Actualización en la patofisiología de la esquizofrenia desde la perspectiva de la neurociencia de sistemas / Update on the pathophysiology of schizophrenia from the systems neuroscience point of view

La patofisiología de la esquizofrenia (EQZ) sólo podrá entenderse en una aproximación integrativa, basada en la neurociencia de sistemas, para tratar de explicar cómo múltiples genes y neurotransmisores pueden actuar de manera sinérgica para producir el trastorno. En este trabajo se analizarán por separado los diversos endofenotipos de esta enfermedad para tratar de explicar, sobre la base de aproximaciones sistémicas, cómo ocurren los cambios en las interneuronas GABAérgicas en la EQZ, comenzando con la hipofunción GABAérgica y sus consecuencias sobre las neuronas piramidales corticales y la disfunción dopaminérgica a punto de origen hipocampal, lo que permite conciliar eventos neurobiológicos con sus consecuencias conductuales (consilience). Los circuitos involucrados por Lisman, Grace, Coyle, Green y otros autores en esta revisión integran las neurotransmisiones glutamatérgica, GABAérgica, dopaminérgica y colinérgica en un marco sistémico en que también se involucran factores de riesgo genético, para intentar demostrar sus acciones sinérgicas dentro del circuito y generar una aproximación desde la neurociencia de sistemas. Se intentará desarrollar estrategias de distinto orden para comprender la EQZ como enfermedad que produce sus consecuencias devastadoras a través de la acción sinérgica de genes y diversos neurotransmisores integrados en circuitos de procesamiento que operan en complejas dinámicas de tipo no-lineal.

Understanding the pathophysiology of schizophrenia (SZ) entails adopting a holistic approach based on systems neuroscience that allows to explain how multiple genes and neurotransmitters can act synergistically to trigger the disorder. In this article, the different endophenotypes of schizophrenia are analysed separaately, with the aim of explaining, by means of systemic approaches, how changes take place in GABAergic interneurons in SZ, starting from the GABAergic hypofunction and ists effects on cortical pyramidal neurons, as well as on the dopaminergic dysfunction at he pont of origin of the hippocampus, which enables to reconcile neurobiological events with their behavioural consequences ("consilience"). The circuits proposed by Lisman, Grace, Coyle, Green and other authors, that make up glutamatergic, GABAerci, dopaminergic and cholinergic neurotransmissions embedded in a systemic framework in whic genetic risk factors are also involved, are included in this review to demonstrate their synergistic actions within the circuit, as well as to develop an approach based on systems neuroscience. The present article will also provide different types of strategies intended to understand SZ as a disease that causes its devastating effects through the synergistic action of genes and the different neurotransmitters organized in processing circuits that operte in complex non-linear dynamics.

Prazosin blocks the glutamatergic effects of N-methyl-D-aspartic acid on lordosis behavior and luteinizing hormone secretion in the estrogen-primed female rat

We have observed that intracerebroventricular (icv) injection of selective N-methyl-D-aspartic acid (NMDA)-type glutamatergic receptor antagonists inhibits lordosis in ovariectomized (OVX), estrogen-primed rats receiving progesterone or luteinizing hormone-releasing hormone (LHRH). When NMDA was injected into OVX estrogen-primed rats, it induced a significant increase in lordosis. The interaction between LHRH and glutamate was previously explored by us and another groups. The noradrenergic systems have a functional role in the regulation of LHRH release. The purpose of the present study was to explore the interaction between glutamatergic and noradrenergic transmission. The action of prazosin, an alpha1- and alpha2b-noradrenergic antagonist, was studied here by injecting it icv (1.75 and 3.5 µg/6 µL) prior to NMDA administration (1 µg/2 µL) in OVX estrogen-primed Sprague-Dawley rats (240-270 g). Rats manually restrained were injected over a period of 2 min, and tested 1.5 h later. The enhancing effect induced by NMDA on the lordosis/mount ratio at high doses (67.06 ± 3.28, N = 28) when compared to saline controls (6 and 2 µL, 16.59 ± 3.20, N = 27) was abolished by prazosin administration (17.04 ± 5.52, N = 17, and 9.33 ± 3.21, N = 20, P < 0.001 for both doses). Plasma LH levels decreased significantly only with the higher dose of prazosin (1.99 ± 0.24 ng/mL, N = 18, compared to saline-NMDA effect, 5.96 ± 2.01 ng/mL, N = 13, P < 0.05). Behavioral effects seem to be more sensitive to the alpha-blockade than hormonal effects. These findings strongly suggest that the facilitatory effects of NMDA on both lordosis and LH secretion in this model are mediated by alpha-noradrenergic transmission.

NMDA Antagonist: ketamine for balanced analgesia in the perioperative period. What is the preferential route?

This study aimed to investigate whether intraoperative sub-anesthetic doses of ketamine could represent an efficient constituent of balanced analgesia and which is the preferential route of administration, either systemic [intravenous] or epidural. Fifty patients scheduled for upper abdominal operations under combined epidural/general anesthesia were included in the study. Before skin incision, all patients received an epidural bolus, followed by an infusion of continuous bupivacaine/fentanyl/clonidine mixture. They were randomly assigned to receive: No ketamine [group 1]; i.v. ketamine at a bolus dose of 0.25 mg/kg, followed by an infusion of 0.125 mg/kg/h [group 2]; i.v. ketamine 0.5 mg/kg and followed by an infusion of 0.25 mg/kg/h [group 3]; epidural ketamine 0.25 mg/kg and 0.125 mg/kg/h [group 4] or 0.5 mg/kg and 0.25 mg/kg/h [group 5]. All i.v. And epidural anesthesia stopped at the end of surgery and the patients were connected to i.v. Morphine patient-controlled analgesia [PCA] device. The study supported the theory that sub-anesthetic doses of i.v. ketamine [0.5 mg/kg bolus, followed by 0.25 mg/kg/h] given during anesthesia are useful adjuvant in perioperative-balanced analgesia. Moreover, they showed that the systemic route is the preferential route

Preferential blockade by clozapine of hyperlocomotion induced by non-competitive NMDA antagonist MK-801.

Effect of clozapine on MK-801-induced hyperlocomotion and stereotypy as well as open field behavior was studied. Clozapine (0.1-7.5 mg/kg) dose-dependently blocked MK-801(0.5 mg/kg)-induced stereotypy. Both total and ambulatory responses were blocked by even the lower doses (0.1-0.5 mg/kg) of clozapine. In open field test, clozapine selectively blocked hyperambulation induced by MK-801 (0.1 mg/kg) whereas it potentiated MK-801 (0.1 mg/kg)-induced stereotypy at all the doses used. Haloperidol (0.25 and 0.5 mg/kg) and SCH 23390 (0.5 and 1 mg/kg) showed a dose-dependent effect on MK-801-induced behaviors while sulpiride (25 and 50 mg/kg) failed to modify MK-801-induced open field behavior. This study supports the preferential effect of clozapine on dopamine receptors located in mesolimbic area and further suggests the possibility of using open field behavior induced by MK-801 as a model for studying atypical antipsychotics.

Antagonistas del receptor NMDA en isquemia cerebral focal: modelo experimental / Antagonist of NMDA receptors on focal cerebral ischemia:experimental model

En el daño neuronal isquémico, uno de los mecanismos finales de la lesión celular es la entrada abrupta de calcio al interior de la célula mediada por canales depredientes de voltaje o por activación de receptores NMDA (N-metil D-aspartato), que origina destrucción de las membranas y el citoesqueleto. Se probó la utilidad terapeútica de un bloqueador no competitivo del receptor NMDA (MK-801, 2mg/kg intraperitoneal), para reducir la extensión del daño neuronal en un modelo de oclusión de la arteria cerebral media en rata. El MK-801 se administró 10 minutos antes (grupo 3) y una hora después de la oclusión (grupo 4), y los resultados se compararon con un grupo de oclusión sin medicamento (grupo 2) y un grupo control (grupo 1). Se encontró que la administración de MK-801 redujo significativamente el área de infarto en relación al grupo de oclusión sin medicamento (p < 0.05), con mayor efectividad cuando se administró de forma profiláctica (10 minutos antes de la oclusión) (grupo 3). Estos resultados sugieren que el MK-801 puede ser efectivo en la prevención de daño neurológico post-isquémico. Sin embargo, antes de recomendar su aplicación clínica, deberán definirse sus posibles efectos colaterales

Dizocilpine, ketamine and ethanol reverse NMDA-induced EEG changes and convulsions in rats and mice.

Electroencephalographic (EEG) activity in neocortex of rats following intracerebroventricular (icv) administration of NMDA (0.25-2 nmol/10 microliters) and its modification by noncompetitive NMDA-receptor antagonists, dizocilpine (MK-801) (0.025-0.1 mg/kg, ip) and ketamine (10-50 mg/kg, ip) was recorded at 0, 0.5, 4, 8 and 24 hr with chronically implanted electrodes. NMDA (0.25 and 1 nmol) showed longer lasting decrease in frequency in cortical neurons while 2 nmol produced convulsions and death. Administration of MK 801 (0.05 mg/kg) and ketamine (50 mg/kg) prior to NMDA offered protection in 40% of animals against NMDA-induced convulsions and blocked NMDA-induced long term influence. However, ketamine and MK 801 showed an increase in percent amplitude and also had long lasting effects per se. In conscious mice, NMDA (0.5-10 nmol/microliters icv) induced dose dependent convulsions. Both MK 801 and ketamine showed potent anticonvulsant effect. Ethanol (0.5-2 g/kg, ip) also offered significant protection against NMDA-induced convulsions. MK 801 (0.1 mg/kg) when administered concurrently with ethanol (0.5 g/kg) exhibited synergistic anticonvulsant effect. The EEG study in rats and effect of NMDA in conscious mice provide a direct evidence for the role of NMDA-receptor system in convulsions and in anticonvulsant action of ethanol.