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GABA Receptors
D Reviews • BIOTREND Reviews • BIOTREND Reviews • BIOTREND Reviews • BIOTREND Reviews Review No.7 / 1-2011 GABA receptors Wolfgang Froestl , CNS & Chemistry Expert, AC Immune SA, PSE Building B - EPFL, CH-1015 Lausanne, Phone: +41 21 693 91 43, FAX: +41 21 693 91 20, E-mail: [email protected] GABA Activation of the GABA A receptor leads to an influx of chloride GABA ( -aminobutyric acid; Figure 1) is the most important and ions and to a hyperpolarization of the membrane. 16 subunits with γ most abundant inhibitory neurotransmitter in the mammalian molecular weights between 50 and 65 kD have been identified brain 1,2 , where it was first discovered in 1950 3-5 . It is a small achiral so far, 6 subunits, 3 subunits, 3 subunits, and the , , α β γ δ ε θ molecule with molecular weight of 103 g/mol and high water solu - and subunits 8,9 . π bility. At 25°C one gram of water can dissolve 1.3 grams of GABA. 2 Such a hydrophilic molecule (log P = -2.13, PSA = 63.3 Å ) cannot In the meantime all GABA A receptor binding sites have been eluci - cross the blood brain barrier. It is produced in the brain by decarb- dated in great detail. The GABA site is located at the interface oxylation of L-glutamic acid by the enzyme glutamic acid decarb- between and subunits. Benzodiazepines interact with subunit α β oxylase (GAD, EC 4.1.1.15). It is a neutral amino acid with pK = combinations ( ) ( ) , which is the most abundant combi - 1 α1 2 β2 2 γ2 4.23 and pK = 10.43. -
Brain Imaging
Publications · Brochures Brain Imaging A Technologist’s Guide Produced with the kind Support of Editors Fragoso Costa, Pedro (Oldenburg) Santos, Andrea (Lisbon) Vidovič, Borut (Munich) Contributors Arbizu Lostao, Javier Pagani, Marco Barthel, Henryk Payoux, Pierre Boehm, Torsten Pepe, Giovanna Calapaquí-Terán, Adriana Peștean, Claudiu Delgado-Bolton, Roberto Sabri, Osama Garibotto, Valentina Sočan, Aljaž Grmek, Marko Sousa, Eva Hackett, Elizabeth Testanera, Giorgio Hoffmann, Karl Titus Tiepolt, Solveig Law, Ian van de Giessen, Elsmarieke Lucena, Filipa Vaz, Tânia Morbelli, Silvia Werner, Peter Contents Foreword 4 Introduction 5 Andrea Santos, Pedro Fragoso Costa Chapter 1 Anatomy, Physiology and Pathology 6 Elsmarieke van de Giessen, Silvia Morbelli and Pierre Payoux Chapter 2 Tracers for Brain Imaging 12 Aljaz Socan Chapter 3 SPECT and SPECT/CT in Oncological Brain Imaging (*) 26 Elizabeth C. Hackett Chapter 4 Imaging in Oncological Brain Diseases: PET/CT 33 EANM Giorgio Testanera and Giovanna Pepe Chapter 5 Imaging in Neurological and Vascular Brain Diseases (SPECT and SPECT/CT) 54 Filipa Lucena, Eva Sousa and Tânia F. Vaz Chapter 6 Imaging in Neurological and Vascular Brain Diseases (PET/CT) 72 Ian Law, Valentina Garibotto and Marco Pagani Chapter 7 PET/CT in Radiotherapy Planning of Brain Tumours 92 Roberto Delgado-Bolton, Adriana K. Calapaquí-Terán and Javier Arbizu Chapter 8 PET/MRI for Brain Imaging 100 Peter Werner, Torsten Boehm, Solveig Tiepolt, Henryk Barthel, Karl T. Hoffmann and Osama Sabri Chapter 9 Brain Death 110 Marko Grmek Chapter 10 Health Care in Patients with Neurological Disorders 116 Claudiu Peștean Imprint 126 n accordance with the Austrian Eco-Label for printed matters. -
Radiotracers for SPECT Imaging: Current Scenario and Future Prospects
Radiochim. Acta 100, 95–107 (2012) / DOI 10.1524/ract.2011.1891 © by Oldenbourg Wissenschaftsverlag, München Radiotracers for SPECT imaging: current scenario and future prospects By S. Adak1,∗, R. Bhalla2, K. K. Vijaya Raj1, S. Mandal1, R. Pickett2 andS.K.Luthra2 1 GE Healthcare Medical Diagnostics, John F Welch Technology Center, Bangalore, India 560066 2 GE Healthcare Medical Diagnostics, The Grove Centre, White Lion Road, Amersham, HP7 9LL, UK (Received October 4, 2010; accepted in final form July 18, 2011) Nuclear medicine / 99m-Technetium / 123-Iodine / ton emission computed tomography (SPECT or less com- Oncological imaging / Neurological imaging / monly known as SPET) and positron emission tomogra- Cardiovascular imaging phy (PET). Both techniques use radiolabeled molecules to probe molecular processes that can be visualized, quanti- fied and tracked over time, thus allowing the discrimination Summary. Single photon emission computed tomography of healthy from diseased tissue with a high degree of con- (SPECT) has been the cornerstone of nuclear medicine and today fidence. The imaging agents use target-specific biological it is widely used to detect molecular changes in cardiovascular, processes associated with the disease being assessed both at neurological and oncological diseases. While SPECT has been the cellular and subcellular levels within living organisms. available since the 1980s, advances in instrumentation hardware, The impact of molecular imaging has been on greater under- software and the availability of new radiotracers that are creating a revival in SPECT imaging are reviewed in this paper. standing of integrative biology, earlier detection and charac- The biggest change in the last decade has been the fusion terization of disease, and evaluation of treatment in human of CT with SPECT, which has improved attenuation correction subjects [1–3]. -
Meth/Amphetamine Use and Associated HIV: Implications for Global Policy and Public Health
International Journal of Drug Policy 21 (2010) 347–358 Contents lists available at ScienceDirect International Journal of Drug Policy journal homepage: www.elsevier.com/locate/drugpo Review Meth/amphetamine use and associated HIV: Implications for global policy and public health Louisa Degenhardt ∗,1, Bradley Mathers 2, Mauro Guarinieri 3, Samiran Panda 4, Benjamin Phillips 5, Steffanie A. Strathdee 6, Mark Tyndall 7, Lucas Wiessing 8, Alex Wodak 9, John Howard 10, the Reference Group to the United Nations on HIV and injecting drug use National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia article info abstract Article history: Amphetamine type stimulants (ATS) have become the focus of increasing attention worldwide. There are Received 29 May 2009 understandable concerns over potential harms including the transmission of HIV. However, there have Received in revised form 30 October 2009 been no previous global reviews of the extent to which these drugs are injected or levels of HIV among Accepted 24 November 2009 users. A comprehensive search of the international peer-reviewed and grey literature was undertaken. Multiple electronic databases were searched and documents and datasets were provided by UN agencies and key experts from around the world in response to requests for information on the epidemiology of use. Keywords: Amphetamine or methamphetamine (meth/amphetamine, M/A) use was documented in 110 countries, Methamphetamine Amphetamine and injection in 60 of those. Use may be more prevalent in East and South East Asia, North America, South HIV Africa, New Zealand, Australia and a number of European countries. In countries where the crystalline Injecting form is available, evidence suggests users are more likely to smoke or inject the drug; in such countries, Epidemiology higher levels of dependence may be occurring. -
Evidence-Based Guidelines for the Pharmacological Management of Substance Abuse, Harmful Use, Addictio
444324 JOP0010.1177/0269881112444324Lingford-Hughes et al.Journal of Psychopharmacology 2012 BAP Guidelines BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, Journal of Psychopharmacology 0(0) 1 –54 harmful use, addiction and comorbidity: © The Author(s) 2012 Reprints and permission: sagepub.co.uk/journalsPermissions.nav recommendations from BAP DOI: 10.1177/0269881112444324 jop.sagepub.com AR Lingford-Hughes1, S Welch2, L Peters3 and DJ Nutt 1 With expert reviewers (in alphabetical order): Ball D, Buntwal N, Chick J, Crome I, Daly C, Dar K, Day E, Duka T, Finch E, Law F, Marshall EJ, Munafo M, Myles J, Porter S, Raistrick D, Reed LJ, Reid A, Sell L, Sinclair J, Tyrer P, West R, Williams T, Winstock A Abstract The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short- and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people. Keywords Substance misuse, addiction, guidelines, pharmacotherapy, comorbidity Introduction guidelines (e.g. -
Randomized Controlled Trial of Dexamphetamine Maintenance for the Treatment of Methamphetamine
RESEARCH REPORT doi:10.1111/j.1360-0443.2009.02717.x Randomized controlled trial of dexamphetamine maintenance for the treatment of methamphetamine dependenceadd_2717 146..154 Marie Longo1, Wendy Wickes1, Matthew Smout1, Sonia Harrison1, Sharon Cahill1 & Jason M. White1,2 Pharmacotherapies Research Unit, Drug and Alcohol Services South Australia, Norwood, South Australia, Australia1 and Discipline of Pharmacology, University of Adelaide, Adelaide, South Australia, Australia2 ABSTRACT Aim To investigate the safety and efficacy of once-daily supervised oral administration of sustained-release dexam- phetamine in people dependent on methamphetamine. Design Randomized, double-blind, placebo-controlled trial. Participants Forty-nine methamphetamine-dependent drug users from Drug and Alcohol Services South Australia (DASSA) clinics. Intervention Participants were assigned randomly to receive up to 110 mg/day sustained- release dexamphetamine (n = 23) or placebo (n = 26) for a maximum of 12 weeks, with gradual reduction of the study medication over an additional 4 weeks. Medication was taken daily under pharmacist supervision. Measurements Primary outcome measures included treatment retention, measures of methamphetamine consump- tion (self-report and hair analysis), degree of methamphetamine dependence and severity of methamphetamine withdrawal. Hair samples were analysed for methamphetamine using liquid chromatography-mass spectrometry. Findings Treatment retention was significantly different between groups, with those who received dexamphetamine remaining in treatment for an average of 86.3 days compared with 48.6 days for those receiving placebo (P = 0.014). There were significant reductions in self-reported methamphetamine use between baseline and follow-up within each group (P < 0.0001), with a trend to a greater reduction among the dexamphetamine group (P = 0.086). -
Physiological Roles of Endogenous Neurosteroids at Α2 Subunit-Containing GABAA Receptors
Physiological roles of endogenous neurosteroids at α2 subunit-containing GABAA receptors Elizabeth Jane Durkin A thesis submitted to University College London for the degree of Doctor of Philosophy October 2012 Department of Neuroscience, Physiology and Pharmacology University College London Gower Street London WC1E 6BT Declaration 2 Declaration I, Elizabeth Durkin, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis Abstract 3 Abstract Neurosteroids are important endogenous modulators of the major inhibitory neurotransmitter receptor in the brain, the γ-amino-butyric acid type A (GABAA) receptor. They are involved in numerous physiological processes, and are linked to several central nervous system disorders, including depression and anxiety. The neurosteroids allopregnanolone and allo-tetrahydro-deoxy-corticosterone (THDOC) have many effects in animal models (anxiolysis, analgesia, sedation, anticonvulsion, antidepressive), suggesting they could be useful therapeutic agents, for example in anxiety, stress and mood disorders. Neurosteroids potentiate GABA-activated currents by binding to a conserved site within α subunits. Potentiation can be eliminated by hydrophobic substitution of the α1Q241 residue (or equivalent in other α isoforms). Previous studies suggest that α2 subunits are key components in neural circuits affecting anxiety and depression, and that neurosteroids are endogenous anxiolytics. It is therefore possible that this anxiolysis occurs via potentiation at α2 subunit-containing receptors. To examine this hypothesis, α2Q241M knock-in mice were generated, and used to define the roles of α2 subunits in mediating effects of endogenous and injected neurosteroids. Biochemical and imaging analyses indicated that relative expression levels and localization of GABAA receptor α1-α5 subunits were unaffected, suggesting the knock- in had not caused any compensatory effects. -
Management of Acute Withdrawal and Detoxification for Adults Who Misuse Methamphetamine: a Review of the Clinical Evidence and Guidelines
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Management of Acute Withdrawal and Detoxification for Adults who Misuse Methamphetamine: A Review of the Clinical Evidence and Guidelines Service Line: Rapid Response Service Version: 1.0 Publication Date: February 08, 2019 Report Length: 28 Pages Authors: Michelle Clark, Robin Featherstone Cite As: Management of Acute Withdrawal and Detoxification for Adults who Misuse Methamphetamine: A Review of the Clinical Evidence and Guidelines. Ottawa: CADTH; 2019 Feb. (CADTH rapid response report: summary with critical appraisal). ISSN: 1922-8147 (online) Disclaimer: The information in this document is intended to help Canadian health care decision-makers, health care professionals, health systems leaders, and policy-makers make well-informed decisions and thereby improve the quality of health care services. While patients and others may access this document, the document is made available for informational purposes only and no representations or warranties are made with respect to its fitness for any particular purpose. The information in this document should not be used as a substitute for professional medical advice or as a substitute for the application of clinical judgment in respect of the care of a particular patient or other professional judgment in any decision-making process. The Canadian Agency for Drugs and Technologies in Health (CADTH) does not endorse any information, drugs, therapies, treatments, products, processes, or services. While care has been taken to ensure that the information prepared by CADTH in this document is accurate, complete, and up-to-date as at the applicable date the material was first published by CADTH, CADTH does not make any guarantees to that effect. -
Alcohol and Brain Damage in Adults with Reference to High-Risk Groups
CR185 Alcohol and brain damage in adults With reference to high-risk groups © 2014 Royal College of Psychiatrists For full details of reports available and how to obtain them, contact the Book Sales Assistant at the Royal College of Psychiatrists, 21 Prescot Street, COLLEGE REPORT London E1 8BB (tel. 020 7235 2351; fax 020 3701 2761) or visit the College website at http://www.rcpsych.ac.uk/publications/collegereports.aspx Alcohol and brain damage in adults With reference to high-risk groups College report CR185 The Royal College of Psychiatrists, the Royal College of Physicians (London), the Royal College of General Practitioners and the Association of British Neurologists May 2014 Approved by the Policy Committee of the Royal College of Psychiatrists: September 2013 Due for review: 2018 © 2014 Royal College of Psychiatrists College Reports constitute College policy. They have been sanctioned by the College via the Policy Committee. For full details of reports available and how to obtain them, contact the Book Sales Assistant at the Royal College of Psychiatrists, 21 Prescot Street, London E1 8BB (tel. 020 7235 2351; fax 020 7245 1231) or visit the College website at http://www.rcpsych. ac.uk/publications/collegereports.aspx The Royal College of Psychiatrists is a charity registered in England and Wales (228636) and in Scotland (SC038369). | Contents List of abbreviations iv Working group v Executive summary and recommendations 1 Lay summary 6 Introduction 12 Clinical definition and diagnosis of alcohol-related brain damage and related -
The Effect of Chronic Alcohol Abuse on the Benzodiazepine Receptor
f Ps al o ych rn ia u tr o y J Journal of Psychiatry Shushpanova et al., J Psychiatry 2016, 19:3 DOI: 10.4172/2378-5756.1000365 ISSN: 2378-5756 Research Article OpenOpen Access Access The Effect of Chronic Alcohol Abuse on the Benzodiazepine Receptor System in Various Areas of the Human Brain Shushpanova TV1*, Bokhan NA2, Lebedeva VF2, Solonskii AV1 and Udut VV3 1Department of Clinical Neuroimmunology and Neurobiology, Mental Health Research Institute, Russia 2Department of Addictive Disorders, Mental Health Research Institute, Russia 3Department of Molecular and Clinical Pharmacology, Research Institute of Pharmacology and Regenerative Medicine, Russia Abstract Objective: Alcohol abuse induces neuroadaptive changes in the functioning of neurotransmitter systems in the brain. Decrease of GABAergic neurotransmission found in alcoholics and persons with a high risk of alcohol dependence. Benzodiazepine receptor (BzDR) is allosterical modulatory site on GABA type A receptor complex (GABAAR), that modulate GABAergic function and may be important in mechanisms regulating the excitability of the brain processes involved in the alcohol addiction. The purpose of this study was to investigate the effects of chronic alcohol abuse on the BzDR in various areas of the human brain. Materials and Methods: Investigation of BzDR properties were studied in synaptosomal and mitochondrial membrane fractions from different brain areas of alcohol abused patients and non-alcoholic persons by radioreceptor assay with using selective ligands: [3H] flunitrazepam and [3H] PK-11195. Brain samples obtained at autopsy urgent. In total 126 samples of human brain areas were obtained to study radioreceptor binding, including a study group and control group. Results: Comparative study of kinetic parameters (Kd, Bmax) of [3H] flunitrazepam and [3H] PK-11195 binding with membrane fractions in studding brain samples was showed that affinity of BzDR was decreased and capacity increased in different areas of human brain under influence of alcohol abuse. -
Evaluation of Cerebral Infarction with Iodine 123-Iomazenil SPECT
Evaluation of Cerebral Infarction with Iodine 123-Iomazenil SPECT Jun Hatazawa, Takao Satoh, Eku Shimosegawa,Toshio Okudera, Atsushi Inugami, Toshihide Ogawa, Hideaki Fujita, Kyo Noguchi, Iwao Kanno, Shuhichi Miura, Matsutaroh Murakami, Hidehiro lida, Yuhko Miura and Kazuo Uemura Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Senshuh-Kubota Mach4 Akita, Japan predicted the clinical outcome (4). By measuring perfusion This study evaluatesischemicdamageto centralbenzodiaz and metabolism, the balance of the supply and demand of epine(BZD)receptorbindingin the brainwith r23oiom&enil substrates (i.e., misery or luxury perfusion) was evaluated SPECTin relationto CT hypodenselesionsand blood flow (5). Nevertheless, these imaging modalities are unable to abnormalities.Methods:Ninepatientswithmiddlecerebralar provide direct information on neuron-specific damage after teryterritoryinfarctionwerestudied.lomazenilimagesobtained ischemic insult. 180 mm postinjectionwere analyzedfor BZD receptor binding. Recently, Sette et al. performed in vivo mapping in the Thecorticalinfarction,visualizedasCThypodenseareaon CT, baboon of the central benzodiazepine (BZD) receptor after the peti-infarctarea,visualizedas normodensttysurroundingthe focal ischemia with PET and 11C-flumazenil (6). The cen infarctionon CT, the intrahemisphencremote areaand the car ebellum ware analyzedby taking the ratio of the lesionto con tral BZD receptor exists with variable density in the mem tralateral mirror region (tiC ratio). -
Heterogeneity of Stimulant Dependence: a National Drug Abuse Treatment Clinical Trials Network Study
The American Journal on Addictions, 18: 206–218, 2009 Copyright C American Academy of Addiction Psychiatry ISSN: 1055-0496 print / 1521-0391 online DOI: 10.1080/10550490902787031 Heterogeneity of Stimulant Dependence: A National Drug Abuse Treatment Clinical Trials Network Study Li-Tzy Wu, ScD,1 Dan G. Blazer, MD, PhD,1 Ashwin A. Patkar, MD,1 Maxine L. Stitzer, PhD,2 Paul G. Wakim, PhD,3 Robert K. Brooner, PhD2 1Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Duke Clinical Research Institute, Durham, North Carolina 2Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland 3National Institute on Drug Abuse, Bethesda, Maryland We investigated the presence of DSM-IV subtyping for of disorders has noteworthy advantages because it facilitates dependence on cocaine and amphetamines (with versus with- research, improves communications among clinicians and out physical dependence) among outpatient stimulant users researchers, and serves as a necessary tool for collecting enrolled in a multisite study of the Clinical Trials Network 1 (CTN). Three mutually exclusive groups were identified: and communicating public health statistics. The categorical primary cocaine users (n = 287), primary amphetamine users classification, however, also constitutes a primary limitation (n = 99), and dual users (cocaine and amphetamines; n = because it works best when all members of a given diagnosis 29). Distinct subtypes were examined with latent class and are homogeneous and when there are clear boundaries between logistic regression procedures. Cocaine users were distinct distinct diagnoses.1 from amphetamine users in age and race/ethnicity. There were four distinct classes of primary cocaine users: non- DSM-IV acknowledges this limitation and further suggests dependence (15%), compulsive use (14%), tolerance and the presence of heterogeneity among individuals who share compulsive use (15%), and physiological dependence (toler- a diagnosis.