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How is the brain capable of mediating pain relief via the mind alone? Placebo analgesia is just such a case, wherein an inert substance yields relief from a number of pain inducing stimuli. Scholars typically separate several factors thought to contribute to the placebo effect into psychological and neurobiological influences. Psychological mechanisms include expectation and conditioning of analgesic effects, while neurobiological mechanisms implicate the opioidergic descending pain system. The current paper proposes an integrative model in which the rostral anterior cingulate cortex (rACC), implicated in cognitive-affective modulation, receives goal-directed input (i.e., expected pain relief) from the prefrontal cortex. As the rACC processes the cognitive difference between expected and actual pain, it recruits a critical descending pain pathway by means of modulating the periaqueductal gray area (PAG). The PAG is a key relay station that connects to other endogenous subsystems of opioidergic pain relief. Whether the rACC and its connection to the PAG are necessary for the placebo effect is a question future research will have to address.

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A dor é um fenômeno multidimensional, que geralmente desencadeia reações emocionais desconfortáveis quando identificada. Sua relação com injúria tecidual pode ser interpretado como um mecanismo adaptativo de defesa à integridade do organismo, tendo em vista sua preservação evolutiva. Porém, o substrato neurobiológico do organismo parece determinar a complexificação do repertório comportamental em diferentes espécies. Nesse sentido, o córtex cingulado anterior (CCA) tem sido amplamente descrito em mamíferos modulando diferentes aspectos da dor. O presente trabalho utilizou os testes algesimétricos de vocalização e da formalina em cobaias, para se avaliar o decurso temporal do efeito da microinjeção de agonistas e antagonistas GABAérgico (muscimol e bicuculina); colinérgico (carbacol e atropina) e opioidérgico (morfina e naloxona). A microinjeção de bicuculina (1 nmol / 0,2 µl) exacerbou as respostas nociceptivas em ambos os testes, porém diferentes doses de muscimol (0,5, 1 e 2 nmol / 0,2 µl), não modificaram as respostas. O efeito da bicuculina foi bloqueado em ambos os testes pela microinjeção prévia de muscimol (1 nmol/ 0,2 µl) no CCA. A microinjeção de carbacol (2,7 nmol /0,2 µl) neste substrato promoveu antinocicepção, evidenciada por meio da atenuação da amplitude das vocalizações, mas não pelo teste da formalina. Esse efeito foi bloqueado pela administração prévia de atropina (0,7 nmol /0,2 µl) e de naloxona (2,7 nmol /0,2 µl). A microinjeção de morfina (4,4 nmol /0,2 µl) promoveu antinocicepção em ambos os testes. Concluímos que a inibição do tônus GABAérgico no CCA exacerba os comportamentos nociceptivos e que a antinocicepção promovida por carbacol pode ter sido mediada pelo sistema de opióides endógenos, tendo em 9 vista o bloqueio do seu efeito com naloxona. Além disso, a estimulação opióide promove uma contundente antinocicepção. / Pain is a multidimensional phenomenon which usually triggers uncomfortable emotional reactions when identified. Its relation injury can be interpreted as an adaptive mechanism to defend the integrity of the body given its evolutionary conservation. However the neurobiological substrate of the body seems to determine the complexification of behavioral repertoire in different species. Thus, the anterior cingulated cortex (ACC) has been widely described in mammals by modulating different cognitive aspects of pain. This study used algesimetric tests of vocalization and formalin in guinea pigs to evaluate the time course of the effect of microinjection of GABA agonists and antagonists (bicuculline and muscimol) and cholinergic (carbachol and atropine) beyond the opioid antagonist naloxone. The microinjection of bicuculline (1 nmol / 0,2 µl) exacerbated the nociceptive behavior in both tests but different doses of muscimol (0,5; 1 e 2 nmol / 0,2 µl) did not change the responses. The effect of bicuculline was blocked in both tests by prior microinjection of muscimol (1 nmol / 0,2 µl) in the ACC. The microinjection of carbachol (2,7 nmol / 0,2 µl) on this substrate promoted antinociception as evidenced by attenuation of the amplitude of the vocalizations, but not by the formalin test. This effect was blocked by prior administration of atropine (0,7 / 0,2 µl) and naloxone (0,7 nmol / 0, 2 µl). The microinjection of morphine (4,4 nmol / 0,2 µl) promoted antinociception in both tests. We conclude that inhibition of GABAergic tone in the ACC exacerbates nociceptive behaviors and that the antinociception promoted by carbachol may 11 have been mediated by endogenous opioid system in order blocking its effect with naloxone. In addition opioid stimulation promotes a striking antinociception.

Introduction: The aim of the project was to investigate the effects of antidepressants on brain networks whilst at rest. My hypothesis was that antidepressants work by reversing persistent activity in the brain’s default mode network (DMN). The DMN is implicated in self-reflection and rumination in MDD. The methodologies and results of studies of resting state networks in MDD and the effects of antidepressants are reviewed in the thesis. Increasing evidence implicates glutamate in the action of antidepressant drugs. Whether there are illness related changes in glutamate function is unresolved, largely because of the lack of techniques for assessing it. Ketamine and other NMDA antagonists have improved MDD symptoms within 24 hours though the effects are short lasting. The molecular neural networks involved in ketamine’s putative antidepressant effects are unclear. The thesis reviews the evidence. Much evidence implicates ACC as a site of action of antidepressant effects but whether this is through its regulation of the DMN or other networks is not known. This thesis compares the effect of ketamine and citalopram on ACC-related systems. Method: The thesis combines two systematic reviews of the effects of MDD and antidepressant drugs on i) resting state networks (53 studies) and ii) glutamate neurotransmission (45 studies of clinical efficacy of ketamine). There are two experimental chapters. The first describes investigation into two rapid acting antidepressant drugs acting via glutamate mechanisms. 54 unmedicated cMDD were scanned across two centres on 3T MRI scanners while being infused with placebo (0.5% saline), 0.5mg/kg ketamine or 100mg AZD6765 over 1 hour. fMRI resting state data between drug treatments was compared for the final 25 minutes of the drug infusion and for a 25 minute resting state scan a day later. The second experimental chapter examines whether these effects were shared by citalopram, a standard antidepressant. 67 unmedicated cMDD, rMDD and HC were administered citalopram 7.5mg i.v. and scanned on a 1.5T MRI scanner. In a second study 63 cMDD and HC were administered i.v. citalopram 7.5mg or placebo (0.5% saline). fMRI resting state data for the final 12 ½ minutes following drug infusion was compared. Independent Component Analysis was performed using the Group ICA for fMRI toolbox. The resting component with the highest spatial correlation to the ACC was used. Brain maps of the intensity of the selected component were constructed for each individual. Group averages were calculated and compared using SPM. Regional analysis was performed using Marseille Boite a Regions d'interet. Results: On day 1 AZD6765 significantly increased mean intensity of ACC resting component in the right insula, right IPL and left cingulate gyrus greater than ketamine or placebo. Ketamine increased mean intensity of ACC resting component greater than placebo in the right lentiform nucleus and left mFG. Significantly decreased mean intensity of ACC resting component in the left insula in the AZD6765 group compared to placebo was noted. On day 2 AZD6765 increased mean intensity of ACC resting component greater than ketamine and placebo in the left and right lentiform nuclei. AZD6765 reduced mean intensity of the ACC resting component in the left and right MFG. The first citalopram study revealed reduced mean intensity of ACC resting component in cMDD compared to rMDD and HC in PCC. rMDD had reduced mean intensity of ACC resting component in the precuneus compared to HC. In the second study, citalopram had no effect in HC but normalised precuneus activity in cMDD producing a significant drug x group interaction. Conclusions: The acute antidepressant effects of citalopram are modulated by changes in the bilateral precuneus. The precuneus is central to connectivity with other regions in MDD. It has a prominent role in the DMN and is linked to rumination. The mechanism of the antidepressant effects of AZD6765 is different from those of ketamine and citalopram. The insula, IPL, MFG, cingulate gyrus and lentiform nuclei are all regions implicated in MDD suggesting antidepressant effects. The rapid antidepressant effects of AZD6765 are possibly due to a resetting of the interface between DMN and salience networks.

Autism spectrum disorder (ASD) is associated with functional abnormalities of the anterior cingulate cortex (ACC), a brain area that mediates social behavior. Given evidence of a role of inflammation in ASD, markers of pro-inflammatory and anti-inflammatory microglia were studied using postmortem ACC tissues from ASD and age-matched typically developed control donors. Gene expression levels of pro-inflammatory (CD68, HLA-DRA, IL1B, NOS2, PTGS2) and anti-inflammatory (ARG1, IGF1, MRC1, PPARG) microglial genes were measured using quantitative real-time PCR. Additionally, brain sections were immunohistochemically stained for a microglial marker. Expression levels of IGF1 were modestly higher, while the expression of MRC1 was modestly lower in ASD donors when compared to control donors. No other differences in gene expression levels between the two groups of donors were observed. Statistical significance for changes in expression levels IGF1 and MRC1 did not survive correction for multiple comparisons. Further research on anti-inflammatory microglial involvement in ASD is warranted.

Abstract In the 1990s researchers discovered task-deactivated regions in the human brain. Together, these areas make up the default mode network (DMN). It was originally proposed to act as a balancing mechanism between different brain systems, explaining the deactivations, but is now mostly studied with regards to internal awareness, such as daydreaming and mental imagery. The purpose of this thesis is to present a summary of DMN research, focusing on the network’s suggested role in internal awareness. This will be done by reviewing a wide variety of research that either explicitly or indirectly correlate default mode network features with aspects of consciousness and internal awareness. The subjective experience of being conscious have been a source of argument primarily among philosophers, but the qualities we feel are intimately linked to cognitive functions that are supported by the regions found in the DMN. Cognitive neuroscience may therefore be able to contribute to the concept of internal awareness and consciousness.

Generalized anxiety disorder (GAD) is a prevalent anxiety disorder that is characterized by persistent excessive worrying that is often difficult to control. The pathology of GAD has been associated with abnormal neural activity and functional connectivity. This systematic review has examined the central neural correlates of GAD which are the prefrontal cortex (PFC), the anterior cingulate cortex (ACC) and the amygdala and how activation and functional connectivity in these brain areas differ between patients with GAD and healthy controls. This review also investigated how abnormal functional connectivity and activation in these brain regions relates to worry which is the most prominent psychological symptom in patients with GAD. A systematic review was conducted and seven original functional magnetic resonance imaging (fMRI) studies were included after a literature search on PubMed, Scopus and, Web of Science. The main findings from this review revealed decreased activation in the PFC and ACC and enhanced activation in the amygdala during the viewing of negative stimuli in patients with GAD. Identifying the neural correlates of GAD and how it relates to worry may provide improved treatment in the future such as developing more effective psychotropic drugs or improved psychotherapy. GAD has been associated with lower well-being and life satisfaction and may even be a risk factor for suicidal thoughts. One of the limitations from this review is that several of the included studies recruited patients with comorbidities and for that reason results from these studies cannot be generalized and applied to individuals with GAD.

This study investigated the effects of repeated administrations of nicotine (0.7 mg/kg) on dendritic morphology in the nucleus accumbens (NAcc), prefrontal cortex (Cg 3), and parietal cortex (Par 1). Animals were habituated for 3 days to a locomotor box, and after habituation, every second day for 5 weeks rats were placed into the locomotor chamber immediately after a subcutaneous injection of nicotine or saline. Rats demonstrated tolerance to an initial hypoactive response after each nicotine injection, and this was followed by an increase in activity after each injection (behavioral sensitization). This increase in activity was still present on a nicotine challenge after a 2-week abstinence period. One week after the nicotine challenge day, all rats were perfused and brains were removed. These brains we stained using Golgi-Cox procedures, and dendrites from the nucleus accumbens (N Acc), medial frontal cortex (Cg 3) and parietal cortex (Par 1) were analyzed using the camera lucida procedure. Results showed that rats receiving nicotine demonstrated an increase in dendritic length and spine density relative to controls in the NAcc and Cg3 brain areas, but not Par 1. The increase observed in the NAcc was significantly greater than what has been found with amphetamine or cocaine, and possible underlying mechanisms were discussed.

The prefrontal cortices, in particular lateral prefrontal cortex (LPFC) and anterior cingulate cortex (ACC), have been implicated in top-down control of attention switching and behavioral flexibility. These cortices and their networks are disrupted in autism, a condition in which diverse behaviors such as social communication and attention control are dysregulated. However, little is known about the typical development of these cortical areas or the ways in which this process is altered in neurodevelopmental disorders. In order to identify changes that could affect the local processing of signals transmitted by the short-range pathways connecting the ACC and LPFC I assessed developmental changes in the distinct cortical layers, which send and receive different pathways and have unique inhibitory microenvironments that dictate excitatory-inhibitory balance. Normative developmental trends were compared with those seen in individuals with autism to identify changes that may contribute to symptoms of attention dysfunction. Unbiased quantitative methods were used to study overall neuron density, the density of inhibitory neurons labeled by the calcium-binding proteins calbindin (CB), calretinin (CR), and parvalbumin (PV), and the density, size, and trajectory of myelinated axons in the individual cortical layers in children and adults with and without a diagnosis of autism. There was a reduction in neuron density and an increase in the density of myelinated axons in both areas during neurotypical development. Axons in layers 1-3 of LPFC were disorganized in autism, with increased variability in the trajectory of axons in children and a decrease in the proportion of thin axons in adults. These findings were most significant in layer 1, the ultimate feedback-receiving layer in the cortex. While there were no differences in neuron populations between cohorts in children, in adults with autism there was a significant reduction in the density of CR-expressing neurons in LPFC layers 2-6 and a significant increase in the density of PV-expressing neurons in ACC layers 5-6. In autism, these findings suggest that dysregulation of the normal development of axonal networks, seen in children, may induce compensatory developmental changes in cell and axon populations in adults that could be connected to attention dysregulation. / 2021-10-07T00:00:00Z