Adherence, acceptability and tolerability of venlafaxine extended release at dose of 300 mg/day in patients with major depressive disorder.

Adherence to antidepressants is essential for good outcomes when treating depressive disorders.

Adherencia al tratamiento, aceptabilidad y tolerabilidad de venlafaxina XR a dosis de 300 mg/día en pacientes con trastorno depresivo mayor / Adherence, acceptability and tolerability of venlafaxine extended release at dose of 300 mg/ day in patients with major depressive disorder

Introducción. La adherencia a los antidepresivos es fundamental para obtener buenos resultados en el tratamiento de la depresión. El objetivo del actual estudio fue evaluar la adherencia, aceptabilidad y tolerabilidad de venlafaxina XR a dosis de 300 mg/día, administrada en uno o dos comprimidos, tras un periodo de tratamiento de 6 ± 2 meses en pacientes con trastorno depresivo mayor (TDM). Metodología. Estudio observacional, transversal, de práctica clínica habitual en el que participaron 590 pacientes con TDM que asistían a consultas de centros públicos o privados de toda España, de los cuales 361 y 229 recibieron uno (300 mg) o dos comprimidos (150+150 mg o 225+75 mg) de venlafaxina XR, respectivamente. Los datos del estudio se obtuvieron de la entrevista con el paciente, de la historia clínica y de cuestionarios validados. Resultados. El método Haynes-Sackett y el cuestionario de Morisky-Green revelaron que la adherencia al tratamiento fue similar en ambos grupos. Los pacientes que recibieron la dosis de venlafaxina XR en un comprimido mostraron mayor satisfacción con el tratamiento según el cuestionario TSQM9. La escala MADRS reveló que en el 23% de los pacientes el TDM había remitido, y solo en el 9% se mantenía grave, en el 26% era moderado y en el 42% leve. Igual resultado se obtuvo con el cuestionario PHQ-9. En general, los pacientes mostraron buena tolerabilidad a la venlafaxina XR a dosis altas con las dos pautas de administración, y los efectos adversos más comunes fueron la disfunción sexual, sudoración y estreñimiento. Conclusiones. La adherencia al tratamiento con venlafaxina XR de 300 mg/día en uno o dos comprimidos fue similar. Los pacientes que recibieron un solo comprimido mostraron mayor satisfacción con el tratamiento. El perfil de seguridad de venlafaxina XR 300 mg fue favorable. No se produjeron abandonos, ni elevaciones clínicamente significativas de la presión arterial que condicionaran la pauta de uso. (AU)

Background. Adherence to antidepressants is essential for good outcomes when treating depressive disorders. The objective of the current study was to evaluate the adherence, acceptability and tolerability of venlafaxine XR at a dose of 300 mg/day, administered in one or two tablets, after a treatment period of 6 ± 2 months in patients with major depressive disorder (MDD). Subjects and methods. Observational, cross-sectional study of routine clinical practice in 590 outpatients with MDD who attended at public or private centers all over country, of whom 361 and 229 received one (300 mg) or two tablets (150+150 mg o 225+75 mg) of venlafaxine XR, respectively. The study data were obtained from the interview with the patient, the clinical history and validated questionnaires. Results. The Haynes-Sackett method and the MoriskyGreen questionnaire revealed that adherence to treatment was similar in both groups. The patients who received the dose of venlafaxine XR in one tablet showed greater satisfaction with the treatment according to the TSQM-9 questionnaire. The MADRS scale revealed that in 23% of the patients the MDD had remitted, and only in 9% it remained severe, in 26% it was moderate and in 42% mild. The same result was obtained with the PHQ-9 questionnaire. In general, the patients showed good tolerability to high doses of venlafaxine XR with both dosing regimens, and the most common adverse effects were sexual dysfunction, sweating and constipation. Conclusions. Adherence to treatment with venlafaxine XR 300 mg/day in one or two tablets was similar. Patients who received a single tablet showed greater satisfaction with the treatment. The safety profile of high dose venlafaxine was favorable and there was dropouts or clinically significant elevations that affected the dosing regimen. (AU)

Morphological Diversity of Calretinin Interneurons Generated From Adult Mouse Olfactory Bulb Core Neural Stem Cells.

Neural stem cells (NSCs) in the olfactory bulb (OB) core can generate mature interneurons in the adult mice brain. The vast majority of these adult generated cells express the calcium-binding protein Calretinin (CalR), and they migrate towards different OB layers. However, these cells have yet to be fully characterized and hence, to achieve this we injected retroviral particles expressing GFP into the OB core of adult animals and found that the CalR+ neurons generated from NSCs mainly migrate to the granule cell layer (GCL) and glomerular layer (GL) in similar proportions. In addition, since morphology and function are closely related, we used three-dimensional imaging techniques to analyze the morphology of these adult born cells, describing new subtypes of CalR+ interneurons based on their dendritic arborizations and projections, as well as their localization in the GCL or GL. We also show that the migration and morphology of these newly generated neurons can be altered by misexpressing the transcription factor Tbr1 in the OB core. Therefore, the morphology acquired by neurons located in a specific OB layer is the result of a combination of both extrinsic (e.g., layer allocation) and intrinsic mechanisms (e.g., transcription factors). Defining the cellular processes and molecular mechanisms that govern adult neurogenesis might help better understand brain circuit formation and plasticity, as well as eventually opening the way to develop strategies for brain repair.

Distinct Effects of BDNF and NT-3 on the Dendrites and Presynaptic Boutons of Developing Olfactory Bulb GABAergic Interneurons In Vitro.

Brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3) are known to regulate neuronal morphology and the formation of neural circuits, yet the neuronal targets of each neurotrophin are still to be defined. To address how these neurotrophins regulate the morphological and synaptic differentiation of developing olfactory bulb (OB) GABAergic interneurons, we analyzed the effect of BDNF and NT-3 on GABA+-neurons and on different subtypes of these neurons: tyrosine hydroxylase (TH+); calretinin (Calr+); calbindin (Calb+); and parvalbumin (PVA+). These cells were generated from cultured embryonic mouse olfactory bulb neural stem cells (eOBNSCs) and after 14 days in vitro (DIV), when the neurons expressed TrkB and/or TrkC receptors, BDNF and NT-3 did not significantly change the number of neurons. However, long-term BDNF treatment did produce a longer total dendrite length and/or more dendritic branches in all the interneuron populations studied, except for PVA+-neurons. Similarly, BDNF caused an increase in the cell body perimeter in all the interneuron populations analyzed, except for PVA+-neurons. GABA+- and TH+-neurons were also studied at 21 DIV, when BDNF produced significantly longer neurites with no clear change in their number. Notably, these neurons developed synaptophysin+ boutons at 21 DIV, the size of which augmented significantly following exposure to either BDNF or NT-3. Our results show that in conditions that maintain neuronal survival, BDNF but not NT-3 promotes the morphological differentiation of developing OB interneurons in a cell-type-specific manner. In addition, our findings suggest that BDNF and NT-3 may promote synapse maturation by enhancing the size of synaptic boutons.

Neural stem cells in the adult olfactory bulb core generate mature neurons in vivo.

Although previous studies suggest that neural stem cells (NSCs) exist in the adult olfactory bulb (OB), their location, identity, and capacity to generate mature neurons in vivo has been little explored. Here, we injected enhanced green fluorescent protein (EGFP)-expressing retroviral particles into the OB core of adult mice to label dividing cells and to track the differentiation/maturation of any neurons they might generate. EGFP-labeled cells initially expressed adult NSC markers on days 1 to 3 postinjection (dpi), including Nestin, GLAST, Sox2, Prominin-1, and GFAP. EGFP+ -doublecortin (DCX) cells with a migratory morphology were also detected and their abundance increased over a 7-day period. Furthermore, EGFP-labeled cells progressively became NeuN+ neurons, they acquired neuronal morphologies, and they became immunoreactive for OB neuron subtype markers, the most abundant representing calretinin expressing interneurons. OB-NSCs also generated glial cells, suggesting they could be multipotent in vivo. Significantly, the newly generated neurons established and received synaptic contacts, and they expressed presynaptic proteins and the transcription factor pCREB. By contrast, when the retroviral particles were injected into the subventricular zone (SVZ), nearly all (98%) EGFP+ -cells were postmitotic when they reached the OB core, implying that the vast majority of proliferating cells present in the OB are not derived from the SVZ. Furthermore, we detected slowly dividing label-retaining cells in this region that could correspond to the population of resident NSCs. This is the first time NSCs located in the adult OB core have been shown to generate neurons that incorporate into OB circuits in vivo.

In Vitro Evaluation of Biocompatibility of Uncoated Thermally Reduced Graphene and Carbon Nanotube-Loaded PVDF Membranes with Adult Neural Stem Cell-Derived Neurons and Glia.

Graphene, graphene-based nanomaterials (GBNs), and carbon nanotubes (CNTs) are being investigated as potential substrates for the growth of neural cells. However, in most in vitro studies, the cells were seeded on these materials coated with various proteins implying that the observed effects on the cells could not solely be attributed to the GBN and CNT properties. Here, we studied the biocompatibility of uncoated thermally reduced graphene (TRG) and poly(vinylidene fluoride) (PVDF) membranes loaded with multi-walled CNTs (MWCNTs) using neural stem cells isolated from the adult mouse olfactory bulb (termed aOBSCs). When aOBSCs were induced to differentiate on coverslips treated with TRG or control materials (polyethyleneimine-PEI and polyornithine plus fibronectin-PLO/F) in a serum-free medium, neurons, astrocytes, and oligodendrocytes were generated in all conditions, indicating that TRG permits the multi-lineage differentiation of aOBSCs. However, the total number of cells was reduced on both PEI and TRG. In a serum-containing medium, aOBSC-derived neurons and oligodendrocytes grown on TRG were more numerous than in controls; the neurons developed synaptic boutons and oligodendrocytes were more branched. In contrast, neurons growing on PVDF membranes had reduced neurite branching, and on MWCNTs-loaded membranes oligodendrocytes were lower in numbers than in controls. Overall, these findings indicate that uncoated TRG may be biocompatible with the generation, differentiation, and maturation of aOBSC-derived neurons and glial cells, implying a potential use for TRG to study functional neuronal networks.

IGF-I: A Key Growth Factor that Regulates Neurogenesis and Synaptogenesis from Embryonic to Adult Stages of the Brain.

The generation of neurons in the adult mammalian brain requires the activation of quiescent neural stem cells (NSCs). This activation and the sequential steps of neuron formation from NSCs are regulated by a number of stimuli, which include growth factors. Insulin-like growth factor-I (IGF-I) exert pleiotropic effects, regulating multiple cellular processes depending on their concentration, cell type, and the developmental stage of the animal. Although IGF-I expression is relatively high in the embryonic brain its levels drop sharply in the adult brain except in neurogenic regions, i.e., the hippocampus (HP) and the subventricular zone-olfactory bulb (SVZ-OB). By contrast, the expression of IGF-IR remains relatively high in the brain irrespective of the age of the animal. Evidence indicates that IGF-I influences NSC proliferation and differentiation into neurons and glia as well as neuronal maturation including synapse formation. Furthermore, recent studies have shown that IGF-I not only promote adult neurogenesis by regulating NSC number and differentiation but also by influencing neuronal positioning and migration as described during SVZ-OB neurogenesis. In this article we will revise and discuss the actions reported for IGF-I signaling in a variety of in vitro and in vivo models, focusing on the maintenance and proliferation of NSCs/progenitors, neurogenesis, and neuron integration in synaptic circuits.

Thermally reduced graphene is a permissive material for neurons and astrocytes and de novo neurogenesis in the adult olfactory bulb in vivo.

Graphene and graphene-based nanomaterials (GBNs) are being investigated as potential substrates for the growth of neural stem cells (NSCs), neurons and glia in cell culture models. In contrast, reports testing the effects of graphene directly with adult neural cells in vivo are missing. Here we studied the biocompatibility of thermally reduced graphene (TRG) with neurons and glia, as well as with the generation of new neurons in the adult brain in vivo. TRG injected in the brain together with a retroviral vector expressing GFP to label dividing progenitor cells in the core of the adult olfactory bulb (OB) did not alter de novo neurogenesis, neuronal and astrocyte survival nor did it produce a microglial response. These findings indicate that TRG may be a biocompatible material with neuronal and glial cells in vivo and support its use in studies of brain repair and function.

HCN1 channels in cerebellar Purkinje cells promote late stages of learning and constrain synaptic inhibition.

Neural computations rely on ion channels that modify neuronal responses to synaptic inputs. While single cell recordings suggest diverse and neurone type-specific computational functions for HCN1 channels, their behavioural roles in any single neurone type are not clear. Using a battery of behavioural assays, including analysis of motor learning in vestibulo-ocular reflex and rotarod tests, we find that deletion of HCN1 channels from cerebellar Purkinje cells selectively impairs late stages of motor learning. Because deletion of HCN1 modifies only a subset of behaviours involving Purkinje cells, we asked whether the channel also has functional specificity at a cellular level. We find that HCN1 channels in cerebellar Purkinje cells reduce the duration of inhibitory synaptic responses but, in the absence of membrane hyperpolarization, do not affect responses to excitatory inputs. Our results indicate that manipulation of subthreshold computation in a single neurone type causes specific modifications to behaviour.

Use of second-person pronouns and schizophrenia.

A masked analysis of videotaped assessments of people at high genetic risk of schizophrenia revealed that those who subsequently went on to develop schizophrenia used significantly more second-person pronouns. This was evident before diagnosis, at two separate assessments approximately 18 months apart. This supports the view that people who go on to develop schizophrenia may have an abnormality in the deictic frame of interpersonal communication - that is, the distinction between concepts being self-generated or from elsewhere may be blurred prior to the onset of a diagnosis of schizophrenia.