Tu Zhaoyuan, Ma Yao, Shang Huiping, Zhao Sha, Xue Bao, Qu Yu, Chen Jiangfan, Li Yulong, Hu Ji, Gao Fang, Xu Huamin, Xu Xufeng, Zhang Xia
Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
Institute of Brain Function and Diseases, West China Hospital of Sichuan University, Chengdu, China.
Neuropsychopharmacology. 2025 Jun;50(7):1063-1074. doi: 10.1038/s41386-024-02029-4. Epub 2024 Nov 24.
Up to 45% of patients surviving from transient global cerebral ischemia (GCI) after cardiac arrest develop post-global cerebral ischemia depression (PGCID), but how to treat PGCID is clinically unknown. Here we find that cannabinoid type-1 receptor (CBR) antagonists, CBR knockout and endocannabinoid (eCB) synthesis inhibition block acute stress-induced PGCID. Application of acute stress to GCI mice increases CBR activity from ventromedial prefrontal cortical (vmPFC) terminals synapsing with the basolateral amygdala (BLA) neurons, indicating the involvement of increased vmPFC-BLA synaptic eCB signaling in PGCID induction. This idea is supported by findings that optogenetic activation of CBRs in vmPFC-BLA projections mimics stress effects to induce PGCID, which is blocked by knock-down of eCB biosynthesis enzyme genes in vmPFC-BLA synapses. Interestingly, GCI mice show decreased mRNA expression of eCB degradation enzymes in vmPFCs without significant changes on mRNA expression of eCB biosynthesis and degradation enzymes in BLA cells. Thus, over-expression of eCB degradation enzymes in vmPFC cells innervating BLA neurons or activation of vmPFC-BLA projections blocks stress effects to induce PGCID. Our findings suggest that decreased eCB degradation and subsequent stress-increased eCB signaling in vmPFC-BLA circuits participate in the mechanism of PGCID, which can be treated clinically by eCB signaling interference systemically or in vmPFC-BLA circuits.
心脏骤停后短暂性全脑缺血(GCI)存活的患者中,高达45%会发生全脑缺血后抑郁(PGCID),但临床上如何治疗PGCID尚不清楚。在此,我们发现1型大麻素受体(CBR)拮抗剂、CBR基因敲除和内源性大麻素(eCB)合成抑制可阻断急性应激诱导的PGCID。对GCI小鼠施加急性应激会增加腹内侧前额叶皮质(vmPFC)与基底外侧杏仁核(BLA)神经元突触的CBR活性,表明vmPFC - BLA突触eCB信号增强参与了PGCID的诱导。vmPFC - BLA投射中CBR的光遗传学激活模拟应激效应诱导PGCID这一发现支持了这一观点,而vmPFC - BLA突触中eCB生物合成酶基因的敲低可阻断这一效应。有趣的是,GCI小鼠vmPFC中eCB降解酶的mRNA表达降低,而BLA细胞中eCB生物合成和降解酶的mRNA表达无显著变化。因此,在支配BLA神经元的vmPFC细胞中过表达eCB降解酶或激活vmPFC - BLA投射可阻断应激效应诱导PGCID。我们的研究结果表明,vmPFC - BLA回路中eCB降解减少以及随后应激导致的eCB信号增强参与了PGCID的机制,临床上可通过全身或vmPFC - BLA回路中的eCB信号干扰进行治疗。