Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA, 92093-0804, USA.
Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
Neuropsychopharmacology. 2018 Jul;43(8):1721-1731. doi: 10.1038/s41386-018-0031-y. Epub 2018 Feb 27.
Developing novel therapeutics for bipolar disorder (BD) has been hampered by limited mechanistic knowledge how sufferers switch between mania and depression-how the same brain can switch between extreme states-described as the "holy grail" of BD research. Strong evidence implicates seasonally-induced switching between states, with mania associated with summer-onset, depression with winter-onset. Determining mechanisms of and sensitivity to such switching is required. C57BL/6J and dopamine transporter hypomorphic (DAT-HY 50% expression) mice performed a battery of psychiatry-relevant behavioral tasks following 2-week housing in chambers under seasonally relevant photoperiod extremes. Summer-like and winter-like photoperiod exposure induced mania-relevant and depression-relevant behaviors respectively in mice. This behavioral switch paralleled neurotransmitter switching from dopamine to somatostatin in hypothalamic neurons (receiving direct input from the photoperiod-processing center, the suprachiasmatic nucleus). Mice with reduced DAT expression exhibited hypersensitivity to these summer-like and winter-like photoperiods, including more extreme mania-relevant (including reward sensitivity during reinforcement learning), and depression-relevant (including punishment-sensitivity and loss-sensitivity during reinforcement learning) behaviors. DAT mRNA levels switched in wildtype littermate mice across photoperiods, an effect not replicated in DAT hypomorphic mice. This inability to adjust DAT levels to match photoperiod-induced neurotransmitter switching as a homeostatic control likely contributes to the susceptibility of DAT hypormophic mice to these switching photoperiods. These data reveal the potential contribution of photoperiod-induced neuroplasticity within an identified circuit of the hypothalamus, linked with reduced DAT function, underlying switching between states in BD. Further investigations of the circuit will likely identify novel therapeutic targets to block switching between states.
开发双相情感障碍 (BD) 的新型治疗方法一直受到限制,因为人们对患者如何在躁狂和抑郁之间切换的机制知之甚少——同一大脑如何在极端状态之间切换,这被描述为 BD 研究的“圣杯”。强有力的证据表明,状态之间的季节性切换与此有关,躁狂与夏季发病有关,抑郁与冬季发病有关。需要确定这种切换的机制和敏感性。在 2 周的季节性相关光周期极端环境下,C57BL/6J 和多巴胺转运体低表达(DAT-HY 表达 50%)小鼠进行了一系列精神病学相关行为任务。夏季样和冬季样光周期暴露分别诱导小鼠出现与躁狂相关和与抑郁相关的行为。这种行为转变与下丘脑神经元中的神经递质从多巴胺到生长抑素的转变相平行(接受来自光周期处理中心即视交叉上核的直接输入)。具有较低 DAT 表达的小鼠对这些夏季样和冬季样光周期表现出超敏反应,包括更极端的与躁狂相关的行为(包括强化学习期间的奖励敏感性)和与抑郁相关的行为(包括强化学习期间的惩罚敏感性和损失敏感性)。野生型同窝小鼠的 DAT mRNA 水平在光周期之间发生了变化,但在 DAT 低表达小鼠中没有复制这种变化。作为一种体内平衡控制,DAT 水平无法适应光周期诱导的神经递质转换的这种能力,可能导致 DAT 低表达小鼠对这些转换光周期的易感性。这些数据揭示了光周期诱导的神经可塑性在下丘脑确定的回路中的潜在贡献,该回路与降低的 DAT 功能相关,是 BD 中状态之间切换的基础。对该回路的进一步研究可能会确定阻止状态之间切换的新的治疗靶点。