Accumbens D2-MSN hyperactivity drives antipsychotic-induced behavioral supersensitivity.

Accumbens D2-MSN hyperactivity drives antipsychotic-induced behavioral supersensitivity.
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DOI:
10.1038/s41380-021-01235-6
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发表时间:
2021-11
影响因子:
11
通讯作者:
Amato D
Amato D
中科院分区:
医学1区
文献类型:
--
作者:
Kruyer A;Parrilla-Carrero J;Powell C;Brandt L;Gutwinski S;Angelis A;Chalhoub RM;Jhou TC;Kalivas PW;Amato D

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抗精神病药物诱导的多巴胺超敏反应或行为超敏反应是长期抗精神病药物治疗的一个问题性后果,其特征在于出现运动异常、难治性症状和反弹性精神病。潜在的机制尚不清楚,也没有方法可以预防或逆转抗精神病药物治疗的这些不良反应。在这里,我们表明,行为超敏源于长期持久的前,后和突触周围的可塑性,包括插入钙渗透AMPA受体和D2受体依赖性抑制性突触后电流(IPSC)的D2受体表达中型多刺神经元(D2-MSNs)的神经核(NAcore)的损失。由此产生的过度兴奋,在D2-MSNs(21%)的亚群中突出,引起可卡因的运动敏感性,并与抗精神病药物治疗抵抗和物质使用障碍的行为内表型相关,包括破坏消退学习和增强线索诱导的可卡因寻求行为。NAcore中D2-MSNs中IPSC的化学发生恢复足以防止抗精神病药物诱导的超敏反应,为克服这种情况指出了一个全新的治疗方向。
Antipsychotic-induced dopamine supersensitivity, or behavioral supersensitivity, is a problematic consequence of long-term antipsychotic treatment characterized by the emergence of motor abnormalities, refractory symptoms, and rebound psychosis. The underlying mechanisms are unclear and no approaches exist to prevent or reverse these unwanted effects of antipsychotic treatment. Here we demonstrate that behavioral supersensitivity stems from long-lasting pre, post and perisynaptic plasticity, including insertion of Ca2+-permeable AMPA receptors and loss of D2 receptor-dependent inhibitory postsynaptic currents (IPSCs) in D2 receptor-expressing medium spiny neurons (D2-MSNs) in the nucleus accumbens core (NAcore). The resulting hyperexcitability, prominent in a subpopulation of D2-MSNs (21%), caused locomotor sensitization to cocaine and was associated with behavioral endophenotypes of antipsychotic treatment resistance and substance use disorder, including disrupted extinction learning and augmented cue-induced cocaine-seeking behavior. Chemogenetic restoration of IPSCs in D2-MSNs in the NAcore was sufficient to prevent antipsychotic-induced supersensitivity, pointing to an entirely novel therapeutic direction for overcoming this condition.
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