Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK.
Sci Transl Med. 2023 Apr 5;15(690):eade1779. doi: 10.1126/scitranslmed.ade1779.
Poor outcomes are common in individuals with anxiety and depression, and the brain circuits underlying symptoms and treatment responses remain elusive. To elucidate these neural circuits, experimental studies must specifically manipulate them, which is only possible in animals. Here, we used a chemogenetics strategy involving engineered designer receptors exclusively activated by designer drugs (DREADDs) to activate a region of the marmoset brain that is dysfunctional in human patients with major depressive disorder, called the subcallosal anterior cingulate cortex area 25 (scACC-25). Using this DREADDs system, we identified separate scACC-25 neural circuits that underlie specific components of anhedonia and anxiety in marmosets. Activation of the neural pathway connecting the scACC-25 to the nucleus accumbens (NAc) caused blunting of anticipatory arousal (a form of anhedonia) in marmosets in response to a reward-associated conditioned stimulus in an appetitive Pavlovian discrimination test. Separately, activation of the circuit between the scACC-25 and the amygdala increased a measure of anxiety (the threat response score) when marmosets were presented with an uncertain threat (human intruder test). Using the anhedonia data, we then showed that the fast-acting antidepressant ketamine when infused into the NAc of marmosets prevented anhedonia after scACC-25 activation for more than 1 week. These neurobiological findings provide targets that could contribute to the development of new treatment strategies.
焦虑和抑郁患者的预后通常较差,而症状和治疗反应的大脑回路仍然难以捉摸。为了阐明这些神经回路,实验研究必须专门对其进行操作,这在动物身上才有可能实现。在这里,我们使用了一种化学遗传学策略,涉及专门被设计药物激活的工程化设计受体(DREADDs),以激活在患有重度抑郁症的人类患者中功能失调的狨猴大脑区域,即扣带前皮质 25 区(scACC-25)。使用这种 DREADDs 系统,我们确定了狨猴快感缺失和焦虑的特定成分背后的单独的 scACC-25 神经回路。激活连接 scACC-25 到伏隔核(NAc)的神经通路会导致狨猴在奖赏相关条件刺激的预期唤醒(一种快感缺失形式)中出现迟钝,在奖赏性巴甫洛夫辨别测试中。另外,激活 scACC-25 和杏仁核之间的回路会增加焦虑的度量(威胁反应得分),当狨猴面临不确定的威胁(人类入侵者测试)时。然后,我们使用快感缺失数据表明,当将快速作用的抗抑郁药氯胺酮输注到狨猴的 NAc 中时,在 scACC-25 激活超过 1 周后,可以预防快感缺失。这些神经生物学发现为开发新的治疗策略提供了目标。