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UNIVERSITY OF CINCINNATI Date: 5-Oct-2009 I, Jennifer McGuire , hereby submit this original work as part of the requirements for the degree of: Doctor of Philosophy in Developmental Biology It is entitled: Chronic variable stress as a rodent model of PTSD; A potential role for neuropeptide Y (NPY) Student Signature: Jennifer McGuire This work and its defense approved by: Committee Chair: Floyd Sallee, MD, PhD Floyd Sallee, MD, PhD Sandra Degen, PhD Sandra Degen, PhD Renu Sah, PhD Renu Sah, PhD Steve Danzer, PhD Steve Danzer, PhD James Herman, PhD James Herman, PhD 11/10/2009 287 Chronic variable stress as a rodent model of PTSD; A potential role for neuropeptide Y (NPY) A Dissertation submitted to the Division of Research and Advanced Studies of the University of Cincinnati In Partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY In the Graduate Program in Molecular and Developmental Biology College of Medicine 2009 By Jennifer McGuire B.S. University of Massachusetts Thesis Committee Committee Chair: Floyd R Sallee, M.D. Ph.D. Renu Sah, Ph.D. James P Herman, Ph.D. Sandra Degen, Ph.D. Steve Danzer Ph.D. Abstract Posttraumatic stress disorder (PTSD) occurs in 20-25% of people who experience trauma. Eight million people in the United States are treated for PTSD annually and the number is increasing. Sustained trauma exposure, such as combat, can develop into particularly severe and difficult to treat forms of PTSD. PTSD is thought to be a disorder of learning and memory in which hyperactivity of the amygdala leads to “overconsolidation”, increased accessibility, and enhanced reconsolidation of emotional and fearful memories. Increased amygdalar activity is a consistent finding in PTSD imaging studies. Concurrent suppression of medial prefrontal cortical and hippocampal functioning could further exacerbate amygdalar excitability. There is currently an emphasis in PTSD research to identify the molecular mechanisms behind these changes and to identify “resilience factors” that may help prevent the development of PTSD following trauma. Neuropeptide Y (NPY) is a putative resilience factor based on multiple lines of evidence. NPY is abundantly expressed in PTSD-relevant brain regions, inhibits excitatory neurotransmission, and antagonizes the effects of the pro-stress hormones corticotropin-releasing hormone and norepinephrine. Directly relevant to PTSD, NPY levels are reduced in the cerebrospinal fluid of combat veterans diagnosed with PTSD. The hypothesis tested in these studies is that chronic traumatization, results in depletion of NPY in PTSD-relevant brain regions and the development of PTSD-relevant behaviors. The emergence of PTSD-like behaviors following trauma was tested in a rodent model of chronic variable stress, a paradigm pertinent to chronic traumatization. The overwhelming majority of current animal models of PTSD focus on the effect of acute trauma. The 7-day CVS paradigm is intended to model multiple single-unit traumas within a traumatization period such as may be experienced during combat. Behavioral outcomes related to fear memory, anxiety and arousal as well as neuroendocrine stress response were measured at early (16hr) and delayed (1 week) post CVS iii recovery. In the contextual fear conditioning and extinction test, CVS rats allowed to recover for 1 week had a substantially increased freezing response to a trauma reminder than non-stressed rats. This is highly suggestive of enhanced fear recall and consistent with a PTSD-like phenotype. CVS rats allowed a 1-week recovery also had a reduced threshold for fearful arousal when tested on the EPM under aversive bright light. This behavior was not seen under dim light or 1 day after CVS under bright light indicating selective expression in fear-arousing contexts and a progression of physiological changes during recovery. At this same 7-day recovery timepoint, NPY peptide in CVS animals was significantly depleted in amygdala and increased in prefrontal cortex. Both of these changes are consistent with increased amygdalar excitability. Amygdalar NPY depletion persisted at least 15 days after CVS. In summary, chronic trauma modeled by CVS potentiated fear memory recall and fearful arousal. Consistent with the hypothesis, chronic trauma induces a persistent depletion of NPY in the amygdala, which may contribute to these PTSD-like behaviors. Future studies supplementing NPY before, during and after stress are warranted to further investigate the relevance of NPY in trauma resilience. iv v Acknowledgements Thank you to all of my committee members, but especially Dr. Renu Sah, Dr. Jim Herman and Dr. Randy Sallee for guiding me through. Thank you also to my husband Matthew for patiently listening to me for months when my single topic of conversation was neuropeptide Y and PTSD. I’d like to thank Erica Doczy for generously lending us acoustic startle chambers and all the rest of the equipment for that experiment, driving it down from Dayton and going way above and beyond the call of duty. I owe you. I’d like to acknowledge Anne Christiansen, Rong Zhang, Matia Solomon, Jon Flak, Ryan Jankord, Amanda Jones, Kenny Jones, Sripana Ghosal and especially Ben Packard for their help on my experiments, thank you. Thank you to my parents for always being there. Finally, I’d like to acknowledge the rats for their cooperation and sacrifice vi Table of Contents Abstract……………………………………………………………………………ii Acknowledgements…………………………………………………………….…vi Table of Contents………………………………………………….……………...vii List of Tables and Figures………………………………………………………...x List of Acronyms and Abbreviations……………………………………………..xii Chapter 1 Introduction and Review of Literature 1.0 Posttraumatic stress disorder…………………………………………………...1 1.1 DSM-IV diagnostic criteria 1.2 Treatment options for PTSD 1.3 The neurobiology of PTSD and systems regulating fear memory and stress. ... .5 1.31 The amygdala 1.32 The prefrontal cortex 1.33 The hippocampus 1.34 The noradrenergic system 1.35 The hypothalamic-pituitary-adrenocortical axis 1.4 Rodent models of PTSD……………………………………………………..….26 1.5 Stress resilience and neuropeptide Y.………………………………………..….33 1.6 Neuropeptide Y: physiological functions, roles in behavioral regulation and potential in stress-resilience……………………………………………………………….....35 1.61 Neuropeptide Y in the periphery 1.62 Neuropeptide Y in the central nervous system 1.63 Neuropeptide Y in the amygdala vii 1.64 Neuropeptide Y in the prefrontal cortex 1.65 Neuropeptide Y in the hippocampus 1.66 Neuropeptide Y in the locus coeruleus and nucleus of the solitary tract 1.67 Effects of stress on neuropeptide Y expression 1.68 Hypothesis Chapter 2 The Chronic Variable Stress-Recovery paradigm as a potential model for posttraumatic stress-like behaviors…………………………………….......50 2.0 The CVS model 2.1 Physiological measures 2.2 Fear conditioning 2.3 Elevated Plus-maze two conditions 2.4 Social Interaction 2.5 Acoustic Startle 2.6 HPA-axis activation 2.7 Discussion of Results Chapter 3 Effects of CVS on NPY expression……………………………………………..79 3.0 The effects of CVS on NPY peptide expression in select brain regions 3.1 Immunohistochemical analysis of subregional NPY expression 3.2 Immunohistochemistry for tyrosine hydroxylase 3.3 Discussion of results Chapter 4 Summary and Conclusions……………………………………………….……..98 4.0 CVS as a model of chronic traumatization 4.1 Integrating CVS induced behavioral changes with NPY dysregulation viii 4.2 Potential pharmacotherapeutic relevance of NPY for stress associated disorders Bibliography………………………………………………………………….....103 Appendix 1: Enhanced fear recall and emotional arousal in rats recovering from chronic variable stress……………………………….……………………….128 ix List of Tables and Figures Chapter 1 Figure 1: A neurocircuitry model of fear and extinction learning and recall…………………...7 Figure 2: Drawing of the human brain illustrating limbic and brainstem regions regulating stress, emotion and memory…………………………………………………....….8 Figure 3: NPY in limbic and catecholaminergic structures……………………………...…….42 Table 1: Rodent models of posttraumatic stress disorder…………………………………...….29 Table 2: Physiological role of NPY in the periphery: genetic studies….……………….……...39 Table 3: Physiological role of NPY in the periphery: pharmacological studies………….….…40 Table 4: Physiological role of NPY in the brain: genetic studies…………………………..…..42 Table 5: Physiological role of NPY in the brain: pharmacological studies…………….….…...43 Chapter 2 Figure 1: Representative temporal schematic of the CVS experiments and composition of stressors…………………………………………………………………………..…..….52 Figure 2: Physiologic measures after CVS………………………………………………..…....54 Figure 3: Sensitization of conditioned fear and fear memory as well as impaired extinction in CVS animals……………………………………………………………………………..58 Figure 4: Elevated Plus-Maze testing reveals delayed expression of fear-associated arousal in rats exposed to CVS………………………………………………………………….…..61 Figure 5: Social interaction is not affected by CVS exposure…………………………….........65 Figure 6: Suppression of startle response in early recovery from CVS…………………….…..69 Figure 7: Rats exposed to CVS exhibit sensitized plasma corticosterone response to a x novel acute stressor……………………………………………………………….….…..…72 Chapter 3 Figure 1: Post-CVS neuropeptide Y concentrations in forebrain limbic structures at early and delayed recovery………………………………………………………………..…..…..85 Figure 2: Illustration of the rat brain, sagital view………………………………………….…..86 Figure 3: Reduced amygdalar neuropeptide Y immunoreactivity…………………….…....…..88