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Frequent vocalizations and deep brain stimulation-responsive hyperkinesia in a striatal disinhibition rat model for Tourette syndrome. 图雷特综合征纹状体去抑制大鼠模型中的频繁发声和dbs反应性运动亢进。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-23 DOI: 10.1093/ijnp/pyaf039
Boriss Sagalajev, Lina Lennartz, Niloofar Mokhtari, Mikolaj Szpak, Meryem Sinem Uyar, Thomas Schüller, Juan Carlos Baldermann, Pablo Andrade, Veerle Visser-Vandewalle, Thibaut Sesia

Background: The lack of a rodent model for both motor and phonic tics hinders research on deep brain stimulation (DBS) for refractory Tourette syndrome (TS). Striatal disinhibition with a gamma-aminobutyric acid A antagonist (bicuculline) was previously shown to induce hyperkinesia and vocalizations in monkeys, indicating its potential as a TS model. In rats, however, only hyperkinesia was validated, prompting us to investigate whether they can also develop abnormal vocalizations and whether both conditions respond to thalamic DBS.

Methods: Rats underwent surgical implantation of a unilateral guide cannula targeting the caudate putamen (CPu) or nucleus accumbens (NAc). Additionally, they were implanted with an ipsilateral stimulation electrode targeting the border between the central medial (CM) and ventrolateral (VL) thalamic nuclei. Motor changes and ultrasound vocalizations were recorded and characterized offline.

Results: CPu bicuculline elicited arrhythmic shoulder jerks that tend to appear in fading bursts and sporadically alternate with sustained generalized hyperextension. Nucleus accumbens bicuculline elicited similar hyperkinesia, but at a much lower dose to prevent convulsions. DBS of CM/VL, but not adjacent regions, attenuated hyperkinesia with lower intensity showing stronger effects. In addition, bicuculline in NAc, but not CPu, elicited nonsensical vocalizations. However, the effect of CM/VL DBS on vocalizations remained inconclusive.

Conclusions: Hyperkinesia temporal features, co-development with vocalizations, and responsiveness to CM/VL DBS suggest striatal disinhibition may serve as a TS rat model. However, other movement disorders with vocal complications cannot be excluded, given the challenge of validating key tic indicators in animals, such as premonitory urge and suppressibility.

背景:缺乏运动和语音抽搐的啮齿动物模型阻碍了深部脑刺激(DBS)治疗难治性抽动秽语综合征(TS)的研究。GABA-A拮抗剂(双管碱)的纹状体去抑制作用先前被证明可以诱导猴子运动亢进和发声,这表明它有可能成为TS模型。然而,在大鼠中,只有运动亢进得到了验证,这促使我们研究它们是否也会产生异常的发声,以及这两种情况是否对丘脑DBS有反应。方法:在大鼠尾状壳核(CPu)或伏隔核(NAc)内置入单侧引导套管。此外,他们还被植入了一个针对丘脑中央内侧核(CM)和腹外侧核(VL)之间边界的同侧刺激电极。离线记录和表征运动变化和超声发声。结果:CPu双核线引起的不规则肩部抽搐往往出现在消退的爆发和零星交替与持续的全身性过伸。NAc二胡碱引起了类似的运动亢进,但剂量要低得多,以防止抽搐。CM/VL的DBS,而不是相邻区域,减弱运动亢进,强度越低,效果越强。此外,NAc的双丘线会引起无意义的发声,而CPu则不会。然而,CM/VL DBS对发声的影响尚不明确。结论:运动亢进的时间特征、与发声的共同发育以及对CM/VL DBS的反应表明纹状体去抑制可能是TS大鼠的模型。然而,考虑到在动物中验证关键的抽搐指标(如先兆冲动和抑制性)的挑战,不能排除其他伴有声带并发症的运动障碍。
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引用次数: 0
Correction to: From theory to therapy: unlocking the potential of muscarinic receptor activation in schizophrenia with the dual M1/M4 muscarinic receptor agonist xanomeline and trospium chloride and insights from clinical trials. 更正:从理论到治疗:利用双重M1/M4毒蕈碱受体激动剂xanomeline和trospium氯释放精神分裂症毒蕈碱受体激活的潜力和临床试验的见解。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-23 DOI: 10.1093/ijnp/pyaf051
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引用次数: 0
Involvement of a stress-responsive orbito-striatal projection in impulsive action in male rats. 应激反应性眶纹状体投射在雄性大鼠冲动行为中的作用。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-23 DOI: 10.1093/ijnp/pyaf043
Milena Girotti, Maisie G Boehmer-Cortez, Kathleen Tuite, David A Morilak

Background: Motor impulsivity is a symptom shared by several psychiatric disorders. Stress exacerbates impulsivity, but the neurocircuits involved are unknown. We have shown that the orbitofrontal cortex (OFC) is activated during a rodent motor impulsivity task and that chronic unpredictable stress (CUS) increases premature responding. In this study, we examine the role of the OFC projection to dorsal medial striatum (DMS) in motor control, and test whether this pathway mediates the effects of stress on impulsive action.

Methods: Motor impulsivity was measured with the 1-choice serial reaction time test (1-CSRTT). To determine if OFC-DMS projections are involved in controlling impulsivity, we used pathway-specific Designer Receptors Exclusively Activated by Designer Drugs (DREADD)-mediated chemogenetic manipulation during 1-CSRTT. We examined stress effects on OFC-DMS neuronal activation using Fos immunohistochemistry. To assess if stress increases impulsivity through OFC-DMS projections, we chemogenetically manipulated the pathway in stressed rats during behavior.

Results: We found OFC-DMS projections inhibit premature responding in a well-mastered task. Stress attenuated OFC neuronal activation, including the OFC-DMS projection neurons, during behavior. However, selectively activating the projection in stressed rats was not sufficient to abolish the stress effects. Finally, the response to stress depended on baseline trait impulsivity. Rats with low trait impulsivity were more vulnerable to stress and showed attenuated activation of OFC-DMS neurons but increased activation of other OFC cell populations.

Conclusions: These results suggest the OFC-DMS pathway modulates impulsivity in concert with other OFC neuronal populations. Furthermore, stress effects are baseline-dependent and affect only low-impulsivity rats, possibly by altering the balance of activation in functionally opposing neuronal populations.

背景:运动冲动是多种精神疾病共有的症状。压力会加剧冲动,但涉及的神经回路尚不清楚。我们已经证明,在啮齿动物的运动冲动性任务中,眶额皮质(OFC)被激活,慢性不可预测的压力(CUS)增加了过早反应。在这项研究中,我们研究了OFC投射到背内侧纹状体(DMS)在运动控制中的作用,并测试了这一途径是否介导了应激对冲动行为的影响。方法:采用单选题连续反应时间测验(1-CSRTT)测量运动冲动性。为了确定OFC-DMS投射是否参与控制冲动性,我们在1-CSRTT期间使用了特定途径的化学发生操作。我们使用Fos免疫组织化学检测应激对OFC-DMS神经元激活的影响。为了评估压力是否会通过OFC-DMS投射增加冲动,我们在行为过程中对应激大鼠的通路进行了化学调控。结果:我们发现OFC-DMS投影抑制了熟练掌握任务中的过早反应。在行为过程中,应激会减弱OFC神经元的激活,包括OFC- dms投射神经元。然而,选择性地激活应激大鼠的投射并不足以消除应激效应。最后,对压力的反应取决于基线特质冲动性。低特质冲动性的大鼠更易受到应激的影响,OFC- dms神经元的激活减弱,而其他OFC细胞群的激活增加。结论:这些结果表明OFC- dms通路与其他OFC神经元群一起调节冲动性。此外,应激效应是基线依赖性的,只影响低冲动性的大鼠,可能是通过改变功能相反的神经元群的激活平衡。
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引用次数: 0
Predicting antidepressant responsiveness in major depressive disorder patients via electroencephalography gamma-band dynamic functional connectivity in response to salient auditory stimuli. 通过显著听觉刺激下脑电伽马带动态功能连通性预测重度抑郁症患者抗抑郁反应性。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-23 DOI: 10.1093/ijnp/pyaf042
Kang-Min Choi, Taegyeong Lee, Seung-Hwan Lee, Chang-Hwan Im

Background: Heterogeneous pathophysiological characteristics in patients with major depressive disorder (MDD) lead to individually differentiated sensitivities to antidepressants. Based on the hypothesis that gamma-band dynamic fluctuations in cortical functional connectivity (FC) in response to salient stimuli are linked to pathophysiological characteristics, we conducted a classification analysis for antidepressant responsiveness prediction.

Methods: Biosignals and psychological measures were acquired from 47 patients with MDD prior to treatment. After 8 weeks of antidepressant therapy, patients were divided into non-remitted MDD (nrMDD; aged 42.55 ± 11.52 years; n = 20) and remitted MDD (rMDD; aged 47.22 ± 11.59 years; n = 27) groups based on their depressive symptom reduction. Electroencephalography (EEG) signals were acquired during the duration-variant auditory mismatch negativity paradigm. From the deviant condition, gamma-band weighted phase-lag index-based dynamic fluctuations were evaluated using a template generated from 21 demography-matched healthy control (aged 43.81 ± 14.10 years) data.

Results: Using these dynamic functional connectivity (dFC) features, a machine learning-based classification analysis was performed for nrMDD and rMDD. Using leave-one-out cross-validation, the linear discriminant analysis classifier achieved the best accuracy (82.98%) for classifying nrMDD and rMDD. Further simple effect analyses identified three core dFC features for nrMDD: (i) relatively intact time-dependent FC between the left frontal and right temporal regions; (ii) disrupted right frontoparietal FC; and (iii) disrupted left fronto-temporal FC. These dFC features commonly exhibit transient hyperconnections in patients with nrMDD.

Conclusions: We demonstrated that gamma-band dFC responses to salient stimuli could serve as potential biomarkers for antidepressant responsiveness prediction in patients with MDD.

背景:重度抑郁障碍(MDD)患者的不同病理生理特征导致其对抗抑郁药的敏感性存在个体差异。基于皮层功能连接(FC)对显著刺激反应的伽马带动态波动与病理生理特征相关的假设,我们对抗抑郁反应性预测进行了分类分析。方法:对47例重度抑郁症患者进行治疗前的生物信号和心理测量。在沃替西汀治疗8周后,患者被分为未缓解型MDD (nrMDD;年龄42.55±11.52岁;n = 20)和汇款MDD (rMDD;年龄47.22±11.59岁;N = 27)组。在持续时间变化的听觉失配负性(MMN)模式下获得脑电图(EEG)信号。从异常情况出发,利用21例人口统计学匹配的健康对照(HC,年龄43.81±14.10岁)数据生成的模板评估基于伽玛波段加权相位滞后指数的动态波动。结果:利用这些动态FC (dFC)特征,对nrMDD和rMDD进行了基于机器学习的分类分析。通过留一交叉验证,线性判别分析分类器对nrMDD和rMDD的分类准确率最高(82.98%)。进一步的简单效应分析确定了nrMDD的三个核心dFC特征:(i)左额叶和右颞叶区域之间相对完整的时间依赖性FC;(ii)右侧额顶叶FC破坏;(iii)左侧额颞叶FC受损。这些dFC特征通常在nrMDD患者中表现为短暂的超连接。结论:我们证明了对显著刺激的伽马波段动态FC反应可以作为MDD患者抗抑郁反应性预测的潜在生物标志物。
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引用次数: 0
Correction to: Inflammation and Blood-Brain Barrier in Depression: Interaction of CLDN5 and IL6 Gene Variants in Stress-Induced Depression. 抑郁症中的炎症和血脑屏障:应激性抑郁症中CLDN5和IL6基因变异的相互作用。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-23 DOI: 10.1093/ijnp/pyaf054
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引用次数: 0
Exploring the influence of synaptic density and anxiety on pain perception: evidence from a [11C]UCB-J positron emission tomography imaging study. 探讨突触密度和焦虑对疼痛感知的影响:来自UCB-J PET成像研究的证据[11]。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-23 DOI: 10.1093/ijnp/pyaf040
Karina Moisieienko, Ruth H Asch, Margaret T Davis, Robert H Pietrzak, Irina Esterlis

Background: Structural and functional brain alterations may be associated with pain and anxiety. We hypothesized that synaptic density (measured in vivo with [11C]UCB-J and positron emission tomography quantification of synaptic vesicle glycoprotein 2A, SV2A) alterations may play a role in higher pain sensitivity and that this relationship may be mediated by anxiety symptoms.

Methods: Twenty-one mentally and medically healthy subjects (11 males, 10 females; age 45.1 ± 16.9 years) participated in imaging, acute pain (cold pressor test) and anxiety (State-Trait Anxiety Inventory) assessments. Synaptic vesicle glycoprotein 2A density was quantified as regional volumes of distribution (VT) using a 1-tissue compartment model with a plasma input function. Synaptic vesicle glycoprotein 2A density was assessed in 5 regions of interest that were previously shown to be associated with pain: dorsolateral prefrontal cortex (dlPFC), amygdala, anterior cingulate cortex (ACC), fusiform gyrus, and cerebellum.

Results: State anxiety was positively correlated with pain sensitivity (r = 0.60, P = .004). Significant negative correlations were observed between pain sensitivity and SV2A density in the cerebellum (r = -0.67, P = .001), fusiform gyrus (r = -0.66, P = .001), dlPFC (r = -0.63, P = .002), and ACC (r = -0.58, P = .006). Mediation analysis revealed a significant indirect effect of cerebellar synaptic density on pain sensitivity through state anxiety symptoms (B = -0.77, 95% CI [-1.89, -0.04]), accounting for 33% of the total effect. For the fusiform gyrus, the direct effect on pain sensitivity remained significant after controlling for anxiety symptoms (B = -1.67, P = .020), while the indirect effect through anxiety symptoms was not significant (B = -0.43, 95% CI [-1.44, 0.37]).

Conclusions: Results provide the first known in vivo evidence that lower synaptic (SV2A) density is associated with greater pain sensitivity, particularly in the fusiform gyrus and cerebellum. Mediation analyses revealed that state anxiety partially mediated the relationship between cerebellar synaptic density and pain sensitivity, while having an additive-but not mediating-effect on the relationship between fusiform synaptic density and pain sensitivity.

背景:大脑结构和功能的改变可能与疼痛和焦虑有关。我们假设突触密度(体内用[11C]UCB-J和突触囊泡SV2A正电子发射断层成像定量测量)的改变可能在更高的疼痛敏感性中起作用,这种关系可能是由焦虑症状介导的。方法:21名心理健康、身体健康的受试者(男11名,女10名;年龄(45.1±16.9岁)参加影像学、急性疼痛[冷压试验(CPT)]和焦虑(状态-特质焦虑量表)评估。采用带血浆输入函数的单组织室模型将SV2A密度量化为区域分布体积(VT)。SV2A的密度在五个先前被证明与疼痛相关的感兴趣区域(roi)进行评估:背外侧前额叶皮层(DLPFC)、杏仁核、前扣带皮层(ACC)、梭状回和小脑。结果:状态焦虑与疼痛敏感性呈正相关(r = 0.60, p= 0.004)。疼痛敏感性与小脑(r = -0.67, p=.001)、梭状回(r = -0.66, p=.001)、DLPFC (r = -0.63, p=.002)、ACC (r = -0.58, p=.006) SV2A密度呈显著负相关。中介分析显示,小脑突触密度通过状态焦虑症状间接影响疼痛敏感性(B = -0.77, 95% CI[-1.89, -0.04]),占总效应的33%。在控制焦虑症状后,梭状回对疼痛敏感性的直接影响仍然显著(B = -1.67, p= 0.020),而焦虑症状对疼痛敏感性的间接影响不显著(B = -0.43, 95% CI[-1.44, 0.37])。结论:研究结果提供了第一个已知的体内证据,即较低的突触(SV2A)密度与较高的疼痛敏感性有关,特别是在梭状回和小脑中。中介分析表明,状态焦虑在小脑突触密度与疼痛敏感性之间具有部分中介作用,而在梭状回突触密度与疼痛敏感性之间具有加性作用,但不具有中介作用。
{"title":"Exploring the influence of synaptic density and anxiety on pain perception: evidence from a [11C]UCB-J positron emission tomography imaging study.","authors":"Karina Moisieienko, Ruth H Asch, Margaret T Davis, Robert H Pietrzak, Irina Esterlis","doi":"10.1093/ijnp/pyaf040","DOIUrl":"10.1093/ijnp/pyaf040","url":null,"abstract":"<p><strong>Background: </strong>Structural and functional brain alterations may be associated with pain and anxiety. We hypothesized that synaptic density (measured in vivo with [11C]UCB-J and positron emission tomography quantification of synaptic vesicle glycoprotein 2A, SV2A) alterations may play a role in higher pain sensitivity and that this relationship may be mediated by anxiety symptoms.</p><p><strong>Methods: </strong>Twenty-one mentally and medically healthy subjects (11 males, 10 females; age 45.1 ± 16.9 years) participated in imaging, acute pain (cold pressor test) and anxiety (State-Trait Anxiety Inventory) assessments. Synaptic vesicle glycoprotein 2A density was quantified as regional volumes of distribution (VT) using a 1-tissue compartment model with a plasma input function. Synaptic vesicle glycoprotein 2A density was assessed in 5 regions of interest that were previously shown to be associated with pain: dorsolateral prefrontal cortex (dlPFC), amygdala, anterior cingulate cortex (ACC), fusiform gyrus, and cerebellum.</p><p><strong>Results: </strong>State anxiety was positively correlated with pain sensitivity (r = 0.60, P = .004). Significant negative correlations were observed between pain sensitivity and SV2A density in the cerebellum (r = -0.67, P = .001), fusiform gyrus (r = -0.66, P = .001), dlPFC (r = -0.63, P = .002), and ACC (r = -0.58, P = .006). Mediation analysis revealed a significant indirect effect of cerebellar synaptic density on pain sensitivity through state anxiety symptoms (B = -0.77, 95% CI [-1.89, -0.04]), accounting for 33% of the total effect. For the fusiform gyrus, the direct effect on pain sensitivity remained significant after controlling for anxiety symptoms (B = -1.67, P = .020), while the indirect effect through anxiety symptoms was not significant (B = -0.43, 95% CI [-1.44, 0.37]).</p><p><strong>Conclusions: </strong>Results provide the first known in vivo evidence that lower synaptic (SV2A) density is associated with greater pain sensitivity, particularly in the fusiform gyrus and cerebellum. Mediation analyses revealed that state anxiety partially mediated the relationship between cerebellar synaptic density and pain sensitivity, while having an additive-but not mediating-effect on the relationship between fusiform synaptic density and pain sensitivity.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
N6-methyladenosine methylation: a novel key to unlocking mental disorders. m6A甲基化:解开精神障碍的新钥匙。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-23 DOI: 10.1093/ijnp/pyaf044
Yinuo Wang, Xiaobing Li, Min Liu, Xiaoxu Xu, Yue Ma, Yang Luo, Yue Wang

More than 100 types of RNA modifications have been identified in mammalian cells, among which N6-methyladenosine (m6A) is the most prevalent. This reversible and dynamic modification involves methyltransferases, demethylases, and reader proteins. Aberrant expression of m6A-related regulatory proteins in the nervous system significantly impacts neuronal physiology, contributing to mental disorders such as depression, autism spectrum disorder, and schizophrenia. This review summarizes the role of m6A methylation in the pathogenesis of mental disorders and highlights its potential as a biomarker and therapeutic target, providing a comprehensive reference for future research and clinical interventions.

在哺乳动物细胞中已经发现了100多种类型的RNA修饰,其中n6 -甲基腺苷(m6A)修饰最为普遍。这种可逆和动态的修饰涉及甲基转移酶、去甲基化酶和解读蛋白。神经系统中m6a相关调节蛋白的异常表达显著影响神经元生理,导致抑郁症、自闭症谱系障碍和精神分裂症等精神障碍。本文综述了m6A甲基化在精神障碍发病机制中的作用,并强调了其作为生物标志物和治疗靶点的潜力,为今后的研究和临床干预提供综合参考。
{"title":"N6-methyladenosine methylation: a novel key to unlocking mental disorders.","authors":"Yinuo Wang, Xiaobing Li, Min Liu, Xiaoxu Xu, Yue Ma, Yang Luo, Yue Wang","doi":"10.1093/ijnp/pyaf044","DOIUrl":"10.1093/ijnp/pyaf044","url":null,"abstract":"<p><p>More than 100 types of RNA modifications have been identified in mammalian cells, among which N6-methyladenosine (m6A) is the most prevalent. This reversible and dynamic modification involves methyltransferases, demethylases, and reader proteins. Aberrant expression of m6A-related regulatory proteins in the nervous system significantly impacts neuronal physiology, contributing to mental disorders such as depression, autism spectrum disorder, and schizophrenia. This review summarizes the role of m6A methylation in the pathogenesis of mental disorders and highlights its potential as a biomarker and therapeutic target, providing a comprehensive reference for future research and clinical interventions.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of the Muscarinic Receptor Agonist KarXT (Xanomeline-Trospium) in Schizophrenia: A Systematic Review, Meta-Analysis and Bayesian Sensitivity Analysis. 毒蕈碱受体激动剂KarXT (Xanomeline-Trospium)治疗精神分裂症的疗效和安全性:系统评价、meta分析和贝叶斯敏感性分析。
IF 4.5 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-07-07 DOI: 10.1093/ijnp/pyaf045
Nikhil Sharma, Mahalaqua Nazli Khatib, R Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Vinamra Mittal, Muhammed Shabil, Amit Kumar, Ganesh Bushi, Rachana Mehta, Prakasini Satapathy, Sanjit Sah

Background: Schizophrenia significantly impacts global health, with existing treatments primarily focusing on positive symptoms and often causing considerable side effects. KarXT, a novel treatment combining xanomeline, a muscarinic M1/M4 receptor agonist, and trospium, targets a broader range of symptoms including negative and cognitive deficits, potentially with fewer side effects. This systematic review and meta-analysis evaluates the efficacy and safety of KarXT in treating schizophrenia, assessing symptom reduction and safety profiles compared to placebo.

Methods: We searched PubMed, Embase, and Web of Science up to November 10, 2024, for randomized controlled trials (RCTs) assessing the efficacy and safety of KarXT in schizophrenia. Data were pooled using a random-effects model, assessing outcomes like Positive and Negative Syndrome Scale (PANSS) scores and incidence of treatment-emergent adverse events (TEAEs). R software (Version 4.4.) was used for meta-analysis.

Results: Three RCTs involving 674 participants were included. KarXT significantly reduced total PANSS scores of mean difference (MD) -9.707 (95% CI: -12.329 to -7.085), with notable improvements in both negative (MD = -1.623; 95% CI: -2.461 to -0.785) and positive symptom subscales (MD = -3.213; 95% CI: -4.033 to -2.393). The treatment was associated with a higher incidence of TEAEs, predominantly constipation (RR: 2.77; 95% CI: 1.72-4.45) and nausea (RR: 4.87; 95% CI: 2.73-8.68) compared to placebo. Bayesian meta-analysis confirmed the results.

Conclusion: KarXT offers significant improvements in both negative and positive symptoms of schizophrenia with a manageable safety profile. Its potential as a transformative treatment for schizophrenia highlights the need for further research to confirm these findings and to fully understand its long-term efficacy and safety.

背景:精神分裂症对全球健康有重大影响,现有的治疗方法主要侧重于阳性症状,往往造成相当大的副作用。KarXT是一种结合xanomeline(一种毒蕈碱M1/M4受体激动剂)和trospium的新型治疗方法,针对更广泛的症状,包括阴性和认知缺陷,副作用可能更少。本系统综述和荟萃分析评估了KarXT治疗精神分裂症的有效性和安全性,评估了与安慰剂相比症状减轻和安全性。方法:我们检索PubMed、Embase和Web of Science,检索截止到2024年11月10日的随机对照试验(rct),评估KarXT治疗精神分裂症的有效性和安全性。使用随机效应模型汇总数据,评估阳性和阴性综合征量表(PANSS)评分和治疗中出现的不良事件(teae)发生率等结果。采用R软件(Version 4.4.)进行meta分析。结果:纳入3项随机对照试验,共674名受试者。KarXT显著降低了总PANSS评分的平均差值(MD) -9.707 (95% CI: -12.329至-7.085),两组均有显著改善(MD = -1.623;95% CI: -2.461 ~ -0.785)和阳性症状亚量表(MD = -3.213;95% CI: -4.033至-2.393)。治疗与较高的teae发生率相关,主要是便秘(RR: 2.77;95% CI: 1.72-4.45)和恶心(RR: 4.87;95% CI: 2.73-8.68)。贝叶斯荟萃分析证实了结果。结论:KarXT对精神分裂症阴性和阳性症状均有显著改善,且安全性可控。它作为精神分裂症变革性治疗的潜力突出表明,需要进一步的研究来证实这些发现,并充分了解其长期疗效和安全性。
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引用次数: 0
NMDA receptor involvement in dopaminergic modulation of neuroplasticity induced by paired associative stimulation. NMDA受体参与配对联想刺激诱导的多巴胺能调节神经可塑性。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf038
Marie C Beaupain, Elham Ghanavati, Amba M Frese, Lorena Melo, Min-Fang Kuo, Michael A Nitsche

Background: Dopamine (DA) modulates long-term potentiation (LTP)-like neuroplasticity. While particularly D1 and D2 receptors are thought to influence neuroplasticity through glutamatergic N-methyl-D-aspartate (NMDA) receptor and gamma-aminobutyric acid (GABA) modulation, the exact mechanisms are not completely clarified.

Objective: We aimed to explore the relevance of NMDA receptor activity for DAergic modulation of focal LTP-like plasticity induced by excitatory paired associative stimulation (ePAS).

Methods: In a double-blinded, randomized, and placebo-controlled design, 17 healthy participants received DAergic agents (100 mg L-Dopa for general DAergic enhancement, 10 mg bromocriptine for selective D2 receptor activation, or placebo) with different doses of the partial NMDA receptor agonist D-cycloserine (CYC; 50, 100, 200 mg, or placebo) and underwent ePAS. Cortical excitability was monitored via motor-evoked potentials induced by TMS over the left motor cortex for up to 2 hours post-stimulation.

Results: We did not find significant interactions between DAergic agents, CYC, and time across the entire sample, but significant group differences depending on sensitivity to ePAS. In high-sensitivity, but not low-sensitivity participants, ePAS induced LTP-like effects. CYC produced nonlinear, dose-dependent effects on plasticity in both groups. In the high-sensitivity group, LTP-like effects persisted under both DAergic agents, but were significantly reduced under bromocriptine. CYC had a nonlinear effect when combined with bromocriptine. In the low-sensitivity group, ePAS under DAergic agents did not induce LTP-like effects, and only additional intervention with medium-dose CYC restored facilitatory effects under L-Dopa.

Conclusions: These findings suggest that optimal NMDA receptor activation is necessary for ePAS-induced neuroplasticity and that D2 receptor activity may reduce LTP-like effects by downregulating NMDA receptor function.

背景:多巴胺(DA)调节长时程增强(LTP)样神经可塑性。虽然D1和D2受体被认为通过谷氨酸能NMDA受体和GABA调节影响神经可塑性,但确切的机制尚不完全清楚。目的:探讨NMDA受体活性与兴奋性配对联想刺激(ePAS)诱导的局灶ltp样可塑性的能量调节的相关性。方法:在双盲、随机和安慰剂对照设计中,17名健康参与者接受了不同剂量的部分NMDA受体激动剂d -环丝氨酸(CYC)和不同剂量的达能药物(100 mg左旋多巴用于一般达能增强,10 mg溴隐肽用于选择性D2受体激活,或安慰剂);50、100、200毫克或安慰剂),并接受ePAS治疗。刺激后2小时,通过经颅磁刺激在左侧运动皮层诱导的运动诱发电位监测皮质兴奋性。结果:在整个样本中,我们没有发现抗癌药、CYC和时间之间的显著相互作用,但根据对ePAS的敏感性,组间存在显著差异。在高灵敏度而非低灵敏度的受试者中,ePAS诱导ltp样效应。CYC对两组小鼠的可塑性均产生非线性、剂量依赖性的影响。在高敏感组,ltp样效应在两种能药下持续存在,但在溴隐亭下明显减弱。CYC与溴隐亭联用时呈非线性效应。在低敏感组中,ePAS在达能药物作用下未诱导ltp样效应,只有中剂量CYC的额外干预才能恢复左旋多巴作用下的促进效应。结论:epas诱导的神经可塑性需要最佳的NMDA受体激活,而D2受体活性可能通过下调NMDA受体功能来降低ltp样效应。
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引用次数: 0
Role of endogenous serotonin in psychedelic-like effects of psilocybin in mice. 内源性血清素在小鼠裸盖菇素致幻作用中的作用。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf035
Ines Erkizia-Santamaría, Nerea Martínez-Álvarez, Leyre Salinas-Novoa, Jose Javier Meana, Jorge Emilio Ortega

Background: The psychedelic psilocybin has been posited as efficacious for the treatment of depression. However, the potential link between the intensity of acute psychedelic effects and long-term therapeutic outcomes remains undiscovered. Moreover, the impact of classical antidepressant drugs that modulate serotonergic activity on psilocybin's effects is a clinically relevant concern. The aim of the present study was to assess serotonergic mechanisms implicated in the regulation of the intensity of the psilocybin-induced acute effects.

Methods: The head-twitch response (HTR), the most translational behavioral assay to characterize the psychedelic-like effect in rodents was performed. Moreover, the role of endogenous serotonin (5-HT) on psilocybin-induced HTR was studied by in vivo brain microdialysis technique.

Results: Maximally effective psilocybin dose (1 mg/kg) induced progressively lower HTR in heterozygous and homozygous knockout mice for serotonin 2A receptor (5HT2AR), compared to wild type. Synaptic increase of 5-HT by citalopram dose-dependently attenuated psilocybin-induced HTR after both acute and chronic dosing regimens. Conversely, depletion of 5-HT by p-chlorophenylalanine potentiated psilocybin-evoked HTR. Serotonin 1A receptor (5HT1AR) agonist 8-OH-DPAT dose-dependently decreased psilocybin-induced HTR, demonstrating functional interaction between 5HT2AR and 5HT1AR for psychedelic effects.

Conclusions: The present findings reveal an inverse correlation between cortical 5-HT levels and the acute psychedelic-like effects of psilocybin. Consequently, the enhancement of serotonergic activity induced by prior antidepressant treatment may underlie interindividual variability in the acute response to psychedelics. Investigating these mechanisms in relation to the sustained therapeutic outcomes of psilocybin could contribute to optimizing the efficacy of psychedelic-based therapies.

背景:迷幻药裸盖菇素被认为是治疗抑郁症的有效药物。然而,急性致幻剂效应强度与长期治疗结果之间的潜在联系仍未被发现。此外,经典抗抑郁药物调节5 -羟色胺能活性对裸盖菇素作用的影响是一个临床相关的问题。本研究的目的是评估涉及调节裸盖菇素诱导的急性效应强度的血清素能机制。方法:采用头抽搐反应(HTR)这一最具翻译性的行为测定方法来表征啮齿动物的致幻剂样效应。此外,通过体内脑微透析技术研究内源性5-羟色胺(5-HT)在裸盖菇素诱导的HTR中的作用。结果:与野生型相比,最大有效裸盖菇素剂量(1 mg/kg)可使杂合和纯合敲除小鼠血清素2A受体(5HT2AR)的HTR逐渐降低。在急性和慢性给药方案后,西酞普兰剂量依赖性减毒裸盖菇素诱导的HTR使5-HT突触增加。相反,对氯苯丙氨酸消耗5-羟色胺可增强裸盖菇素诱发的HTR。5 -羟色胺1A受体(5HT1AR)激动剂8-OH-DPAT剂量依赖性降低裸盖草碱诱导的HTR,证明5HT2AR和5HT1AR在致幻作用中的功能相互作用。结论:本研究结果显示皮质5-羟色胺水平与裸盖菇素的急性致幻作用呈负相关。因此,先前抗抑郁治疗诱导的血清素活性增强可能是致幻药急性反应的个体差异的基础。研究这些与裸盖菇素持续治疗结果相关的机制有助于优化以迷幻药为基础的治疗效果。
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International Journal of Neuropsychopharmacology
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