Electroconvulsive therapy (ECT) is one of the oldest and most effective treatments for depression; however, its biological underpinnings are poorly understood. Brain-derived neurotrophic factor (BDNF) and the hypothalamic-pituitary-adrenal (HPA) axis are two chemical messenger systems implicated in the antidepressant action and cognitive side effects of ECT. The Wistar-Kyoto (WKY) strain is a genetic model of depression that shows biological, cognitive, behavioural, and treatment-response abnormalities, making it potentially a useful model in which to investigate the underpinnings of the action of electroconvulsive stimulus (ECS: the amimal model of ECT). In addition, the WKY presents a potentially useful model for translational research on depression. The WKY strain is particularly valuable for the measurement of serum BDNF protein, for which the association with antidepressant treatments is much less clear (mostly stemming from investigations in humans) than that between brain BDNF and antidepressant treatments in rodent studies. The three studies presented add insight into the biological and behavioural effects of ECS. The first study (chapter 2) found no evidence of increased (R)-[11C]rolipram binding (an indirect marker of cyclic-adenosine monophosphate, cAMP) in the brain, despite significant increases of brain BDNF protein expression after repeated ECS. The second study (chapter 3) demonstrated the validity of the WKY strain in the investigation of ECS. Relative to Wistar controls, WKY showed similar antidepressant and cognitive effects (despite some abnormal behavioural responses), immediate but not sustained increases in brain BDNF protein, and a novel finding of increased extra-hypothalamic CRF after 5 daily ECS. The final study (chapter 4) demonstrated baseline strain differences in serum (WKY < Wistar) but not brain BDNF and, in both strains, no change in serum BDNF despite significant changes in brain BDNF after repeated ECS treatment. Preliminary results from a human pilot study investigating similar measures in a small group of people receiving ECT for depression are also presented. The results of this body of work advance our understanding of the activation and role of brain and serum measures of BDNF and the HPA axis in ECS/ECT, and raise important issues in the translation of research from basic science to the human condition of depression.

Introdução: A cefaleia do tipo tensional crônica (CTTC) é caracterizada por dor de cabeça quase diária e sensibilização central. A acupuntura tem sido estudada no tratamento de diversos tipos de cefaleia, porém os resultados são controversos e apenas sugerem maior eficácia em relação ao placebo. A eletroacupuntura (EA) modula algumas das funções do sistema nervoso central (SNC), podendo modificar a neuroplasticidade. A plasticidade do SNC pode ser rastreada através dos níveis séricos do fator neurotrófico derivado do cérebro (BDNF), um mediador de neuroplasticidade. Objetivo: Este estudo testou a hipótese de que a analgesia pela EA na CTTC estaria relacionada à neuroplasticidade, avaliada através dos níveis séricos de BDNF. Métodos: Foram recrutadas mulheres, com idades entre 18-60 anos, portadoras de CTTC, para um ensaio clinico randomizado, cegado, controlado por placebo-sham. Foram aplicadas 10 sessões de EA, durante 30 minutos (2- 10 Hz, com intensidade conforme a tolerância) na cervical e áreas autonômicas, duas vezes por semana, que foram comparadas com placebosham. Os períodos de tratamento foram separados por duas semanas de intervalo. Avaliou-se dor (através de escala análoga visual (VAS) de 10 cm) e níveis séricos de BDNF como desfechos primários. Resultados: Trinta e quatro pacientes foram randomizadas e vinte e nove completaram o protocolo. Os escores da VAS foram menores durante o tratamento com EA, do que no tratamento com placebo-sham. (2.38±1.77, 3.02±2.49 respectivamente, P=0.005). Os escores de dor variaram conforme a sequência de intervenção, demonstrando efeito de carreamento (P<0.05). Utilizando regressão múltipla, os níveis séricos de BDNF foram ajustados para a escala de depressão de Hamilton e VAS (r-squared= 0.07, standard β coefficients= -0.2, -0.14, respectivamente). Ao final do período da primeira intervenção os valores de BDNF ajustados, foram maiores no grupo EA, (29.31±3.24, 27.53±2.94 ng/mL) a magnitude de efeito mensurada pela diferença na media padronizada expressou um efeito moderado (Cohen´s d= 0.55). Conclusão: A analgesia produzida pela EA pode estar relacionada à neuroplasticidade, avaliada através do BDNF ajustado para dor e depressão. A modulação pela EA na dor e BDNF depende da condição do SNC, uma vez que está relacionada à depressão e depende do momento da aplicação da intervenção. / Background: Chronic tension-type headache (CTTH) is characterized by almost daily headaches and central sensitization. Electroacupunture (EA) is effective for this condition and modules some central nervous system (CNS) functions. CNS plasticity could be tracked in serum using the brain derived neurotrophic factor (BDNF), a neuroplasticity mediator. Objective: We tested the hypothesis that EA analgesia in CTTH would be related to neuroplasticity indexed by the BDNF. Patients and methods: We enrolled females aging 18-60 with CTTH in a randomized, blinded, placebo-controlled crossover trial, comparing ten EA sessions applied during 30 minutes (2-10 Hz, intensity by tolerance) in cervical and autonomic areas twice per week, vs. placebo-sham (PS). Treatment periods were separated by two washout weeks. Pain on the 10 cm visual analog scale (VAS) and serum BDNF were assessed as primary outcomes. Results: Thirty-four subjects underwent randomization, twenty-nine completed the protocol. VAS during EA period was lower than during PS (2.38±1.77, 3.02±2.49 respectively, P=0.005). VAS differed according to intervention sequence demonstrating carry-over effect (P<0.05). Using multiple regression serum BDNF was adjusted for the Hamilton depression rating scale (HDRS) and VAS (r-squared=0.07, standard β coefficients=-0.2, -0.14, respectively; omnibus-test P<0.001). At the end of the first intervention period the adjusted BDNF was higher in the EA cohort (29.31±3.24, 27.53±2.94 ng/mL, Cohen´s d= 0.55). Conclusion: EA analgesia may relate to neuroplasticity indexed by the adjusted BDNF. EA modulation on pain and BDNF depends on the situation of the CNS, as is related to depression and depends on the timing of the intervention.

Nicotine sensitization and levels of brain-derived neurotrophic factor (BDNF) were analyzed in adolescent beta-arrestin-2 knockout (betaA-2 KO) and wild type (WT) mice. The beta-arrestin-2 protein has been shown to be important in G-protein hydrolysis and receptor internalization. Four- to five-week-old adolescent betaA-2 KO and WT C57/Bl6 mice were administered either nicotine (0.5 mg/kg free base) or saline 10 min before being placed into a locomotor arena on each of 7 (Experiment 1) or 14 (Experiment 2) consecutive days. A nicotine challenge was given 7 days after sensitization was complete. In Experiment 1, betaA-2 KO mice administered nicotine or saline and WT mice administered nicotine demonstrated significant hypoactivity during early in testing, and neither WT nor betaA-2 KO mice administered nicotine demonstrated sensitization. On the nicotine challenge, WT mice administered nicotine demonstrated significantly higher activity levels compared to all groups, and this same group demonstrated significantly higher levels of accumbal BDNF compared to all groups. In Experiment 2, betaA-2 KO mice were again hypoactive compared to WT mice, whereas WT mice administered nicotine demonstrated significant hypoactivity during initial testing and significantly higher levels of activity compared to all other groups late in testing. On the nicotine challenge, WT mice that received nicotine demonstrated a significant increase in activity compared to all groups, and showed increased accumbal BDNF compared to all groups. These results show that the beta-arrestin-2 protein is important in induction and expression of nicotine sensitization as well as nicotine's effects on accumbal BDNF.

京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第23426号 / 人健博第93号 / 新制||人健||6(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 山田 重人, 教授 林 悠, 教授 森本 尚樹 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Background/Aims: Neonatal quinpirole (NQ) treatment to rats increases dopamine D2 (DAD2) receptor sensitivity in adult animals. We investigated if increased DAD2 sensitivity would be passed to the next (F1) generation, and if these animals demonstrated sensorimotor gating deficits and enhanced behavioral responses to nicotine. Methods: Male and female rats were intraperitoneal (IP) administered quinpirole (1 mg/kg) or saline (NS) from postnatal day (P)1–21. Animals were either behaviorally tested (F0) or raised to P60 and mated, creating F1 offspring. Results: Experiment 1 revealed that F1 generation animals that were the offspring of at least one NQ-treated founder increased yawning behavior, a DAD2-mediated behavioral event, in response to acute quinpirole (0.1 mg/kg). F1 generation rats also demonstrated increased striatal β arrestin-2 and decreased phospho-AKT signaling, consistent with increased G-protein independent DAD2 signaling, which was equal to F0 NQ-treated founders, although this was not observed in all groups. RNA-Seq analysis revealed significant gene expression changes in the F1 generation that were offspring of both NQ-treated founders compared to F0 NQ founders and controls, with enrichment in sensitivity to stress hormones and cell signaling pathways. In Experiment 2, all F1 generation offspring demonstrated sensorimotor gating deficits compared to controls, which were equivalent to F0 NQ-treated founders. In Experiment 3, all F1 generation animals demonstrated enhanced nicotine behavioral sensitization and nucleus accumbens (NAcc) brain-derived neurotrophic factor (BDNF) protein. Further, F1 generation rats demonstrated enhanced adolescent nicotine conditioned place preference equivalent to NQ-treated founders conditioned with nicotine. Conclusions: This represents the first demonstration of transgenerational effects of increased DAD2 sensitivity in a rodent model.

No description available.

Chronic stress and Alzheimer’s disease (AD) both lead to degenerative changes in the hippocampus, a brain structure involved in episodic memory and regulation of the stress response. Mechanisms of aging (inflammation, oxidative stress, membrane damage, mitochondrial dysfunction, and insulin resistance) and a loss of brain-derived neurotrophic factor (BDNF), occur in cases of both stress-related depression and AD. Three studies were conducted using mouse models to determine whether exercise or treatment with an anti-aging multi-ingredient supplement (MDS) designed to counteract these aging mechanisms could protect the hippocampus, and associated behavioural functions, from either stress or AD. The first experiment revealed that the upregulation of neurogenesis by aerobic exercise in c57Bl/6 male mice does not occur after stress exposure. The MDS and exercise, but neither intervention alone, alleviated anhedonia, upregulated BDNF and increased neurogenesis. The other two experiments evaluated whether the MDS could counteract a range of AD behavioural and biological manifestations in both sexes of the 3xTg-AD mouse model. At 3-4 months of age, 2 months of MDS-supplementation protected 3xTg-AD mice from developing deficits in working memory and spatial learning seen in vehicle-treated transgenic mice. The MDS continued to benefit 3xTg-AD females, but not males, on tests of 24-h recall under conditions of high interference until 11-12 months of age, along with upregulating hippocampal BDNF. The MDS also attenuated the splenomegaly seen in 3xTg-AD mice and normalized the previously undiscovered aberrant recruitment of CA1 and CA3 neurons by 3xTg-AD males during spatial encoding. This work supports the use of diet and exercise to buffer against major depressive disorder (MDD) and AD in part by acting upon the hippocampus. It also recommends the use of lifestyle-based interventions to promote functional improvements in MDD or AD, and further elucidates the potential of BDNF and neurogenesis as therapeutic targets in counteracting these debilitating conditions. / Thesis / Doctor of Philosophy (PhD)

Introduction: L'exercice physique est l’une des approches les plus prometteuses permettant de ralentir l’affaiblissement des fonctions cognitives relié au vieillissement. Différents programmes d'exercice physique peuvent améliorer la cognition et l'humeur, via leur impact sur certaines voies moléculaires. En effet, différentes interventions d’exercice physique peuvent augmenter la production du facteur neurotrophique dérivé du cerveau (BDNF). Cette protéine est une neurotrophine qui augmente la survie et la croissance des neurones et favorise donc la neuroplasticité. Cependant, peu d'études ont comparé les différents types d’interventions et leur impact sur les niveaux de BDNF, en particulier chez les participants âgés de 60 ans et plus. L’objectif de cette étude était de comparer les effets de deux protocoles d'exercice distincts sur les niveaux sériques de BDNF chez des ainés sains. Méthodologie: Au total, trente-quatre adultes âgés de 65 ans et plus ont participé à un des deux groupes d’intervention. Le premier groupe présentait une combinaison d’entrainements par résistance et d’aérobie (CSA, âge: 70,5 ± 5,3 ans) et le deuxième groupe pratiquait des exercices de motricité avancé et de flexibilité. (GMA, âge: 74,6 ± 5,2 ans). Les deux interventions comprenaient trois séances hebdomadaires de 60 minutes, pour une période de 8 semaines. Les exercices du groupe CSA incluaient des exercices physiques en résistance de force maximale et des intervalles d’aérobies à haute intensité. Le groupe GMA pratiquait des activités de locomotion (manipulation de balle, parcours à obstacles, exercices de coordination et d’équilibre) et des étirements. Une analyse de covariance a été réalisée sur le changement absolu de chaque variable, tout en contrôlant pour l'âge et la valeur de base. Résultats: Seuls les participants CSA ont enregistré une augmentation significative au niveau de leurs performances aérobies (VO2max) due à l’intervention. Toutefois, les niveaux sériques de BDNF ont augmenté de façon significative seulement chez participants du groupe GMA grâce à l’intervention. Conclusion: Les résultats suggèrent que les activités motrices pourraient potentiellement conduire à des améliorations de la cognition par l’augmentation des niveaux de BDNF chez les participants. / Introduction: Physical exercise has been reported as a promising approach to counteract aging-associated decreased cognitive functions. Different exercise training programs have been associated with improvement of cognition and mood potentially by acting on several molecular pathways. Different exercise interventions have been shown to increase the levels of Brain-derived neurotrophic factor (BDNF). This protein is a key neurotrophin, it increases the survival and growth of neurons and consequently favours neuroplasticity. However, few studies have compared different types of physical exercise training protocols and their impact on BDNF levels, especially in participants over 60 years old. The goal of this study was to compare the effects of two different exercise protocols on serum BDNF levels in healthy older adults. Methods: Thirty-four older adults were divided in two groups; combined strength and aerobic group (CSA, age: 70.5±5.3 yrs.) and gross motor activities and flexibility group (GMA, age: 74.6 ± 5.2 yrs.). Both interventions were composed of three weekly 60-minute sessions for a period of 8 weeks. The intervention for the CSA group included maximal strength exercises and high intensity aerobic interval training. GMA involved locomotion activities, ball manipulation (hand-eye coordination), and stretching exercises. One-way ANCOVAs were performed on variable absolute change, while controlling for age and baseline value. Results: As expected, CSA participants showed significant increase in aerobic capacity (VO2max). In contrast, only the GMA group showed significant change in BDNF serum levels following intervention. Conclusion: These results suggest that gross motor activities could potentially lead to improvements in cognition through the enhancement of BDNF production.

Estudos clínicos nos pacientes com epilepsia mostram a importância da neurotransmissão modulada pela dopamina na epilepsia. Múltiplos fatores genéticos predispõem à epilepsia e há evidências de uma relação direta entre a epilepsia e as variações nos genes que codificam proteínas envolvidas na neurotransmissão dopaminérgica. O objetivo do nosso estudo foi investigar se os polimorfismos da via dopaminérgica e o Val66Met do BDNF estavam associados à ocorrência de epilepsia do lobo temporal causada por esclerose hipocampal. Para este fim, avaliamos 119 pacientes com epilepsia do lobo temporal causada por esclerose hipocampal e 113 voluntários saudáveis. Os participantes foram genotipados para os polimorfismos do gene DAT (3\'UTR e Intron 8), receptores dopaminérgicos (DRD2 e DRD4), COMT, MAO e BDNF (Val66Met). Não houve diferença entre pacientes e controles para os polimorfismos relacionados ao DAT, Íntron 8 VNTR (p 0,395) e 3\'UTR VNTR (p 0,614) e para a análise dos haplótipos (3\'UTR e Intron 8) (p 0.205). Não houve diferença entre pacientes e controles para os polimorfismos dos receptores dopaminérgicos DRD2 rs1800497 (p 0.440), DRD4 rs1800955 (p 0.548) e DRD4 VNTR (p 0.318). Não observamos diferença entre pacientes e controles quanto aos polimorfismos COMT rs4680 (p 0.482) e MAOA_uVNTR (p 0.753), metabolizadores de DA. Não observamos diferença na distribuição genotípica do polimorfismo Val66Met (rs6265) do BDNF (p 0,636) e a distribuição alélica (p 0.471) no grupo de pacientes com epilepsia do lobo temporal causada por esclerose do hipocampo. Nossos achados demonstraram que os polimorfismos da via dopaminérgica e BDNF Val66Met analisados neste estudo não parecem estar associados à epilepsia de lobo temporal causada por esclerose de hipocampo / Clinical studies in patients with epilepsy showed the role of neurotransmission modulated by dopamine in epilepsy. Multiple genetic factors predispose to epilepsy; there is evidence for a direct relationship between epilepsy and variations in genes encoding proteins involved in dopaminergic neurotransmission. The aim of our study was to investigate if the polymorphism related to the dopaminergic pathway and BDNF polymorphism Val66Met were associated with the occurrence of temporal lobe epilepsy caused by hippocampal sclerosis. We assessed 119 patients with unequivocal temporal lobe epilepsy caused by hippocampal sclerosis and 113 healthy volunteers. Individuals were genotyped for DAT gene polymorphisms (3\'UTR and Intron 8), dopaminergic receptors (DRD2 and DRD4), COMT, MAO and BDNF. There was no difference between patients and controls considering the polymorphisms related to DAT, Intron 8 VNTR (p 0,395) and 3\'UTR VNTR (p 0.614) and for the analysis of haplotypes (3\'UTR and Intron 8) (p 0.205). There was no difference between patients and controls considering the dopaminergic receptor polymorphisms DRD2 rs1800497 (p 0.440), DRD4 rs1800955 (p 0.548) and DRD4 VNTR (p 0.318). We observed no difference between patients and controls regarding COMT polymorphisms rs4680 (p 0.482) and MAOA_uVNTR (p 0.753), of dopaminergic metabolizers. We did not observe difference in the genotypic distribution of BDNF Val66Met polymorphism (rs6265) (p 0.636) and in the allelic distribution (p 0.4711) in the group with temporal lobe epilepsy caused by hippocampal sclerosis. Our findings suggest that the polymorphisms of the dopaminergic pathway evaluated in this study and BDNF Val66Me do not appear to be associated with temporal lobe epilepsy caused by hippocampal sclerosis

O Transtorno Bipolar (TB) tipo I é uma doença caracterizada por episódios de mania e depressão recorrentes com importante prejuízo do funcionamento global e comprometimento das funções cognitivas. Além disso, sabe-se que o número de episódios de humor patológico ao longo da vida pode também influenciar o funcionamento cognitivo destes sujeitos. Neste cenário, ocorreu a necessidade de se investigar marcadores genéticos para disfunção cognitiva no TB com o objetivo de estudar este fenômeno. Dentre os potenciais genes responsáveis por influenciar a cognição destacam-se os polimorfismos funcionais do fator neurotrófico derivado do cérebro (BDNF), da catecol-O-metiltransferase (COMT), da apolipoproteína-E (APOE) e do canal de cálcio de baixa voltagem subunidade 1-C (CACNA1C). Sabe-se, também, que no TB os marcadores de estresse oxidativo estão aumentados durante todas as fases da doença, entretanto, não é claro qual impacto destes na disfunção cognitiva de indivíduos com TB. O objetivo dessa tese foi avaliar o desempenho cognitivo de pacientes jovens com bipolaridade tipo I e sua associação com o genótipo de BDNF, COMT, APOE e CACNA1C e também com os níveis plasmáticos de oxidação da guanosina (8-OHdG) e citosina (5-Mec) durante os episódios de humor, eutimia e em controles. Para investigar essa associação foram incluídos 116 pacientes (79 em episódio de humor patológico e 37 eutímicos) com diagnóstico de TB tipo I (DSMIV-TR); 97 controles saudáveis foram submetidos à avaliação neuropsicológica e coleta de sangue para extração de DNA visando genotipagem para BDNF (rs6265), COMT (rs4680; rs165599), APOE (rs429358 e rs7412), CACNA1C (rs1006737), 8-OhdG e 5-Mec. A análise dos dados obtidos revelou que pacientes portadores do genótipo Met/Met rs4680/rs165599 do COMT apresentam comprometimento cognitivo mais grave (função executiva, fluência verbal, memória e inteligência) comparado ao genótipo Val/Met ou Val/Val durante episódios maníacos ou mistos. Na mesma direção destes resultados, verificou-se que pacientes portadores do alelo Met rs4680 do COMT apresentam comprometimento do reconhecimento de emoções faciais em episódios de mania e depressão. Nenhum efeito do COMT foi observado em controles. O alelo de risco Met do CACNA1C se associou a um pior comprometimento executivo independente dos sintomas maníacos ou depressivos no TB, porém nenhum efeito se observou nos controles. O alelo Met do BDNF rs6265 ou a presença do alelo 4 da APOE não representa um fator que identifique um grupo com desempenho cognitivo diferenciado durante as fases do TB ou em controles. Sujeitos com TB apresentaram níveis mais elevados de 8-OHdG e tais níveis eram diretamente proporcionais ao número de episódios maníacos ao longo da vida, sugerindo um papel dos episódios hiperdopaminérgicos na oxidação das bases de DNA. Concluiu-se que a genotipagem para COMT e CACNA1C em pacientes com TB pode identificar um grupo de pacientes associados a pior disfunção cognitiva durante as fases maníacas e mistas do TB. Tal dado pode ser um indicador do envolvimento do sistema dopaminérgico e dos canais de cálcio de baixa voltagem na fisiopatologia da disfunção cognitiva no TB e deve ser explorado em outros estudos / Bipolar I disorder (BD) is a disease whose main features include severe mood swings that cause severe impairment in global functioning and cognitive domains. Moreover, the number of mood episodes throughout patients life is also associated with deterioration in cognitive functions. In this context, it is important to study genetic markers for the cognitive dysfunction observed in BD to elucidate the physiopathology of this phenomenon. The main candidates for genetic modulation of cognition are the genes brain derived neurotrophic factor (BDNF), catechol-o-methyltransferase (COMT), apolipoprotein E (APOE) and 1-C subunit of the L-type voltage-gated calcium channel (CACNA1C). Furthermore, elevated levels of oxidative stress have been reported in BD for all types of mood episodes but no data is available on their impact on cognitive functioning of BD patients. The aim of this thesis was to investigate whether cognitive functioning of BD patients is influenced by BDNF, COMT, APOE, CACNA1C genotypes or by levels of oxidative damage to the DNA base guanosine (8-OHdG) and cytosine (5-Mec). One hundred sixteen patients (79 during mood episode and 37 euthymic) with BD type I (mania, depression or euthymia) and 97 healthy controls were submitted to neuropsychological evaluation and blood collection for DNA analysis. All subjects were genotyped for BDNF (rs6265), COMT (rs4680; rs165599), APOE (rs429358 and rs7412), CACNA1C (rs1006737), DNA levels of 8-OHdG and 5-Mec were also measured. Our results revealed that BD subjects that carried the rs4680/rs165599 Met/Met genotype had more severe cognitive dysfunction (executive function, verbal fluency, memory and intelligence) than carriers of other genotypes during manic or mixed episodes. Moreover, patients carrying the COMT rs4680 Met allele had worse performance on facial emotion recognition tests during manic and depressive episodes. BD carriers of the Met allele of CACNA1C had more severe executive dysfunction than non-carriers, regardless of manic or depressive symptoms. No effect of CACNA1C or COMT genotypes was observed in controls. The genotypes of BDNF or APOE were not associated with cognitive dysfunction in BD patients or controls. The BD group exhibited higher levels of 8-OHdG than the control group and these levels were influenced by the lifetime number of manic episodes, suggesting that hyperdopaminergic episodes may influence the oxidation of DNA bases. In summary, the genotype of COMT and CACNA1C may represent a useful tool for identifying BD subjects at risk of developing more severe cognitive dysfunction in all mood states of the disease. This evidence associating dopamine catabolism and calcium channels to degree of cognitive dysfunction in BD should be further explored by future research