Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75390-9070, USA.
Neuropsychopharmacology. 2011 Jun;36(7):1478-88. doi: 10.1038/npp.2011.33. Epub 2011 Mar 23.
Lithium has been used extensively for mood stabilization, and it is particularly efficacious in the treatment of bipolar mania. Like other drugs used in the treatment of psychiatric diseases, it has little effect on the mood of healthy individuals. Our previous studies found that mice with a mutation in the Clock gene (ClockΔ19) have a complete behavioral profile that is very similar to human mania, which can be reversed with chronic lithium treatment. However, the cellular and physiological effects that underlie its targeted therapeutic efficacy remain unknown. Here we find that ClockΔ19 mice have an increase in dopaminergic activity in the ventral tegmental area (VTA), and that lithium treatment selectively reduces the firing rate in the mutant mice with no effect on activity in wild-type mice. Furthermore, lithium treatment reduces nucleus accumbens (NAc) dopamine levels selectively in the mutant mice. The increased dopaminergic activity in the Clock mutants is associated with cell volume changes in dopamine neurons, which are also rescued by lithium treatment. To determine the role of dopaminergic activity and morphological changes in dopamine neurons in manic-like behavior, we manipulated the excitability of these neurons by overexpressing an inwardly rectifying potassium channel subunit (Kir2.1) selectively in the VTA of ClockΔ19 mice and wild-type mice using viral-mediated gene transfer. Introduction of this channel mimics the effects of lithium treatment on the firing rate of dopamine neurons in ClockΔ19 mice and leads to a similar change in dopamine cell volume. Furthermore, reduction of dopaminergic firing rates in ClockΔ19 animals results in a normalization of locomotor- and anxiety-related behavior that is very similar to lithium treatment; however, it is not sufficient to reverse depression-related behavior. These results suggest that abnormalities in dopamine cell firing and associated morphology underlie alterations in anxiety-related behavior in bipolar mania, and that the therapeutic effects of lithium come from a reversal of these abnormal phenotypes.
锂已被广泛用于情绪稳定,并且在治疗双相情感障碍躁狂症方面特别有效。像其他用于治疗精神疾病的药物一样,它对健康个体的情绪几乎没有影响。我们之前的研究发现,Clock 基因突变(ClockΔ19)的小鼠具有与人类躁狂症非常相似的完整行为特征,这种特征可以通过慢性锂治疗来逆转。然而,其靶向治疗效果的细胞和生理作用尚不清楚。在这里,我们发现 ClockΔ19 小鼠的腹侧被盖区(VTA)多巴胺能活性增加,锂治疗选择性地降低突变小鼠的放电率,而对野生型小鼠的活性没有影响。此外,锂治疗选择性降低突变小鼠的伏隔核(NAc)多巴胺水平。Clock 突变体中增加的多巴胺能活性与多巴胺神经元的细胞体积变化有关,锂治疗也可挽救这些变化。为了确定多巴胺神经元的多巴胺能活性和形态变化在躁狂样行为中的作用,我们通过病毒介导的基因转移,在 ClockΔ19 小鼠和野生型小鼠的 VTA 中选择性过表达内向整流钾通道亚基(Kir2.1)来操纵这些神经元的兴奋性。引入该通道模拟了锂治疗对 ClockΔ19 小鼠中多巴胺神经元放电率的影响,并导致多巴胺细胞体积发生类似的变化。此外,降低 ClockΔ19 动物的多巴胺神经元放电率会导致运动和焦虑相关行为的正常化,这与锂治疗非常相似;然而,这不足以逆转与抑郁相关的行为。这些结果表明,双相情感障碍躁狂症中焦虑相关行为的改变源于多巴胺细胞放电和相关形态的异常,而锂的治疗效果来自于这些异常表型的逆转。