) and controls (n=141) were recruited. A 7.5-ml blood sample was drawn for proteomic multiplex profiling of 320 proteins utilizing the Myriad RBM Discovery Multi-Analyte Profiling platform. After correcting for multiple testing and adjusting for covariates, growth differentiation factor 15 (GDF-15), hemopexin (HPX), hepsin (HPN), matrix metalloproteinase-7 (MMP-7), retinol-binding protein 4 (RBP-4) and transthyretin (TTR) all showed statistically significant differences among groups. In a series of three post hoc analyses correcting for multiple testing, MMP-7 was significantly different in mood disorder (BP-I+BP-II+UP) vs controls, MMP-7, GDF-15, HPN were significantly different in bipolar cases (BP-I+BP-II) vs controls, and GDF-15, HPX, HPN, RBP-4 and TTR proteins were all significantly different in BP-I vs controls. Good diagnostic accuracy (ROC-AUC⩾0.8) was obtained most notably for GDF-15, RBP-4 and TTR when comparing BP-I vs controls. While based on a small sample not adjusted for medication state, this discovery sample with a conservative method of correction suggests feasibility in using proteomic panels to assist in identifying and distinguishing mood disorders, in particular bipolar I disorder. Replication studies for confirmation, consideration of state vs trait serial assays to delineate proteomic expression of bipolar depression vs previous mania, and utility studies to assess proteomic expression profiling as an advanced decision making tool or companion diagnostic are encouraged.
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Affiliation(s)
- M A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA,Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, 200 First Street South West, Rochester, MN 55905, USA. E-mail:
| | - M Nassan
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - G D Jenkins
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - S Kung
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - M Veldic
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - B A Palmer
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - S E Feeder
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - S J Tye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - D S Choi
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA,Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - J M Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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Hosain MK, Kouzani AZ, Tye SJ, Samad MF, Kale RP, Bennet KE, Manciu FS, Berk M. Radio frequency energy harvesting from a feeding source in a passive deep brain stimulation device for murine preclinical research. Med Eng Phys 2015; 37:1020-6. [PMID: 26318799 DOI: 10.1016/j.medengphy.2015.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 06/15/2015] [Accepted: 07/20/2015] [Indexed: 11/26/2022]
Abstract
This paper presents the development of an energy harvesting circuit for use with a head-mountable deep brain stimulation (DBS) device. It consists of a circular planar inverted-F antenna (PIFA) and a Schottky diode-based Cockcroft-Walton 4-voltage rectifier. The PIFA has the volume of π × 10(2) × 1.5 mm(3), resonance frequency of 915 MHz, and bandwidth of 16 MHz (909-925 MHz) at a return loss of -10 dB. The rectifier offers maximum efficiency of 78% for the input power of -5 dBm at a 5 kΩ load resistance. The developed rectenna operates efficiently at 915 MHz for the input power within -15 dBm to +5 dBm. For operating a DBS device, the DC voltage of 2 V is recorded from the rectenna terminal at a distance of 55 cm away from a 26.77 dBm transmitter in free space. An in-vitro test of the DBS device is presented.
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Affiliation(s)
- Md Kamal Hosain
- School of Engineering, Deakin University, Waurn Ponds, Victoria 3216, Australia.
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Waurn Ponds, Victoria 3216, Australia
| | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA
| | - Mst Fateha Samad
- School of Engineering, Deakin University, Waurn Ponds, Victoria 3216, Australia
| | - Rajas P Kale
- School of Engineering, Deakin University, Waurn Ponds, Victoria 3216, Australia; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Kevin E Bennet
- School of Engineering, Deakin University, Waurn Ponds, Victoria 3216, Australia; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA; Division of Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Felicia S Manciu
- Department of Physics, University of Texas at El Paso, El Paso, TX 79968, USA
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Waurn Ponds, Victoria 3216, Australia; Orygen, National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health, Department of Psychiatry and Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
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Kale RP, Kouzani AZ, Walder K, Berk M, Tye SJ. Evolution of optogenetic microdevices. Neurophotonics 2015; 2:031206. [PMID: 26158015 PMCID: PMC4481025 DOI: 10.1117/1.nph.2.3.031206] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 05/27/2015] [Indexed: 05/30/2023]
Abstract
Implementation of optogenetic techniques is a recent addition to the neuroscientists' preclinical research arsenal, helping to expose the intricate connectivity of the brain and allowing for on-demand direct modulation of specific neural pathways. Developing an optogenetic system requires thorough investigation of the optogenetic technique and of previously fabricated devices, which this review accommodates. Many experiments utilize bench-top systems that are bulky, expensive, and necessitate tethering to the animal. However, these bench-top systems can make use of power-demanding technologies, such as concurrent electrical recording. Newer portable microdevices and implantable systems carried by freely moving animals are being fabricated that take advantage of wireless energy harvesting to power a system and allow for natural movements that are vital for behavioral testing and analysis. An investigation of the evolution of tethered, portable, and implantable optogenetic microdevices is presented, and an analysis of benefits and detriments of each system, including optical power output, device dimensions, electrode width, and weight is given. Opsins, light sources, and optical fiber coupling are also discussed to optimize device parameters and maximize efficiency from the light source to the fiber, respectively. These attributes are important considerations when designing and developing improved optogenetic microdevices.
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Affiliation(s)
- Rajas P. Kale
- Deakin University School of Engineering, Faculty of Science, Engineering, and Built Environment, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
- Mayo Clinic Department of Psychiatry and Psychology, 200 First Street SW, Rochester, Minnesota 55905, United States
| | - Abbas Z. Kouzani
- Deakin University School of Engineering, Faculty of Science, Engineering, and Built Environment, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Ken Walder
- Deakin University School of Medicine, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, Faulty of Health, School of Medicine, Barwon Health, Geelong, Victoria, Australia
- Orygen, National Centre of Excellence in Youth Mental Health, Department of Psychiatry, 35 Poplar Road, Parkville, Victoria 3052, Australia
- University of Melbourne, Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville Victoria 3052, Australia
| | - Susannah J. Tye
- Mayo Clinic Department of Psychiatry and Psychology, 200 First Street SW, Rochester, Minnesota 55905, United States
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Hosain MK, Kouzani AZ, Tye SJ, Abulseoud OA, Berk M. Design and analysis of an antenna for wireless energy harvesting in a head-mountable DBS device. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2013:3078-81. [PMID: 24110378 DOI: 10.1109/embc.2013.6610191] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper presents design and simulation of a circular meander dipole antenna at the industrial, scientific, and medical band of 915 MHz for energy scavenging in a passive head-mountable deep brain stimulation device. The interaction of the proposed antenna with a rat body is modeled and discussed. In the antenna, the radiating layer is meandered, and a FR-4 substrate is used to limit the radius and height of the antenna to 14 mm and 1.60 mm, respectively. The resonance frequency of the designed antenna is 915 MHz and the bandwidth of 15 MHz at a return loss of -10 dB in free space. To model the interaction of the antenna with a rat body, two aspects including functional and biological are considered. The functional aspect includes input impedance, resonance frequency, gain pattern, radiation efficiency of the antenna, and the biological aspect involves electric field distribution, and SAR value. A complete rat model is used in the finite difference time domain based EM simulation software XFdtd. The simulated results demonstrate that the specific absorption rate distributions occur within the skull in the rat model, and their values are higher than the standard regulated values for the antenna receiving power of 1W.
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Davis J, Maes M, Andreazza A, McGrath JJ, Tye SJ, Berk M. Towards a classification of biomarkers of neuropsychiatric disease: from encompass to compass. Mol Psychiatry 2015; 20:152-3. [PMID: 25349167 DOI: 10.1038/mp.2014.139] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 09/12/2014] [Accepted: 09/17/2014] [Indexed: 01/03/2023]
Abstract
There is currently considerable imprecision in the nosology of biomarkers used in the study of neuropsychiatric disease. The neuropsychiatric field lags behind others such as oncology, wherein, rather than using 'biomarker' as a blanket term for a diverse range of clinical phenomena, biomarkers have been actively classified into separate categories, including prognostic and predictive tests. A similar taxonomy is proposed for neuropsychiatric diseases in which the core biology remains relatively unknown. This paper divides potential biomarkers into those of (1) risk, (2) diagnosis/trait, (3) state or acuity, (4) stage, (5) treatment response and (6) prognosis, and provides illustrative exemplars. Of course, biomarkers rely on available technology and, as we learn more about the neurobiological correlates of neuropsychiatric disorders, we will realize that the classification of biomarkers across these six categories can change, and some markers may fit into more than one category.
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Affiliation(s)
- J Davis
- IMPACT Strategic Research Centre, Deakin University School of Medicine, Barwon Health, Geelong, VIC, Australia
| | - M Maes
- IMPACT Strategic Research Centre, Deakin University School of Medicine, Barwon Health, Geelong, VIC, Australia
| | - A Andreazza
- Department of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - J J McGrath
- 1] Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia [2] Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - S J Tye
- 1] Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA [2] School of Psychology, Deakin University, Burwood, VIC, Australia
| | - M Berk
- 1] IMPACT Strategic Research Centre, Deakin University School of Medicine, Barwon Health, Geelong, VIC, Australia [2] Centre of Youth Mental Health, University of Melbourne, Parkville, VIC, Australia [3] Orygen Youth Health Research Centre, Parkville, VIC, Australia [4] Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia [5] Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
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Frye MA, Prieto ML, Bobo WV, Kung S, Veldic M, Alarcon RD, Moore KM, Choi DS, Biernacka JM, Tye SJ. Current landscape, unmet needs, and future directions for treatment of bipolar depression. J Affect Disord 2014; 169 Suppl 1:S17-23. [PMID: 25533910 DOI: 10.1016/s0165-0327(14)70005-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/08/2014] [Accepted: 09/03/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Depression is the predominant pole of illness disability in bipolar disorder and, compared with acute mania, has less systematic research guiding treatment development. The aim of this review is to present the therapeutic options currently available for managing bipolar depression and to highlight areas of unmet need and future research. METHODS Literature search of PubMed, PsycINFO, and Cochrane databases and bibliographies from 2000 to August 2013 for treatments that have regulatory approval for bipolar depression or early controlled preliminary data on efficacy. RESULTS Treatment options for bipolar depression have increased over the last decade, most notably with regulatory approval for olanzapine/fluoxetine combination, quetiapine, and lurasidone. Conventional mood stabilizers lamotrigine and divalproex have meta-analyses suggesting acute antidepressant response. Manual-based psychotherapies also appear to be effective in treating bipolar depression. The therapeutic utility of unimodal antidepressants, as a class, for the treatment of patients with bipolar depression, as a group, remains to be confirmed. There is a substantially unmet need to develop new interventions that are efficacious, effective, and have low side effect burden. LIMITATIONS Additional compounds are currently being developed that may ultimately be applicable to the treatment of bipolar depression and early open-trial data encourage further studies, but both of these topics are beyond the scope of this review. CONCLUSION Future registrational trials will need to establish initial efficacy, but increasing interest for personalized or individualized medicine will encourage further studies on individual predictors or biomarkers of response.
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Affiliation(s)
- Mark A Frye
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA.
| | - Miguel L Prieto
- Universidad de los Andes, Facultad de Medicina, Departamento de Psiquiatría, Santiago, Chile
| | - William V Bobo
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Simon Kung
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Marin Veldic
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Renato D Alarcon
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA; Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Katherine M Moore
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Doo-Sup Choi
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA; Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Joanna M Biernacka
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Susannah J Tye
- Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
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Hosain MDK, Kouzani AZ, Tye SJ, Abulseoud OA, Amiet A, Galehdar A, Kaynak A, Berk M. Development of a Compact Rectenna for Wireless Powering of a Head-Mountable Deep Brain Stimulation Device. IEEE J Transl Eng Health Med 2014; 2:1500113. [PMID: 27170863 PMCID: PMC4861548 DOI: 10.1109/jtehm.2014.2313856] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 12/18/2013] [Accepted: 03/05/2014] [Indexed: 11/29/2022]
Abstract
Design of a rectangular spiral planar inverted-F antenna (PIFA) at 915 MHz for wireless power transmission applications is proposed. The antenna and rectifying circuitry form a rectenna, which can produce dc power from a distant radio frequency energy transmitter. The generated dc power is used to operate a low-power deep brain stimulation pulse generator. The proposed antenna has the dimensions of 10 mm \documentclass[12pt]{minimal}
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\end{document} with thickness of 1.5 mm is used for both antenna and rectifier circuit simulation and fabrication because of its availability and low cost. An L-section impedance matching circuit is used between the PIFA and voltage doubler rectifier. The impedance matching circuit also works as a low-pass filter for elimination of higher order harmonics. Maximum dc voltage at the rectenna output is 7.5 V in free space and this rectenna can drive a deep brain stimulation pulse generator at a distance of 30 cm from a radio frequency energy transmitter, which transmits power of 26.77 dBm.
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Walker AJ, Kim Y, Price JB, Kale RP, McGillivray JA, Berk M, Tye SJ. Stress, Inflammation, and Cellular Vulnerability during Early Stages of Affective Disorders: Biomarker Strategies and Opportunities for Prevention and Intervention. Front Psychiatry 2014; 5:34. [PMID: 24782789 PMCID: PMC3988376 DOI: 10.3389/fpsyt.2014.00034] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 03/17/2014] [Indexed: 12/27/2022] Open
Abstract
The mood disorder prodrome is conceptualized as a symptomatic, but not yet clinically diagnosable stage of an affective disorder. Although a growing area, more focused research is needed in the pediatric population to better characterize psychopathological symptoms and biological markers that can reliably identify this very early stage in the evolution of mood disorder pathology. Such information will facilitate early prevention and intervention, which has the potential to affect a person's disease course. This review focuses on the prodromal characteristics, risk factors, and neurobiological mechanisms of mood disorders. In particular, we consider the influence of early-life stress, inflammation, and allostatic load in mediating neural mechanisms of neuroprogression. These inherently modifiable factors have known neuroadaptive and neurodegenerative implications, and consequently may provide useful biomarker targets. Identification of these factors early in the course of the disease will accordingly allow for the introduction of early interventions which augment an individual's capacity for psychological resilience through maintenance of synaptic integrity and cellular resilience. A targeted and complementary approach to boosting both psychological and physiological resilience simultaneously during the prodromal stage of mood disorder pathology has the greatest promise for optimizing the neurodevelopmental potential of those individuals at risk of disabling mood disorders.
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Affiliation(s)
- Adam J Walker
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia
| | - Yesul Kim
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia
| | - J Blair Price
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA
| | - Rajas P Kale
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Engineering, Deakin University , Geelong, VIC , Australia
| | | | - Michael Berk
- School of Medicine, Deakin University , Geelong, VIC , Australia ; Department of Psychiatry, University of Melbourne , Melbourne, VIC , Australia ; Orygen Youth Health Research Centre , Melbourne, VIC , Australia ; The Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia
| | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia ; Department of Psychiatry, University of Minnesota , Minneapolis, MN , USA
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